Health reform will let insurers charge smokers up to 50 percent higher premiums, which is likely to have a big impact in Kentucky

"Millions of smokers could be priced out of health insurance" because the health-care reform law will let health-insurance companies charge smokers as much as 50 percent more starting next year on individual policies, according to experts who are just now teasing out the potential impact of a little-noted provision in the massive legislation," The Associated Press reports.

The provision is likely to have a major impact in Kentucky, where 29 percent of adults are smokers, a figure exceeded by no other state, and where 25 to 30 percent of people under 65 are estimated to have no health insurance.

"For a 55-year-old smoker, the penalty could reach nearly $4,250 a year" AP reports. "A 60-year-old could wind up paying nearly $5,100 on top of premiums. Younger smokers could be charged lower penalties under rules proposed last fall by the Obama administration."

A state health insurance exchange, now being created under the law, will be a place to buy insurance with tax credits depending on income. Gov. Steve Beshear has said he wants to expand the state Medicaid program to cover people in households with incomes up to 138 percent of the federal poverty level, but many Republicans in the legislature are opposed to that because the state would ultimately have to pay 10 percent of the expansion's cost.

The provisions to discourage smoking would allow employees covered by employer plans to avoid penalties by joining smoking-cessation programs,"but experts say that option is not guaranteed to smokers trying to purchase coverage individually," AP reports.

There is concern about the provision's effect on older smokers who "could face a heavy hit on their household budgets at a time in life when smoking-related illnesses tend to emerge. . . . Several provisions in the federal health care law work together to leave older smokers with a bleak set of financial options," AP reports, citing Karen Pollitz, a health-insurance expert with the Kaiser Family Foundation and former deputy director of the Office of Consumer Support in the U.S. Department of Health and Human Services.

Pollitz notes that the reform law lets insurers charge older customers up to three times as much as their youngest customers; charge the full 50 percent penalty on older smokers while charging less to younger ones; and does not allow smokers to use tax credits to offset the cost of the penalty.

And there's a good argument to charge the full penalty, insurance consultant Robert Laszewski told AP: "If you don’t charge the 50 percent, your competitor is going to do it, and you are going to get a disproportionate share of the less-healthy older smokers,” said Laszewski. “They are going to have to play defense." (Read more)

"Millions of smokers could be priced out of health insurance" because the health-care reform law will let health-insurance companies charge smokers as much as 50 percent more starting next year on individual policies, according to experts who are just now teasing out the potential impact of a little-noted provision in the massive legislation," The Associated Press reports.

The provision is likely to have a major impact in Kentucky, where 29 percent of adults are smokers, a figure exceeded by no other state, and where 25 to 30 percent of people under 65 are estimated to have no health insurance.

"For a 55-year-old smoker, the penalty could reach nearly $4,250 a year" AP reports. "A 60-year-old could wind up paying nearly $5,100 on top of premiums. Younger smokers could be charged lower penalties under rules proposed last fall by the Obama administration."

A state health insurance exchange, now being created under the law, will be a place to buy insurance with tax credits depending on income. Gov. Steve Beshear has said he wants to expand the state Medicaid program to cover people in households with incomes up to 138 percent of the federal poverty level, but many Republicans in the legislature are opposed to that because the state would ultimately have to pay 10 percent of the expansion's cost.

The provisions to discourage smoking would allow employees covered by employer plans to avoid penalties by joining smoking-cessation programs,"but experts say that option is not guaranteed to smokers trying to purchase coverage individually," AP reports.

There is concern about the provision's effect on older smokers who "could face a heavy hit on their household budgets at a time in life when smoking-related illnesses tend to emerge. . . . Several provisions in the federal health care law work together to leave older smokers with a bleak set of financial options," AP reports, citing Karen Pollitz, a health-insurance expert with the Kaiser Family Foundation and former deputy director of the Office of Consumer Support in the U.S. Department of Health and Human Services.

