California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

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Covered California & The Health Law

Democratic Attorneys General Seek Role In ACA Subsidy Case: ‘Lives Are At Stake’

The subsidies that are paid to insurance companies under the Affordable Care Act have been a threatened negotiation tool by President Donald Trump and have long been targeted by congressional Republicans. But not paying them would wreak havoc on the marketplaces, insurers and Democrats say.

Reuters: Democratic Attorneys General Seek To Intervene In Obamacare Case
More than a dozen Democratic attorneys general on Thursday sought to intervene to defend a key part of the Obamacare healthcare law - subsidy payments to insurance companies - which is under threat in a court case. The 16 attorneys general, led by California Attorney General Xavier Becerra and New York Attorney General Eric Schneiderman, filed a motion to intervene in the case pending in the U.S. Court of Appeals for the District of Columbia Circuit. (Levin, Hurley and Abutaleb, 5/18)

The Wall Street Journal: Democratic Attorneys General Seek To Preserve Affordable Care Act Subsidies
The group, led by California Attorney General Xavier Becerra and New York Attorney General Eric Schneiderman, filed a motion to intervene in a House Republican lawsuit over the payments. GOP lawmakers have asserted that the payments to insurers are illegal because Congress never appropriated the funding. ... “Millions of families across the country—including hundreds of thousands right here in New York—rely on these subsidies for their basic health care,” Mr. Schneiderman said in a statement about the motion, which was filed in the pending case in the U.S. Court of Appeals for the District of Columbia. (Armour, 5/18)

Sacramento Bee: California Takes Legal Action To Prevent Obamacare Cuts 
House Republicans contend that the federal payments are illegal because they were not authorized by Congress when the Affordable Care Act was passed in 2010. A federal district judge last year agreed, and the Obama administration appealed. With Trump in the White House, Obamacare advocates fear his administration could simply drop the appeal and end the subsidies – especially if efforts to overhaul the law fail in Congress. If California and other states are granted access to the lawsuit, they would be in position to oppose that maneuver. (Hart, 5/18)

ACA Helped Cut Uninsured Rates For Self-Employed In California By Nearly Half

"When I think about the people I know personally who’ve benefited from the Affordable Care Act, most of them work for themselves or a small business," said Laurel Lucia, one of the report's authors.

KPCC: How Obamacare Helped The Self-Employed In California
Self-employed Californians are most likely to be impacted if Obamacare is repealed, according to an analysis released Thursday by the UC Berkeley Center for Labor Research and Education. In 2013, 885,000 self-employed Californians didn’t have health insurance. That number dropped to 476,000 by 2015, according to the analysis, which examines data from the California Health Information Survey. (Faust, 5/18)

In other news —

KQED: Women’s Health Clinics In California Struggle In A Shifting Healthcare Landscape
Closures and consolidations have been increasing among community clinics that provide reproductive health services. Because of the health law, more women in California have coverage for a full range of health services through Medi-Cal. As a result, many of those women are now going to a regular doctor or primary care center for their family planning needs, instead of a dedicated women’s clinic. In addition, the state is paying these clinics less money under Obamacare. (Dembosky, 5/19)

Politico Pro: Covered California To Hold 3-Month Open Enrollment Period 
Word that Obamacare is failing apparently hasn’t reached California. Covered California is preparing for a three-month open enrollment period this fall, and the exchange is operating solidly in the black. Covered California’s open enrollment period for 2018 coverage will run from Nov. 15 to Jan. 31, 2018 — the same as last year — despite the federal government’s plans to shorten HealthCare.gov's enrollment period to six weeks, Peter Lee, the exchange’s executive director, said at Thursday’s Covered California board meeting. (Colliver, 5/18)

Health IT

Company Aims To Remove Barriers For Blind With New OnStar-Like Technology

Using camera-equipped smart glasses that connect to Aira’s smartphone app, a visually impaired person is able to connect with a remote agent to assist them in real time.

