Author Archives: LocalHealthGuide

If Supreme Court rules against insurance subsidies, most want them restored


U.S. Supreme CourtBy Julie Rovner

A new poll finds that most people think Congress or states should act to restore health insurance subsidies if the Supreme Court decides later this year they are not permitted in states where the federal government is running the marketplace.

The court in March is set to hear King v. Burwell, a lawsuit arguing that the wording of the Affordable Care Act means that financial assistance with premiums is available only in the 13 states that created and are running their own online insurance exchanges.

If the court were to invalidate subsidies in the federally run states, 64 % said Congress should restore them, and 59% said states should create their own exchanges.

If the court sides with those challenging the law, millions of people in the 37 states that use the federal site would lose the help they have been getting. A decision in the case is expected in late June.

Less than half the respondents in the monthly tracking poll by the Kaiser Family Foundation said they had heard about the case. (Kaiser Health News is an editorially independent project of the foundation.)

But if the court were to invalidate subsidies in the federally run states, 64 percent said Congress should restore them, and 59 percent said states should create their own exchanges. Continue reading


Obamacare cost to be 20% less than forecast, budget office says – LA Times


Twenty-dollar bill in a pill bottlePresident Obama’s healthcare law will cost about 20% less over the next decade than originally projected, the Congressional Budget Office reported Monday, in part because lower-than-expected healthcare inflation has led to smaller premiums.

So far, the number of uninsured Americans has dropped by about 12 million. By the end of 2016, 24 million fewer Americans will lack insurance, the nonpartisan budget office forecast.

Excluding immigrants in the country illegally, who are not eligible for coverage under the law, only about 8% of Americans under age 65 will lack insurance by the time Obama leaves office, the budget office’s latest report on the law estimates.

via Obamacare cost to be 20% less than forecast, budget office says – LA Times.


Adminstration to quicken pace towards quality-based Medicare payments


cms-logo-200pxBy Jordan Rau

HHS Pledges To Quicken Pace Toward Quality-Based Medicare Payments

The Obama administration Monday announced a goal of accelerating changes to Medicare so that within four years, half of the program’s traditional spending will go to doctors, hospitals and other providers that coordinate their patient care, stressing quality and frugality.

The announcement by Health and Human Services Secretary Sylvia Burwell is intended to spur efforts to supplant Medicare’s traditional fee-for-service medicine, in which doctors, hospitals and other medical providers are paid for each case or service without regard to how the patient fares.

Within four years, half of the program’s traditional spending will go to doctors, hospitals and other providers that coordinate their patient care, stressing quality and frugality.

Since the passage of the federal health law in 2010, the administration has been designing new programs and underwriting experiments to come up with alternate payment models.

Last year, 20 percent of traditional Medicare spending, about $72 billion, went to models such as accountable care organizations, or ACOs, where doctors and others band together to care for patients with the promise of getting a piece of any savings they bring to Medicare, administration officials said.

There are now 424 ACOs, and 105 hospitals and other health care groups that accept bundled payments, where Medicare gives them a fixed sum for each patient, which is supposed to cover not only their initial treatment for a specific ailment but also all the follow-up care.

Other Medicare-funded pilot projects give doctors extra money to coordinate patient care among specialists and seek to get Medicare to work more in harmony with Medicaid, the state-federal health insurer for low-income people.

Burwell’s targets are for 30 percent, or about $113 billion, of Medicare’s traditional spending to go to these kind of endeavors by the end of President Barack Obama’s term in 2016, and 50 percent — about $215 billion — to be spent by the end of 2018. Continue reading


Uninsured? Beware of the health law’s tax penalty


The penalty for being uninsured in 2014 is $95 or 1 percent of income, whichever is greater. Next year, it’s 2 percent.

By April Dembosky, KQED and Jeff Cohen, WNPR

Are you thinking about tax day yet? Your friendly neighborhood tax preparer is.

“This year taxes and health care intersect in a brand new way. ‘

IRS Commissioner John Koskinen declared this tax season one of the most complicated ever, and tax preparers from coast to coast are trying to get ready for the first year that the Affordable Care Act will show up on your tax form.

Sue Ellen Smith manages an H&R Block office in San Francisco, and she is expecting things to get busy soon.

“This year taxes and health care intersect in a brand new way,” Smith says.

cohen hr block 570

An H&R Block office in Hartford, Conn., is decorated with cardboard cutouts from a national ad campaign on the health law’s tax implications. (Photo by Jeff Cohen/WNPR)

For most people, who get insurance through work, the change will be simple: checking a box on the tax form that says, “yes, I had health insurance all year.”