Pollitz notes that the reform law lets insurers charge older customers up to three times as much as their youngest customers; charge the full 50 percent penalty on older smokers while charging less to younger ones; and does not allow smokers to use tax credits to offset the cost of the penalty.

And there's a good argument to charge the full penalty, insurance consultant Robert Laszewski told AP: "If you don’t charge the 50 percent, your competitor is going to do it, and you are going to get a disproportionate share of the less-healthy older smokers,” said Laszewski. “They are going to have to play defense." (Read more)

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Health departments prepare for challenges posed by health-care reform law

No one really has a clue what changes from the health-care reform law will mean to Kentuckians and public health departments are preparing for the uncertainty, reports Kristy Cox of Business Lexington.

"The Affordable Care Act will have an impact on health departments.  It is going to put a whole lot more people out there on the street on health insurance" of one kind or another, Dr. Rice Leach, head of the Lexington-Fayette County Health Department, told Cox.

"I think how health departments are impacted is going to look a little different depending on what part of the state they're in," Rice said. "The United States has passed a law that creates an entitlement for 30 or 40 million people, and here in Lexington, for 10,000 or 20,000 more people to have health insurance. Now, who is going to take care of them?"

If the private sector can't handle the increased patient load, Leach said, the stress goes onto the health departments, meaning they may be expected to provide a broad "continuum" of care for acute medical needs, including doctors and laboratory services. Leach said he hopes other systems will step up to provide care so health departments can continue to focus on preventative services.

Many factors determine what health departments can and can't do as well as their ability to generate dollars. Leach called  the services mandates by state and federal governments as "mission critical activities," which include preventive health, communicable disease control, public health education, emergency response, sanitary code and restaurant inspection and public health policy, writes Cox. 

Despite the challenging economic environment created by budget cuts and managed-care non-payment issues, Kentucky health departments are trying to stay focused on their big-picture mission.  Some departments are writing grants and others, like the Lincoln Trail District Health Department, has sent nurses into school systems in attempt to increase revenue through expanded clinical services, Cox reports.

No one really has a clue what changes from the health-care reform law will mean to Kentuckians and public health departments are preparing for the uncertainty, reports Kristy Cox of Business Lexington.

"The Affordable Care Act will have an impact on health departments.  It is going to put a whole lot more people out there on the street on health insurance" of one kind or another, Dr. Rice Leach, head of the Lexington-Fayette County Health Department, told Cox.

"I think how health departments are impacted is going to look a little different depending on what part of the state they're in," Rice said. "The United States has passed a law that creates an entitlement for 30 or 40 million people, and here in Lexington, for 10,000 or 20,000 more people to have health insurance. Now, who is going to take care of them?"

If the private sector can't handle the increased patient load, Leach said, the stress goes onto the health departments, meaning they may be expected to provide a broad "continuum" of care for acute medical needs, including doctors and laboratory services. Leach said he hopes other systems will step up to provide care so health departments can continue to focus on preventative services.

Many factors determine what health departments can and can't do as well as their ability to generate dollars. Leach called  the services mandates by state and federal governments as "mission critical activities," which include preventive health, communicable disease control, public health education, emergency response, sanitary code and restaurant inspection and public health policy, writes Cox. 

Despite the challenging economic environment created by budget cuts and managed-care non-payment issues, Kentucky health departments are trying to stay focused on their big-picture mission.  Some departments are writing grants and others, like the Lincoln Trail District Health Department, has sent nurses into school systems in attempt to increase revenue through expanded clinical services, Cox reports.

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Poll shows registered voters in Ky. favor expanding Medicaid

By Molly Burchett and Al Cross
Kentucky Health News

A statewide poll last month found that most registered voters in Kentucky, when presented with specific facts and options, generally favored expansion of Medicaid under federal health-care reform. Similar results were found in six other states surveyed by a bipartisan pair of pollsters working for the American Cancer Society Cancer Action Network.