The San Diego Union-Tribune: Aira Pulls In $12M For Smart-Glasses Tech To Help The Blind, Visually Impaired 
San Diego start-up Aira, which makes a smart-glasses-based, OnStar-like service for the visually impaired, said this week that it has raised $12 million in a second round of venture capital funding. Jazz Venture Partners and Arboretum Ventures led the round. Existing investors Lux Capital, Arch Venture Partners and Felicis Ventures also participated. The company is wrapping up a series of beta trails of its technology with 200 customers. This latest funding round aims to enable Aira to expand its service to additional blind and visually impaired people. (Freeman, 5/18)

Public Health and Education

What Goes Awry In The Brain To Lead To Alzheimer's? Scientists Still Aren't Quite Sure

The Los Angeles Times' series looks at dementia, Alzheimer's and aging.

Los Angeles Times: When The Memory Flickers Out
Facts, faces, experiences: Our brain’s capacity to learn new things, store the memories and summon them up on demand is a marvel. Yet we take it all for granted until the skills start to crumble in those we love, or in ourselves. What goes awry in the brain to make this happen? (Dance, 5/18)

Los Angeles Times: Why Exercise Is The Best Medicine For Your Brain
Given time, any brain can succumb to dementia — memories fade, thoughts scatter, basic abilities wither on the vine. Brains don’t come with lifetime guarantees, but there is one major step you can take to protect yourself from Alzheimer’s or other causes of mental decline: exercise your body. Nothing protects the brain quite like regular exercise, says Jennifer Heisz, a cognitive neuroscientist at McMaster University in Ontario, Canada. Not crossword puzzles, not supplements, not prescription medications. Exercise seems to beat them all, reducing the risk of Alzheimer’s disease or cognitive decline by about 35% to 45%, according to the latest evidence. (Woolston, 5/18)

Los Angeles Times: Eight Things You Can Do Now That Might Reduce Your Odds Of Dementia Later
It’s a safe bet that you’d like to avoid getting Alzheimer’s. But you probably haven’t done the one thing that could make you five times more likely to reach the age of 85 without getting the disease and 7.5 times more likely to have suffered no memory loss or other major cognitive decline. Don’t kick yourself. The only way you could have achieved this spectacular risk reduction was to be born with a genetic variant that’s been found in fewer than 0.5% of people studied. (Ravn, 5/18)

Stringent Gun Laws Help Cut Down On Fatal Police Shootings, Study Finds

Fatal police shootings were about half as common in states whose gun laws place them in the top 25 percent of stringency than they were in states where such restrictions ranked in the bottom 25 percent.

Los Angeles Times: When States Have Strong Guns Laws, They Also Have Fewer Fatal Police Shootings
Fatal shootings of civilians by police officers are less common in states with stricter gun laws than they are in states that take a more relaxed approach to regulating the sale, storage and use of firearms, new research says. A study published Thursday in the American Journal of Public Health has found that fatal police shootings were about half as common in states whose gun laws place them in the top 25% of stringency than they were in states where such restrictions ranked in the bottom 25%. (Healy, 5/18)

In other public health news —

Los Angeles Times: Area School Districts See Gains In Vaccination Rates
Area school districts made gains in the rates of vaccinated students because of a change in state law that eliminated personal exemptions as a reason not to immunize children, according to an Orange County Grand Jury report released earlier this week... The law, which took effect on July 1, 2016, requires all children enrolled in day-care facilities and public or private schools in California to be fully vaccinated against several communicable diseases including diphtheria, hepatitis B, Haemophilus influenza type B, measles, mumps and pertussis, according to the report. (Alderton, 5/18)

