U.S. House of Representatives possibly “injured” by ACA spending, judge OKs lawsuit
Susan Jaffe | Washington Correspondent for The Lancet | 15th September 2015
A new threat to the Affordable Care Act emerged last week when a federal judge decided to allow an unusual lawsuit by Republicans in the U. S. House of Representatives against President Barack Obama, claiming that his Administration violated the U. S. Constitution by spending billions of dollars for the Affordable Care Act that Congress did not approve. [Continued here] House of Representatives 091515
Billions served but Cleveland Clinic says no thanks to McDonald’s
Susan Jaffe | Washington Correspondent for The Lancet 9th September 2015
McDonald’s, the giant fast-food restaurant chain, has been adding healthy options to its menu of burgers, fries and shakes, but the new choices are too little, too late for the Cleveland Clinic.
After 20 years of serving patients, visitors, and Clinic employees in Cleveland, Ohio, the restaurant’s last day will be September 18. The world renowned hospital is not renewing its contract with McDonald’s.
“As a part of Cleveland Clinic’s commitment to health and wellness, we have made a number of changes across our health system over the past ten years that promote healthy food choices, exercise, and a smoke free environment,” said Eileen Sheil, the Clinic’s executive director for corporate communications, explaining why McDonald’s had to go. [Continued here]
Home-Care Workers
Susan Jaffe | Washington Correspondent for The Lancet | 28 August 2015
Home-care workers are excluded from the federal law requiring most employees to receive a minimum wage—currently $7·25 an hour—and 150% of that pay when they work overtime. After 40 years, the US Department of Labor (DOL) issued rules eliminating that exemption. The new rule was supposed to take effect last January but it was blocked by a lawsuit filed by associations representing companies that hire these workers. [Continued here.] [with video of Illinois Congresswoman Jan Schakowsky shadowing home-care worker Gilda Pipersburgh]
Congressional showdown threatens NIH funding boost
Volume 386, Issue 9996, 29 August 2015
WORLD REPORT Bills providing extra funding for the National Institutes of Health while cutting other programmes could a face presidential veto. Susan Jaffe, The Lancet’s Washington correspondent, reports.
After years of mostly stagnant funding for the US National Institutes of Health (NIH), two powerful congressional committees that control government spending have approved separate budget bills containing record increases for the agency.
But last month, President Barack Obama’s Office of Management and Budget director Shaun Donovan wrote to the chairman of the Senate Committee on Appropriations warning that he expects the president to veto its bill. Among other reasons, Donovan said it “drastically” cuts money for public health programmes including Medicare for the elderly and Medicaid, serving low-income Americans. And it would deny funds for operating the health insurance exchanges essential to the president’s signature health reform law, the Affordable Care Act. [Continued in full text or PDF ]
Clean Power Plan
Susan Jaffe | Washington Correspondent for The Lancet 25th August 2015
Before President Barack Obama’s Clean Power Plan can inspire other nations to control greenhouse gases by following the USA’s lead in dramatically reducing carbon emissions, the Administration has to convince West Virginia—and at least 15 other skeptical states. [Continued here]
21st Century Cures
12 August 2015
A dispatch from our Washington correspondent on the sluggish progress of the 21st Century Cures Act.
Republicans and Democrats in the U.S. House of Representatives last month overwhelmingly passed the 21st Century Cures Act aimed at speeding up drug development. But the Senate is not expected to vote on its version until next year.
More than 80 percent of the House backed the legislation after it was unanimously — a word rarely heard on Capitol Hill — approved by the House Committee on Energy and Commerce. In the process, the bill was revised to address concerns that drug approvals would happen a little too quickly, circumventing safety and efficacy standards. [Continued here]
50 Years of Medicare
Volume 386, Issue 9992, 1 August 2015
WORLD REPORT In July, 1965, Medicare, America’s landmark national health insurance programme, became law. Today, it covers 55 million people. Susan Jaffe, The Lancet’s Washington correspondent, reports.
An American woman thanks President Lyndon Johnson for Medicare, April, 1965.
Richard Troeh joined a very busy solo family medicine practice in 1966 but even with two doctors, their offi ce in Independence, Missouri, seemed just as hectic. The year before, President Lyndon Baines Johnson came to town to sign the Medicare legislation into law at the Truman library. Former President Harry Truman—an advocate of national health insurance since the 1940s—and his wife attended the event and were among the fi rst Americans to receive Medicare cards.