"Respondents in the seven states polled were informed that federal funds are available to pay 100 percent of the costs to cover more uninsured people through Medicaid beginning in 2014, with the federal share gradually decreasing to 90 percent," the network said in a news release. "Respondents in each state were two to three times more likely to support accepting federal dollars to cover more people than they were to prefer turning down federal funds and leaving vulnerable populations uninsured." The poll asked:

Next I’d like to ask you about an issue being talked about by the governor and the state legislature. Under the new federal health care law, [number of] people in [state] who are uninsured right now could get health care coverage through Medicaid starting in 2014. The governor and state elected officials can choose to accept federal dollars that have been allocated to cover these people in [state], or to turn the money down and not cover these people. The federal dollars cover 100% of the costs in the first few years, and 90% of the costs after that.

The release said the result in Kentucky was 63 percent for expansion and 23 percent opposed. The results were not quite as strong, 60-30, when voters were presented with arguments from both sides of the debate:

Side A says we can cover more people in [state] and save taxpayer dollars that are currently spent on treating uninsured people in emergency rooms. Covering more people gives hard-working families the security of knowing they can get preventive care and see a doctor when they need to. The alternative is people showing up in the emergency room when they are sicker. By accepting the money, we could cover more people and save taxpayer dollars.

Side B says Kentucky will eventually have to pay 10% of the costs of covering these people, and even more if the federal government fails to follow through on its promises. We cannot afford to spend even more on health care coverage, which is already a big part of the state budget. We have too many other priorities in the state that need attention, like education and roads. By turning down the money, we could avoid future increases in state health care spending.

Which side do you agree with more?

The results in other states were Florida, 62-28; Iowa, 55-34; Michigan, 62-29; New Jersey, 65-29; New Mexico, 61-29; and Texas, 55-35. The Kentucky poll found that 49 percent of registered voters in Kentucky have close friends or family members who are uninsured, and 43 percent of voters who are not currently receiving coverage through Medicaid say they or someone close to them has been covered by it.

The poll did not mention the key standard for expansion, that a state must cover people in households with incomes up to 138 percent of the federal poverty threshold. Kentucky now covers people with incomes below approximately 70 percent of poverty, and the federal government pays a little more than 70 percent of the cost. It would pay all the cost of expansion in 2014-16, then the state would have to start paying an increasing share, reaching 10 percent by 2020. Democratic Gov. Steve Beshear has said he wants to expand Medicaid if the state can afford it.

The telephone poll surveyed 812 registered voters, giving it an error margin of plus or minus 3.44 percentage points. It was conducted by Lake Research Partners, a Democratic firm, and GS Strategy Group, a Republican firm, between Dec. 13 and 22. For more details, click here.

By Molly Burchett and Al Cross
Kentucky Health News

A statewide poll last month found that most registered voters in Kentucky, when presented with specific facts and options, generally favored expansion of Medicaid under federal health-care reform. Similar results were found in six other states surveyed by a bipartisan pair of pollsters working for the American Cancer Society Cancer Action Network.

"Respondents in the seven states polled were informed that federal funds are available to pay 100 percent of the costs to cover more uninsured people through Medicaid beginning in 2014, with the federal share gradually decreasing to 90 percent," the network said in a news release. "Respondents in each state were two to three times more likely to support accepting federal dollars to cover more people than they were to prefer turning down federal funds and leaving vulnerable populations uninsured." The poll asked:

Next I’d like to ask you about an issue being talked about by the governor and the state legislature. Under the new federal health care law, [number of] people in [state] who are uninsured right now could get health care coverage through Medicaid starting in 2014. The governor and state elected officials can choose to accept federal dollars that have been allocated to cover these people in [state], or to turn the money down and not cover these people. The federal dollars cover 100% of the costs in the first few years, and 90% of the costs after that.

