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"content": "\u003cp>People who smoke marijuana reported having more sexual intercourse than non-users, according to a new study conducted by urologists at the \u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\">Stanford University School of Medicine\u003c/a>.\u003c/p>\n\u003cp>The results were modest but statistically significant: Non-users said they had engaged in sexual intercourse between five and six times in the previous month. Daily pot smokers reported having intercourse around seven times over that same period. The frequency was in-between for people who smoked marijuana less often, on a weekly or monthly basis: they reported having sex more than abstainers, but less than daily users.\u003c/p>\n\u003cp>“I was surprised,” said\u003ca href=\"https://stanfordhealthcare.org/doctors/e/michael-eisenberg.html\" target=\"_blank\" rel=\"noopener\"> Dr. Michael Eisenberg\u003c/a>, the study’s senior author and an assistant professor of urology at Stanford University Medical Center.\u003c/p>\n\u003cp>“The daily users for example, compared to the never users, reported about 20 more sexual encounters a year. So I think that is a significant difference,\" he said.\u003c/p>\n\u003cp>It’s the first study to look at the connection between pot smoking and sex at the population level. To tease out the association, Eisenberg and his co-author Dr. Andrew Sun used survey data drawn from more than 50,000 Americans between the ages of 25 and 45.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The data comes from the National Center for Health Statistics at the CDC. Since that survey does not ask about homosexual encounters, the results only apply to straight men and women.\u003c/p>\n\u003cp>Eisenberg decided to do the study because more of his patients had been asking him if smoking marijuana could be contributing to their sexual difficulties. He had previously told them it might, and to abstain just in case. He was basing his assumptions on research about the negative vascular effects of cigarette smoking. In addition, some past studies and case reports have indicated heavy marijuana use may be associated with erectile dysfunction or depressed sperm count.\u003c/p>\n\u003cp>But now Eisenberg is rethinking his advice, at least for some patients.\u003c/p>\n\u003cp>“If somebody is using marijuana to help them for chronic back pain or something like that, there may be other interventions that we can think about targeting,” he said. “Rather than telling them they have to stop, otherwise their sex life is doomed.”\u003c/p>\n\u003cp>For \u003ca href=\"http://sexandthesoma.com/\" target=\"_blank\" rel=\"noopener\">Dr. Holly Richmond\u003c/a>, a sex therapist, the study results are “pretty remarkable.”\u003c/p>\n\u003cp>In her offices in Los Angeles and Portland, Oregon, Richmond has seen mixed results when her clients use marijuana. Some couples tell her that they have more sex when they use pot, but others have less sex.\u003c/p>\n\u003cp>She said those differences are probably attributable to how much pot someone smokes, instead of how often.\u003c/p>\n\u003cp>“Too much can lead to lethargy and really checking out, which does not facilitate [emotional] connection at all, and definitely doesn't encourage sexual activity.”\u003c/p>\n\u003cp>Eisenberg cautioned against drawing unwarranted conclusions from the study, and cited the old statistical adage “correlation does not equal causation.”\u003c/p>\n\u003cp>“This doesn’t mean that if you want to have more sex you should start smoking marijuana,” he said. “That’s definitely not what this data supports.”\u003c/p>\n\u003cp>The study can’t explain what factors are driving the association between pot use and sex, said Dr. Igor Grant, chair of psychiatry and director of the \u003ca href=\"http://www.cmcr.ucsd.edu/\" target=\"_blank\" rel=\"noopener\">Center for Medicinal Cannabis Research\u003c/a> at the University of California San Diego.\u003c/p>\n\u003cp>He said one explanation is that people who use marijuana —or are willing to admit marijuana use in a survey —are more likely to report their sexual encounters, or remember more of them. Grant said marijuana users are also sensation seekers, and may be more driven to have sex.\u003c/p>\n\u003cp>“Drug use is one type of sensation-seeking behavior, and obviously sex is another,” Grant said.\u003c/p>\n\u003cp>Eisenberg agreed that personality and other behaviors could be a factor, but if that was the case, he would expect to see different results from different demographic groups. For example, young and single respondents might be more willing and able to engage in risky or sensation-seeking behavior, when compared to married people with children. But the results held across all categories, including race and ethnicity, educational level, income level, religious affiliation, and family status.\u003c/p>\n\u003cp>“For every group, the more marijuana use that they reported, the more sex they reported as well. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>People who smoke marijuana reported having more sexual intercourse than non-users, according to a new study conducted by urologists at the \u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\">Stanford University School of Medicine\u003c/a>.\u003c/p>\n\u003cp>The results were modest but statistically significant: Non-users said they had engaged in sexual intercourse between five and six times in the previous month. Daily pot smokers reported having intercourse around seven times over that same period. The frequency was in-between for people who smoked marijuana less often, on a weekly or monthly basis: they reported having sex more than abstainers, but less than daily users.\u003c/p>\n\u003cp>“I was surprised,” said\u003ca href=\"https://stanfordhealthcare.org/doctors/e/michael-eisenberg.html\" target=\"_blank\" rel=\"noopener\"> Dr. Michael Eisenberg\u003c/a>, the study’s senior author and an assistant professor of urology at Stanford University Medical Center.\u003c/p>\n\u003cp>“The daily users for example, compared to the never users, reported about 20 more sexual encounters a year. So I think that is a significant difference,\" he said.\u003c/p>\n\u003cp>It’s the first study to look at the connection between pot smoking and sex at the population level. To tease out the association, Eisenberg and his co-author Dr. Andrew Sun used survey data drawn from more than 50,000 Americans between the ages of 25 and 45.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The data comes from the National Center for Health Statistics at the CDC. Since that survey does not ask about homosexual encounters, the results only apply to straight men and women.\u003c/p>\n\u003cp>Eisenberg decided to do the study because more of his patients had been asking him if smoking marijuana could be contributing to their sexual difficulties. He had previously told them it might, and to abstain just in case. He was basing his assumptions on research about the negative vascular effects of cigarette smoking. In addition, some past studies and case reports have indicated heavy marijuana use may be associated with erectile dysfunction or depressed sperm count.\u003c/p>\n\u003cp>But now Eisenberg is rethinking his advice, at least for some patients.\u003c/p>\n\u003cp>“If somebody is using marijuana to help them for chronic back pain or something like that, there may be other interventions that we can think about targeting,” he said. “Rather than telling them they have to stop, otherwise their sex life is doomed.”\u003c/p>\n\u003cp>For \u003ca href=\"http://sexandthesoma.com/\" target=\"_blank\" rel=\"noopener\">Dr. Holly Richmond\u003c/a>, a sex therapist, the study results are “pretty remarkable.”\u003c/p>\n\u003cp>In her offices in Los Angeles and Portland, Oregon, Richmond has seen mixed results when her clients use marijuana. Some couples tell her that they have more sex when they use pot, but others have less sex.\u003c/p>\n\u003cp>She said those differences are probably attributable to how much pot someone smokes, instead of how often.\u003c/p>\n\u003cp>“Too much can lead to lethargy and really checking out, which does not facilitate [emotional] connection at all, and definitely doesn't encourage sexual activity.”\u003c/p>\n\u003cp>Eisenberg cautioned against drawing unwarranted conclusions from the study, and cited the old statistical adage “correlation does not equal causation.”\u003c/p>\n\u003cp>“This doesn’t mean that if you want to have more sex you should start smoking marijuana,” he said. “That’s definitely not what this data supports.”\u003c/p>\n\u003cp>The study can’t explain what factors are driving the association between pot use and sex, said Dr. Igor Grant, chair of psychiatry and director of the \u003ca href=\"http://www.cmcr.ucsd.edu/\" target=\"_blank\" rel=\"noopener\">Center for Medicinal Cannabis Research\u003c/a> at the University of California San Diego.\u003c/p>\n\u003cp>He said one explanation is that people who use marijuana —or are willing to admit marijuana use in a survey —are more likely to report their sexual encounters, or remember more of them. Grant said marijuana users are also sensation seekers, and may be more driven to have sex.\u003c/p>\n\u003cp>“Drug use is one type of sensation-seeking behavior, and obviously sex is another,” Grant said.\u003c/p>\n\u003cp>Eisenberg agreed that personality and other behaviors could be a factor, but if that was the case, he would expect to see different results from different demographic groups. For example, young and single respondents might be more willing and able to engage in risky or sensation-seeking behavior, when compared to married people with children. But the results held across all categories, including race and ethnicity, educational level, income level, religious affiliation, and family status.\u003c/p>\n\u003cp>“For every group, the more marijuana use that they reported, the more sex they reported as well. So that was really interesting to me, and also made me think that there could potentially be some biologic explanation here,” Eisenberg said.\u003c/p>\n\u003cp>Richmond, the sex therapist, says she wouldn’t advise any client who doesn’t already smoke to start smoking marijuana as a sexual aid. But she said it could be reassuring to her pot-using clients to learn from the study that smoking pot doesn’t appear to \u003cem>decrease\u003c/em> sexual activity.\u003c/p>\n\u003cp>“Individuals and couples look for additional ways to create novelty in the relationship and have fun, and that's now a legal and accessible way to do it,” she said.\u003c/p>\n\u003cp>Medicinal marijuana is now legal in 29 states, and eight of them allow recreational use as well. (The District of Columbia allows both).\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dr. Eisenberg said that’s why learning more about the potential side effects of marijuana use is so critical.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hospice Scrambled During Wildfires to Evacuate Patients Determined to Die at Home",
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"content": "\u003cp>Even when the fires threatened her home in downtown Sonoma, the elderly woman inside refused to leave. Smoke was everywhere. Her caretaker begged her to heed the mandatory evacuation order.\u003c/p>\n\u003cp>Another woman on the outskirts of town said all the young people telling her to get out were just “making hay” over nothing.\u003c/p>\n\u003cp>“They didn't want to leave because they wanted to die in their home,” said Karna Dawson, a social worker with \u003ca href=\"http://hospicebythebay.org/\" target=\"_blank\" rel=\"noopener\">Hospice by the Bay\u003c/a>. \"They didn't want to leave because they didn't realize the severity of the problem. They didn't want to leave because they were stubborn.”\u003c/p>\n\u003cp>At critical moments, when the worst wildfires in state history were ravaging Wine Country, Dawson and other members of the hospice team had to intervene in several such standoffs with terminally ill clients.\u003c/p>\n\u003cp>“Some people were feeling like if they were going to die they wanted to die in their house, and [were] not really thinking that through very clearly,” she said. “We're not talking about dying of your cancer. We're talking about dying in a fire. And those are two very different deaths.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When the fires broke out Oct. 8, nurses and staff with Hospice by the Bay were providing home care, pain management, and spiritual counseling to 108 patients in Napa and Sonoma counties. Half of those patients had to be evacuated.\u003c/p>\n\u003cp>Under federal rules, hospice agencies that receive payment from the Medicare program are required to have a disaster plan in place for their patients, including how to get bed-bound patients out of their homes.\u003c/p>\n\u003cp>Dawson was at work, enacting the plan, by 4 a.m. on Oct. 9, as the fires exploded across the area. She sat huddled over her laptop at home in Petaluma, wearing her grey pajamas and tattered pink bathrobe. She was talking on two phones at once, trying to find all their patients and ordering ambulances. In some cases, once the ambulances picked up the patients, they just drove away from the fires, to get to safety. The hospice staff had to figure out where exactly they had gone .\u003c/p>\n\u003cp>“It was just a moving target of where people were going and where they were landing,” said Wendy Ranzau, the hospice’s chief operating officer.\u003c/p>\n\u003cp>For many patients, the first stop was a Red Cross evacuation shelter. This required hospice leaders to adjust their goals, while still trying to fulfill the mission of providing patients an opportunity to die with dignity.\u003c/p>\n\u003cp>“Our priority was to make sure that we did not have a patient die in an evacuation center,” Ranzau said. “So even if they can’t die at home, they’re going to die someplace other than a cot in an auditorium.”\u003c/p>\n\u003cfigure id=\"attachment_361727\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-361727\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/Karna-Dawson-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Karna Dawson helped lead the effort to make sure patients getting care from Hospice by the Bay were safely evacuated during the North Bay wildfires. \u003ccite>(April Dembosky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Within two days, the hospice had safely relocated all of the patients, even ones who had temporarily ended up in shelters. Some patients went to live with relatives all over the state, from Citrus Heights in the north, to Santa Barbara down south. Some were resettled in assisted living or skilled nursing facilities, with Hospice by the Bay dipping into its reserves to pay the fees, something the Medicare program does not require.\u003c/p>\n\u003cp>But there were a couple of hold-outs who found the shelters surprisingly hospitable.\u003c/p>\n\u003cp>“There was one gentleman who didn't want to leave the shelter. He had lived alone and he was loving the attention. He thought it was great,” Dawson said. “It took us 24 hours and the medics saying 'You can't really stay here.'”\u003c/p>\n\u003cp>Many patients were eventually able to return to their homes. But Ranzau predicts some never will. Either their homes burned down, or there’s no power, or because the are too medically fragile tosurvive another move. One patient lost five pounds in the week after the fire started.\u003c/p>\n\u003cp>“When you think about hospice, our median length of stay is about three weeks,” Ranzau said. “A week in the life of a hospice patient, unfortunately, is a third of their time on hospice. So it just doesn't make sense. You know, is a trauma of transferring again, too much for them?”\u003c/p>\n\u003cp>That means some patients will not have the death they planned, making them a tragic piece of the overall hospice trend: 70 percent of Californians say they want to die at home, but only 32 percent do. Now the Sonoma woman with cancer, whose dying wish was to spend her final days in her own house, will die in a nursing home.\u003c/p>\n\u003cp>“She’s okay. She’s okay,” Dawson said uncertainly, when asked about her status a week after the fires began. “She’s adjusting.”\u003c/p>\n\u003cp>For most of their patients, there just isn’t enough time to adapt to all the changes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I, or you, can have six months or a year to process this and think it through,” she said. “We can have another fall that's pretty and recover. Where they might not, and likely won’t.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Even when the fires threatened her home in downtown Sonoma, the elderly woman inside refused to leave. Smoke was everywhere. Her caretaker begged her to heed the mandatory evacuation order.\u003c/p>\n\u003cp>Another woman on the outskirts of town said all the young people telling her to get out were just “making hay” over nothing.\u003c/p>\n\u003cp>“They didn't want to leave because they wanted to die in their home,” said Karna Dawson, a social worker with \u003ca href=\"http://hospicebythebay.org/\" target=\"_blank\" rel=\"noopener\">Hospice by the Bay\u003c/a>. \"They didn't want to leave because they didn't realize the severity of the problem. They didn't want to leave because they were stubborn.”\u003c/p>\n\u003cp>At critical moments, when the worst wildfires in state history were ravaging Wine Country, Dawson and other members of the hospice team had to intervene in several such standoffs with terminally ill clients.\u003c/p>\n\u003cp>“Some people were feeling like if they were going to die they wanted to die in their house, and [were] not really thinking that through very clearly,” she said. “We're not talking about dying of your cancer. We're talking about dying in a fire. And those are two very different deaths.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When the fires broke out Oct. 8, nurses and staff with Hospice by the Bay were providing home care, pain management, and spiritual counseling to 108 patients in Napa and Sonoma counties. Half of those patients had to be evacuated.\u003c/p>\n\u003cp>Under federal rules, hospice agencies that receive payment from the Medicare program are required to have a disaster plan in place for their patients, including how to get bed-bound patients out of their homes.\u003c/p>\n\u003cp>Dawson was at work, enacting the plan, by 4 a.m. on Oct. 9, as the fires exploded across the area. She sat huddled over her laptop at home in Petaluma, wearing her grey pajamas and tattered pink bathrobe. She was talking on two phones at once, trying to find all their patients and ordering ambulances. In some cases, once the ambulances picked up the patients, they just drove away from the fires, to get to safety. The hospice staff had to figure out where exactly they had gone .\u003c/p>\n\u003cp>“It was just a moving target of where people were going and where they were landing,” said Wendy Ranzau, the hospice’s chief operating officer.\u003c/p>\n\u003cp>For many patients, the first stop was a Red Cross evacuation shelter. This required hospice leaders to adjust their goals, while still trying to fulfill the mission of providing patients an opportunity to die with dignity.\u003c/p>\n\u003cp>“Our priority was to make sure that we did not have a patient die in an evacuation center,” Ranzau said. “So even if they can’t die at home, they’re going to die someplace other than a cot in an auditorium.”\u003c/p>\n\u003cfigure id=\"attachment_361727\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-361727\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/Karna-Dawson-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Karna Dawson helped lead the effort to make sure patients getting care from Hospice by the Bay were safely evacuated during the North Bay wildfires. \u003ccite>(April Dembosky)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Within two days, the hospice had safely relocated all of the patients, even ones who had temporarily ended up in shelters. Some patients went to live with relatives all over the state, from Citrus Heights in the north, to Santa Barbara down south. Some were resettled in assisted living or skilled nursing facilities, with Hospice by the Bay dipping into its reserves to pay the fees, something the Medicare program does not require.\u003c/p>\n\u003cp>But there were a couple of hold-outs who found the shelters surprisingly hospitable.\u003c/p>\n\u003cp>“There was one gentleman who didn't want to leave the shelter. He had lived alone and he was loving the attention. He thought it was great,” Dawson said. “It took us 24 hours and the medics saying 'You can't really stay here.'”\u003c/p>\n\u003cp>Many patients were eventually able to return to their homes. But Ranzau predicts some never will. Either their homes burned down, or there’s no power, or because the are too medically fragile tosurvive another move. One patient lost five pounds in the week after the fire started.\u003c/p>\n\u003cp>“When you think about hospice, our median length of stay is about three weeks,” Ranzau said. “A week in the life of a hospice patient, unfortunately, is a third of their time on hospice. So it just doesn't make sense. You know, is a trauma of transferring again, too much for them?”\u003c/p>\n\u003cp>That means some patients will not have the death they planned, making them a tragic piece of the overall hospice trend: 70 percent of Californians say they want to die at home, but only 32 percent do. Now the Sonoma woman with cancer, whose dying wish was to spend her final days in her own house, will die in a nursing home.\u003c/p>\n\u003cp>“She’s okay. She’s okay,” Dawson said uncertainly, when asked about her status a week after the fires began. “She’s adjusting.”\u003c/p>\n\u003cp>For most of their patients, there just isn’t enough time to adapt to all the changes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I, or you, can have six months or a year to process this and think it through,” she said. “We can have another fall that's pretty and recover. Where they might not, and likely won’t.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Despite Loss of Clinic, Sonoma County’s Largest Community Health Center Kept Going After the Fires",