Santa Rosa Press Democrat: Lyme Disease Leaves Victims Frustrated, Searching For Answers 
The question of whether someone has Lyme disease can run into murky medical territory that pits western medicine against naturopathic medicine, in part because there is no specific test or symptom that designates the infection with 100 percent accuracy. One side of the argument says Lyme is under-diagnosed, while the other claims that alternative medicine is over-diagnosing the illness. But the one thing both sides agree upon is that it exists and, with the peak of the North Coast tick season now in full swing, steps should be taken to avoid Lyme infection. Record rains last winter have created favorable conditions for tick habitat in Sonoma County, raising concerns among health care professionals that tick-borne illnesses such as Lyme disease could increase this year. (Espinoza, 5/18)

Orange County Register: Two New Mumps Cases In Orange County Are Unrelated To Chapman Outbreak
Two new mumps cases have been diagnosed that are unrelated to the Chapman University outbreak, the Orange County Health Care Agency said Thursday, May 18. The two patients, both in their 20s, did not have contact with the 13 Chapman students who fell ill between January and April 18, but had close contact with each other. One became sick in April and the other earlier this month. (Perkes, 5/18)

Spending and Fiscal Battles

County Eliminates Funding For Mental Health Program In 'Painful' Spending Cut

Those who have been a part of the program expressed their dismay.

Ventura County Star: Critics Question Mental Health Cuts
Critics expressed dismay and shock this week over plans to stop funding a program that connects people recovering from mental illness with those struggling with psychiatric disorders. Seventeen full- and part-time jobs for peer counselors are scheduled to be lost in the Ventura County Behavioral Health Department, effective July 1. In the wake of that announcement made last week, about 10 people expressed their opposition at a meeting of a mental health advisory board in Oxnard. Among them were peer counselors, an administrator and an Oxnard woman who said her counselor helped save her life when she was suicidal. (Wilson, 5/18)

Around California

Outcry Over School's Sex Education Curriculum Grows

Parents say the curriculum goes beyond what is required by a new state law to teach comprehensive sex education.

The San Diego Union-Tribune: Complaints About Sex Education Classes Escalate
Tuesday’s meeting marked the second time an organized group of parents have appeared before the board to complain about the curriculum. District public information officer Andrew Sharp said the board received a letter requesting trustees discuss the issue, and district officials are working to place it on the agenda. The new curriculum is taught in grades 6, 8 and in high school. Almost 300 San Diego Unified classroom teachers have been trained in the curriculum, which was adopted last year in response to the California Healthy Youth Act, which went into effect in January. The new law requires school districts to provide comprehensive sexual health education and HIV prevention lessons in middle and high school, and calls for the curriculum to address sexual orientations, gender identities and sexually transmitted diseases. (Warth, 5/18)

In other news from across the state —

KPCC: Hundreds Of California Foster Children Are Arrested When They Lash Out
California's foster children are some of the state's most vulnerable people, and the trauma out of being separated from loved ones means they may develop emotional problems. So some might act out. In certain shelters and group homes around the state, that's led to children as young as 8 being arrested. (Duran, 5/18)

The Mercury News: Santa Clara County Sued By Pediatrician Fired In Wake Of Toddler’s Killing 
A pediatrician who was one of two fired by Santa Clara County last year for allegedly failing to report glaring signs of abuse on a toddler — which may have spared the 2-year-old boy a horrific death had it come to light — has filed a lawsuit against the county, saying she was scapegoated for problems she was trying to fix. Melissa Egge and her then-boss John Stirling were first suspended then terminated last April. On Wednesday, Egge’s attorney filed a complaint for damages alleging that she was sent packing after she spoke up about “systemic failures and mistakes of her supervisors,” and that she had told Stirling about her concerns about the boy and was assured that he would notify Child Protective Services. (Kurhi, 5/18)

National Roundup

'There Are No Hands On The Wheel': Insurers Heap Blame On Administration For Next Year's Rate Hikes

The finger-pointing toward the Trump administration undermines GOP arguments that the marketplaces are collapsing under their own weight. Meanwhile, Republicans are seizing on the increases to drum up support for their repeal-and-replace push.