The release said the result in Kentucky was 63 percent for expansion and 23 percent opposed. The results were not quite as strong, 60-30, when voters were presented with arguments from both sides of the debate:

Side A says we can cover more people in [state] and save taxpayer dollars that are currently spent on treating uninsured people in emergency rooms. Covering more people gives hard-working families the security of knowing they can get preventive care and see a doctor when they need to. The alternative is people showing up in the emergency room when they are sicker. By accepting the money, we could cover more people and save taxpayer dollars.

Side B says Kentucky will eventually have to pay 10% of the costs of covering these people, and even more if the federal government fails to follow through on its promises. We cannot afford to spend even more on health care coverage, which is already a big part of the state budget. We have too many other priorities in the state that need attention, like education and roads. By turning down the money, we could avoid future increases in state health care spending.

Which side do you agree with more?

The results in other states were Florida, 62-28; Iowa, 55-34; Michigan, 62-29; New Jersey, 65-29; New Mexico, 61-29; and Texas, 55-35. The Kentucky poll found that 49 percent of registered voters in Kentucky have close friends or family members who are uninsured, and 43 percent of voters who are not currently receiving coverage through Medicaid say they or someone close to them has been covered by it.

The poll did not mention the key standard for expansion, that a state must cover people in households with incomes up to 138 percent of the federal poverty threshold. Kentucky now covers people with incomes below approximately 70 percent of poverty, and the federal government pays a little more than 70 percent of the cost. It would pay all the cost of expansion in 2014-16, then the state would have to start paying an increasing share, reaching 10 percent by 2020. Democratic Gov. Steve Beshear has said he wants to expand Medicaid if the state can afford it.

The telephone poll surveyed 812 registered voters, giving it an error margin of plus or minus 3.44 percentage points. It was conducted by Lake Research Partners, a Democratic firm, and GS Strategy Group, a Republican firm, between Dec. 13 and 22. For more details, click here.

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Kentuckians think their children's generation will be less healthy and worse off economically than current working-age generation

Forty percent of Kentucky adults think their children's generation will be less healthy than the current generation of working-age Kentuckians, and 61 percent think the newer generation will be worse off economically, according to a statewide poll conducted last fall.

The Kentucky Health Issues Poll also found that 54 percent think their parents' generation was better off economically, and 42 percent thought that generation was healthier than the current generation of Kentuckians.

“It is a cornerstone of the American Dream that, if we work hard, we will get ahead and be better off than our parents were,” said Dr. Susan Zepeda, President and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll. “Our polling suggests that optimism for a better future may be slipping away.”

Zepeda added, “Policymakers in Kentucky and Washington are grappling with economic and health policy issues that have long term impacts. Our polling clearly indicates the concern Kentuckians have, on the need to do better for our kids.”

For details of the poll, go to the foundation's website, www.healthy-ky.org.

The poll was conducted for the foundation and the Health Foundation of Greater Cincinnati from Sept 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by landline and cell telephones. The margin of error for each figure is plus or minus 2.5 percentage points.

Forty percent of Kentucky adults think their children's generation will be less healthy than the current generation of working-age Kentuckians, and 61 percent think the newer generation will be worse off economically, according to a statewide poll conducted last fall.

The Kentucky Health Issues Poll also found that 54 percent think their parents' generation was better off economically, and 42 percent thought that generation was healthier than the current generation of Kentuckians.

“It is a cornerstone of the American Dream that, if we work hard, we will get ahead and be better off than our parents were,” said Dr. Susan Zepeda, President and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll. “Our polling suggests that optimism for a better future may be slipping away.”

Zepeda added, “Policymakers in Kentucky and Washington are grappling with economic and health policy issues that have long term impacts. Our polling clearly indicates the concern Kentuckians have, on the need to do better for our kids.”

For details of the poll, go to the foundation's website, www.healthy-ky.org.

The poll was conducted for the foundation and the Health Foundation of Greater Cincinnati from Sept 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by landline and cell telephones. The margin of error for each figure is plus or minus 2.5 percentage points.