"title": "Despite Loss of Clinic, Sonoma County’s Largest Community Health Center Kept Going After the Fires",
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"content": "\u003cp>Just two weeks after fires ripped through her hometown of Santa Rosa, Dr. Deb Donlon still smiles easily. She sat at a co-worker's desk at \u003ca href=\"http://srhealth.org/\" target=\"_blank\" rel=\"noopener\">Santa Rosa Community Health's\u003c/a> Lombardi Campus; free space is hard to come by these days.\u003c/p>\n\u003cp>That's because Vista Family Health Center, the largest of nine clinics operated by Santa Rosa Community Health, suffered smoke and water damage during the wildfires, and was forced to close.\u003c/p>\n\u003cp>Taking her stethoscope off her neck and resting it on the desk in front of her, Donlon joked that she's writing a book about her experience over the past few weeks, as she and her colleagues are figuring out how to see their 50,000 regular patients in essentially half the space they once had.\u003c/p>\n\u003cp>Donlon's \"book\" will be of the Dr. Seuss variety, she quipped. Her working title is “Oh, the Places We’ll Care for Patients.”\u003c/p>\n\u003cp>\"We will see them in a van, and we will see them in a can,\" she rhymed. \"We will see them on a cot and we will see them in the parking lot. And we will see them here and there and we will see them everywhere. That's as far as I've gotten.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She was referring to the creative ways staff are converting resources into places to see patients: administrative offices are now therapy spaces, mobile health vans borrowed from other clinics are parked out back, and staff are working on getting shipping containers that have been turned into exam rooms. Donlon and staff call these \"cans.\"\u003c/p>\n\u003cp>Santa Rosa Community Health is the largest community health agency in Sonoma County. Nearly half of its patients sought care at the \u003ca href=\"http://srhealth.org/location/vista-campus/\" target=\"_blank\" rel=\"noopener\">Vista Campus,\u003c/a> where they were treated by 180 staff members.\u003c/p>\n\u003cp>But starting the day after the fire, staff have worked long shifts to be able to continue to care for the community as usual.\u003c/p>\n\u003cp>Donlon's lighthearted approach to the situation was one way to deal with the intensity of what has happened. For others, coping has meant diving into work.\u003c/p>\n\u003cp>Clinic doctor Patricia Kulawiak and her family fled their house as the fire was breaking out. She and her husband returned just hours later to find a smoking pile of ash. But two days later, Kulawiak went back to work.\u003c/p>\n\u003cp>\"It’s such a deep kind of commitment that we have here,\" she said. \"Because we’re set up to take care of vulnerable people.\"\u003c/p>\n\u003cp>Health centers like this one have a mission to see some of the most vulnerable patients in any community: agricultural workers, the homeless and veterans. This \"mission focus\" is one reason they've continued to work tirelessly. \"It’s just kind of an impulse that’s impossible to ignore,\" Kulawiak said.\u003c/p>\n\u003cfigure id=\"attachment_361701\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-361701 size-medium\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-800x600.jpg\" alt=\"When other community health centers heard the fire rendered one of Santa Rosa Community Health's buildings unusable, they sent their own mobile units to serve as extra exam rooms. This mobile clinic is from Tiburcio Vasquez Health Center of Hayward. Their CEO plans to donate it permanently to the Santa Rosa clinic.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">When other community health centers heard the fire rendered one of Santa Rosa Community Health's buildings unusable, they sent their own mobile units to serve as extra exam rooms. This mobile clinic is from Tiburcio Vasquez Health Center of Hayward. Their CEO plans to donate it permanently to the Santa Rosa clinic. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Other community health centers have pitched in to help Santa Rosa Community Health by loaning mobile clinics, each a converted truck housing two small exam rooms. These are parked behind the health center's Lombardi Campus.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For now, Dr. Donlon said, t\u003cspan style=\"font-weight: 400\">he clinic has prioritized fire-related cases -- people struggling with respiratory issues and anxiety -- but they're slowly resuming regular patient visits. \u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Just two weeks after fires ripped through her hometown of Santa Rosa, Dr. Deb Donlon still smiles easily. She sat at a co-worker's desk at \u003ca href=\"http://srhealth.org/\" target=\"_blank\" rel=\"noopener\">Santa Rosa Community Health's\u003c/a> Lombardi Campus; free space is hard to come by these days.\u003c/p>\n\u003cp>That's because Vista Family Health Center, the largest of nine clinics operated by Santa Rosa Community Health, suffered smoke and water damage during the wildfires, and was forced to close.\u003c/p>\n\u003cp>Taking her stethoscope off her neck and resting it on the desk in front of her, Donlon joked that she's writing a book about her experience over the past few weeks, as she and her colleagues are figuring out how to see their 50,000 regular patients in essentially half the space they once had.\u003c/p>\n\u003cp>Donlon's \"book\" will be of the Dr. Seuss variety, she quipped. Her working title is “Oh, the Places We’ll Care for Patients.”\u003c/p>\n\u003cp>\"We will see them in a van, and we will see them in a can,\" she rhymed. \"We will see them on a cot and we will see them in the parking lot. And we will see them here and there and we will see them everywhere. That's as far as I've gotten.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She was referring to the creative ways staff are converting resources into places to see patients: administrative offices are now therapy spaces, mobile health vans borrowed from other clinics are parked out back, and staff are working on getting shipping containers that have been turned into exam rooms. Donlon and staff call these \"cans.\"\u003c/p>\n\u003cp>Santa Rosa Community Health is the largest community health agency in Sonoma County. Nearly half of its patients sought care at the \u003ca href=\"http://srhealth.org/location/vista-campus/\" target=\"_blank\" rel=\"noopener\">Vista Campus,\u003c/a> where they were treated by 180 staff members.\u003c/p>\n\u003cp>But starting the day after the fire, staff have worked long shifts to be able to continue to care for the community as usual.\u003c/p>\n\u003cp>Donlon's lighthearted approach to the situation was one way to deal with the intensity of what has happened. For others, coping has meant diving into work.\u003c/p>\n\u003cp>Clinic doctor Patricia Kulawiak and her family fled their house as the fire was breaking out. She and her husband returned just hours later to find a smoking pile of ash. But two days later, Kulawiak went back to work.\u003c/p>\n\u003cp>\"It’s such a deep kind of commitment that we have here,\" she said. \"Because we’re set up to take care of vulnerable people.\"\u003c/p>\n\u003cp>Health centers like this one have a mission to see some of the most vulnerable patients in any community: agricultural workers, the homeless and veterans. This \"mission focus\" is one reason they've continued to work tirelessly. \"It’s just kind of an impulse that’s impossible to ignore,\" Kulawiak said.\u003c/p>\n\u003cfigure id=\"attachment_361701\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-361701 size-medium\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-800x600.jpg\" alt=\"When other community health centers heard the fire rendered one of Santa Rosa Community Health's buildings unusable, they sent their own mobile units to serve as extra exam rooms. This mobile clinic is from Tiburcio Vasquez Health Center of Hayward. Their CEO plans to donate it permanently to the Santa Rosa clinic.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/RS27690_tvhc-van-qut-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">When other community health centers heard the fire rendered one of Santa Rosa Community Health's buildings unusable, they sent their own mobile units to serve as extra exam rooms. This mobile clinic is from Tiburcio Vasquez Health Center of Hayward. Their CEO plans to donate it permanently to the Santa Rosa clinic. \u003ccite>(Laura Klivans/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Other community health centers have pitched in to help Santa Rosa Community Health by loaning mobile clinics, each a converted truck housing two small exam rooms. These are parked behind the health center's Lombardi Campus.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For now, Dr. Donlon said, t\u003cspan style=\"font-weight: 400\">he clinic has prioritized fire-related cases -- people struggling with respiratory issues and anxiety -- but they're slowly resuming regular patient visits. \u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>After nearly two months of negotiations, key senators said Tuesday they have reached a bipartisan deal on a proposal intended to stabilize the Affordable Care Act’s insurance market, which has been rocked by recent actions by President Donald Trump.\u003c/p>\n\u003cp>Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), respectively the chairman and the top Democrat of the Senate Health, Education, Labor and Pensions Committee, negotiated the emerging deal. The milestone agreement, they said, would guarantee payment of “cost-sharing reduction” subsidies that help some policyholders with low incomes afford their deductibles and other out-of-pocket costs for two years, 2018 and 2019.\u003c/p>\n\u003cp>Trump \u003ca href=\"https://khn.org/news/trump-acting-solo-what-you-need-to-know-about-changes-to-the-health-law/\">announced last week\u003c/a> that he would stop funding the subsidies, which have been the subject of a \u003ca href=\"https://khn.org/news/5-things-to-know-about-the-health-issue-that-could-shut-down-the-government/\">long-running lawsuit\u003c/a>. These subsidies are separate from the tax credit subsidies that help eligible consumers pay for their premiums. Those premium subsidies are not affected by Trump’s action.\u003c/p>\n\u003cp>Even if it fails to become law, the deal marks a singular achievement that has been almost completely missing in Congress for the past eight years — a bipartisan compromise on how to make the nation’s health insurance system work.\u003c/p>\n\u003cp>“This is an agreement I am proud to support,” said Murray on the Senate floor, “because of the message it sends about how to get things done.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The proposal — which will require 60 votes to pass the Senate and agreement from a still-dubious House of Representatives — would also restore $110 million in \u003ca href=\"https://khn.org/news/latest-snag-in-aca-sign-ups-those-who-guide-consumers-are-hitting-roadblocks/\">“outreach” funding\u003c/a> cut by the Trump administration. That funding would help guide eligible individuals to sign up for coverage on the health insurance exchanges during the open enrollment period that runs from Nov. 1 to Dec. 15.\u003c/p>\n\u003cp>In exchange for those provisions, urged by Democrats and \u003ca href=\"https://khn.org/news/5-governors-press-congress-for-fast-bucks-to-secure-obamacare-market-in-2018/\">state officials\u003c/a>, Republicans will win some changes to make it easier for states to apply for “waivers” that would let them experiment with alternative ways to provide and subsidize health insurance. The deal would also allow the sale of less comprehensive “catastrophic” plans in the health exchanges. Such plans currently can be sold only to those under age 30.\u003c/p>\n\u003cp>On the Senate floor Tuesday afternoon, Alexander said, “This agreement avoids chaos. I don’t know a Democrat or a Republican who benefits from chaos.”\u003c/p>\n\u003cp>Senate Majority Leader Mitch McConnell (R-Ky.) reserved judgment about the deal.\u003c/p>\n\u003cp>Both parties still have some major disagreements when it comes to health care, Senate Minority Leader Chuck Schumer (D-N.Y.) told reporters Tuesday afternoon, but “I think there’s a growing consensus that in the short term we need stability in the markets. So we’ve achieved stability if this agreement becomes law.”\u003c/p>\n\u003cp>More than 60 senators have already participated in the meetings that led to the deal, Alexander said on the Senate floor. But the path to passage in the House is uncertain — with many conservatives vehemently opposed to anything that could be construed as helping the law they call “Obamacare” succeed.\u003c/p>\n\u003cp>Tweeted Rep. Mark Walker (R-N.C.), chairman of the conservative Republican Study Committee, Tuesday: “The GOP should focus on repealing & replacing Obamacare, not trying to save it. This bailout is unacceptable.”\u003c/p>\n\u003cp>Both Murray and Alexander said Tuesday they were still struggling over language to make sure that if the cost-sharing payments are resumed, insurers would not receive a windfall by keeping both those payments and the higher premiums that many states are allowing in anticipation of the payments being ended.\u003c/p>\n\u003cp>“We want to make sure that the cost-sharing payments go to the benefit of consumers, not the insurance companies,” Alexander said.\u003c/p>\n\u003cp>Trump, who as \u003ca href=\"https://www.whitehouse.gov/the-press-office/2017/10/16/remarks-president-trump-cabinet-meeting\">recently as Monday\u003c/a> called the cost-sharing subsidies “a payoff” to insurance companies, took credit for the negotiations. “If I didn’t cut the CSR’s, they wouldn’t be meeting,” he said. That was not, in fact, the case. The negotiations had picked up \u003ca href=\"http://www.politico.com/story/2017/09/28/alexander-murray-obamacare-plan-243258\">some weeks ago\u003c/a> after being called off earlier in September while the Senate tried for one last-ditch repeal vote.\u003c/p>\n\u003cp>On Friday, White House Budget Director Mick Mulvaney told \u003ca href=\"http://www.politico.com/story/2017/10/13/trump-opposes-bipartisan-obamacare-rescue-plan-243752\">Politico\u003c/a> that the president would not allow a short-term fix, calling a restoration of the cost-sharing reduction funds “corporate welfare and bailouts for the insurance companies.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But on Tuesday the president hailed the deal. “We think it’s going to not only save money, but give people much better health care with a very, very much smaller premium spike,” he told reporters.\u003c/p>\n\n",