50 years later, the Social Security Amendments of 1965 provide health care for 55 million people older than 65 years or disabled receiving Medicare and nearly 73 million low-income adults, children, pregnant women, and people with disabilities receiving Medicaid, an optional programme also created under the same law.
And in the process, the government programmes have transformed health care in the USA. Medicare is the nation’s largest single purchaser of health care, consuming 14% of last year’s federal budget, or US$505 billion. And it also has a fiercely loyal following that opposes efforts to cut benefits. Speaking earlier this month at the White House Conference on Aging, President Barack Obama drew laughs when he said, “And now we’ve got [protest] signs saying, “Get your government hands off of my Medicare”. [Continued in full text or PDF ] [listen to podcast here]
Congress Overwhelmingly Approves Bill Bolstering Medicare Patients’ Hospital Rights
By Susan Jaffe | Kaiser Health News | July 29, 2015 | This KHN story also ran in 
The U.S. Senate unanimously approved legislation Monday night requiring hospitals across the nation to tell Medicare patients when they receive observation care but have not been admitted to the hospital. It’s a distinction that’s easy to
miss until patients are hit with big medical bills after a short stay.
The vote follows overwhelming approval in the U. S. House of Representatives in March. The legislation is expected to be signed into law by President Barack Obama, said its House sponsor, Texas Democratic Rep. Lloyd Doggett.
It’s called the NOTICE Act, short for “Notice of Observation Treatment and Implication for Care Eligibility.” The law would require hospitals to provide written notification to patients 24 hours after receiving observation care, explaining that they have not been admitted to the hospital, the reasons why, and the potential financial implications.
Those implications can be dire. Observation care hurts seniors in two ways: It keeps Medicare’s more comprehensive hospitalization coverage from kicking in, and it means they may not get Medicare’s limited nursing home benefit if they need care in a facility after being in a hospital.
To qualify for Medicare’s nursing home coverage, beneficiaries must first spend three consecutive midnights as an admitted patient in a hospital, and observation days don’t count. Without that coverage, seniors could pay thousands of dollars for the nursing home care their doctor ordered, or else try to recover on their own. Observation care is a classification used when patients are not well enough to go home but not sick enough to be admitted. [Continued in Kaiser Health News]
New Regulations Would Require Modernizing Nursing Home Care
By Susan Jaffe | July 13, 2015 | Kaiser Health News in collaboration with 
After nearly 30 years, the Obama administration wants to modernize the rules nursing homes must follow to qualify for Medicare and Medicaid payments.
The hundreds of pages of proposed changes cover everything from meal times to use of 
antipsychotic drugs to staffing. Some are required by the Affordable Care Act and other recent federal laws, as well as the president’s executive order directing agencies to simplify regulations and minimize the costs of compliance.
“Today’s measures set high standards for quality and safety in nursing homes and long-term care facilities,” said Health and Human Services Secretary Sylvia M. Burwell. “When a family makes the decision for a loved one to be placed
in a nursing home or long-term care facility, they need to know that their loved one’s health and safety are priorities.”
Officials announced the update as the White House Conference on Aging convenes Monday. The once-a-decade conclave sets the agenda for meeting the diverse needs of older Americans, including long-term care options. This month also marks the 50th anniversary of the Medicare and Medicaid programs, which cover almost 125 million older, disabled or low-income Americans. Medicare and Medicaid beneficiaries make up the majority of residents in the country’s more than 15,000 long-term care facilities. [MORE from Kaiser Health News and NPR]
Want a good laugh? Head to the hospital.
By Susan Jaffe KAISER HEALTH NEWS | July 7, 2015 | This KHN story also ran in 
Every month, a group of older adults goes to Washington’s Sibley Memorial Hospital, but they don’t see a doctor or get tests. They’re not sick. They come just for laughs.
Joanne Philleo, 79, enjoys a joke at the monthly “Laugh Cafe” event at Sibley Memorial Hospital. (Amanda Voisard for The Washington Post)
They gather in a room next to the hospital cafeteria for the “Laugh Cafe,” one of the activities offered to local seniors, including the 7,300 members of Sibley’s Senior Association. The price of admission is one joke, recited out loud. Experts say laughing can be good for your health, and everyone in the room strongly agrees.