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Evaluating outcomes for perineal urethrostomy in the cat

Ruda L and Heiene R. Short- and long-term outcome after perineal urethrostomy in 86 cats with feline lower urinary tract disease. J Small Anim Pract. 2012; 53: 693-8.

Perineal urethrostomy is a surgical procedure used to treat some cats experiencing obstruction in the lower urinary tract, especially those with complicated or recurrent disease. There are few published studies evaluating the long-term outcome of this surgery. The goal of this study was to evaluate the long-term prognosis, recurrent episodes, quality of life, and survival times in cats who underwent perineal urethrostomy.
 
The investigators collected data from the medical records of 86 cats that had received the surgery. The average length of survival after surgery was 3.5 years. Five cats did not survive 2 weeks after surgery, while another 6 cats did not survive 6 months. The vast majority lived longer than 6 months, with a majority remaining asymptomatic after surgery. For 19 cats, information was available for more than 6 years; among these, 13 were still alive at the time of the study. Six cats were euthanized due to diseases unrelated to the urinary tract. Quality of life was categorized as good by owners in 88% of the cases. This study showed that long term complications are minimal and quality of life is good after perineal urethrostomy. [MK]

See also: Bass M, Howard J, Gerber B and Messmer M. Retrospective study of indications for and outcome of perineal urethrostomy in cats. J Small Anim Pract. 2005; 46: 227-31.

More on cat health:
Winn Feline Foundation Library
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Ruda L and Heiene R. Short- and long-term outcome after perineal urethrostomy in 86 cats with feline lower urinary tract disease. J Small Anim Pract. 2012; 53: 693-8.

Perineal urethrostomy is a surgical procedure used to treat some cats experiencing obstruction in the lower urinary tract, especially those with complicated or recurrent disease. There are few published studies evaluating the long-term outcome of this surgery. The goal of this study was to evaluate the long-term prognosis, recurrent episodes, quality of life, and survival times in cats who underwent perineal urethrostomy.
 
The investigators collected data from the medical records of 86 cats that had received the surgery. The average length of survival after surgery was 3.5 years. Five cats did not survive 2 weeks after surgery, while another 6 cats did not survive 6 months. The vast majority lived longer than 6 months, with a majority remaining asymptomatic after surgery. For 19 cats, information was available for more than 6 years; among these, 13 were still alive at the time of the study. Six cats were euthanized due to diseases unrelated to the urinary tract. Quality of life was categorized as good by owners in 88% of the cases. This study showed that long term complications are minimal and quality of life is good after perineal urethrostomy. [MK]

See also: Bass M, Howard J, Gerber B and Messmer M. Retrospective study of indications for and outcome of perineal urethrostomy in cats. J Small Anim Pract. 2005; 46: 227-31.

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

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Avoid virus-linked cancers, including cervical cancer, with shots

With a simple vaccine, you can avoid HPV-linked cancer, including cervical cancer and many cancers of the mouth, throat, anus and genitals, which constitute more than 3 percent of all U.S. cancer diagnoses. Vaccination against the human papilloma virus (HPV) thwarts the virus’s spread, wrecks its ability to jump between people and inhibits a virus that in 2009 led to a cancer diagnosis for 30,000 people in the U.S., according to the National Cancer Insititue. 

HPV infection is common. More than half of women between 14 and 59 catch a genital HPV. Many of these infections are low-risk, but when the body does not sweep out HPV intruders, high-risk HPV infected cells may lead to the unchecked growth of cancerous cells, according to Newswise, a research-reporting service.

HPV is actually a family of more than 150 viruses that infect human skin and mucosa, the moist membranes lining the nostrils, mouth and genital cavities. Two vaccines, Gardasil and Cervarix, prevent people from getting HPV infections by helping the body stockpile a medley of cellular defenses. Gardasil and Cervarix target HPV types 16 and 18, the two responsible for most cervical, anal, genital, and oropharynx cancer.  Blocking infection by types 16 and 18 also fights off other cancers, and the vaccines’ protection could last a lifetime. Gardasil also targets types 6 and 11.