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"nprByline": "\u003cstrong>Julie Rovner\u003c/strong>, Kaiser Health News",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>After nearly two months of negotiations, key senators said Tuesday they have reached a bipartisan deal on a proposal intended to stabilize the Affordable Care Act’s insurance market, which has been rocked by recent actions by President Donald Trump.\u003c/p>\n\u003cp>Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), respectively the chairman and the top Democrat of the Senate Health, Education, Labor and Pensions Committee, negotiated the emerging deal. The milestone agreement, they said, would guarantee payment of “cost-sharing reduction” subsidies that help some policyholders with low incomes afford their deductibles and other out-of-pocket costs for two years, 2018 and 2019.\u003c/p>\n\u003cp>Trump \u003ca href=\"https://khn.org/news/trump-acting-solo-what-you-need-to-know-about-changes-to-the-health-law/\">announced last week\u003c/a> that he would stop funding the subsidies, which have been the subject of a \u003ca href=\"https://khn.org/news/5-things-to-know-about-the-health-issue-that-could-shut-down-the-government/\">long-running lawsuit\u003c/a>. These subsidies are separate from the tax credit subsidies that help eligible consumers pay for their premiums. Those premium subsidies are not affected by Trump’s action.\u003c/p>\n\u003cp>Even if it fails to become law, the deal marks a singular achievement that has been almost completely missing in Congress for the past eight years — a bipartisan compromise on how to make the nation’s health insurance system work.\u003c/p>\n\u003cp>“This is an agreement I am proud to support,” said Murray on the Senate floor, “because of the message it sends about how to get things done.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The proposal — which will require 60 votes to pass the Senate and agreement from a still-dubious House of Representatives — would also restore $110 million in \u003ca href=\"https://khn.org/news/latest-snag-in-aca-sign-ups-those-who-guide-consumers-are-hitting-roadblocks/\">“outreach” funding\u003c/a> cut by the Trump administration. That funding would help guide eligible individuals to sign up for coverage on the health insurance exchanges during the open enrollment period that runs from Nov. 1 to Dec. 15.\u003c/p>\n\u003cp>In exchange for those provisions, urged by Democrats and \u003ca href=\"https://khn.org/news/5-governors-press-congress-for-fast-bucks-to-secure-obamacare-market-in-2018/\">state officials\u003c/a>, Republicans will win some changes to make it easier for states to apply for “waivers” that would let them experiment with alternative ways to provide and subsidize health insurance. The deal would also allow the sale of less comprehensive “catastrophic” plans in the health exchanges. Such plans currently can be sold only to those under age 30.\u003c/p>\n\u003cp>On the Senate floor Tuesday afternoon, Alexander said, “This agreement avoids chaos. I don’t know a Democrat or a Republican who benefits from chaos.”\u003c/p>\n\u003cp>Senate Majority Leader Mitch McConnell (R-Ky.) reserved judgment about the deal.\u003c/p>\n\u003cp>Both parties still have some major disagreements when it comes to health care, Senate Minority Leader Chuck Schumer (D-N.Y.) told reporters Tuesday afternoon, but “I think there’s a growing consensus that in the short term we need stability in the markets. So we’ve achieved stability if this agreement becomes law.”\u003c/p>\n\u003cp>More than 60 senators have already participated in the meetings that led to the deal, Alexander said on the Senate floor. But the path to passage in the House is uncertain — with many conservatives vehemently opposed to anything that could be construed as helping the law they call “Obamacare” succeed.\u003c/p>\n\u003cp>Tweeted Rep. Mark Walker (R-N.C.), chairman of the conservative Republican Study Committee, Tuesday: “The GOP should focus on repealing & replacing Obamacare, not trying to save it. This bailout is unacceptable.”\u003c/p>\n\u003cp>Both Murray and Alexander said Tuesday they were still struggling over language to make sure that if the cost-sharing payments are resumed, insurers would not receive a windfall by keeping both those payments and the higher premiums that many states are allowing in anticipation of the payments being ended.\u003c/p>\n\u003cp>“We want to make sure that the cost-sharing payments go to the benefit of consumers, not the insurance companies,” Alexander said.\u003c/p>\n\u003cp>Trump, who as \u003ca href=\"https://www.whitehouse.gov/the-press-office/2017/10/16/remarks-president-trump-cabinet-meeting\">recently as Monday\u003c/a> called the cost-sharing subsidies “a payoff” to insurance companies, took credit for the negotiations. “If I didn’t cut the CSR’s, they wouldn’t be meeting,” he said. That was not, in fact, the case. The negotiations had picked up \u003ca href=\"http://www.politico.com/story/2017/09/28/alexander-murray-obamacare-plan-243258\">some weeks ago\u003c/a> after being called off earlier in September while the Senate tried for one last-ditch repeal vote.\u003c/p>\n\u003cp>On Friday, White House Budget Director Mick Mulvaney told \u003ca href=\"http://www.politico.com/story/2017/10/13/trump-opposes-bipartisan-obamacare-rescue-plan-243752\">Politico\u003c/a> that the president would not allow a short-term fix, calling a restoration of the cost-sharing reduction funds “corporate welfare and bailouts for the insurance companies.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But on Tuesday the president hailed the deal. “We think it’s going to not only save money, but give people much better health care with a very, very much smaller premium spike,” he told reporters.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Gov. Brown Signs Into Law Key Health Bills, But Nixes Others",
"title": "Gov. Brown Signs Into Law Key Health Bills, But Nixes Others",
"headTitle": "California Healthline | State of Health | KQED News",
"content": "\u003cp>Wielding his pen, Gov. Jerry Brown has reinforced the Affordable Care Act, stood up to pharmaceutical companies and boosted testing for childhood lead poisoning.\u003c/p>\n\u003cp>Brown had until Sunday, Oct. 15, to approve or reject \u003ca href=\"https://californiahealthline.org/news/state-lawmakers-tackle-public-smoking-and-lead-poisoning-but-punt-on-single-payer/\">measures passed by the legislature \u003c/a>this year, Brown weighed in on some key health care bills, including measures to protect Californians who buy insurance for themselves.\u003c/p>\n\u003cp>One law will ensure that consumers have \u003ca href=\"https://californiahealthline.org/news/california-other-states-to-extend-obamacare-sign-up-beyond-federal-limit/\">three months to shop\u003c/a> for health plans in future years, rebuffing a move by the Trump administration that cuts that time in half. Another law will help people \u003ca href=\"https://californiahealthline.org/news/what-happens-if-you-have-to-switch-health-plans-when-youre-sick/\">keep their health care providers \u003c/a>if insurers cancel their policy.\u003c/p>\n\u003cp>Health consumer advocates said Brown’s signatures on those and other bills will help maintain California’s role as a leader in protecting health care coverage in the face of federal threats. Last week, for instance, \u003ca href=\"https://californiahealthline.org/news/impact-of-trump-subsidy-decision-blunted-in-california-for-now/\">President Donald Trump ended\u003c/a> an important Obamacare health insurance subsidy for consumers — a move that could destabilize insurance markets across the country.\u003c/p>\n\u003cp>Californians will stay “ahead of the curve, and ahead of the federal threats” because of lawmakers’ actions this year, said Betsy Imholz, director of special projects at Consumers Union in San Francisco.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The governor’s health care actions and rhetoric have been particularly impassioned lately, especially in response to federal moves on health care policy, Imholz said.\u003c/p>\n\u003cp>“There’s a lot to be fiery about these days, and he’s using his bully pulpit well,” she said.\u003c/p>\n\u003cp>But Brown didn’t sign off on everything the legislature sent to his desk. He used his veto pen to kill some health care legislation, including a proposed statewide \u003ca href=\"https://californiahealthline.org/news/will-california-kick-butts-off-state-beaches-not-this-year/\">ban on smoking\u003c/a> at state beaches and parks.\u003c/p>\n\u003cp>\u003cstrong>SIGNED BY THE GOVERNOR \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Open Enrollment\u003c/strong>🖋\u003c/p>\n\u003cp>By codifying \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billHistoryClient.xhtml?bill_id=201720180AB156\">AB 156,\u003c/a> by Assemblyman Jim Wood (D-Healdsburg), Brown agreed that Californians who buy insurance for themselves should continue to have a \u003ca href=\"https://californiahealthline.org/news/california-other-states-to-extend-obamacare-sign-up-beyond-federal-limit/\">three-month open enrollment period\u003c/a>, during which they can choose or switch health plans. The law exempts the Golden State from a Trump administration rule that shortens the sign-up period to 45 days, and applies to people who purchase individual market plans for 2019 and beyond. Californians already are assured a three-month open-enrollment period — Nov. 1 to Jan. 31 — for 2018 coverage.\u003c/p>\n\u003cp>\u003cstrong>Keeping Your Doctors\u003c/strong>🖋\u003c/p>\n\u003cp>Brown signed off on \u003ca href=\"https://californiahealthline.org/news/what-happens-if-you-have-to-switch-health-plans-when-youre-sick/\">a measure\u003c/a> to allow some seriously ill patients to continue seeing their current providers for a limited time if their insurer discontinues their plan. The bill, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB133\">SB 133\u003c/a>, was introduced by Sen. Ed Hernandez (D-West Covina) in response to the impending departures of Anthem Blue Cross and Cigna from portions of California’s individual insurance market next year. The law will continue an eligible patient’s coverage even if her doctors don’t contract with the new health plan, so long as the doctors are willing to accept the plan’s reimbursement rates.\u003c/p>\n\u003cp>\u003cstrong>Prescription Drug Costs\u003c/strong>🖋\u003c/p>\n\u003cp>The governor signed a \u003ca href=\"https://californiahealthline.org/news/california-drug-price-bill-sweeping-in-scope-lacking-in-muscle/\">hotly contested bill\u003c/a> by Hernandez that will require drugmakers to report and explain big price hikes. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB17\">SB 17\u003c/a> directs pharmaceutical companies to notify state agencies and insurers 60 days in advance if they plan to raise prices more than 16 percent over two years on drugs with a wholesale cost of at least $40.\u003c/p>\n\u003cp>The governor also approved \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB265\">AB 265\u003c/a> by Wood, which will ban pharmaceutical companies from giving consumers coupons for brand-name drugs when a generic equivalent is available, with some exceptions.\u003c/p>\n\u003cp>\u003cstrong>Childhood Lead Poisoning\u003c/strong>🖋\u003c/p>\n\u003cp>Brown signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1316\">AB 1316\u003c/a> by Assemblyman Bill Quirk (D-Hayward), which calls for all California kids to be evaluated by their doctor for lead poisoning, starting next year. Currently, children who receive government assistance such as Medi-Cal must be screened for lead, but that requirement doesn’t extend to other children. Doctors will also have to consider new factors when evaluating children, such as proximity to potential sources of lead contamination. A report published last month by the Environmental Working Group showed that \u003ca href=\"http://www.ewg.org/research/one-third-california-s-high-risk-kids-not-tested-lead-poisoning#.Wd6u82hSyUk\">one-third of infants\u003c/a> who were at risk for lead poisoning had not been tested. “The current screening process is outdated and leaves many children vulnerable to lead poisoning,” Quirk said in a statement.\u003c/p>\n\u003cp>\u003cstrong>Unapproved Stem Cell Treatments\u003c/strong>🖋\u003c/p>\n\u003cp>Brown approved \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB512\">a bill\u003c/a> that requires doctors to warn their patients before they undergo \u003ca href=\"https://ipscell.com/2017/10/groundbreaking-california-stem-cell-law-gives-consumer-protections-on-clinics/\">unapproved stem cell therapies\u003c/a>. SB 512, also by Hernandez, says health care providers who offer such treatments must disclose to patients that the treatments have not been approved by the Food and Drug Administration, and urge them “to consult with your primary care physician prior to undergoing a stem cell therapy.” Health care providers may face fines for noncompliance.\u003c/p>\n\u003cp>\u003cstrong>VETOED BY THE GOVERNOR \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Valley Fever\u003c/strong>🚫\u003c/p>\n\u003cp>Brown nixed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=201720180AB1279\">AB 1279\u003c/a>, which would have required the state Department of Public Health to develop additional outreach programs to educate people about Valley Fever, an infection caused by inhaling fungal spores often found in soil. The measure, by Assemblyman Rudy Salas (D-Bakersfield), had been watered down from its original form by the time it hit the governor’s desk. The original language called for a $2 million investment in research on the disease, which is common in dry regions, like Salas’ district. In his \u003ca href=\"https://www.gov.ca.gov/docs/AB_1279_Veto_Message_2017.pdf\">veto message\u003c/a>, Brown said the department already provides fact sheets, brochures and other materials to educate the public about Valley Fever.\u003c/p>\n\u003cp>\u003cstrong>Smoking At State Parks\u003c/strong>🚫\u003c/p>\n\u003cp>Once again, Brown \u003ca href=\"https://californiahealthline.org/news/will-california-kick-butts-off-state-beaches-not-this-year/\">vetoed legislation\u003c/a> that would have banned smoking at state beaches and parks. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB725\">AB 725\u003c/a>, by Assemblyman Marc Levine (D-San Rafael), would have established smoking areas at some parks and beaches. People caught smoking outside those designated spaces would have faced a $50 fine. A stricter bill by Sen. Steve Glazer (D-Orinda), \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB386\">SB 386\u003c/a>, proposed a fine of up to $100. Lawmakers had previously sent similar legislation to Brown, but so far they have not won him over. In his \u003ca href=\"https://www.gov.ca.gov/docs/AB_725_Veto_Message_2017.pdf\">veto message\u003c/a>, Brown said a ban would be an overreach of government power. “If people can’t smoke even on a deserted beach, where can they?” he asked.\u003c/p>\n\u003cp>\u003cstrong>Reproductive Bias\u003c/strong>🚫\u003c/p>\n\u003cp>A bill that would have prohibited institutions with religious affiliations from firing employees because of their reproductive choices, such as having abortions, failed to make it past the governor’s desk. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB569\">AB 569\u003c/a>, by Assemblywoman Lorena Gonzalez Fletcher (D-San Diego), would have barred religion-based employers such as a Christian school, from requiring workers to sign a code of conduct that waived their reproductive health rights. \u003ca href=\"https://www.gov.ca.gov/docs/AB_569_Veto_Message_2017.pdf\">In his veto message\u003c/a>, Brown said that “these types of claims should remain within the jurisdiction of the Department of Fair Employment and Housing.”\u003c/p>\n\u003cp>\u003cstrong>SEE YOU NEXT YEAR?\u003c/strong>\u003c/p>\n\u003cp>(Some significant health bills that stalled in the legislature, but may be resurrected for another attempt in 2018)\u003c/p>\n\u003cp>\u003cstrong>Regulating Dialysis Clinics\u003c/strong>🤔\u003c/p>\n\u003cp>A proposal by Sen. Ricardo Lara (D-Bell Gardens) would have required minimum staff-to-patient ratios at dialysis centers, such as one nurse for every eight patients or one technician for every three. The stalled bill, SB 349, also would have mandated more time for staff to prepare between patient appointments. A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB251\">bill\u003c/a> by Assemblyman Rob Bonta (D-Oakland) would have required dialysis centers to spend at least 85 percent of their revenue primarily on direct patient care.\u003c/p>\n\u003cp>Both measures were backed by a large labor union, Service Employees International Union-United Healthcare Workers West (\u003ca href=\"http://www.seiu-uhw.org/\">SEIU-UHW\u003c/a>), which has threatened to take the issue directly to voters if the Legislature does not act.\u003c/p>\n\u003cp>\u003cstrong>Single-Payer Health Care\u003c/strong>🤔\u003c/p>\n\u003cp>The ambitious attempt to create one government-administered or “single-payer” health care system in California has been tabled until next year. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB562\">SB 562\u003c/a> by Lara and Assemblywoman Toni Atkins (D-San Diego) would provide comprehensive health coverage to all Californians, regardless of immigration status. Private insurance companies would be barred from the system, and enrollees would not be charged copayments or premiums. A legislative committee estimated that the program would require $200 billion annually in additional tax revenue.\u003c/p>\n\u003cp>Supporters of universal health care hope to \u003ca href=\"https://oag.ca.gov/system/files/initiatives/pdfs/17-0019%20%28Healthcare%20Roadblock%20Removal%29.pdf\">put a measure\u003c/a> on the statewide ballot that would make it easier to fund a single-payer system.\u003c/p>\n\u003cp>\u003cstrong>Pediatric Dental Anesthesia \u003c/strong>🤔\u003c/p>\n\u003cp>A bill that would have required oral surgeons to have a specially trained staff member with them to monitor a child under anesthesia stalled in committee. Current law allows an oral surgeon to perform surgery and monitor the unconscious child at the same time. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB224\">AB 224\u003c/a>, by Assemblyman Tony Thurmond (D-Richmond), would have built on last year’s “\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160AB2235\">Caleb’s Law\u003c/a>,” named after Caleb Sears, a 6-year-old boy who died in 2015 after oral surgery under anesthesia.\u003c/p>\n\u003cp>\u003cstrong>Containing Drug Costs\u003c/strong>🤔\u003c/p>\n\u003cp>\u003ca href=\"https://californiahealthline.org/news/negotiating-drug-prices-should-state-agencies-band-together/\">A measure\u003c/a> by Assemblyman David Chiu (D-San Francisco) would have brought together administrators from 17 state agencies to devise ways to reduce state drug costs. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB587\">AB 587\u003c/a> would have expanded an existing state purchasing collaborative that buys drugs for a handful of public health programs, and directed the new group to develop cost controls, such as creating a uniform drug formulary for state agencies.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB790\">SB 790\u003c/a> by Sen. Mike McGuire (D-North Coast/North Bay) sought to \u003ca href=\"https://californiahealthline.org/news/bill-aims-to-loosen-drugmaker-doctor-ties-by-limiting-perks-for-promoting-meds/\">restrict the pharmaceutical industry’s\u003c/a> marketing to doctors, limiting their spending to mostly educational or scientific purposes, which McGuire said could reduce unnecessary prescriptions of pricey drugs.\u003c/p>\n\n",
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"excerpt": "Gov. Jerry Brown signed many critical health care bills sent to him by the state Legislature, cementing California’s role as a health care champion.",
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"title": "Gov. Brown Signs Into Law Key Health Bills, But Nixes Others | KQED",