Los Angeles Times: Health Insurers Plan Big Obamacare Rate Hikes — And They Blame Trump
Health insurers across the country are making plans to dramatically raise Obamacare premiums or exit marketplaces amid growing exasperation with the Trump administration’s erratic management, inconsistent guidance and seeming lack of understanding of basic healthcare issues. At the same time, state insurance regulators — both Democrat and Republican — have increasingly concluded they cannot count on the Trump administration to help them ensure that consumers will have access to a health plan next year. (Levey, 5/18)

The Wall Street Journal: Republicans Lock Onto Insurance Troubles In Push To Topple Health Law
Republicans are seizing on early signs of premium increases and diminishing insurer participation on next year’s insurance exchanges as proof the Affordable Care Act is floundering and must be overturned, pitting them against Democrats who say the GOP repeal effort itself is to blame. The finger-pointing is taking on new urgency as Republican lawmakers cite the ACA’s problems to drum up support for their legislation to topple the law, often called Obamacare. A bill passed the House earlier this month, and the Senate is now trying to craft its own version. (Armour, Wilde Mathews and Radnofsky, 5/18)

In other national health care news —

Bloomberg: House May Need To Vote Again On GOP Obamacare Repeal Bill
House Republicans barely managed to pass their Obamacare repeal bill earlier this month, and they now face the possibility of having to vote again on their controversial health measure. House Speaker Paul Ryan hasn’t yet sent the bill to the Senate because there’s a chance that parts of it may need to be redone, depending on how the Congressional Budget Office estimates its effects. House leaders want to make sure the bill conforms with Senate rules for reconciliation, a mechanism that allows Senate Republicans to pass the bill with a simple majority. (House, 5/18)

The Hill: Abortion Poses Hurdle For Senate Healthcare Bill 
Abortion has emerged as a potential stumbling block for Senate Republicans as they seek to craft an ObamaCare repeal-and-replace bill that can garner 51 votes. Senators are fretting that a provision in the House healthcare bill that bars financial assistance from being used to buy plans covering abortion will be stripped out under the Senate’s rules of reconciliation. Republicans hope to use that special budgetary procedure to bypass a Democratic filibuster. (Roubein, 5/19)

CQ HealthBeat: GOP Senators Discuss Health Tax Credits Ahead Of CBO Score
Senate Republicans on Thursday wrestled with questions of how to factor in consumers’ ages and income in devising a new set of federal subsidies for medical insurance, which would replace those created by Democrats’ 2010 health care law. Sen. Lamar Alexander of Tennessee, underscoring just how preliminary the meetings have been, suggested the Senate might split its massive rewrite of the health care law into two parts, the first of which would focus on stabilizing the market in 2018 and 2019. A scaled-back bill would be far easier to get through the Senate and perhaps could attract bipartisan support, but would represent a retrenchment in Republicans’ efforts to overhaul President Barack Obama’s health care law. (Young and Mershon, 5/18)

The Washington Post Fact Checker: Nancy Pelosi’s Claim That ‘Seven Million Veterans Will Lose Their Tax Credit’ Under The GOP Health Bill
While listing a series of criticisms of the House Republican bill to overhaul the Affordable Care Act, Pelosi described it as “Robin Hood in reverse” that hurts those in need, such as veterans. In its earlier iteration, the American Health Care Act (AHCA) contained a provision protecting tax credits for veterans, regardless of whether or not they were enrolled in the Department of Veterans Affairs health-care system. The version of the bill that was passed in May omitted this provision, meaning some veterans may no longer have access to subsidized private insurance. But Pelosi glossed over the nuances of this issue in her claim, so we dug into it. (Lee, 5/18)

Editorials and Opinions

Viewpoints: Trump, GOP Are Succeeding In Undermining Obamacare, But Blame Will Be On Their Shoulders

A selection of opinions on health care developments from around the state.