…The association for those age 50 or older also offers other activities, including French and Italian conversation classes, day trips to museums, a current events group, and — the latest addition — tango lessons. In addition, members receive discounts on hospital parking and at the gift shop, pharmacy and restaurant. In all, more than 10,000 seniors participate.
Sibley is one of several hospitals in the Washington area — along with others across the country — offering social activities and other benefits to help seniors stay healthy and out of the hospital, while encouraging them to visit. Participants do not need to have been patients.
But some experts are concerned that the activities are less about health than about marketing to Medicare beneficiaries, especially those who can go to the hospital of their choice when they need care because they are not enrolled in private insurance plans with limited provider networks.[Continued in Washington Post]
US Supreme Court upholds ACA subsidies
Volume 385, Issue 9988, 4 July 2015
WORLD REPORT Officials expect to launch the US President’s new health project later this year. But Congress has yet to decide whether to fully fund it. The Lancet’s Washington correspondent, Susan Jaffe, reports.
ACA supporters celebrate outside the Supreme Court following the judgment on June 25 (Bloomberg)
Although critics still deride it as Obamacare, President Barack Obama’s Supreme Court victory last week
enshrined the Affordable Care Act (ACA) as one of his greatest domestic accomplishments. The court might have also effectively disarmed the opposition, shifting the debate to next year’s campaign for the presidency as the next chance for critics to try to dismantle the law.
But for 6·4 million Americans who could have lost the health law’s insurance subsidies—the key issue before the court—the historic ruling has a different meaning. “Thank God, I can still get my medical care”, said Jacqueline Clay, a New Jersey woman receiving treatment for breast cancer who turned 61 years of age the day the court upheld the subsidies. “I am not going to die.” [Continued in full text or PDF ]
When Turning 65, Consumers With Marketplace Plans Need To Be Vigilant In Choosing Health Coverage
By Susan Jaffe | June 25, 2015 | Kaiser Health News
Befor
e the Affordable Care Act, older adults who couldn’t afford to buy their own health insurance would count the days until their 65th birthday, when Medicare would kick in. Now, 10,000 Americans hit that milestone every day, but for some who have coverage through the ACA’s insurance marketplaces, Medicare may not be the obvious next step.
“Consumers eligible for Medicare can keep or renew their marketplace plan,” said Medicare spokesman Alper Ozinal, as long as they don’t also join Medicare. [Continued in Kaiser Health News]
Planning for US Precision Medicine Initiative underway
Volume 385, Issue 9986, 20 June 2015
WORLD REPORT Officials expect to launch the US President’s new health project later this year. But Congress has yet to decide whether to fully fund it. The Lancet’s Washington correspondent, Susan Jaffe, reports.
While continuing to defend his besieged health-care reform law against lawsuits and repeal threats, US President Barack Obama is championing a new health initiative. This one also has a bold goal: to radically change the medical treatment patients receive in the USA. “I want the country that eliminated polio and mapped the human genome to lead a new era of medicine—one that delivers the right treatment at the right time”, the President said when he unveiled his Precision Medicine Initiative (PMI) in his annual State of the Union address to the nation in January. …Central to the PMI will be the creation of a research cohort of 1 million US volunteers who agree to provide researchers with biological, environmental, lifestyle, and other information as well as tissue samples….The effort to vastly expand the scope and practice of individually designed treatments based on genetic information could revolutionise medicine, supporters say. But the success of the PMI depends on whether Congress agrees to fund it. [Continued in full text or PDF ]
Obamacare, Private Medicare Plans Must Keep Updated Doctor Directories In 2016
By Susan Jaffe | March 9, 2015 | Kaiser Health News and also published in 
Starting next year, the federal government will require health insurers to give millions of Americans enrolled in Medicare Advantage plans or in policies sold in the federally run health exchange up-to-date details about which doctors are in their plans 
and taking new patients.
Medicare Advantage plans and most exchange plans restrict coverage to a network of doctors, hospitals and other health care providers that can change during the year. Networks can also vary among plans offered by the same insurer. So it’s not always easy to figure out who’s in and who’s out, and many consumers have complained that their health coverage doesn’t amount to much if they can’t find doctors who accept their insurance. [More from KHN] [More in USA Today]