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"nprByline": "\u003ca href=\"https://californiahealthline.org/news/author/pauline-bartolone/\">\u003cstrong>Pauline Bartolone\u003c/strong>\u003c/a> and \u003ca href=\"https://californiahealthline.org/news/author/ana-b-ibarra/\">\u003cstrong>Ana B. Ibarra\u003c/strong>\u003c/a>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Wielding his pen, Gov. Jerry Brown has reinforced the Affordable Care Act, stood up to pharmaceutical companies and boosted testing for childhood lead poisoning.\u003c/p>\n\u003cp>Brown had until Sunday, Oct. 15, to approve or reject \u003ca href=\"https://californiahealthline.org/news/state-lawmakers-tackle-public-smoking-and-lead-poisoning-but-punt-on-single-payer/\">measures passed by the legislature \u003c/a>this year, Brown weighed in on some key health care bills, including measures to protect Californians who buy insurance for themselves.\u003c/p>\n\u003cp>One law will ensure that consumers have \u003ca href=\"https://californiahealthline.org/news/california-other-states-to-extend-obamacare-sign-up-beyond-federal-limit/\">three months to shop\u003c/a> for health plans in future years, rebuffing a move by the Trump administration that cuts that time in half. Another law will help people \u003ca href=\"https://californiahealthline.org/news/what-happens-if-you-have-to-switch-health-plans-when-youre-sick/\">keep their health care providers \u003c/a>if insurers cancel their policy.\u003c/p>\n\u003cp>Health consumer advocates said Brown’s signatures on those and other bills will help maintain California’s role as a leader in protecting health care coverage in the face of federal threats. Last week, for instance, \u003ca href=\"https://californiahealthline.org/news/impact-of-trump-subsidy-decision-blunted-in-california-for-now/\">President Donald Trump ended\u003c/a> an important Obamacare health insurance subsidy for consumers — a move that could destabilize insurance markets across the country.\u003c/p>\n\u003cp>Californians will stay “ahead of the curve, and ahead of the federal threats” because of lawmakers’ actions this year, said Betsy Imholz, director of special projects at Consumers Union in San Francisco.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The governor’s health care actions and rhetoric have been particularly impassioned lately, especially in response to federal moves on health care policy, Imholz said.\u003c/p>\n\u003cp>“There’s a lot to be fiery about these days, and he’s using his bully pulpit well,” she said.\u003c/p>\n\u003cp>But Brown didn’t sign off on everything the legislature sent to his desk. He used his veto pen to kill some health care legislation, including a proposed statewide \u003ca href=\"https://californiahealthline.org/news/will-california-kick-butts-off-state-beaches-not-this-year/\">ban on smoking\u003c/a> at state beaches and parks.\u003c/p>\n\u003cp>\u003cstrong>SIGNED BY THE GOVERNOR \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Open Enrollment\u003c/strong>🖋\u003c/p>\n\u003cp>By codifying \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billHistoryClient.xhtml?bill_id=201720180AB156\">AB 156,\u003c/a> by Assemblyman Jim Wood (D-Healdsburg), Brown agreed that Californians who buy insurance for themselves should continue to have a \u003ca href=\"https://californiahealthline.org/news/california-other-states-to-extend-obamacare-sign-up-beyond-federal-limit/\">three-month open enrollment period\u003c/a>, during which they can choose or switch health plans. The law exempts the Golden State from a Trump administration rule that shortens the sign-up period to 45 days, and applies to people who purchase individual market plans for 2019 and beyond. Californians already are assured a three-month open-enrollment period — Nov. 1 to Jan. 31 — for 2018 coverage.\u003c/p>\n\u003cp>\u003cstrong>Keeping Your Doctors\u003c/strong>🖋\u003c/p>\n\u003cp>Brown signed off on \u003ca href=\"https://californiahealthline.org/news/what-happens-if-you-have-to-switch-health-plans-when-youre-sick/\">a measure\u003c/a> to allow some seriously ill patients to continue seeing their current providers for a limited time if their insurer discontinues their plan. The bill, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB133\">SB 133\u003c/a>, was introduced by Sen. Ed Hernandez (D-West Covina) in response to the impending departures of Anthem Blue Cross and Cigna from portions of California’s individual insurance market next year. The law will continue an eligible patient’s coverage even if her doctors don’t contract with the new health plan, so long as the doctors are willing to accept the plan’s reimbursement rates.\u003c/p>\n\u003cp>\u003cstrong>Prescription Drug Costs\u003c/strong>🖋\u003c/p>\n\u003cp>The governor signed a \u003ca href=\"https://californiahealthline.org/news/california-drug-price-bill-sweeping-in-scope-lacking-in-muscle/\">hotly contested bill\u003c/a> by Hernandez that will require drugmakers to report and explain big price hikes. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB17\">SB 17\u003c/a> directs pharmaceutical companies to notify state agencies and insurers 60 days in advance if they plan to raise prices more than 16 percent over two years on drugs with a wholesale cost of at least $40.\u003c/p>\n\u003cp>The governor also approved \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB265\">AB 265\u003c/a> by Wood, which will ban pharmaceutical companies from giving consumers coupons for brand-name drugs when a generic equivalent is available, with some exceptions.\u003c/p>\n\u003cp>\u003cstrong>Childhood Lead Poisoning\u003c/strong>🖋\u003c/p>\n\u003cp>Brown signed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1316\">AB 1316\u003c/a> by Assemblyman Bill Quirk (D-Hayward), which calls for all California kids to be evaluated by their doctor for lead poisoning, starting next year. Currently, children who receive government assistance such as Medi-Cal must be screened for lead, but that requirement doesn’t extend to other children. Doctors will also have to consider new factors when evaluating children, such as proximity to potential sources of lead contamination. A report published last month by the Environmental Working Group showed that \u003ca href=\"http://www.ewg.org/research/one-third-california-s-high-risk-kids-not-tested-lead-poisoning#.Wd6u82hSyUk\">one-third of infants\u003c/a> who were at risk for lead poisoning had not been tested. “The current screening process is outdated and leaves many children vulnerable to lead poisoning,” Quirk said in a statement.\u003c/p>\n\u003cp>\u003cstrong>Unapproved Stem Cell Treatments\u003c/strong>🖋\u003c/p>\n\u003cp>Brown approved \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB512\">a bill\u003c/a> that requires doctors to warn their patients before they undergo \u003ca href=\"https://ipscell.com/2017/10/groundbreaking-california-stem-cell-law-gives-consumer-protections-on-clinics/\">unapproved stem cell therapies\u003c/a>. SB 512, also by Hernandez, says health care providers who offer such treatments must disclose to patients that the treatments have not been approved by the Food and Drug Administration, and urge them “to consult with your primary care physician prior to undergoing a stem cell therapy.” Health care providers may face fines for noncompliance.\u003c/p>\n\u003cp>\u003cstrong>VETOED BY THE GOVERNOR \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Valley Fever\u003c/strong>🚫\u003c/p>\n\u003cp>Brown nixed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=201720180AB1279\">AB 1279\u003c/a>, which would have required the state Department of Public Health to develop additional outreach programs to educate people about Valley Fever, an infection caused by inhaling fungal spores often found in soil. The measure, by Assemblyman Rudy Salas (D-Bakersfield), had been watered down from its original form by the time it hit the governor’s desk. The original language called for a $2 million investment in research on the disease, which is common in dry regions, like Salas’ district. In his \u003ca href=\"https://www.gov.ca.gov/docs/AB_1279_Veto_Message_2017.pdf\">veto message\u003c/a>, Brown said the department already provides fact sheets, brochures and other materials to educate the public about Valley Fever.\u003c/p>\n\u003cp>\u003cstrong>Smoking At State Parks\u003c/strong>🚫\u003c/p>\n\u003cp>Once again, Brown \u003ca href=\"https://californiahealthline.org/news/will-california-kick-butts-off-state-beaches-not-this-year/\">vetoed legislation\u003c/a> that would have banned smoking at state beaches and parks. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB725\">AB 725\u003c/a>, by Assemblyman Marc Levine (D-San Rafael), would have established smoking areas at some parks and beaches. People caught smoking outside those designated spaces would have faced a $50 fine. A stricter bill by Sen. Steve Glazer (D-Orinda), \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB386\">SB 386\u003c/a>, proposed a fine of up to $100. Lawmakers had previously sent similar legislation to Brown, but so far they have not won him over. In his \u003ca href=\"https://www.gov.ca.gov/docs/AB_725_Veto_Message_2017.pdf\">veto message\u003c/a>, Brown said a ban would be an overreach of government power. “If people can’t smoke even on a deserted beach, where can they?” he asked.\u003c/p>\n\u003cp>\u003cstrong>Reproductive Bias\u003c/strong>🚫\u003c/p>\n\u003cp>A bill that would have prohibited institutions with religious affiliations from firing employees because of their reproductive choices, such as having abortions, failed to make it past the governor’s desk. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB569\">AB 569\u003c/a>, by Assemblywoman Lorena Gonzalez Fletcher (D-San Diego), would have barred religion-based employers such as a Christian school, from requiring workers to sign a code of conduct that waived their reproductive health rights. \u003ca href=\"https://www.gov.ca.gov/docs/AB_569_Veto_Message_2017.pdf\">In his veto message\u003c/a>, Brown said that “these types of claims should remain within the jurisdiction of the Department of Fair Employment and Housing.”\u003c/p>\n\u003cp>\u003cstrong>SEE YOU NEXT YEAR?\u003c/strong>\u003c/p>\n\u003cp>(Some significant health bills that stalled in the legislature, but may be resurrected for another attempt in 2018)\u003c/p>\n\u003cp>\u003cstrong>Regulating Dialysis Clinics\u003c/strong>🤔\u003c/p>\n\u003cp>A proposal by Sen. Ricardo Lara (D-Bell Gardens) would have required minimum staff-to-patient ratios at dialysis centers, such as one nurse for every eight patients or one technician for every three. The stalled bill, SB 349, also would have mandated more time for staff to prepare between patient appointments. A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB251\">bill\u003c/a> by Assemblyman Rob Bonta (D-Oakland) would have required dialysis centers to spend at least 85 percent of their revenue primarily on direct patient care.\u003c/p>\n\u003cp>Both measures were backed by a large labor union, Service Employees International Union-United Healthcare Workers West (\u003ca href=\"http://www.seiu-uhw.org/\">SEIU-UHW\u003c/a>), which has threatened to take the issue directly to voters if the Legislature does not act.\u003c/p>\n\u003cp>\u003cstrong>Single-Payer Health Care\u003c/strong>🤔\u003c/p>\n\u003cp>The ambitious attempt to create one government-administered or “single-payer” health care system in California has been tabled until next year. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB562\">SB 562\u003c/a> by Lara and Assemblywoman Toni Atkins (D-San Diego) would provide comprehensive health coverage to all Californians, regardless of immigration status. Private insurance companies would be barred from the system, and enrollees would not be charged copayments or premiums. A legislative committee estimated that the program would require $200 billion annually in additional tax revenue.\u003c/p>\n\u003cp>Supporters of universal health care hope to \u003ca href=\"https://oag.ca.gov/system/files/initiatives/pdfs/17-0019%20%28Healthcare%20Roadblock%20Removal%29.pdf\">put a measure\u003c/a> on the statewide ballot that would make it easier to fund a single-payer system.\u003c/p>\n\u003cp>\u003cstrong>Pediatric Dental Anesthesia \u003c/strong>🤔\u003c/p>\n\u003cp>A bill that would have required oral surgeons to have a specially trained staff member with them to monitor a child under anesthesia stalled in committee. Current law allows an oral surgeon to perform surgery and monitor the unconscious child at the same time. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB224\">AB 224\u003c/a>, by Assemblyman Tony Thurmond (D-Richmond), would have built on last year’s “\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160AB2235\">Caleb’s Law\u003c/a>,” named after Caleb Sears, a 6-year-old boy who died in 2015 after oral surgery under anesthesia.\u003c/p>\n\u003cp>\u003cstrong>Containing Drug Costs\u003c/strong>🤔\u003c/p>\n\u003cp>\u003ca href=\"https://californiahealthline.org/news/negotiating-drug-prices-should-state-agencies-band-together/\">A measure\u003c/a> by Assemblyman David Chiu (D-San Francisco) would have brought together administrators from 17 state agencies to devise ways to reduce state drug costs. \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB587\">AB 587\u003c/a> would have expanded an existing state purchasing collaborative that buys drugs for a handful of public health programs, and directed the new group to develop cost controls, such as creating a uniform drug formulary for state agencies.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB790\">SB 790\u003c/a> by Sen. Mike McGuire (D-North Coast/North Bay) sought to \u003ca href=\"https://californiahealthline.org/news/bill-aims-to-loosen-drugmaker-doctor-ties-by-limiting-perks-for-promoting-meds/\">restrict the pharmaceutical industry’s\u003c/a> marketing to doctors, limiting their spending to mostly educational or scientific purposes, which McGuire said could reduce unnecessary prescriptions of pricey drugs.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>California Gov. Jerry Brown defied the drug industry Monday, signing the most comprehensive drug price transparency bill in the nation, one which will force drug makers to publicly justify big price hikes.\u003c/p>\n\u003cp>“Californians have a right to know why their medical costs are out of control, especially when pharmaceutical profits are soaring,” Brown said. “This measure is a step at bringing transparency, truth, exposure to a very important part of our lives, that is the cost of prescription drugs.”\u003c/p>\n\u003cp style=\"background: white;margin: 0in 0in .25in 0in\">\u003cspan style=\"color: #222222\">Brown said the bill was part of a broader push toward correcting growing economic inequities in the U.S., and called on the pharmaceutical leaders “at the top” to consider doing business in a way that helps those with a lot less. \u003c/span>\u003c/p>\n\u003cp style=\"background: white;margin: 0in 0in .25in 0in\">\u003cspan style=\"color: #222222\">“The rich are getting richer. \u003c/span>The powerful are getting more powerful,” Brown said. “So this is just another example where the powerful get more power and take more… We've got to point to the evils, and there's a real evil when so many people are suffering so much from rising drug profits.”\u003c/p>\n\u003cp>The drug lobby fiercely opposed the bill, SB 17, hiring 45 firms to try to defeat it and spending $16.8 million on lobbying against the full range of drug legislation.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The new law will shine light into the mystery of how drugs are priced, requiring pharmaceutical companies to notify the state and health insurers anytime they plan to raise the price of a medication by 16 percent or more over two years. And, companies will have to provide justification for the increase.\u003c/p>\n\u003cp>The legislation was supported by a diverse coalition, including labor and consumer groups, hospital groups and even health insurers, who agreed to share some of their own data under the bill. They will have to report what percentage of premium increases are due to drug prices.\u003c/p>\n\u003cp>“Health coverage premiums directly reflect the cost of providing medical care, and prescription drug prices have become one of the main factors driving up these costs,” said Charles Bacchi, CEO of the California Association of Health Plans. “SB 17 will help us understand why, so we can prepare for and address the unrelenting price increases.”\u003c/p>\n\u003cp>Drug companies criticized the governors move, saying the new law focuses too narrowly on just one part of the drug distribution chain and won't help consumers afford their medicine.\u003c/p>\n\u003cp>“It is disappointing that Gov. Brown has decided to sign a bill that is based on misleading rhetoric instead of what’s in the best interest of patients,” said Priscilla VanderVeer, spokesperson for the Pharmaceutical Research and Manufacturers of America. “There is no evidence that SB 17 will lower drug costs for patients because it does not shed light on the large rebates and discounts insurance companies and pharmacy benefit managers are receiving that are not always being passed on to patients.”\u003c/p>\n\u003cp>Policy experts are clear that this law is part of a long game toward developing a stronger web of drug laws across the country. In that respect, it makes sense to start with the source of the drug prices: the drug makers themselves, said Gerard Anderson, a health policy professor at Johns Hopkins Bloomberg School of Public Health who tracks drug legislation in the states.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The manufacturers get most of the money – probably about three quarters or more of the money that you pay for a drug, and they're the ones that set the price initially,” he said. “So they are not the only piece of the drug supply chain, but they are the key piece to this.”\u003c/p>\n\n",
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"excerpt": "Drug manufacturers must notify the state and health insurance companies anytime they plan to raise the price of a medication by 16 percent or more, over two years. Then they must explain why. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California Gov. Jerry Brown defied the drug industry Monday, signing the most comprehensive drug price transparency bill in the nation, one which will force drug makers to publicly justify big price hikes.\u003c/p>\n\u003cp>“Californians have a right to know why their medical costs are out of control, especially when pharmaceutical profits are soaring,” Brown said. “This measure is a step at bringing transparency, truth, exposure to a very important part of our lives, that is the cost of prescription drugs.”\u003c/p>\n\u003cp style=\"background: white;margin: 0in 0in .25in 0in\">\u003cspan style=\"color: #222222\">Brown said the bill was part of a broader push toward correcting growing economic inequities in the U.S., and called on the pharmaceutical leaders “at the top” to consider doing business in a way that helps those with a lot less. \u003c/span>\u003c/p>\n\u003cp style=\"background: white;margin: 0in 0in .25in 0in\">\u003cspan style=\"color: #222222\">“The rich are getting richer. \u003c/span>The powerful are getting more powerful,” Brown said. “So this is just another example where the powerful get more power and take more… We've got to point to the evils, and there's a real evil when so many people are suffering so much from rising drug profits.”\u003c/p>\n\u003cp>The drug lobby fiercely opposed the bill, SB 17, hiring 45 firms to try to defeat it and spending $16.8 million on lobbying against the full range of drug legislation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new law will shine light into the mystery of how drugs are priced, requiring pharmaceutical companies to notify the state and health insurers anytime they plan to raise the price of a medication by 16 percent or more over two years. And, companies will have to provide justification for the increase.\u003c/p>\n\u003cp>The legislation was supported by a diverse coalition, including labor and consumer groups, hospital groups and even health insurers, who agreed to share some of their own data under the bill. They will have to report what percentage of premium increases are due to drug prices.\u003c/p>\n\u003cp>“Health coverage premiums directly reflect the cost of providing medical care, and prescription drug prices have become one of the main factors driving up these costs,” said Charles Bacchi, CEO of the California Association of Health Plans. “SB 17 will help us understand why, so we can prepare for and address the unrelenting price increases.”\u003c/p>\n\u003cp>Drug companies criticized the governors move, saying the new law focuses too narrowly on just one part of the drug distribution chain and won't help consumers afford their medicine.\u003c/p>\n\u003cp>“It is disappointing that Gov. Brown has decided to sign a bill that is based on misleading rhetoric instead of what’s in the best interest of patients,” said Priscilla VanderVeer, spokesperson for the Pharmaceutical Research and Manufacturers of America. “There is no evidence that SB 17 will lower drug costs for patients because it does not shed light on the large rebates and discounts insurance companies and pharmacy benefit managers are receiving that are not always being passed on to patients.”\u003c/p>\n\u003cp>Policy experts are clear that this law is part of a long game toward developing a stronger web of drug laws across the country. In that respect, it makes sense to start with the source of the drug prices: the drug makers themselves, said Gerard Anderson, a health policy professor at Johns Hopkins Bloomberg School of Public Health who tracks drug legislation in the states.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The manufacturers get most of the money – probably about three quarters or more of the money that you pay for a drug, and they're the ones that set the price initially,” he said. “So they are not the only piece of the drug supply chain, but they are the key piece to this.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Will California Kick Butts Off State Beaches? Not This Year",