It is important to complete the three-dose series for the vaccines; series completion rates are low for people in the Southern states, especially those that are poor and without private insurance, according to Newswise. Scientists are working to make a single vaccine that blocks infection by all HPV types, but today’s vaccines can prevent infection by two of the most common high-risk HPVs and may be the first step toward preventing HPV-linked cancers. (Read more)

With a simple vaccine, you can avoid HPV-linked cancer, including cervical cancer and many cancers of the mouth, throat, anus and genitals, which constitute more than 3 percent of all U.S. cancer diagnoses. Vaccination against the human papilloma virus (HPV) thwarts the virus’s spread, wrecks its ability to jump between people and inhibits a virus that in 2009 led to a cancer diagnosis for 30,000 people in the U.S., according to the National Cancer Insititue. 

HPV infection is common. More than half of women between 14 and 59 catch a genital HPV. Many of these infections are low-risk, but when the body does not sweep out HPV intruders, high-risk HPV infected cells may lead to the unchecked growth of cancerous cells, according to Newswise, a research-reporting service.

HPV is actually a family of more than 150 viruses that infect human skin and mucosa, the moist membranes lining the nostrils, mouth and genital cavities. Two vaccines, Gardasil and Cervarix, prevent people from getting HPV infections by helping the body stockpile a medley of cellular defenses. Gardasil and Cervarix target HPV types 16 and 18, the two responsible for most cervical, anal, genital, and oropharynx cancer.  Blocking infection by types 16 and 18 also fights off other cancers, and the vaccines’ protection could last a lifetime. Gardasil also targets types 6 and 11.

It is important to complete the three-dose series for the vaccines; series completion rates are low for people in the Southern states, especially those that are poor and without private insurance, according to Newswise. Scientists are working to make a single vaccine that blocks infection by all HPV types, but today’s vaccines can prevent infection by two of the most common high-risk HPVs and may be the first step toward preventing HPV-linked cancers. (Read more)

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UK quickens drumbeat of tobacco-free policy through report line

The University of Kentucky promotes compliance and enforcement of its tobacco-free policy through a community report line, among many other measures.  Although the report line was established last spring, its mention in recent campus communications suggests a hightened emphasis on compliance measures. 

The line to report violations of the smoking ban engages the community in developing an environment in which compliance is expected, said Dr. Ellen Hahn, a nursing professor and co-chair of UK's Tobacco-free Taskforce and director of its Kentucky Center for Smoke-free Policy.

"Since these policies are self-enforcing, we need a mechanism by which everyone on campus can easily report violations," Hahn said. "Most people do not feel comfortable approaching a violator, so this is a way to encourage everyone to be involved in promoting compliance." She said the report line was a suggested "best practice" from other campuses with similar policies.

Implementation of the policy, the ultimate goal of the policy is to promote a healthy place to live, work and learn, has been a success, Hahn said: The air is healthier, and exposure to secondhand smoke has decreased. Also, since the policy was established in the fall of 2009, there has been a four-fold increase in the use of nicotine replacement to quit using tobacco, and UK has many low- or no-cost options to help students and employees do so.

Click here to report a violation of the tobacco-free policy, here for a tobacco-free brochure. 

The University of Kentucky promotes compliance and enforcement of its tobacco-free policy through a community report line, among many other measures.  Although the report line was established last spring, its mention in recent campus communications suggests a hightened emphasis on compliance measures. 

The line to report violations of the smoking ban engages the community in developing an environment in which compliance is expected, said Dr. Ellen Hahn, a nursing professor and co-chair of UK's Tobacco-free Taskforce and director of its Kentucky Center for Smoke-free Policy.

