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California Healthline Original Stories
With ACA’s Future In Peril, California Reins In Rising Health Insurance Premiums
Premiums will grow by an average of 0.8% next year on the state health insurance exchange. Officials cite two new policies for the relatively low rate hike: a new state tax penalty on Californians who don’t have health insurance coupled with state-based tax credits to help enrollees afford their premiums, including middle-income people who make too much money to qualify for federal financial aid. (Barbara Feder Ostrov and Ana B. Ibarra, )
Good morning! San Francisco homelessness numbers have skyrocketed 30 percent since 2017, new more precise data show. The increase is a small snapshot of the crisis that local and state officials have been trying to address. More on that below, but first here are some of your other top California health stories.
California Expands Medi-Cal To Cover Young Adults Living In Country Illegally As Issue Gains Traction In 2020 Race: Democratic Gov. Gavin Newsom signed a bill into law on Tuesday that makes low-income adults age 25 and younger eligible for the state's Medicaid program regardless of their immigration status. Since 2016, California has allowed children under 18 to receive taxpayer-backed health care despite immigration status. And state officials expect that the plan will cover roughly 90,000 people. "If you believe in universal health care, you believe in universal health care," Newsom said. "We are the most un-Trump state in America when it comes to health policy." In California, extending health benefits to undocumented immigrants is widely popular. A March survey conducted by the nonpartisan Public Policy Institute of California found that almost two-thirds of state residents support providing coverage to young adults who are not legally authorized to live in the country. While the state has expanded options for children and young adults, most undocumented people in California still have limited access to health care. They can sign up for “restricted” Medi-Cal, but it only covers emergencies and pregnancy-related care. The issue received national attention at the second night of the first Democratic debate, when the candidates overwhelmingly supported the idea of providing undocumented immigrants with health coverage. Read more from Bobby Allyn of NPR; Sammy Caiola of Capital Public Radio; Mark Z. Barabak and Noam Levey of the Los Angeles Times; and The Associated Press
Covered California’s Premium Increases For Individual Marketplace Are Smallest In Agency’s History: Covered California announced Tuesday morning that it expects an average premium increase of 0.8 percent for 2020 in the state’s individual marketplace, the lowest such rate change since the health insurance exchange started business in 2013. Peter V. Lee, the executive director of Covered California, attributed the low rate change to bills passed by the California Legislature and signed into law by Gov. Gavin Newsom over the past six months. The legislation includes a so-called individual mandate that will impose a state tax penalty on any California resident who does not maintain health insurance coverage and offers state subsidies that will help an estimated 922,000 residents pay for insurance. Lee also noted that the legislative changes so improved insurer confidence that a major national insurer, Anthem Blue Cross, decided to return to offering coverage in much of the state. Read more from Cathie Anderson of the Sacramento Bee; and Barbara Feder Ostrov and Ana B. Ibarra of California Healthline.
Debate Over Surprise Medical Bills In California’s Legislature Pits Insurers, Hospitals And Other Players Against Each Other: While most people agree patients shouldn’t be stuck with outrageous surprise medical bills, there’s a fight over who exactly should pick up the costs. A bill by Assemblyman David Chiu (D-San Francisco) would make sure emergency patients never pay more than their copays or deductibles, even if they are treated at an out-of-network hospital. But the bill would cap what hospitals can charge insurance companies, because advocates and some lawmakers view hospitals as a monopoly with too much power over prices. The California Hospital Association strongly opposes that approach, and advocates worry their position could doom the bill's chances of passage this year. But a key test will be today, when the Senate Health Committee has scheduled a hearing on the proposal. Read more from Adam Beam of The Associated Press.
Below, check out the full round-up of California Healthline original stories, state coverage and the best of the rest of the national news for the day.