But it will be much more complex for an estimated 25 million to 30 million people who didn’t have health insurance or who bought subsidized coverage through the exchanges.

To get ready, Smith and her team have been training for months, running through a range of hypothetical scenarios. One features “Ray” and “Vicky,” a fictional couple from an H&R Block flyer. Together they earn $65,000 a year, and neither has health insurance.

“The biggest misconception I hear people say is, ‘Oh the penalty’s only $95, that’s easy,’” says Smith, but the Rays and Vickys of the world are in for a surprise that will hit their refund. “In this situation, it’s almost $450.” Continue reading


Q & A about Public Health’s investigation of an endoscope associated outbreak


Tcrehe Seattle Times reported this morning that there had been an outbreak of multidrug-resistant “superbug” infections spread by contaminated endoscopes between 2012 and 2014 in which at least 32 patients at Virginia Mason Medical Center were infected .

Neither the hospital nor health officials notified patients or the public, the Seattle Times reported.

In response to the paper’s report, Public Health – Seattle & King County has posted the following  Q & A on its Public Health Insider blog:

Q & A about Public Health’s investigation of an endoscope associated outbreak

Voluntary reporting by Virginia Mason Medical Center led to identification of an outbreak of multidrug resistant bacterial infections in 2013. After months of investigative work, Public Health—working with Virginia Mason Medical Center, Washington State Department of Health and the Centers for Disease Control Prevention (CDC)—linked the outbreak to a procedure called endoscopic retrograde cholanCREgiopancreatography (ERCP). Since discovering the risk from this procedure, our Communicable Disease Epidemiology staff has taken a leadership role in drawing national attention to this issue in the medical community. Dr. Jeff Duchin, Interim Health Officer and Chief of Communicable Disease Epidemiology answered questions about this outbreak.

What is an ERCP used for?

The ERCP procedure uses a scope, or tube, that goes through a patient’s mouth and throat to reach their upper small bowel and bile duct system. ERCP is used in persons with serious medical problems including cancers and other diseases that cause obstruction or narrowing of the bile ducts.

What kind of bacteria caused the infections?

Infections were caused by two closely-related types of bacteria that are resistant to many antibiotics. In some cases, the bacteria were also resistant to powerful antibiotics called carbapenems.  These bacteria are referred to as CRE (carbapenem resistant Enterobacteriaceae).

Was the outbreak caused by a CRE “superbug?”

No. The type of CRE that has caused outbreaks in other healthcare facilities has been referred to as a “CRE superbug.” It usually produces an enzyme that inactivates carbapenem antibiotics. The outbreak we investigated was not caused by this type of CRE, which did not have a carbapenemase enzyme.

What is the role of Public Health in this investigation? Continue reading


Public Health asks court to stop two hookah bars from violating smoking law


Photo courtesy of Solix via Wikipedia

From Public Health – Seattle & King County

Public Health – Seattle & King County has filed papers in King County Superior Court asking the court to stop two hookah bars for exposing employees and the public to tobacco smoke in violation of Washington’s Smoking in Public Places Act and local Board of Health Code.

The request for an injunction was filed against The Night Owl in Seattle’s University District and Medina Hookah Lounge in south Seattle.

A hookah is a glass pipe filled with water that is used for smoking flavored tobacco, often by several people at once.

During a typical 45-minute session of hookah use, a person may inhale as much smoke, tobacco and carcinogens as smoking 100 cigarettes or more.

Smoking in public places law

Washington’s Smoking in Public Places law was passed by voters in 2005 and prohibits smoking in public places and places of employment. The local Board of Health code mirrors the state law and includes provisions that prohibit the use of electronic smoking devices.

Hookah bars have claimed that they are exempt from the indoor smoking law because they are private clubs. However, smoking is prohibited by law if an establishment has employees and/or the club is open to the public.

A previous ruling by a King County Hearing Examiner on February 12, 2014 found that both the Night Owl and Medina are open to the public, operating similarly to night clubs that charge a cover for admission.

“Hookah smoke is as addictive as traditional cigarettes”, said Patty Hayes, Interim Director, Public Health- Seattle & King County. “Asking the court for an injunction is a measure of last resort, but it is necessary now to ensure all our businesses are protecting the health of employees and the public.” Continue reading


Texas prisons try telemedicine to curb spending | Dallas Morning News


200px-Flag-map_of_TexasThe high-tech medical consultation, known as telemedicine, uses technology to connect prisoners, who are often housed in remote areas, with medical experts throughout the state.

