HEALTHCARE REFORM: Judge Allows Ind. To Sue IRS Over ACA Rule

A federal judge on Aug. 12 ruled that Indiana can sue the Internal Revenue Service over a 2012 rule governing eligibility for federal subsidies through the federal health insurance exchange (AP/Washington Times, 8/13). Indiana and several public school districts filed the suit in 2013, claiming IRS exceeded its legal authority by establishing a rule permitting the subsidies to be available through federal insurance exchanges. In their lawsuit, Indiana and 39 school districts said that the rule would compel them to comply with requirements that forced them to recognize workers formerly classified as part-time before the ACA required them to be designated as full-time employees (Harris, Bloomberg, 8/13). The districts said offering coverage to all employees working at least 30 hours per week constituted an undue financial burden, and they argued that they should not be taxed if they refused to provide health care for all full-time employees (WRTV, 8/12). In his ruling, U.S. District Judge William Lawrence refused a request from CMS to dismiss part of the lawsuit and rejected the claim that Indiana and the 39 districts would not suffer harm from the rule. However, he also rejected the state's claim that the rule violated Indiana's sovereignty (Bloomberg, 8/13). Click here for the AP/Washington Times article. Click here for the Bloomberg article. Click here for the WRTV article.

HEALTHCARE REFORM: Ky. Uninsured Rate Falls Dramatically, Poll Says

Kentucky's uninsured rate has declined by 8.5 percentage points since January, the second-largest decline of any state, according to a Gallup survey (Brammer, Lexington Herald-Leader, 8/6). For the survey, Gallup conducted telephone interviews with 88,678 U.S. adults from Jan. 2 to June 30 (Gallup survey, 8/5). The survey found that Kentucky's uninsured rate declined from 20.4% in 2013 to 11.9% in mid-2014. According to Kentucky Gov. Steve Beshear (D), more than 521,000 state residents have enrolled in health coverage through the state's exchange -- called Kynect -- as of July 31. Beshear said, "To see this steep decline in the uninsured rate in such a short period of time reaffirms that Kynect is working and we made the right decision for the health and well-being of our citizens" (Lexington Herald-Leader, 8/6). Click here for the Gallup survey. Click here for the Lexington Herald-Leader article.

HEALTHCARE REFORM: ACA Premiums Up by 7.5% for 2015, Report Says

Premiums for plans sold through the Affordable Care Act's health insurance exchanges will increase by 7.5% on average next year, according to a report by PricewaterhouseCoopers' Health Research Institute (Viebeck, The Hill, 8/11). The estimates are based on preliminary data from 27 states and the District of Columbia (Reichard, CQ HealthBeat, 8/11). According to HRI Managing Director Ceci Connolly, the average 7.5% increase is "well below the double-digit increases many feared." However, the report noted that premiums will vary, with some consumers seeing substantial rate hikes and others experiencing premium declines. For example, premiums for exchange plans in Indiana are estimated to increase by 15.4% and Arizona residents in some plans could see their rates decrease by as much as 23%. Connolly noted that overall, average individual monthly premiums for ACA plans in 2015 will cost about $384 before federal subsidies are applied. According to the report, insurers generally are raising their premium rates for exchange plans if their beneficiary pools are made up of more sicker, elderly individuals who are likely to use more medical care than previously estimated. The report also noted that the rates are not yet set in stone (The Hill, 8/11). Click here to view the PricewaterhouseCooper report. Click here for The Hill article. Click here for the CQ article (password required). 

CMS last month returned Indiana Gov. Mike Pence's (R) Medicaid expansion proposal -- called "Healthy Indiana Plan 2.0" -- because it does not include input from a band of Potawatomi Indians. The plan hopes to use federal Medicaid funding to establish a hybrid insurance model that includes health savings accounts for individuals with incomes below 138% of the federal poverty level and better coverage for anyone paying into the plan. Family and Social Services Administration spokesperson Jim Gavin said CMS previously told the state it did not need to consult with the tribe, but is now sending state officials to meet with the group and get feedback on the expansion proposal. This is the second time CMS has returned the proposal. Last year the agency said the state had not conducted public hearings before the plan's submission (LoBianco, AP/IndyStar, 8/5). Click here for the AP/IndyStar story.

MEDICAID: Ohio Hospital's Early Medicaid Expansion Proves Successful

An Ohio hospital, MetroHealth in Cleveland, that created its own version of Medicaid expansion before the state expanded its Medicaid program has proven successful. The hospital redirected $30 million of public funds to create its own Medicaid program for Cuyahoga County residents. The hospital determined which patients were uninsured by examining their electronic health records and sent Medicaid cards to 28,000 uninsured patients without requiring the patients to apply for the program. The hospital then provided personalized attention to and kept track of 18,000 of the patients, who were frequent visitors to the hospital. Under the program, the hospital assigned a nurse to each patient who booked the patient's appointments, called the patient if he or she missed an appointment and checked to make sure the patient took his or her medications. During the program's first nine months visits to the hospital's emergency department declined by 60%, primary care visits increased by 50% and the hospital saved an average of $150 per patient each month (Jane, WCPN/NPR/Kaiser Health News, 8/5). Click here for the WCPN/NPR/Kaiser Health News article.