"title": "Will California Kick Butts Off State Beaches? Not This Year",
"headTitle": "California Healthline | State of Health | KQED News",
"content": "\u003cp class=\"p1\">For years, state lawmakers have been trying to eliminate second-hand smoke and cigarette butts from California’s 280 illustrious beaches and natural parks.\u003c/p>\n\u003cp class=\"p1\">Once again, they have come up short.\u003c/p>\n\u003cp class=\"p1\">Late Friday, Gov. Jerry Brown vetoed two bills that would have banned or drastically curtailed smoking and vaping in parks and beaches run by the state.\u003c/p>\n\u003cp class=\"p1\">“If people can’t even smoke on a deserted beach, where can they?” Brown pondered in his \u003ca href=\"https://www.gov.ca.gov/docs/AB_725_Veto_Message_2017.pdf\" target=\"_blank\" rel=\"noopener\">\u003cspan class=\"s1\">veto \u003c/span>\u003c/a>\u003cspan class=\"s1\">message\u003c/span>. “There must be some limit to the coercive power of government.”\u003c/p>\n\u003cp class=\"p1\">Lawmakers who supported the legislation said banning smoking at state parks would protect people from health hazards associated with second-hand smoke and prevent the risks that cigarette butts pose to marine life.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cimg class=\"alignnone size-medium wp-image-361399\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/Butt-on-beach-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp class=\"p2\">\u003cspan class=\"s2\">The author of one of the bills, \u003c/span>Assemblyman Marc Levine (D-San Rafael), said \u003cspan class=\"s2\">he was \u003c/span>disappointed by Brown’s decision. Trying to protect people and wildlife from “poisonous” cigarette butts is hardly coercive, he said in an emailed statement.\u003c/p>\n\u003cp class=\"p1\">“The common person knows these dangers too well, and flippantly dismissing them isn't cool. Even for a governor who is featured in Rolling Stone magazine,” Levine said, referring to an \u003cspan class=\"s1\">\u003ca href=\"http://www.rollingstone.com/politics/features/jerry-browns-california-dream-the-rolling-stone-interview-w507082\" target=\"_blank\" rel=\"noopener\">interview\u003c/a> with Brown \u003c/span>that ran last week in the popular culture biweekly.\u003c/p>\n\u003cp class=\"p2\">Levine’s \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB725\" target=\"_blank\" rel=\"noopener\">\u003cspan class=\"s1\">bill \u003c/span>\u003c/a>would have established designated smoking areas at some parks and beaches and imposed a fine of $50 on anyone caught lighting up outside of them.\u003c/p>\n\u003cp class=\"p2\">Another\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB386\" target=\"_blank\" rel=\"noopener\"> bill\u003c/a>, by Senator Steve Glazer (D-Orinda), would have banned smoking altogether on state beaches, and established designated smoking zones at state parks. The fine for any violation would have been $100.\u003c/p>\n\u003cp class=\"p2\">Brown and former Gov. Arnold Schwarzenegger both have vetoed similar measures in the past.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s3\">Last year, Brown \u003c/span>said a smoking ban passed by the Legislature in 2016 was \u003cspan class=\"s1\">too “broad” and “punitive\u003c/span>.”\u003c/p>\n\u003cp class=\"p1\">Beachgoers in southern California, speaking to a reporter before Brown issued Friday’s vetoes, gave mixed reviews to the idea.\u003c/p>\n\u003cp class=\"p1\">“I’m all for banning smoking on the beach. I think it's repulsive,” said MaryAnn Morton, a resident of Orange County’s Huntington Beach who regularly visits the shoreline, including a stretch of state-owned beach where smoking is permitted.\u003c/p>\n\u003cp class=\"p1\">Smoking is already prohibited on the city-controlled portion of the beach, as well as many other locally-managed beaches in California.\u003c/p>\n\u003cp class=\"p1\">Others at Huntington Beach said they didn’t think they would be harmed by second-hand smoke there.\u003c/p>\n\u003cp>\"I don't see how you can get second hand smoke from such a big public place,\" said Letty Herrera. \"I mean look at our neighbors, how they're not that close to us. If I was out here smoking a joint, I don't think they'd smell it.\"\u003c/p>\n\u003cfigure id=\"attachment_361396\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-361396\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/IMG_7926-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Letty Herrera, right, enjoys the fresh air at Huntington State Beach with her friends George and Jennifer Cortez. An adjoining beach controlled by the city prohibits smoking. \u003ccite>(Pauline Bartolone/California Healthline)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">“Sometimes they ban things without a sole reason,\" said Jesse Miller, 24, who was drinking with friends on the city-managed stretch of beach. \"It feels more for votes.”\u003c/p>\n\u003cp class=\"p1\">Miller admitted he and his friends had just smoked on the city beach, where it is prohibited.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He said the government should focus instead on more significant contributors to poor air quality, such as a nearby industrial plant, and the offshore oil rigs that are visible from Huntington Beach.\u003c/span>\u003c/p>\n\u003cp>\"There's pollution being created,\" Miller said.\u003c/p>\n\u003cp class=\"p1\">Glen Stainer, a cigar-smoking tourist from Pennsylvania, said he could get on board with a smoking ban that allowed for designated areas. But in general, people should not smoke when others are nearby, he said.\u003c/p>\n\u003cp class=\"p1\">Stainer said can understand both sides of the issue: “It’s not fair to have smoke being blown on little children that aren’t asking for that. And yet, a beach should be a public place where I can do what I want.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cem>This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Gov. Jerry Brown last week vetoed two bills that would have limited or completely banned smoking at state parks and beaches.",
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"description": "Gov. Jerry Brown last week vetoed two bills that would have limited or completely banned smoking at state parks and beaches.",
"title": "Will California Kick Butts Off State Beaches? Not This Year | KQED",
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"nprByline": "\u003cstrong>\u003ca href=\"https://khn.org/news/author/pauline-bartolone/\" rel=\"noopener\" target=\"_blank\">Pauline Bartolone\u003c/a>\u003c/strong>, California Healthline",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">For years, state lawmakers have been trying to eliminate second-hand smoke and cigarette butts from California’s 280 illustrious beaches and natural parks.\u003c/p>\n\u003cp class=\"p1\">Once again, they have come up short.\u003c/p>\n\u003cp class=\"p1\">Late Friday, Gov. Jerry Brown vetoed two bills that would have banned or drastically curtailed smoking and vaping in parks and beaches run by the state.\u003c/p>\n\u003cp class=\"p1\">“If people can’t even smoke on a deserted beach, where can they?” Brown pondered in his \u003ca href=\"https://www.gov.ca.gov/docs/AB_725_Veto_Message_2017.pdf\" target=\"_blank\" rel=\"noopener\">\u003cspan class=\"s1\">veto \u003c/span>\u003c/a>\u003cspan class=\"s1\">message\u003c/span>. “There must be some limit to the coercive power of government.”\u003c/p>\n\u003cp class=\"p1\">Lawmakers who supported the legislation said banning smoking at state parks would protect people from health hazards associated with second-hand smoke and prevent the risks that cigarette butts pose to marine life.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cimg class=\"alignnone size-medium wp-image-361399\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/Butt-on-beach-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/Butt-on-beach-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp class=\"p2\">\u003cspan class=\"s2\">The author of one of the bills, \u003c/span>Assemblyman Marc Levine (D-San Rafael), said \u003cspan class=\"s2\">he was \u003c/span>disappointed by Brown’s decision. Trying to protect people and wildlife from “poisonous” cigarette butts is hardly coercive, he said in an emailed statement.\u003c/p>\n\u003cp class=\"p1\">“The common person knows these dangers too well, and flippantly dismissing them isn't cool. Even for a governor who is featured in Rolling Stone magazine,” Levine said, referring to an \u003cspan class=\"s1\">\u003ca href=\"http://www.rollingstone.com/politics/features/jerry-browns-california-dream-the-rolling-stone-interview-w507082\" target=\"_blank\" rel=\"noopener\">interview\u003c/a> with Brown \u003c/span>that ran last week in the popular culture biweekly.\u003c/p>\n\u003cp class=\"p2\">Levine’s \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB725\" target=\"_blank\" rel=\"noopener\">\u003cspan class=\"s1\">bill \u003c/span>\u003c/a>would have established designated smoking areas at some parks and beaches and imposed a fine of $50 on anyone caught lighting up outside of them.\u003c/p>\n\u003cp class=\"p2\">Another\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB386\" target=\"_blank\" rel=\"noopener\"> bill\u003c/a>, by Senator Steve Glazer (D-Orinda), would have banned smoking altogether on state beaches, and established designated smoking zones at state parks. The fine for any violation would have been $100.\u003c/p>\n\u003cp class=\"p2\">Brown and former Gov. Arnold Schwarzenegger both have vetoed similar measures in the past.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s3\">Last year, Brown \u003c/span>said a smoking ban passed by the Legislature in 2016 was \u003cspan class=\"s1\">too “broad” and “punitive\u003c/span>.”\u003c/p>\n\u003cp class=\"p1\">Beachgoers in southern California, speaking to a reporter before Brown issued Friday’s vetoes, gave mixed reviews to the idea.\u003c/p>\n\u003cp class=\"p1\">“I’m all for banning smoking on the beach. I think it's repulsive,” said MaryAnn Morton, a resident of Orange County’s Huntington Beach who regularly visits the shoreline, including a stretch of state-owned beach where smoking is permitted.\u003c/p>\n\u003cp class=\"p1\">Smoking is already prohibited on the city-controlled portion of the beach, as well as many other locally-managed beaches in California.\u003c/p>\n\u003cp class=\"p1\">Others at Huntington Beach said they didn’t think they would be harmed by second-hand smoke there.\u003c/p>\n\u003cp>\"I don't see how you can get second hand smoke from such a big public place,\" said Letty Herrera. \"I mean look at our neighbors, how they're not that close to us. If I was out here smoking a joint, I don't think they'd smell it.\"\u003c/p>\n\u003cfigure id=\"attachment_361396\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-361396\" src=\"https://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2017/10/IMG_7926-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2017/10/IMG_7926-520x347.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Letty Herrera, right, enjoys the fresh air at Huntington State Beach with her friends George and Jennifer Cortez. An adjoining beach controlled by the city prohibits smoking. \u003ccite>(Pauline Bartolone/California Healthline)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">“Sometimes they ban things without a sole reason,\" said Jesse Miller, 24, who was drinking with friends on the city-managed stretch of beach. \"It feels more for votes.”\u003c/p>\n\u003cp class=\"p1\">Miller admitted he and his friends had just smoked on the city beach, where it is prohibited.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He said the government should focus instead on more significant contributors to poor air quality, such as a nearby industrial plant, and the offshore oil rigs that are visible from Huntington Beach.\u003c/span>\u003c/p>\n\u003cp>\"There's pollution being created,\" Miller said.\u003c/p>\n\u003cp class=\"p1\">Glen Stainer, a cigar-smoking tourist from Pennsylvania, said he could get on board with a smoking ban that allowed for designated areas. But in general, people should not smoke when others are nearby, he said.\u003c/p>\n\u003cp class=\"p1\">Stainer said can understand both sides of the issue: “It’s not fair to have smoke being blown on little children that aren’t asking for that. And yet, a beach should be a public place where I can do what I want.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cem>This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Frets Over Funding After Congress Misses Health Care Deadlines",
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"content": "\u003cp>More than a million California children get their health insurance from the Children's Health Insurance Program, also know as \"CHIP.\" Like they do with Medicaid, states split the costs for CHIP with the federal government. But Congress missed an Oct. 1 deadline to renew CHIP funding -- a lapse that many blame on the drawn-out effort to repeal the Affordable Care Act. That fight put other health care priorities on the back burner, and anxiety is growing about when -- or if -- Congress will reauthorize the money to pay for them.\u003c/p>\n\u003cp>\u003cem>What exactly is CHIP?\u003c/em>\u003c/p>\n\u003cp>CHIP is a little-known program but very important. Everyone knows about Medi-Cal, which covers lots of low-income children (and many adults as well), but CHIP is for children whose parents make too much money to qualify them for Medi-Cal, but don't have insurance through their jobs.\u003c/p>\n\u003cp>\"It saddens me because, I mean, they're children. Children should not be politicized,\" said Dr. Porshia Mack, chief medical officer at the \u003ca href=\"http://www.tvhc.org/Home.aspx\" target=\"_blank\" rel=\"noopener\">Tiburcio Vasquez Health Center\u003c/a> in Hayward.\u003c/p>\n\u003cp>A lot of people agree with Mack. CHIP has never been a controversial program, unlike the Affordable Care Act. It's always had bipartisan support since its start in 1997. Everyone professes a desire to insure children, and kids are relatively cheap to insure, compared to adults and seniors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cem>So what happened?\u003c/em>\u003c/p>\n\u003cp>Congress simply missed the deadline to renew the funding. In September, the Senate decided to try yet again to repeal and replace the Affordable Care Act, and it was so busy that CHIP was one of many programs that just didn't get voted on in time.\u003c/p>\n\u003cp>This week, Congress is starting to discuss reauthorizing the money for CHIP, but some of the ideas include ratcheting down the funding amounts. In recent years, CHIP funding had gotten a financial boost from the Affordable Care Act. Right now, California's share of CHIP's costs amount to $364 million a year, but some of the new funding proposals being floated in Congress would increase California's CHIP contribution to $1.5 billion a year.\u003c/p>\n\u003cp>California's CHIP program does have enough money to keep going through the end of 2017, according to the state's Medicaid director, Mari Cantwell. If the federal funding does not come back by January, the state could face some difficult decisions. Cantwell said most children won't actually be kicked off of their insurance, but California would have to pay much more to move them into Medi-Cal plans to keep them insured.\u003c/p>\n\u003cp>\u003cem>What else has been put on the back burner while Congress debated the Affordable Care Act?\u003c/em>\u003c/p>\n\u003cp>There were a number of health programs that also had funding deadlines of Sept. 30. One \u003ca href=\"https://khn.org/news/congress-cold-shoulder-sends-shivers-through-community-health-centers/\" target=\"_blank\" rel=\"noopener\">program\u003c/a> provides federal funding for community health clinics like Tiburcio Vasquez in Hayward. These are safety-net clinics that typically treat low-income people on Medi-Cal, and also provide a last resort for uninsured or undocumented people who have no other options. In California, the federal funding for these clinics came to $1.6 billion over the past five years. Clinic directors in California have been \u003ca href=\"https://www.sfccc.org/blog/2017/9/19/time-to-fight-back-against-graham-cassidy-repeal-bill-and-health-center-funding-cliff\" target=\"_blank\" rel=\"noopener\">vocal\u003c/a> about the importance of this money over the past few weeks, and are especially anxious now that the deadline has been missed. They're saying Congress really has to act soon.\u003c/p>\n\u003cp>\u003cem>What about the future of Obamacare itself? It seems to be very unclear about which direction it's heading.\u003c/em>\u003c/p>\n\u003cp>The repeal efforts seem to have stopped for now, or at least for 2017. But there was also a separate bill to fix one of the chief problems plaguing Obamacare, and that has also been delayed. The bill would have stabilized the individual insurance markets in the states by locking in funding that the Trump administration has threatened to cut. As a result of the ongoing uncertainty, some insurance companies have dropped out of the markets, and some have raised premiums for 2018.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Some states are waiting to see if that bill gets passed, and there is \u003ca href=\"http://thehill.com/policy/healthcare/353671-gop-willing-to-give-ground-on-obamacare-subsidies\" target=\"_blank\" rel=\"noopener\">movement\u003c/a> this week to revive it. But others have already announced that the premiums are going to increase. In Georgia, for example, premiums are set to go up by 50 percent for 2018 -- all because Congress hasn't yet fixed this funding gap. California still hasn't released the rates for Covered California plans for 2018, but they will have to do that soon, because open enrollment for 2018 starts on Nov. 1.\u003c/p>\n\n",