Los Angeles Times: The Costs Of Trump's Sabotage Of Obamacare Already Are Showing Up In Rate Hikes
The easiest prediction to make about the healthcare business was that the efforts by Congress and the Trump administration to sabotage the Affordable Care Act would produce a flood of rate hikes by insurers for 2018. We are now standing on the edge of the water. Early rate requests have come in from insurers in five states, according to ace ACA-tracker Charles Gaba, who calculates the weighted average rate request increase in those states at about 30% (that is, weighted for the enrollment of each insurer). (Michael Hiltzik, 5/16)

Los Angeles Times: Trump And Congress Are About To Take An Ax To Children's Healthcare 
Republican lawmakers seldom target children’s health programs with the fervid hostility they aim at Obamacare or Medicaid, but there are pockets of opposition. As a Georgia state legislator, Secretary of Health and Human Services Tom Price voted twice, in 2007 and 2008, against expanding CHIP in his state to cover millions more kids. (Michael Hiltzik, 5/15)

Los Angeles Times: Miss USA Spoke For Many Americans When She Said Healthcare Isn't A Right
[W]e probably shouldn’t be surprised that the person who has most clearly articulated America’s core philosophical belief when it comes to healthcare is our newly crowned Miss USA, Kara McCullough. She was asked at this week’s celebration of swimsuits, evening gowns and womanhood whether she thought “affordable healthcare for all U.S. citizens is a right or a privilege.” "I'm definitely going to say it's a privilege," the 25-year-old answered without hesitation. ... Miss USA initially was voicing a position common to many Americans, mostly conservatives — a stance that has prevented the United States from joining all other developed countries in providing its citizens with universal coverage. (David Lazarus, 5/19)

Ventura County Star: Mental Health Cuts That Make Sense
The American Health Care Act, the Republican plan to repeal and replace Obamacare, included a late amendment that allows states to opt out of the requirement that insurers provide Essential Health Benefits. One of those benefits is mental health and addiction treatment. Trumpcare also would scale back Medicaid, and “patients with mental health and addiction disorders will be especially hurt as they disproportionately rely on traditional Medicaid,” the National Council for Behavioral Health says. We find this and many other aspects of Trumpcare deplorable, and we hope the Senate devises a more compassionate plan. In the meantime, however, given the drift of our federal government, it would behoove local governments to review the effectiveness of their health programs and shift funding to the greatest needs, which is what Ventura County is doing. (5/15)

Sacramento Bee: California Must House Its Mentally Ill 
A report by the nonpartisan Stanford Justice Advocacy Project finds that 30 percent of California state inmates receive treatment for serious mental disorders, a 150 percent increase since 2000. At least in prison they receive care, though no one truly believes prison is the appropriate setting for severely mentally ill people. (5/15)

Orange County Register: Ending Mental Health Stigma 
We need to have a frank discussion about mental health in our community. ... Red flags indicating issues in children and adolescents’ mental health are often overlooked and dismissed. The unfortunate reality is that 50 percent of mental health conditions begin by age 14 and 75 percents begin before age 24 according to a report by the National Alliance on Mental Illness. (Andrew Do, 5/13)

The San Diego Union-Tribune: Is San Diego County Doing Enough To Prevent Suicides In Its Jails? 
Over the past 12 years, 46 people have committed suicide in San Diego County jails, according to a report released this month by the county grand jury. The report cites data from the Sheriff’s Department, which runs the county’s seven detention facilities. The May 4 report also says the suicide rate in San Diego County’s jails is the highest in all of California’s large county jail systems. Something’s wrong with that as well. (Dana Littlefield, 5/14)