MENTAL HEALTH: Lawmaker Calls for Mental Health Reform After Death of Robin Williams

Rep. Tim Murphy (R-Pa.) on August 12 expressed hope that the death of actor Robin Williams -- ruled a suicide by law enforcement officials -- would serve as a call to action to address mental health reform. Murphy -- who previously has introduced legislation (HR 3717) to overhaul the mental health system -- said the legislation is needed because there are nearly 40,000 suicides each year. "In what other discipline of medicine would we ignore such staggering statistics?" Murphy said (Viebeck , The Hill, 8/12). Meanwhile, Mark Hurst -- medical director of the Ohio Department of Mental Health and Addiction Services -- said the actor's suicide could help foster discussion among the public, as well as between physicians and patients. He said, "If I was treating someone with depression or bipolar disorder, after I went through the symptom review and asked how their life is, I would ask them: 'Recently, there was a high-profile suicide -- what are your thoughts about that?'" He added, "That can be a catalyst to open up the discussion another way" (Ward/Gordon, Columbus Dispatch, 8/13). Click here to view HR 3717. Click here for Murphy's statement. Click here for The Hill article. Click here for the Columbus Dispatch article.

RX DRUGS: Pharmaceutical Industry Reacts to FDA Draft Guidance on Social Media

Drugmakers are reacting negatively to FDA guidance on the ways the industry can advertise and interact with customers via social media (Zeller, CQ HealthBeat, 8/11). Under a 2012 law, FDA must offer guidance on product promotion on the Internet. In June, the agency outlined how drugmakers and medical device makers should highlight the benefits and risks of their products via social media and how they should address and correct misinformation regarding their products posted by third parties (Tavernise,  New York Times, 6/17). Drugmakers can ignore the guidance documents, as they are not formal rules, but FDA can respond with a warning letter. Drugmakers argue that restrictions on Twitter advertising will make it harder for consumers and medical professionals to learn more about certain medications. Jeffrey Francer -- vice president and senior counsel of the Pharmaceutical Research and Manufacturers of America -- said, "FDA should avoid chilling manufacturers' responsible communication of medical information about their products and should allow manufacturers to take advantage of the same technologies that FDA and the White House use" (CQ HealthBeat, 8/11). Click here for the CQ HealthBeat article (password required). Click here for the New York Times article.

SUBSTANCE USE DISORDERS: Ind. Program Says Lack of Funding Might Impede Substance Use Disorders Care

An Indiana Family and Social Services Administration program that has helped more than 11,000 state residents combat substance use disorders since 2010 is losing its funding at the end of the year. The program has received $3.3 million over the past four years from the federal Access to Recovery grant. However, FSA spokesperson Marni Lemons said federal budget cuts meant only six states received the funding this year. Lemons said the agency is looking elsewhere for funding to keep the program running, even if in a reduced capacity (AP/Fort-Wayne News-Sentinel, 8/10). Click here for the Fort Wayne News-Sentinel article.

SUBSTANCE USE DISORDERS: Ohio Committee To Explore Remedies to Substance Use Disorder Epidemic

A committee of Ohio lawmakers will hear testimony over the next two months from state officials, law enforcement agents and the public on how to address the state's substance use disorder epidemic. During four meetings, which will be held in August and September, the 10-person committee will explore the needs and experiences of law enforcement when monitoring residents with substance use disorders, in addition to how the substances affect local families. The lawmakers also will address topics such as prevention, law enforcement coordination, treatment and recovery and the scope of the epidemic. According to Ohio House Speaker William Batchelder (R), previous hearings have yielded ideas that eventually were included in state legislation (AP/Sacramento Bee, 8/10). Click here for the AP/Sacramento Bee article.

TOBACCO: Ind., Ohio AGs Call on FDA To Strengthen Proposed E-Cigarette Regulations

Twenty-nine state attorneys general -- including those from Indiana and Ohio -- on Aug. 8 in a letter to FDA urged the agency to strengthen its proposed regulations of electronic cigarettes. The rules, proposed in April, would extend the agency's regulatory authority over tobacco products to include electronic cigarettes, cigars, pipe tobacco and other products. The public comment period for the new FDA rule ended Aug. 8 (Vaughan, Reuters, 8/8). In their letter, the state AGs argued that FDA's proposed rules do not go far enough. Specifically, the stage AGs argued that FDA should further restrict the sale of e-cigarettes over the Internet (Esterl, Wall Street Journal, 8/8). They also wrote that FDA should prohibit sales of most flavored e-cigarettes, which public health experts claim appeal to children; restrict e-cigarettes marketing and advertising to align the product's rules more with restrictions placed on traditional cigarettes (Harris, New York Times, 8/8). Finally, the AGs recommended that FDA strengthen the products' proposed health warning. FDA declined to comment on the letter, but said it would work "as quickly as possible" to review all public comments (Wall Street Journal, 8/8). Click here to view the letter. Click here for the Reuters article. Click here for the Wall Street Journal article. Click here for the New York Times article.