More News From Across The State
Los Angeles Times:
San Francisco Homeless Count Goes From Bad To Worse, Jumping 30% From 2017
Over the last several months, cities and counties across California have been releasing homeless counts. The results have been grim. San Francisco was no exception. In May, the city released data that showed homelessness had jumped 17%. That was bad enough. Last week, a more complete accounting, known as a point-in-time count, showed the problem was even worse. The count revealed that homelessness in a city that’s become a caricature of wealth inequality in the U.S. had actually increased by about 30% from 2017, when the last count took place. (Oreskes, 7/9)
San Francisco Chronicle:
Following SF, Livermore Is 2nd California City To Ban E-Cigarette Sales
The East Bay city of Livermore on Monday became the second California city after San Francisco to pass legislation to ban the sale of e-cigarettes in brick-and-mortar stores. The Livermore City Council unanimously approved the bill, as part of a broader measure to address rising rates of youth vaping. The legislation also establishes a tobacco licensing program for retailers and prohibits stores from selling the nicotine refills that go into e-cigarettes — known as e-liquids, like the nicotine pods made by Juul. (Ho, 7/9)
Los Angeles Times:
Ex-USC Gynecologist Sold Sex Videos He Recorded In Foreign Hotel Rooms, Prosecutor Says
A former USC gynecologist charged with sexual abuse of patients also sold photographs and sex videos he took of young women he lured to his hotel rooms while traveling outside the U.S., a prosecutor said Tuesday. The allegation was raised at a downtown Los Angeles court hearing, during which the prosecutor tried to persuade a judge to keep George Tyndall’s bail at nearly $2.1 million, arguing that the doctor charged with sexual misconduct toward 16 former patients was a danger to the public and a flight risk. (Tchekmedyian, 7/9)
The Associated Press:
Former USC Gynecologist's Bail Lowered In Sex Assaults Case
A Los Angeles judge reduced bail Tuesday for a former University of Southern California gynecologist accused of sexually assaulting 16 women. Superior Court Judge Teresa Sullivan lowered Dr. George Tyndall's bail from nearly $2.1 million to $1.6 million, which he may be able to post using his condominium as collateral. If he posts bail, he will be confined to house arrest with GPS monitoring. (7/9)
Sacramento Bee:
Dignity, Sacramento County To Open Psychiatric Crisis Unit
Sacramento County and Dignity Health are undertaking an $18.7 million effort to relieve pressure on the region’s psychiatric hospitals by opening a facility at Mercy San Juan Medical Center that will treat patients in behavioral health crisis for up to 23 hours. Roughly 4,000 patients a year come to the emergency room at Carmichael’s Mercy San Juan with a behavioral health crisis, said Rosemary Younts, senior director of behavioral health for Dignity Health, and that kind of volume is tough to match or beat in Sacramento County. (Anderson, 7/9)
Los Angeles Times:
Data Breach Exposes Information Of Thousands Of Patients In L.A. County
The personal information of thousands of patients who have received medical care through Los Angeles County’s hospitals and clinics was exposed in a data breach, officials said Tuesday. The Nemadji Research Corp., which contracts with the L.A. County Department of Health Services, fell victim to a phishing attack earlier this year that allowed outside access to medical information for 14,591 patients. (Karlamangla, 7/9)
Los Angeles Times:
Costa Mesa Planning Commission Backs Making Local Needle Exchange Ban Permanent
Despite some concerns that the justification was flimsy, the Costa Mesa Planning Commission agreed Monday that the city should make its ban on needle exchange programs permanent. The prohibition, which has been in place since August under an urgency ordinance, will now head to the City Council for review. (Davis, 7/9)
Los Angeles Times:
UCLA Employee May Have Spread Measles At Campus Food Court
A UCLA employee who contracted measles may have exposed students and others to the highly contagious disease, according to campus officials. A university employee was diagnosed with measles on Monday. But health officials say he may have infected students when he ate lunch at the Court of Sciences Student Center food court between 9 and 11:30 a.m. on July 2 and 3, according to health officials. (Karlamangla, 7/9)
KQED:
Dangerous Chemicals Found In Blood Of Firefighters Who Battled 2017 Tubbs Fire
Firefighters who battled the deadly Tubbs Fire in 2017 left the scene with abnormal levels of mercury and other dangerous chemicals in their blood, according to new findings announced on Tuesday. The San Francisco Firefighters Cancer Prevention Foundation (SFFCPF) and researchers at UC Berkeley analyzed blood and urine samples of roughly 150 first responders three weeks after they had battled the blaze, and compared them to samples from other firefighters who hadn’t been on the frontlines. (Wolffe, 7/10)
The New York Times:
Appeals Court Seems Skeptical About Constitutionality Of Obamacare Mandate