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"excerpt": "A program that covers more than a million children is in funding limbo. Community clinics and Covered California are also waiting on Congress to take action. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>More than a million California children get their health insurance from the Children's Health Insurance Program, also know as \"CHIP.\" Like they do with Medicaid, states split the costs for CHIP with the federal government. But Congress missed an Oct. 1 deadline to renew CHIP funding -- a lapse that many blame on the drawn-out effort to repeal the Affordable Care Act. That fight put other health care priorities on the back burner, and anxiety is growing about when -- or if -- Congress will reauthorize the money to pay for them.\u003c/p>\n\u003cp>\u003cem>What exactly is CHIP?\u003c/em>\u003c/p>\n\u003cp>CHIP is a little-known program but very important. Everyone knows about Medi-Cal, which covers lots of low-income children (and many adults as well), but CHIP is for children whose parents make too much money to qualify them for Medi-Cal, but don't have insurance through their jobs.\u003c/p>\n\u003cp>\"It saddens me because, I mean, they're children. Children should not be politicized,\" said Dr. Porshia Mack, chief medical officer at the \u003ca href=\"http://www.tvhc.org/Home.aspx\" target=\"_blank\" rel=\"noopener\">Tiburcio Vasquez Health Center\u003c/a> in Hayward.\u003c/p>\n\u003cp>A lot of people agree with Mack. CHIP has never been a controversial program, unlike the Affordable Care Act. It's always had bipartisan support since its start in 1997. Everyone professes a desire to insure children, and kids are relatively cheap to insure, compared to adults and seniors.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>So what happened?\u003c/em>\u003c/p>\n\u003cp>Congress simply missed the deadline to renew the funding. In September, the Senate decided to try yet again to repeal and replace the Affordable Care Act, and it was so busy that CHIP was one of many programs that just didn't get voted on in time.\u003c/p>\n\u003cp>This week, Congress is starting to discuss reauthorizing the money for CHIP, but some of the ideas include ratcheting down the funding amounts. In recent years, CHIP funding had gotten a financial boost from the Affordable Care Act. Right now, California's share of CHIP's costs amount to $364 million a year, but some of the new funding proposals being floated in Congress would increase California's CHIP contribution to $1.5 billion a year.\u003c/p>\n\u003cp>California's CHIP program does have enough money to keep going through the end of 2017, according to the state's Medicaid director, Mari Cantwell. If the federal funding does not come back by January, the state could face some difficult decisions. Cantwell said most children won't actually be kicked off of their insurance, but California would have to pay much more to move them into Medi-Cal plans to keep them insured.\u003c/p>\n\u003cp>\u003cem>What else has been put on the back burner while Congress debated the Affordable Care Act?\u003c/em>\u003c/p>\n\u003cp>There were a number of health programs that also had funding deadlines of Sept. 30. One \u003ca href=\"https://khn.org/news/congress-cold-shoulder-sends-shivers-through-community-health-centers/\" target=\"_blank\" rel=\"noopener\">program\u003c/a> provides federal funding for community health clinics like Tiburcio Vasquez in Hayward. These are safety-net clinics that typically treat low-income people on Medi-Cal, and also provide a last resort for uninsured or undocumented people who have no other options. In California, the federal funding for these clinics came to $1.6 billion over the past five years. Clinic directors in California have been \u003ca href=\"https://www.sfccc.org/blog/2017/9/19/time-to-fight-back-against-graham-cassidy-repeal-bill-and-health-center-funding-cliff\" target=\"_blank\" rel=\"noopener\">vocal\u003c/a> about the importance of this money over the past few weeks, and are especially anxious now that the deadline has been missed. They're saying Congress really has to act soon.\u003c/p>\n\u003cp>\u003cem>What about the future of Obamacare itself? It seems to be very unclear about which direction it's heading.\u003c/em>\u003c/p>\n\u003cp>The repeal efforts seem to have stopped for now, or at least for 2017. But there was also a separate bill to fix one of the chief problems plaguing Obamacare, and that has also been delayed. The bill would have stabilized the individual insurance markets in the states by locking in funding that the Trump administration has threatened to cut. As a result of the ongoing uncertainty, some insurance companies have dropped out of the markets, and some have raised premiums for 2018.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Some states are waiting to see if that bill gets passed, and there is \u003ca href=\"http://thehill.com/policy/healthcare/353671-gop-willing-to-give-ground-on-obamacare-subsidies\" target=\"_blank\" rel=\"noopener\">movement\u003c/a> this week to revive it. But others have already announced that the premiums are going to increase. In Georgia, for example, premiums are set to go up by 50 percent for 2018 -- all because Congress hasn't yet fixed this funding gap. California still hasn't released the rates for Covered California plans for 2018, but they will have to do that soon, because open enrollment for 2018 starts on Nov. 1.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Las Vegas Faced a Massacre. Did It Have Enough Trauma Centers?",
"title": "Las Vegas Faced a Massacre. Did It Have Enough Trauma Centers?",
"headTitle": "Kaiser Health News | State of Health | KQED News",
"content": "\u003cp>Las Vegas is not only a glittering strip of casinos and hotels but a fast-growing region with more than 2 million residents — and one hospital designated as a highest-level trauma center.\u003c/p>\n\u003cp>The deadly shooting Sunday that killed at least 59 and sent more than 500 people to area hospitals raised questions about whether that’s enough.\u003c/p>\n\u003cp>Las Vegas is not the only big city with just one such trauma center. Seattle and Nashville, among others, also are in \u003ca href=\"http://www.amtrauma.org/?page=FindTraumaCenter\" target=\"_blank\" rel=\"noopener\">this category\u003c/a>, according to the American Trauma Society, a professional and advocacy organization focused on improving trauma care.\u003c/p>\n\u003cp>Casey Nolan, a hospital consultant and managing director of Navigant Consulting in Washington, D.C., said what matters most is not the number of high-level centers, but the degrees of coordination across the area’s medical network, including the first responders.\u003c/p>\n\u003cp>“It’s how well integrated the care is and whether there is a triage system to get patients to the right place in the right time,” he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>What Makes Up The Network\u003c/strong>\u003c/p>\n\u003cp>The highest-level trauma centers are equipped and staffed around-the-clock to provide care for patients who suffer from traumatic injuries such as gunshot wounds, falls and car accidents.\u003c/p>\n\u003cp>The designation “trauma center” is the result of a validation process at the state or local level. Centers are categorized by Level I, II or III, for instance, in keeping with nationally accepted standards. Centers can also seek additional approval from the American College of Surgeons.\u003c/p>\n\u003cp>Across the country, there are \u003ca href=\"http://www.amtrauma.org/?page=FindTraumaCenters.\" target=\"_blank\" rel=\"noopener\">217 Level I trauma centers\u003c/a>, up from 198 in 2012, according to the trauma society. These centers must see at least 1,200 trauma patients a year and have general surgeons and other specialists immediately available at the facility.\u003c/p>\n\u003cp>There are another 310 Level II centers that face similar staffing rules, but with fewer education and training requirements. Level III centers have emergency medical staff, but will stabilize severely injured patients and often transport them to higher-level trauma centers.\u003c/p>\n\u003cp>For decades, the hospital industry viewed trauma care as a money-losing proposition because of the high costs of keeping doctors and nurses on standby 24 hours a day. Trauma centers, particularly those in inner cities, tended to attract more patients without health insurance.\u003c/p>\n\u003cp>But in recent years, hospitals have been competing to get the designation as a way to increase profits, in part because trauma centers enhance demand for surgery and ancillary services like CT scans. In addition, a trauma designation can boost a facility’s overall reputation, Nolan added.\u003c/p>\n\u003cp>“Trauma had gotten a bad rap,” explained Nolan. “But in suburban locations, where more people have insurance, you can do pretty well on trauma.”\u003c/p>\n\u003cp>Some hospitals also began charging a fee — known as a “trauma activation” fee — to help pay for the extra staffing and equipment trauma units require.\u003c/p>\n\u003cp>Those fees could range from a few hundred dollars to several thousand dollars on patients’ bills, Nolan said.\u003c/p>\n\u003cp>\u003cstrong>Trauma Care In Las Vegas\u003c/strong>\u003c/p>\n\u003cp>Despite the burgeoning population of Las Vegas and surrounding Clark County, which more than doubled to 2.2 million in the past 25 years, University Medical Center has been Las Vegas’ only Level I trauma center since 1992.\u003c/p>\n\u003cp>The metro area includes two other lower-level trauma centers. Sunrise Hospital & Medical Center in Las Vegas is a Level II facility and St. Rose Dominican Hospital in nearby Henderson, Nev., is a Level III.\u003c/p>\n\u003cp>Even the idea of expanding Las Vegas’ trauma network has stirred controversy.\u003c/p>\n\u003cp>Last year, a state agency rejected applications by three hospitals in the Las Vegas area to be designated as Level III trauma centers.\u003c/p>\n\u003cp>HCA, the national, for-profit chain that owned two of these facilities, said adding trauma centers would help ensure quicker care to patients in the growing region. The company has made adding trauma centers a strategy across the country and has met resistance from existing centers.\u003c/p>\n\u003cp>But opponents argued HCA was motivated by the opportunity to boost profits. The \u003ca href=\"http://www.tampabay.com/news/health/how-hca-turned-trauma-into-a-money-maker/2169280\" target=\"_blank\" rel=\"noopener\">Tampa Bay Times\u003c/a> reported last year that the hospital chain charged significantly higher “activation fees” than other hospitals.\u003c/p>\n\u003cp>Opponents also countered that adding trauma centers would affect University Medical Center’s ability to provide quality care and train doctors. Some experts say it could diminish the number of patients seen at each center.\u003c/p>\n\u003cp>That’s because the more trauma patients a center deals with annually, the better the results, studies show.\u003c/p>\n\u003cp>“If you can bring all the patients to one place, then those surgeons become really good at dealing with trauma, instead of spreading it out [around a number of facilities],” said Bill Bullard, senior vice president with the Abaris Group, a California-based consulting firm that advises hospitals on emergency care.\u003c/p>\n\u003cp>Ian Weston, executive director of the American Trauma Society, said the trauma system worked well in Las Vegas, which is a credit to ambulances and other first responders and their ability to triage patients to hospitals across the city.\u003c/p>\n\u003cp>Seriously ill patients have the best outcomes when treated at a Level I trauma center, said David Callaway, a professor of emergency medicine at the Carolinas Medical Center in Charlotte, N.C. But “when you have 500-plus casualties and 58 dead … if all the patients went to a Level I, mortality would not be improved, because they would be completely overwhelmed,” Callaway added.\u003c/p>\n\u003cp>Bullard agreed.\u003c/p>\n\u003cp>“In theory, the more centers you have the more people you have to deal with injuries. However, no trauma system is able to handle a tragedy of this magnitude.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"nprByline": "\u003ca href=\"https://khn.org/news/author/julie-appleby/\">Julie Appleby\u003c/a> and \u003ca href=\"https://khn.org/news/author/phil-galewitz/\">Phil Galewitz\u003c/a>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Las Vegas is not only a glittering strip of casinos and hotels but a fast-growing region with more than 2 million residents — and one hospital designated as a highest-level trauma center.\u003c/p>\n\u003cp>The deadly shooting Sunday that killed at least 59 and sent more than 500 people to area hospitals raised questions about whether that’s enough.\u003c/p>\n\u003cp>Las Vegas is not the only big city with just one such trauma center. Seattle and Nashville, among others, also are in \u003ca href=\"http://www.amtrauma.org/?page=FindTraumaCenter\" target=\"_blank\" rel=\"noopener\">this category\u003c/a>, according to the American Trauma Society, a professional and advocacy organization focused on improving trauma care.\u003c/p>\n\u003cp>Casey Nolan, a hospital consultant and managing director of Navigant Consulting in Washington, D.C., said what matters most is not the number of high-level centers, but the degrees of coordination across the area’s medical network, including the first responders.\u003c/p>\n\u003cp>“It’s how well integrated the care is and whether there is a triage system to get patients to the right place in the right time,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>What Makes Up The Network\u003c/strong>\u003c/p>\n\u003cp>The highest-level trauma centers are equipped and staffed around-the-clock to provide care for patients who suffer from traumatic injuries such as gunshot wounds, falls and car accidents.\u003c/p>\n\u003cp>The designation “trauma center” is the result of a validation process at the state or local level. Centers are categorized by Level I, II or III, for instance, in keeping with nationally accepted standards. Centers can also seek additional approval from the American College of Surgeons.\u003c/p>\n\u003cp>Across the country, there are \u003ca href=\"http://www.amtrauma.org/?page=FindTraumaCenters.\" target=\"_blank\" rel=\"noopener\">217 Level I trauma centers\u003c/a>, up from 198 in 2012, according to the trauma society. These centers must see at least 1,200 trauma patients a year and have general surgeons and other specialists immediately available at the facility.\u003c/p>\n\u003cp>There are another 310 Level II centers that face similar staffing rules, but with fewer education and training requirements. Level III centers have emergency medical staff, but will stabilize severely injured patients and often transport them to higher-level trauma centers.\u003c/p>\n\u003cp>For decades, the hospital industry viewed trauma care as a money-losing proposition because of the high costs of keeping doctors and nurses on standby 24 hours a day. Trauma centers, particularly those in inner cities, tended to attract more patients without health insurance.\u003c/p>\n\u003cp>But in recent years, hospitals have been competing to get the designation as a way to increase profits, in part because trauma centers enhance demand for surgery and ancillary services like CT scans. In addition, a trauma designation can boost a facility’s overall reputation, Nolan added.\u003c/p>\n\u003cp>“Trauma had gotten a bad rap,” explained Nolan. “But in suburban locations, where more people have insurance, you can do pretty well on trauma.”\u003c/p>\n\u003cp>Some hospitals also began charging a fee — known as a “trauma activation” fee — to help pay for the extra staffing and equipment trauma units require.\u003c/p>\n\u003cp>Those fees could range from a few hundred dollars to several thousand dollars on patients’ bills, Nolan said.\u003c/p>\n\u003cp>\u003cstrong>Trauma Care In Las Vegas\u003c/strong>\u003c/p>\n\u003cp>Despite the burgeoning population of Las Vegas and surrounding Clark County, which more than doubled to 2.2 million in the past 25 years, University Medical Center has been Las Vegas’ only Level I trauma center since 1992.\u003c/p>\n\u003cp>The metro area includes two other lower-level trauma centers. Sunrise Hospital & Medical Center in Las Vegas is a Level II facility and St. Rose Dominican Hospital in nearby Henderson, Nev., is a Level III.\u003c/p>\n\u003cp>Even the idea of expanding Las Vegas’ trauma network has stirred controversy.\u003c/p>\n\u003cp>Last year, a state agency rejected applications by three hospitals in the Las Vegas area to be designated as Level III trauma centers.\u003c/p>\n\u003cp>HCA, the national, for-profit chain that owned two of these facilities, said adding trauma centers would help ensure quicker care to patients in the growing region. The company has made adding trauma centers a strategy across the country and has met resistance from existing centers.\u003c/p>\n\u003cp>But opponents argued HCA was motivated by the opportunity to boost profits. The \u003ca href=\"http://www.tampabay.com/news/health/how-hca-turned-trauma-into-a-money-maker/2169280\" target=\"_blank\" rel=\"noopener\">Tampa Bay Times\u003c/a> reported last year that the hospital chain charged significantly higher “activation fees” than other hospitals.\u003c/p>\n\u003cp>Opponents also countered that adding trauma centers would affect University Medical Center’s ability to provide quality care and train doctors. Some experts say it could diminish the number of patients seen at each center.\u003c/p>\n\u003cp>That’s because the more trauma patients a center deals with annually, the better the results, studies show.\u003c/p>\n\u003cp>“If you can bring all the patients to one place, then those surgeons become really good at dealing with trauma, instead of spreading it out [around a number of facilities],” said Bill Bullard, senior vice president with the Abaris Group, a California-based consulting firm that advises hospitals on emergency care.\u003c/p>\n\u003cp>Ian Weston, executive director of the American Trauma Society, said the trauma system worked well in Las Vegas, which is a credit to ambulances and other first responders and their ability to triage patients to hospitals across the city.\u003c/p>\n\u003cp>Seriously ill patients have the best outcomes when treated at a Level I trauma center, said David Callaway, a professor of emergency medicine at the Carolinas Medical Center in Charlotte, N.C. But “when you have 500-plus casualties and 58 dead … if all the patients went to a Level I, mortality would not be improved, because they would be completely overwhelmed,” Callaway added.\u003c/p>\n\u003cp>Bullard agreed.\u003c/p>\n\u003cp>“In theory, the more centers you have the more people you have to deal with injuries. However, no trauma system is able to handle a tragedy of this magnitude.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hepatitis C Drug’s Lower Cost Paves Way For Medicaid, Prisons To Expand Treatment",