Los Angeles Times: Make Good On A Tobacco Tax Promise To Pay Higher Rates To Medi-Cal Doctors
The $183.4-billion revised spending plan [Gov. Jerry] Brown unveiled Thursday restores some things that were on the chopping block in January and even finds a little more money to hand out. There’s $1.4 billion more for education above the amount required by Proposition 98. There’s $500 million more to pay child care providers. There’s about $400 million more to help counties pay for in-home health services and $6.5 million more for the California attorney general to fight President Trump. But no more for Medi-Cal providers? (5/12)

Los Angeles Times: Another Way The Rich Get Richer: Study Shows A Widening Gap In Life Expectancy Between Rich And Poor
The United States can take pride in one indisputable marker of racial equality: The gap in life expectancy between the white and black populations has narrowed over time. What was a disparity of more than eight years for Americans born in 1950 has closed to just over three years for those born in 2014, according to actuarial estimates. But let’s not pat ourselves on the back. A different disparity has opened up: The gap in life expectancy between wealthy and low-income Americans is wide and growing wider. And that has implications not only for lifetime health and wealth, but for Social Security. (Michael Hiltzik, 5/16)

Orange County Register: Community Effort Needed On Homelessness
For far too long, our society has dropped its social ills at government’s doorstep and, after nearly 53 years of the federal “war on poverty,” it has little to show for it. But government has a strange way of measuring success, where increases in the welfare rolls are seen as a success, rather than focusing on boosting the numbers of those who no longer need a handout. In speaking with Supervisor Todd Spitzer, County Executive Officer Frank Kim, Director of Care Coordinator Susan Price and other representatives of the county health agencies recently, they are keenly aware of the issues. (5/19)

Orange County Register: Change Needed To Help Preschoolers With Mental Health Issues
What do you picture when you hear that a child has been kicked out of school following a series of disruptive behaviors? My guess is that you’re imagining a troubled teenager. But that expelled student is three times more likely to be a toddler. While that statistic might be startling to many, those of us who work in the early childhood education and health sectors have long been familiar with the challenges young children face in systems that were not designed to recognize or treat their unique emotional and mental health needs. (Sandra Pierce, 5/19)

Los Angeles Times: Republican Couple Who Lost A Son Want Their GOP Back, Fewer Guns, And A Return Of Statesmanship 
These pitchfork rallies have been happening all over the country, with ticked-off voters speaking up about immigration and environmental policy too. On healthcare, Trump recently took bows for a half-baked House bill that bulldozed some of his oft-repeated promises about better and cheaper healthcare for all. And Democrats — who happen to be having their own nationally televised identity crisis — see that as an opportunity to bounce Republicans in next year’s midterm elections. (Steve Lopez, 5/17)

Los Angeles Times: Texas Wants To Use Federal Money To Attack Planned Parenthood — And Trump Just Might Provide It
Five years ago, Texas voluntarily gave up $30 million a year in federal funding for women’s health programs, just so it could exclude Planned Parenthood from the roster of approved providers. Instead, the state established its own so-called Healthy Texas Women program in which it could set its own rules. Now, staggering under the cost of the program and hopeful that the Trump administration will see things its way, Texas is applying for a restoration of the federal subsidy under the same terms. Signals from the White House and the Department of Health and Human Services suggest the state might succeed. If so, some other states may follow, and the cause of women’s reproductive health will suffer a major blow. (Michael Hiltzik, 5/18)

Los Angeles Times: No Sanctuary For Marijuana In California
When Californians approved Proposition 64 to legalize marijuana in California last November, it was no secret that the drug would remain illegal under federal law. But that fundamental contradiction seemed manageable at the moment .... Now, however, we have President Trump, who seems to have forgotten his laissez faire stance on marijuana, and Atty. Gen. Jeff Sessions, who comes from the “Reefer Madness” school of law enforcement. Proponents of Proposition 64 ... rightly worry that the federal government may decide to crack down on cannabis operators even if they fully comply with state rules. It’s understandable that state lawmakers want to resist potential federal intervention. But a proposal to make California a so-called sanctuary state for marijuana is not the way to go. (5/16)