A panel of federal appeals court judges on Tuesday sounded likely to uphold a lower-court ruling that a central provision of the Affordable Care Act — the requirement that most people have health insurance — is unconstitutional. But it was harder to discern how the court might come down on a much bigger question: whether the rest of the sprawling health law must fall if the insurance mandate does. In 90 minutes of oral arguments on whether a federal district judge in Texas was correct in striking down the Affordable Care Act in December, two appellate judges appointed by Republican presidents peppered lawyers with blunt questions while the third judge, appointed by President Jimmy Carter, remained silent. (Goodnough, 7/9)
The Associated Press:
Validity Of Obama Health Care Law At Issue In Appeal Hearing
It was less clear after the arguments whether the judges also would invalidate the entire health care law, as the Trump administration favors. The hearing marked the latest development in a 2018 lawsuit by 18 Republican-leaning states claiming that the absence of a tax converts the law into an unconstitutional directive to U.S. citizens to buy a product. A lower court judge ruled in December that it did, and that the entire law must fall as a result. That includes popular provisions such as protection for pre-existing conditions. (7/9)
The Washington Post:
Appeals Judges Question Whether The ACA Can Stand Without Insurance Penalty
During oral arguments in a case with momentous stakes for consumers and politicians ahead of the 2020 elections, two members of a three-judge panel of the U.S. Court of Appeals for the 5th Circuit grilled lawyers representing Democratic-led states and the U.S. House to explain why the Affordable Care Act remains valid. “If you no longer have the tax, why isn’t it unconstitutional?” asked Judge Jennifer Walker Elrod, who was appointed by President George W. Bush. She and the other GOP appointee, Judge Kurt Engelhardt, named by President Trump last year, repeatedly noted that the law was written without an explicit feature guaranteeing that if one part were ever removed by Congress or the courts, the rest would remain in place. (Goldstein, 7/9)
The Wall Street Journal:
Appeals Court Signals Peril For Affordable Care Act
California, leading 20 states defending the health law, argued the insurance mandate raised no constitutional problems because it is no longer enforceable without a penalty, making it more of a wish by Congress that people purchase coverage, not a command. “The individual mandate no longer requires anyone to do anything,” said California Deputy Solicitor General Samuel Siegel. Judges Elrod and Kurt Engelhardt, a Trump appointee, voiced doubts about that argument, saying the ACA still included language that requires people to carry coverage, penalty or not. Congress “left in place the mandatory nature of the mandate,” Judge Elrod said. (Kendall, 7/9)
Texas Tribune:
Texas Asks Federal Appeals Court To Declare Obamacare Unconstitutional
Most of the unusually large courtroom audience of journalists and interested but unaffiliated attorneys focused on Elrod at the center. By far the most vocal judge of the three, Elrod probed both sides on the issue of standing — whether they have the right to participate in the lawsuit at all. And she appeared highly focused on her court’s options for ordering a remedy, seeming to weigh options for sending the case back to a lower court for further consideration. Engelhardt, who is among the newest appointees to the court, was harsh and occasionally sarcastic, asking more questions of the blue state coalition than he did of the Texas-led team. He seemed skeptical of the standing of both the California-led coalition and the Democratic-majority U.S. House of Representatives, which intervened in the case although the Republican-majority U.S. Senate did not. (Platoff, 7/9)
Politico:
Appeals Court Skeptical Obamacare Can Survive
Judge Kurt Engelhardt, a Trump appointee, pointed out that Congress could settle the dispute over the health law’s future by immediately stripping out the individual mandate entirely, eliminating the basis for the lawsuit. He also questioned why the Republican-controlled Senate hasn’t weighed in on the lawsuit.“They’re sort of the 800-pound gorilla who’s not in the room,” Engelhardt said. (Demko, 7/9)
CNN:
Republican-Appointed Judges Appear To Side With Texas Challenge To Obamacare
If the challenge to the Affordable Care Act ... is upheld, it would do what Trump and a GOP-led Congress failed to accomplish in 2017: take down Obamacare. And while Trump has repeatedly said that people with pre-existing conditions, such as cancer and diabetes, would be covered even if the law is struck down, he has not issued any specific plans to do so. (Luhby, Berman and Biskupic, 7/9)
Los Angeles Times:
Federal Appeals Court Appears Skeptical Of Obamacare, Putting Future Of Law In Doubt
That would set the stage for another showdown before the Supreme Court, which has twice in the last decade been called upon to rule on the landmark law, often called Obamacare. Such a ruling could also prolong uncertainty over the fate of health coverage for tens of millions of Americans who depend on the law for health insurance and other protections, including the ban on insurers denying coverage to people with preexisting medical conditions. (Levey, 7/9)
The New York Times:
So You Want To Overturn Obamacare. Here Are Some Things That Would Be Headaches.