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"content": "\u003cp>Valerie Green is still waiting to be cured.\u003c/p>\n\u003cp>The Delaware resident was diagnosed with hepatitis C more than two years ago, but she doesn’t qualify yet for the Medicaid program’s criteria for treatment with a new class of highly effective but pricey drugs. The recent approval of a less expensive drug that generally cures hepatitis C in just eight weeks may make it easier for more insurers and correctional facilities to expand treatment.\u003c/p>\n\u003cp>The drug, \u003ca href=\"https://www.mavyret.com\" target=\"_blank\" rel=\"noopener\">Mavyret\u003c/a>, is the first to be \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm570038.htm\" target=\"_blank\" rel=\"noopener\">approved by the Food and Drug Administration\u003c/a> that can cure all six genetic types of hepatitis C in about two months in patients who haven’t previously been treated. Other approved drugs generally require 12 weeks to treat the disease and often aren’t effective for all types of hepatitis C.\u003c/p>\n\u003cp>In addition, Mavyret’s price tag of $26,400 for a course of treatment is significantly below that of other hepatitis C drugs whose sticker price ranges from about \u003ca href=\"https://www.macpac.gov/wp-content/uploads/2017/03/High-Cost-HCV-Drugs-in-Medicaid-Final-Report.pdf\" target=\"_blank\" rel=\"noopener\">$55,000 to $95,000\u003c/a> to beat the disease. Patients and insurers often pay less, however, through negotiated insurance discounts and rebates.\u003c/p>\n\u003cp>“It certainly stands to reason that the continual march downwards on cost would lead to continual opening up of criteria,” said Matt Salo, executive director of the National Association of Medicaid Directors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Hepatitis C is a viral liver infection spread through blood that affects an estimated 3.5 million people in the United States. It can take years to cause problems. Many baby boomers who contracted it decades ago before blood was screened for the virus don’t realize they have it until they develop liver disease. In addition, the growing heroin epidemic is adding to the problem as people become infected by sharing contaminated needles.\u003c/p>\n\u003cp>“Direct acting antiviral” therapies like Harvoni, a once-a-day pill introduced in 2014 that generally cured hepatitis C in 12 weeks, are much more effective than earlier treatments that required weekly interferon injections and multiple daily pills for nearly a year. But the newer regimens came at a price: $94,500, in Harvoni’s case.\u003c/p>\n\u003cp>State Medicaid programs, which cover a high proportion of people with hepatitis C, \u003ca href=\"http://www.governing.com/news/headlines/how-some-state-medicaid-programs-limit-drugs-to-only-sickest-patients.html\" target=\"_blank\" rel=\"noopener\">balked at the high prices\u003c/a>, even with the 23 percent drug discount the programs typically receive. Many threw up roadblocks to limit drug approval until the disease was advanced. Some required people to be drug- and alcohol-free for six months or more before treatment would be approved.\u003c/p>\n\u003cp>Those moves prompted advocates to push for better access, in some cases \u003ca href=\"https://khn.org/news/medicaid-private-insurers-begin-to-lift-curbs-on-pricey-hepatitis-c-drugs/\" target=\"_blank\" rel=\"noopener\">filing suit\u003c/a> to force the programs to cover more people.\u003c/p>\n\u003cp>Faced with a lawsuit in Delaware, the state Medicaid program began loosening up treatment criteria this year, and in January will \u003ca href=\"https://www.chlpi.org//wp-content/uploads/2016/06/DMMA-Prior-Authorization-Policy.pdf\" target=\"_blank\" rel=\"noopener\">begin approving enrollees\u003c/a> regardless of the severity of their disease.\u003c/p>\n\u003cp>The state joins more than a dozen others that no longer (or never did) restrict hepatitis C treatment based on disease severity, said Kevin Costello, director of litigation at Harvard Law School’s Center for Health Law and Policy Innovation, which has been a key player \u003ca href=\"https://www.chlpi.org/in-face-of-class-action-lawsuit-delaware-medicaid-removes-unlawful-restrictions-to-the-cure-for-the-hepatitis-c-virus/\" target=\"_blank\" rel=\"noopener\">in litigation in Delaware\u003c/a> and other states.\u003c/p>\n\u003cp>It can’t happen soon enough, said Green, 58, who believes she contracted the disease 31 years ago when she suffered complications during childbirth and required a blood transfusion. Although her liver isn’t damaged, Green said, she’s suffered with abdominal and joint pain, weight loss and fatigue for decades, symptoms that doctors attribute to the hepatitis C virus.\u003c/p>\n\u003cp>“It’s been a difficult fight for us Medicaid patients,” she said.\u003c/p>\n\u003cp>People who are incarcerated \u003ca href=\"http://content.healthaffairs.org/content/35/10/1893.abstract\" target=\"_blank\" rel=\"noopener\">face an even tougher battle\u003c/a> to get treatment for hepatitis C. Roughly 17 percent of prisoners are infected with hepatitis C, compared with about 1 percent of the general population.\u003c/p>\n\u003cp>Prisons have a duty not to be deliberately indifferent to the medical needs of incarcerated people. Prisons don’t get the price discounts that the Medicaid programs have, and their budgets are fixed.\u003c/p>\n\u003cp>“Administrators have to make do with what is there,” said Dr. Anne Spaulding, an associate professor at Emory University’s public health school who has worked as a medical director in corrections and published research on hepatitis C among prisoners.\u003c/p>\n\u003cp>Lawyers in a handful of states are pursuing class action lawsuits to force prisons to provide hepatitis C treatment. Mavyret may make a difference, said David Rudovsky, a civil rights lawyer who’s litigating a class action lawsuit against the Pennsylvania Department of Corrections.\u003c/p>\n\u003cp>“Everyone recognizes that it’s going to make it easier to cover people,” he said.\u003c/p>\n\u003cp>People with regular private insurance may face some obstacles to coverage of hepatitis C, but coverage is typically less problematic. For example, Mavyret is one of seven hepatitis C drugs that are included in the 2018 \u003ca href=\"http://lab.express-scripts.com/lab/insights/drug-options/2018-national-preferred-formulary\" target=\"_blank\" rel=\"noopener\">national preferred formulary\u003c/a> by Express Scripts, which manages the pharmacy benefits for 83 million people.\u003c/p>\n\u003cp>“The benefit to patients and payers is the additional competition, which brings down costs across the class, thus resulting in greater access and affordability,” said Jennifer Luddy, director of corporate communications at Express Scripts.\u003c/p>\n\u003cp>\u003cem>Please visit \u003ca href=\"http://khn.org/columnists/\" target=\"_blank\" rel=\"noopener\">khn.org/columnists\u003c/a> to send comments or ideas for future topics for the Insuring Your Health column.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003c/em>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a> (KHN). KHN is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\" target=\"_blank\" rel=\"noopener\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "The drug, sold under the name Mavyret, can cure all six genetic types of the liver disease in eight weeks at a cost of $26,400, well below other options.",
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"nprByline": "\u003ca href=\"https://californiahealthline.org/news/author/michelle-andrews/\">\u003cstrong>Michelle Andrews\u003c/strong>\u003c/a>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Valerie Green is still waiting to be cured.\u003c/p>\n\u003cp>The Delaware resident was diagnosed with hepatitis C more than two years ago, but she doesn’t qualify yet for the Medicaid program’s criteria for treatment with a new class of highly effective but pricey drugs. The recent approval of a less expensive drug that generally cures hepatitis C in just eight weeks may make it easier for more insurers and correctional facilities to expand treatment.\u003c/p>\n\u003cp>The drug, \u003ca href=\"https://www.mavyret.com\" target=\"_blank\" rel=\"noopener\">Mavyret\u003c/a>, is the first to be \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm570038.htm\" target=\"_blank\" rel=\"noopener\">approved by the Food and Drug Administration\u003c/a> that can cure all six genetic types of hepatitis C in about two months in patients who haven’t previously been treated. Other approved drugs generally require 12 weeks to treat the disease and often aren’t effective for all types of hepatitis C.\u003c/p>\n\u003cp>In addition, Mavyret’s price tag of $26,400 for a course of treatment is significantly below that of other hepatitis C drugs whose sticker price ranges from about \u003ca href=\"https://www.macpac.gov/wp-content/uploads/2017/03/High-Cost-HCV-Drugs-in-Medicaid-Final-Report.pdf\" target=\"_blank\" rel=\"noopener\">$55,000 to $95,000\u003c/a> to beat the disease. Patients and insurers often pay less, however, through negotiated insurance discounts and rebates.\u003c/p>\n\u003cp>“It certainly stands to reason that the continual march downwards on cost would lead to continual opening up of criteria,” said Matt Salo, executive director of the National Association of Medicaid Directors.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Hepatitis C is a viral liver infection spread through blood that affects an estimated 3.5 million people in the United States. It can take years to cause problems. Many baby boomers who contracted it decades ago before blood was screened for the virus don’t realize they have it until they develop liver disease. In addition, the growing heroin epidemic is adding to the problem as people become infected by sharing contaminated needles.\u003c/p>\n\u003cp>“Direct acting antiviral” therapies like Harvoni, a once-a-day pill introduced in 2014 that generally cured hepatitis C in 12 weeks, are much more effective than earlier treatments that required weekly interferon injections and multiple daily pills for nearly a year. But the newer regimens came at a price: $94,500, in Harvoni’s case.\u003c/p>\n\u003cp>State Medicaid programs, which cover a high proportion of people with hepatitis C, \u003ca href=\"http://www.governing.com/news/headlines/how-some-state-medicaid-programs-limit-drugs-to-only-sickest-patients.html\" target=\"_blank\" rel=\"noopener\">balked at the high prices\u003c/a>, even with the 23 percent drug discount the programs typically receive. Many threw up roadblocks to limit drug approval until the disease was advanced. Some required people to be drug- and alcohol-free for six months or more before treatment would be approved.\u003c/p>\n\u003cp>Those moves prompted advocates to push for better access, in some cases \u003ca href=\"https://khn.org/news/medicaid-private-insurers-begin-to-lift-curbs-on-pricey-hepatitis-c-drugs/\" target=\"_blank\" rel=\"noopener\">filing suit\u003c/a> to force the programs to cover more people.\u003c/p>\n\u003cp>Faced with a lawsuit in Delaware, the state Medicaid program began loosening up treatment criteria this year, and in January will \u003ca href=\"https://www.chlpi.org//wp-content/uploads/2016/06/DMMA-Prior-Authorization-Policy.pdf\" target=\"_blank\" rel=\"noopener\">begin approving enrollees\u003c/a> regardless of the severity of their disease.\u003c/p>\n\u003cp>The state joins more than a dozen others that no longer (or never did) restrict hepatitis C treatment based on disease severity, said Kevin Costello, director of litigation at Harvard Law School’s Center for Health Law and Policy Innovation, which has been a key player \u003ca href=\"https://www.chlpi.org/in-face-of-class-action-lawsuit-delaware-medicaid-removes-unlawful-restrictions-to-the-cure-for-the-hepatitis-c-virus/\" target=\"_blank\" rel=\"noopener\">in litigation in Delaware\u003c/a> and other states.\u003c/p>\n\u003cp>It can’t happen soon enough, said Green, 58, who believes she contracted the disease 31 years ago when she suffered complications during childbirth and required a blood transfusion. Although her liver isn’t damaged, Green said, she’s suffered with abdominal and joint pain, weight loss and fatigue for decades, symptoms that doctors attribute to the hepatitis C virus.\u003c/p>\n\u003cp>“It’s been a difficult fight for us Medicaid patients,” she said.\u003c/p>\n\u003cp>People who are incarcerated \u003ca href=\"http://content.healthaffairs.org/content/35/10/1893.abstract\" target=\"_blank\" rel=\"noopener\">face an even tougher battle\u003c/a> to get treatment for hepatitis C. Roughly 17 percent of prisoners are infected with hepatitis C, compared with about 1 percent of the general population.\u003c/p>\n\u003cp>Prisons have a duty not to be deliberately indifferent to the medical needs of incarcerated people. Prisons don’t get the price discounts that the Medicaid programs have, and their budgets are fixed.\u003c/p>\n\u003cp>“Administrators have to make do with what is there,” said Dr. Anne Spaulding, an associate professor at Emory University’s public health school who has worked as a medical director in corrections and published research on hepatitis C among prisoners.\u003c/p>\n\u003cp>Lawyers in a handful of states are pursuing class action lawsuits to force prisons to provide hepatitis C treatment. Mavyret may make a difference, said David Rudovsky, a civil rights lawyer who’s litigating a class action lawsuit against the Pennsylvania Department of Corrections.\u003c/p>\n\u003cp>“Everyone recognizes that it’s going to make it easier to cover people,” he said.\u003c/p>\n\u003cp>People with regular private insurance may face some obstacles to coverage of hepatitis C, but coverage is typically less problematic. For example, Mavyret is one of seven hepatitis C drugs that are included in the 2018 \u003ca href=\"http://lab.express-scripts.com/lab/insights/drug-options/2018-national-preferred-formulary\" target=\"_blank\" rel=\"noopener\">national preferred formulary\u003c/a> by Express Scripts, which manages the pharmacy benefits for 83 million people.\u003c/p>\n\u003cp>“The benefit to patients and payers is the additional competition, which brings down costs across the class, thus resulting in greater access and affordability,” said Jennifer Luddy, director of corporate communications at Express Scripts.\u003c/p>\n\u003cp>\u003cem>Please visit \u003ca href=\"http://khn.org/columnists/\" target=\"_blank\" rel=\"noopener\">khn.org/columnists\u003c/a> to send comments or ideas for future topics for the Insuring Your Health column.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003c/em>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a> (KHN). KHN is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\" target=\"_blank\" rel=\"noopener\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Other States Closely Watching Fate of California’s Drug Price Transparency Bill",
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"content": "\u003cp>Insurers, hospitals and health advocates are waiting for Gov. Jerry Brown to deal the drug lobby a rare defeat, by signing legislation that would force pharmaceutical companies to justify big price hikes on drugs in California.\u003c/p>\n\u003cp>Drugmakers have spent $16.8 million on lobbying since January 2015 to kill an array of drug legislation in California, according to data from the Secretary of State's Office. For the pricing bill alone, the industry hired 45 lobbyists or firms to fight it. Against the backdrop of this opposition campaign, Brown must decide by Oct.15 whether to sign or veto the bill.\u003c/p>\n\u003cp>“If it gets signed by this governor, it's going to send shock waves throughout the country,” said state \u003ca href=\"http://sd22.senate.ca.gov/\" target=\"_blank\" rel=\"noopener\">Sen. Ed Hernandez\u003c/a> (D-West Covina), the bill's author and an optometrist. “A lot of other states have the same concerns we have, and you're going to see other states try to emulate what we did.”\u003c/p>\n\u003cp>The bill, SB 17, would require drug companies to give California 60 days notice anytime they plan to raise the price of a drug by 16 percent or more over two years. They’d also have to explain why the increases are necessary. In addition, health insurers would have to report what percentage of premium increases are caused by drug spending.\u003c/p>\n\u003cp>This is the second go-round for this drug price bill. Last summer, the same legislation crashed and burned. Its intended regulations were gutted so extensively that Hernandez decided to pull it. But two key things happened after that, he said, which set the stage for a successful second attempt.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>First, in August 2016, less than a week after Hernandez pulled the bill, a firestorm of controversy erupted nationally over the price of EpiPens spiking nearly 500 percent. The increase inspired a chorus of outrage from parents who carry the auto-injectors to save their children from life-threatening allergic reactions.\u003c/p>\n\u003cp>Momentum grew among federal lawmakers last September to do something. They called for hearings. Several proposed bills aimed to reign in drug prices across the country.\u003c/p>\n\u003cp>But then, the election of November 2016 disrupted all order of health care business in Washington. After Donald Trump was elected and Republicans took control of Congress, the number one health policy priority became repealing and replacing the Affordable Care Act.\u003c/p>\n\u003cp>As federal lawmakers focused on taking away health coverage from millions of Americans, Hernandez said he saw another opportunity for state lawmakers to act on drug prices. He reintroduced his bill in early 2017, and this time political support grew quickly, beyond the usual suspects.\u003c/p>\n\u003cp>“It wasn’t just labor,” he recalled. “It was consumer groups, it was health plans. It was the Chambers of Commerce, it was the Hospital Association.”\u003c/p>\n\u003cp>Hernandez is optimistic the governor will sign SB 17 into law. But he knows nothing’s certain. That's because of what happened on Sept. 11, the day the bill came up for a key vote in the state Assembly -- the same place it went down the year before. Hernandez thought he’d secured all the votes he needed, but at the last minute the votes started slipping away.\u003c/p>\n\u003cp>The bill needed 41 votes to pass the Assembly. During the roll call, the tally stalled around 35. Hernandez said he had plenty of colleagues willing to cast the 42nd vote, but with drug lobbyists swarming the Capitol, no legislators wanted to be the one to cast the \u003cem>deciding\u003c/em> vote.\u003c/p>\n\u003cp>“If the bill fails and you’re stuck out there, then you’re the person that’s attacking the industry,” Hernandez said.\u003c/p>\n\u003cp>On the second round of voting, the bill crossed the 41-vote threshold quickly, and the remaining lawmakers glommed on. In the end, the bill passed with 66 votes. All the Democrats and half the Republicans in the state Assembly voted for it.\u003c/p>\n\u003cp>This was much to the dismay of drug companies, which lobbied hard and issued a blitz of advertising in the last weeks before the vote.\u003c/p>\n\u003cp>The Pharmaceutical Research and Manufacturers of America, or \u003ca href=\"http://www.phrma.org/\" target=\"_blank\" rel=\"noopener\">PhRMA\u003c/a>, the industry’s trade group, argued that SB 17 was full of “false promises” that wouldn’t help consumers pay for their medicines, and would instead stifle innovation with cumbersome regulatory compliance.\u003c/p>\n\u003cp>“That takes up a lot of resources and will take up a lot of time,” said Priscilla VanderVeer, deputy vice president of public affairs for PhRMA. “And that could mean pulling resources from research and development and having to put it into the reporting structure.”\u003c/p>\n\u003cp>Experts say the drug industry doesn’t want a large influential state like California forcing them to share their data.\u003c/p>\n\u003cp>“When they have to justify in California, de facto, they have to justify it to the other 49 states,” said \u003ca href=\"https://www.jhsph.edu/faculty/directory/profile/11/gerard-anderson\" target=\"_blank\" rel=\"noopener\">Gerard Anderson\u003c/a>, a public health professor at Johns Hopkins University. “So other states essentially get to piggyback on the good efforts of California, and hopefully, because they might have difficulty justifying the price increases, everybody’s prices around the country will be lower.”\u003c/p>\n\u003cp>Other states, like Maryland, Vermont, Nevada and New York, have passed similar laws aimed at bringing more transparency to prices and curbing price gouging. But the pharmaceutical industry has fought the hardest in California. If drug companies don’t like the disclosure laws in smaller states, they could decide not to sell their drugs there, Anderson said, but the market in California is just too big to ignore.\u003c/p>\n\u003cp>“States like Maryland are just not as powerful,” he said. “It just doesn’t have the clout that a state like California has.”\u003c/p>\n\u003cp>But drugmakers are likely already devising ways to work around the California bill, Anderson warned. They’ve filed lawsuits to try to slow or stop laws from being implemented in other states, or to weaken the rules if and when they go into effect. Policy experts are watching to see what kinds of legal challenges the California law might be vulnerable to, and if it can withstand them.\u003c/p>\n\u003cp>“We learn from the mistakes of other states,” Anderson said. “Legislation is an iterative process. We have 50 states and hopefully, by some time, we'll get it right. We’re looking for California to take the lead on this.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[documentcloud url=\"http://www.documentcloud.org/documents/4065249-CA-Rx-Lobbying-Expenditures-Jan-15-June-17.html\" width=800 height=900]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Insurers, hospitals and health advocates are waiting for Gov. Jerry Brown to deal the drug lobby a rare defeat, by signing legislation that would force pharmaceutical companies to justify big price hikes on drugs in California.