It’s just one way that the Texas Department of Criminal Justice is trying to control spending on prison health care. But while telemedicine has shown some success in curbing spending, it hasn’t been enough to stem rising costs due to an aging prison population.

via Texas prisons try telemedicine to curb spending | Dallas Morning News.


States continue war over Obamacare | Center for Public Integrity


Center for public integrity logoIn Washington, there’s been little consensus on modifying the health reform law—short of repeated votes in the House to kill or cripple it.

That might change as Republicans take control of the House and Senate, though what fixes, if any, Congress might prescribe—and whether any can get a signature from the President— aren’t clear.

But in state capitals around the country, from Albany and Columbia to Austin and Sacramento, lawmakers have been mulling over hundreds of proposals that reflect a myriad of starkly different views on Obamacare as settled law.

via States continue war over Obamacare | Center for Public Integrity.


Renewing customers urged to take immediate action to continue 2015 coverage


Alert Icon

Washington Healthplanfinder Urges Renewing Customers to Take Immediate Action to Continue 2015 Health Coverage

Thousands of Customers Have Not Yet Taken Action; Next Deadline to Enroll is Jan. 23

 The Washington Health Benefit Exchange is urging 2014 customers who have not yet renewed their coverage for 2015 to return as soon as possible to continue their health plan this year.

“There is still time to come back and get enrolled, but time is running out.”

Customers who were unable to renew by the Dec. 23 deadline or were unaware of additional action needed on their account may be eligible for a special 60-day enrollment opportunity. These customers should fill out an online form to initiate eligibility for retroactive coverage that begins on Jan. 1.

Up to 4,000 customers have completed an application for 2015 coverage but did not submit payment by the Dec. 23 deadline for coverage that began on Jan. 1. 

These applications will be reviewed by Exchange staff to ensure that eligible individuals are able to receive retroactive coverage.

“There is still time to come back and get enrolled, but time is running out,” said Richard Onizuka, CEO for the Washington Health Benefit Exchange. “Customers should contact us as soon as possible if they need assistance with their application.” Continue reading


Obama expected to defend health law in State of the Union address


President Obama will deliver his State of the Union address tonight at 9 p.m. ET.

To watch online go to:

The site will include interactive features that make clear what the President’s proposals mean for you, and shareable charts and stats that help supplement and expand on the points you’ll hear Obama make. If you’re watching on your TV, you can still follow along on your phone or tablet.

Watch Tonight



Northwest Kidney Centers names four new medical directors


 Northwest Kidney Centers has named new medical directors to supervise overall patient care at four of its 15 dialysis centers.

2011 Northwest Kidney CentersDr. Scott Bieber is now medical director at Northwest Kidney Centers’ Scribner clinic in the Northgate area at 2150 N. 107th St., Seattle. Bieber is a clinical assistant professor of medicine at the University of Washington-Harborview. He earned a doctor of osteopathy degree at Western University of Health Sciences; completed an internal medicine residency and chief residency at Los Angeles County General Hospital-University of Southern California; and held nephrology and dialysis fellowships at the University of Washington.

Dr. Daniel Hu photo (1214x1280)Dr. Daniel Hu is medical director at Northwest Kidney Centers’ SeaTac clinic, at 17900 International Blvd. S., SeaTac. He practices at the University of Washington-Valley Medical Center nephrology clinic in Renton. He received his medical degree from East Carolina University; completed an internal medicine residency and geriatrics fellowship at Duke University Medical Center; and held a nephrology fellowship at the University of Virginia.  Continue reading


7 Reproductive rights issues to watch in 2015


By Nina Martin ProPublica

Abortion Knoxville-march-for-life-2013-3To say abortion opponents are feeling fired up in 2015 would be a massive understatement.

In their first week back at work, congressional Republicans introduced a sweeping prohibition on abortions after 20 weeks of pregnancy (H.R. 36, the Pain-Capable Unborn Child Protection Act), as well as bills that would ban sex-selective abortions, target funding for groups like Planned Parenthood, require abortion providers to have hospital admitting privileges, and let doctors and nurses opt out of providing abortion care, even in emergencies.

In the states, where the 2014 elections gave Republicans control of two-thirds of state legislative chambers, incoming lawmakers also have supersized their abortion agendas.

But abortion is just one issue on the minds of activists focused on reproductive rights. There’s also birth control, conscience clauses and personhood. Here are seven key trends and themes to watch for this year.

1. A New Wave of Abortion Restrictions

Continue reading