It’s not just that 21 million people would probably lose health insurance, or that 133 million Americans with pre-existing conditions would lose their protection. Those effects would be the major focus of attention if the Affordable Care Act were to be struck down. But the law was much, much broader, affecting a wide range of health programs, even some areas you might not think of as related to health. Overturning the entire law would mean all of its parts, in theory, would go away at once. (Sanger-Katz, 7/10)
The Associated Press:
Trump Revamps Kidney Care To Spur Transplants, Home Dialysis
President Donald Trump is directing the government to revamp the nation's care for kidney disease to give more people with failing kidneys a chance at early transplants and home dialysis. Trump is set to sign an executive order Wednesday aimed at saving lives and millions of Medicare dollars. Senior administration officials tell The Associated Press that the order also is designed to ease financial hardship for living donors and help organizations collecting deceased donations do a better job. (7/10)
The Wall Street Journal:
Rifts Emerge Over Congressional Move To Curb Surprise Medical Bills
A Congressional plan to tackle surprise medical bills is spurring a furious lobbying campaign and disagreements among Republican lawmakers that could make it difficult to pass the legislation this month. Measures protecting patients from high hospital bills from out-of-network doctors and other health providers has the backing of President Trump, who in May urged lawmakers to take action. Senate Health Committee Chairman Lamar Alexander (R., Tenn.) is hoping the full Senate will vote this month on a plan that would address surprise bills, after his committee approved it in late June. (Armour and Peterson, 7/10)
The Associated Press:
Most Attackers Made Threats Before Incident, Report Finds
One-third of the attackers who terrorized schools, houses of worship or businesses nationwide last year had a history of serious domestic violence, two-thirds had mental health issues, and nearly all had made threatening or concerning communications that worried others before they struck, according to a U.S. Secret Service report on mass attacks. (7/9)
Stat:
Top Trump Advisers Hint At Support For Progressive Drug Pricing Idea
A trio of key White House advisors on Tuesday hinted for the first time that they could support a progressive proposal to cap price increases for certain medicines, speaking at a closed-door Capitol Hill briefing of Republican senators. Health secretary Alex Azar joined Joe Grogan, the president’s top policy adviser, to encourage senators to pursue bipartisan legislation on drug pricing and potentially to include one idea from Sen. Ron Wyden (D-Ore.) that would cap some drug price hikes at the rate of inflation, according to senators who attended. (Facher and Florko, 7/10)
Stat:
Do Doctors Prescribe More Painkillers Because Of Pharma Money?
Amid ongoing concern that painkillers other than opioids are being misused, a new analysis suggests industry payments to physicians may cause increased prescribing of a class of drugs known as gabapentinoids, which are used to relieve pain and includes the popular Lyrica pill sold by Pfizer (PFE). After combing through a federal database of payments to doctors and running statistical models, the researchers found that physicians receiving food, gifts, and speaking and consulting fees, among other things, were nearly twice as likely to prescribe these medicines instead of lower-cost generic versions. (Silverman, 7/9)
The New York Times:
C.D.C. Investigates Rare Type Of Paralysis In Children
Last year, health officials confronted a record number of cases of a rare, mysterious neurological condition that caused limb weakness and paralysis in more than 200 children across the country. Officials with the Centers for Disease Control and Prevention said on Tuesday that they were still trying to understand the condition, called acute flaccid myelitis, or A.F.M. And though there have been very few cases so far this year, they urged doctors to be on the lookout because the illness has tended to emerge in late summer and early fall. (Belluck, 7/9)
The New York Times:
Why Women Getting Abortions Now Are More Likely To Be Poor
Abortion access in America is narrowing. There are fewer clinics, longer drives and more restrictions earlier in pregnancy. But something else is different: The women themselves.Women getting abortions today are far more likely to be poor than those who had the procedure done 20 years ago. Half of all women who got an abortion in 2014 lived in poverty, double the share from 1994, when only about a quarter of the women who had abortions were low-income, according to the Guttmacher Institute, a research group that supports abortion rights and conducts a national survey of abortion patients every six years. (Tavernise, 7/9)