\u003c/p>\n\u003cp>Drugmakers have spent $16.8 million on lobbying since January 2015 to kill an array of drug legislation in California, according to data from the Secretary of State's Office. For the pricing bill alone, the industry hired 45 lobbyists or firms to fight it. Against the backdrop of this opposition campaign, Brown must decide by Oct.15 whether to sign or veto the bill.\u003c/p>\n\u003cp>“If it gets signed by this governor, it's going to send shock waves throughout the country,” said state \u003ca href=\"http://sd22.senate.ca.gov/\" target=\"_blank\" rel=\"noopener\">Sen. Ed Hernandez\u003c/a> (D-West Covina), the bill's author and an optometrist. “A lot of other states have the same concerns we have, and you're going to see other states try to emulate what we did.”\u003c/p>\n\u003cp>The bill, SB 17, would require drug companies to give California 60 days notice anytime they plan to raise the price of a drug by 16 percent or more over two years. They’d also have to explain why the increases are necessary. In addition, health insurers would have to report what percentage of premium increases are caused by drug spending.\u003c/p>\n\u003cp>This is the second go-round for this drug price bill. Last summer, the same legislation crashed and burned. Its intended regulations were gutted so extensively that Hernandez decided to pull it. But two key things happened after that, he said, which set the stage for a successful second attempt.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>First, in August 2016, less than a week after Hernandez pulled the bill, a firestorm of controversy erupted nationally over the price of EpiPens spiking nearly 500 percent. The increase inspired a chorus of outrage from parents who carry the auto-injectors to save their children from life-threatening allergic reactions.\u003c/p>\n\u003cp>Momentum grew among federal lawmakers last September to do something. They called for hearings. Several proposed bills aimed to reign in drug prices across the country.\u003c/p>\n\u003cp>But then, the election of November 2016 disrupted all order of health care business in Washington. After Donald Trump was elected and Republicans took control of Congress, the number one health policy priority became repealing and replacing the Affordable Care Act.\u003c/p>\n\u003cp>As federal lawmakers focused on taking away health coverage from millions of Americans, Hernandez said he saw another opportunity for state lawmakers to act on drug prices. He reintroduced his bill in early 2017, and this time political support grew quickly, beyond the usual suspects.\u003c/p>\n\u003cp>“It wasn’t just labor,” he recalled. “It was consumer groups, it was health plans. It was the Chambers of Commerce, it was the Hospital Association.”\u003c/p>\n\u003cp>Hernandez is optimistic the governor will sign SB 17 into law. But he knows nothing’s certain. That's because of what happened on Sept. 11, the day the bill came up for a key vote in the state Assembly -- the same place it went down the year before. Hernandez thought he’d secured all the votes he needed, but at the last minute the votes started slipping away.\u003c/p>\n\u003cp>The bill needed 41 votes to pass the Assembly. During the roll call, the tally stalled around 35. Hernandez said he had plenty of colleagues willing to cast the 42nd vote, but with drug lobbyists swarming the Capitol, no legislators wanted to be the one to cast the \u003cem>deciding\u003c/em> vote.\u003c/p>\n\u003cp>“If the bill fails and you’re stuck out there, then you’re the person that’s attacking the industry,” Hernandez said.\u003c/p>\n\u003cp>On the second round of voting, the bill crossed the 41-vote threshold quickly, and the remaining lawmakers glommed on. In the end, the bill passed with 66 votes. All the Democrats and half the Republicans in the state Assembly voted for it.\u003c/p>\n\u003cp>This was much to the dismay of drug companies, which lobbied hard and issued a blitz of advertising in the last weeks before the vote.\u003c/p>\n\u003cp>The Pharmaceutical Research and Manufacturers of America, or \u003ca href=\"http://www.phrma.org/\" target=\"_blank\" rel=\"noopener\">PhRMA\u003c/a>, the industry’s trade group, argued that SB 17 was full of “false promises” that wouldn’t help consumers pay for their medicines, and would instead stifle innovation with cumbersome regulatory compliance.\u003c/p>\n\u003cp>“That takes up a lot of resources and will take up a lot of time,” said Priscilla VanderVeer, deputy vice president of public affairs for PhRMA. “And that could mean pulling resources from research and development and having to put it into the reporting structure.”\u003c/p>\n\u003cp>Experts say the drug industry doesn’t want a large influential state like California forcing them to share their data.\u003c/p>\n\u003cp>“When they have to justify in California, de facto, they have to justify it to the other 49 states,” said \u003ca href=\"https://www.jhsph.edu/faculty/directory/profile/11/gerard-anderson\" target=\"_blank\" rel=\"noopener\">Gerard Anderson\u003c/a>, a public health professor at Johns Hopkins University. “So other states essentially get to piggyback on the good efforts of California, and hopefully, because they might have difficulty justifying the price increases, everybody’s prices around the country will be lower.”\u003c/p>\n\u003cp>Other states, like Maryland, Vermont, Nevada and New York, have passed similar laws aimed at bringing more transparency to prices and curbing price gouging. But the pharmaceutical industry has fought the hardest in California. If drug companies don’t like the disclosure laws in smaller states, they could decide not to sell their drugs there, Anderson said, but the market in California is just too big to ignore.\u003c/p>\n\u003cp>“States like Maryland are just not as powerful,” he said. “It just doesn’t have the clout that a state like California has.”\u003c/p>\n\u003cp>But drugmakers are likely already devising ways to work around the California bill, Anderson warned. They’ve filed lawsuits to try to slow or stop laws from being implemented in other states, or to weaken the rules if and when they go into effect. Policy experts are watching to see what kinds of legal challenges the California law might be vulnerable to, and if it can withstand them.\u003c/p>\n\u003cp>“We learn from the mistakes of other states,” Anderson said. “Legislation is an iterative process. We have 50 states and hopefully, by some time, we'll get it right. We’re looking for California to take the lead on this.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Congress’ Cold Shoulder Sends Shivers Through Community Health Centers",
"title": "Congress’ Cold Shoulder Sends Shivers Through Community Health Centers",
"headTitle": "California Healthline | State of Health | KQED News",
"content": "\u003cp>One community health center in New York has frozen hiring. Another in Missouri can’t get a bank loan to expand.\u003c/p>\n\u003cp>The nation’s 1,400 community health centers are carefully watching expenses in case the financial rescue they hope Congress delivers this week doesn’t arrive. With four days left in the government’s fiscal year, Congress has not voted on reauthorizing billions of dollars now going to community health centers and other health programs for the 2018 budget year that starts Sunday.\u003c/p>\n\u003cp>“The anxiety level is increasing on almost a daily basis,” said Dan Hawkins, senior vice president of the National Association of Community Health Centers (NACHC) in Washington, D.C. “There is broad support and agreement in Congress that it should get done, but we are working against a ticking clock and a crowded legislative calendar.”\u003c/p>\n\u003cp>For the past two weeks, the GOP’s scramble to repeal the Affordable Care Act before the month ends pushed other health care matters off the congressional agenda. That effort ended Tuesday when Senate Republicans said they would not seek a vote this week because they lacked enough support to pass the bill.\u003c/p>\n\u003cp>It’s not clear if lawmakers’ lighter agenda will now leave room for funding health centers or deciding other issues, such as renewing the Children’s Health Insurance Program (CHIP), which also expires Saturday. At a hearing Monday, Senate Finance Committee Chairman Orrin Hatch (R-Utah) urged his colleagues to work with the Senate’s health committee to settle the matter. NACHC officials privately express optimism that a deal might come later in October if not by Sunday.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Community health centers operate in more than 9,500 locations, serving 27 million people, according to the NACHC. They are the main source of health care for many low-income Americans — and the only source of primary care in many underserved areas.\u003c/p>\n\u003cp>Health centers provide preventive care, counseling, dentistry and primary care to everyone, whether or not they can pay. A sliding fee scale based on income and family size is available to patients without insurance.\u003c/p>\n\u003cp>In 2015, nearly 1 in 6 Medicaid beneficiaries received health center services, the Kaiser Family Foundation \u003ca href=\"http://www.kff.org/medicaid/issue-brief/community-health-centers-recent-growth-and-the-role-of-the-aca/\">reported\u003c/a> this year. (Kaiser Health News is an editorially independent program of the foundation.)\u003c/p>\n\u003cp>“The end result is these are people who will be locked out of health care” without new funding, Hawkins said.\u003c/p>\n\u003cp>Community health centers gained billions of dollars in federal revenue under the ACA, which created a special trust fund to support them from 2011 through 2015. The Community Health Center Fund was extended in 2015 for two years with an additional $3.6 billion annually.\u003c/p>\n\u003cp>That money represents 70 percent of all federal grants to health centers and about a fifth of their annual revenue. Medicaid reimbursements account for the largest share, about 40 percent.\u003c/p>\n\u003cp>One beneficiary is Pamela Richardson, a 60-year-old patient of Valley Community Healthcare in North Hollywood, California, who suffers from an iron absorption disorder called hereditary hemochromatosis. She was unable to get health insurance before Obamacare prohibited insurers from excluding people with preexisting medical conditions. The clinic helped her sign up for coverage through the Medi-Cal expansion.\u003c/p>\n\u003cp>Once Richardson was covered, she received long-delayed primary care, which revealed she had “scary high” blood pressure and a lump in one breast (which proved benign). “When you don’t have insurance you don’t get breast exams. You don’t have Pap smears,” she \u003ca href=\"http://khn.org/news/californias-community-clinics-big-aca-beneficiaries-worry-about-their-future/\">told\u003c/a> a KHN reporter earlier this year. “I wish people had a little more patience with Obamacare. Once you get what’s wrong with you under control, the cost would come down.”\u003c/p>\n\u003cp>California has by far the most federally funded health centers and they serve 6.2 million Californians, according to CaliforniaHealth+ Advocates, which represents state clinics. They have received over $1.6 billion from 2011 through 2016 from the Community Health Center Fund, more than any other state, the Congressional Research Service \u003ca href=\"https://www.everycrsreport.com/files/20170113_R43911_852eca9ca6e96b41176e6609d8cb068ba7e770ed.pdf\">reported\u003c/a> in January.\u003c/p>\n\u003cp>If health centers receive no new funds for 2018, the ensuing financial crunch would cost 51,000 jobs, force the centers to close 2,800 locations and cause 9 million people to lose health care services, according to a budget document that the Health and Human Services Department gave Congress in July.\u003c/p>\n\u003cp>Uncertainty about what Congress will do now is already causing problems. Hawkins said his members call him and his staff every day, fretting about employment contracts, lease agreements and equipment rentals that run past Oct. 1.\u003c/p>\n\u003cp>Neighborhood Health in Nashville, Tennessee, has federal grant money that will carry it through Jan. 31, but CEO Mary Bufwack said some of her 180 staff members live paycheck to paycheck and are getting nervous about Neighborhood’s stability.\u003c/p>\n\u003cp>Bufwack is worried the health center won’t receive money it needs to replace a clinic, a project now being planned.\u003c/p>\n\u003cp>She fears that a new doctor she recruited to join Neighborhood next June will take another job before she can get his signature on an employment contract. And she doesn’t want to do that until she’s sure about her budget.\u003c/p>\n\u003cp>Mostly, she worries that whatever Congress gives her will be only for one year.\u003c/p>\n\u003cp>“We’re already worried about next Sept. 30,” Bufwack said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/p>\n\n",
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"excerpt": "The clinics, which serve many poor people, are tightening spending in case Congress doesn’t approve new funding for them before the government’s 2018 fiscal year starts Sunday. California has the most at stake.",
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"nprByline": "\u003ca href=\"http://khn.org/news/author/rachel-bluth/\" rel=\"noopener\" target=\"_blank\">\u003cstrong>Rachel Bluth\u003c/strong>\u003c/a>, Kaiser Health News",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>One community health center in New York has frozen hiring. Another in Missouri can’t get a bank loan to expand.\u003c/p>\n\u003cp>The nation’s 1,400 community health centers are carefully watching expenses in case the financial rescue they hope Congress delivers this week doesn’t arrive. With four days left in the government’s fiscal year, Congress has not voted on reauthorizing billions of dollars now going to community health centers and other health programs for the 2018 budget year that starts Sunday.\u003c/p>\n\u003cp>“The anxiety level is increasing on almost a daily basis,” said Dan Hawkins, senior vice president of the National Association of Community Health Centers (NACHC) in Washington, D.C. “There is broad support and agreement in Congress that it should get done, but we are working against a ticking clock and a crowded legislative calendar.”\u003c/p>\n\u003cp>For the past two weeks, the GOP’s scramble to repeal the Affordable Care Act before the month ends pushed other health care matters off the congressional agenda. That effort ended Tuesday when Senate Republicans said they would not seek a vote this week because they lacked enough support to pass the bill.\u003c/p>\n\u003cp>It’s not clear if lawmakers’ lighter agenda will now leave room for funding health centers or deciding other issues, such as renewing the Children’s Health Insurance Program (CHIP), which also expires Saturday. At a hearing Monday, Senate Finance Committee Chairman Orrin Hatch (R-Utah) urged his colleagues to work with the Senate’s health committee to settle the matter. NACHC officials privately express optimism that a deal might come later in October if not by Sunday.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Community health centers operate in more than 9,500 locations, serving 27 million people, according to the NACHC. They are the main source of health care for many low-income Americans — and the only source of primary care in many underserved areas.\u003c/p>\n\u003cp>Health centers provide preventive care, counseling, dentistry and primary care to everyone, whether or not they can pay. A sliding fee scale based on income and family size is available to patients without insurance.\u003c/p>\n\u003cp>In 2015, nearly 1 in 6 Medicaid beneficiaries received health center services, the Kaiser Family Foundation \u003ca href=\"http://www.kff.org/medicaid/issue-brief/community-health-centers-recent-growth-and-the-role-of-the-aca/\">reported\u003c/a> this year. (Kaiser Health News is an editorially independent program of the foundation.)\u003c/p>\n\u003cp>“The end result is these are people who will be locked out of health care” without new funding, Hawkins said.\u003c/p>\n\u003cp>Community health centers gained billions of dollars in federal revenue under the ACA, which created a special trust fund to support them from 2011 through 2015. The Community Health Center Fund was extended in 2015 for two years with an additional $3.6 billion annually.\u003c/p>\n\u003cp>That money represents 70 percent of all federal grants to health centers and about a fifth of their annual revenue. Medicaid reimbursements account for the largest share, about 40 percent.\u003c/p>\n\u003cp>One beneficiary is Pamela Richardson, a 60-year-old patient of Valley Community Healthcare in North Hollywood, California, who suffers from an iron absorption disorder called hereditary hemochromatosis. She was unable to get health insurance before Obamacare prohibited insurers from excluding people with preexisting medical conditions. The clinic helped her sign up for coverage through the Medi-Cal expansion.\u003c/p>\n\u003cp>Once Richardson was covered, she received long-delayed primary care, which revealed she had “scary high” blood pressure and a lump in one breast (which proved benign). “When you don’t have insurance you don’t get breast exams. You don’t have Pap smears,” she \u003ca href=\"http://khn.org/news/californias-community-clinics-big-aca-beneficiaries-worry-about-their-future/\">told\u003c/a> a KHN reporter earlier this year. “I wish people had a little more patience with Obamacare. Once you get what’s wrong with you under control, the cost would come down.”\u003c/p>\n\u003cp>California has by far the most federally funded health centers and they serve 6.2 million Californians, according to CaliforniaHealth+ Advocates, which represents state clinics. They have received over $1.6 billion from 2011 through 2016 from the Community Health Center Fund, more than any other state, the Congressional Research Service \u003ca href=\"https://www.everycrsreport.com/files/20170113_R43911_852eca9ca6e96b41176e6609d8cb068ba7e770ed.pdf\">reported\u003c/a> in January.\u003c/p>\n\u003cp>If health centers receive no new funds for 2018, the ensuing financial crunch would cost 51,000 jobs, force the centers to close 2,800 locations and cause 9 million people to lose health care services, according to a budget document that the Health and Human Services Department gave Congress in July.\u003c/p>\n\u003cp>Uncertainty about what Congress will do now is already causing problems. Hawkins said his members call him and his staff every day, fretting about employment contracts, lease agreements and equipment rentals that run past Oct. 1.\u003c/p>\n\u003cp>Neighborhood Health in Nashville, Tennessee, has federal grant money that will carry it through Jan. 31, but CEO Mary Bufwack said some of her 180 staff members live paycheck to paycheck and are getting nervous about Neighborhood’s stability.\u003c/p>\n\u003cp>Bufwack is worried the health center won’t receive money it needs to replace a clinic, a project now being planned.\u003c/p>\n\u003cp>She fears that a new doctor she recruited to join Neighborhood next June will take another job before she can get his signature on an employment contract. And she doesn’t want to do that until she’s sure about her budget.\u003c/p>\n\u003cp>Mostly, she worries that whatever Congress gives her will be only for one year.\u003c/p>\n\u003cp>“We’re already worried about next Sept. 30,” Bufwack said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"onourwatch": {
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"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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},
"pbs-newshour": {
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},
"perspectives": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
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