"Since these policies are self-enforcing, we need a mechanism by which everyone on campus can easily report violations," Hahn said. "Most people do not feel comfortable approaching a violator, so this is a way to encourage everyone to be involved in promoting compliance." She said the report line was a suggested "best practice" from other campuses with similar policies.

Implementation of the policy, the ultimate goal of the policy is to promote a healthy place to live, work and learn, has been a success, Hahn said: The air is healthier, and exposure to secondhand smoke has decreased. Also, since the policy was established in the fall of 2009, there has been a four-fold increase in the use of nicotine replacement to quit using tobacco, and UK has many low- or no-cost options to help students and employees do so.

Click here to report a violation of the tobacco-free policy, here for a tobacco-free brochure. 

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Health-care law addresses the most common chronic health problem in children, tooth decay, by requiring coverage for kids

Tooth decay is children's most common chronic health problem, and the 2010 federal health-care law addresses this problem by requiring insurers to cover pediatric dental services. But some advocates are concerned that the new benefits may not be sufficiently comprehensive or affordable, Michelle Andrews writes for The Washington Post.

She notes that by the time children enter kindergarten, more than a quarter of them have decay in their baby teeth. As they age, the problem gets worse and nearly 68 percent of those age 16 to 19 have decay in their permanent teeth, according the the Centers for Disease Control and Prevention. 
   
Beginning next year, the Affordable Care Act requires individual and small-group health plans cover pediatric dental services, unless a plan has a specific exemption under the law. Those services are already part of the Medicaid benefit package, but most Kentucky dentists don't accept Medicaid.
For the expansion to private insurance, "Coverage requirements will be determined by each state within guidelines set by the federal Department of Health and Human Services," Andrews writes.

Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services, said Kentucky is awaiting the publication of the final rule from HHS, which will define essential health benefits for each state and provide further guidance relating to coverage of benefits. Although no specific publication date for this rule has been announced, she said its release is expected within the next several weeks to allow insurers to modify existing health plans to be made available to individuals and small businesses for purchase through health exchanges by Oct. 1. (Read more)

Tooth decay is children's most common chronic health problem, and the 2010 federal health-care law addresses this problem by requiring insurers to cover pediatric dental services. But some advocates are concerned that the new benefits may not be sufficiently comprehensive or affordable, Michelle Andrews writes for The Washington Post.

She notes that by the time children enter kindergarten, more than a quarter of them have decay in their baby teeth. As they age, the problem gets worse and nearly 68 percent of those age 16 to 19 have decay in their permanent teeth, according the the Centers for Disease Control and Prevention. 
   
Beginning next year, the Affordable Care Act requires individual and small-group health plans cover pediatric dental services, unless a plan has a specific exemption under the law. Those services are already part of the Medicaid benefit package, but most Kentucky dentists don't accept Medicaid.
For the expansion to private insurance, "Coverage requirements will be determined by each state within guidelines set by the federal Department of Health and Human Services," Andrews writes.

Jill Midkiff, chief spokesperson for the Cabinet for Health and Family Services, said Kentucky is awaiting the publication of the final rule from HHS, which will define essential health benefits for each state and provide further guidance relating to coverage of benefits. Although no specific publication date for this rule has been announced, she said its release is expected within the next several weeks to allow insurers to modify existing health plans to be made available to individuals and small businesses for purchase through health exchanges by Oct. 1. (Read more)

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McConnell helped Amgen delay price limits on dialysis drug

Senate Republican Leader Mitch McConnell of Kentucky, whose public statements usually emphasize the need to cut federal spending on entitlement programs, as they did in Lexington Friday, apparently passed up an opportunity to rein in Medicare spending when he signed off on a big favor for a significant campaign contributor in the fiscal-cliff deal.

The deal delayed for two years price controls on a class of drugs including Sensipar, used by kidney-dialysis patients and manufactured by Amgen, "the world's largest biotechnology firm," Eric Lipton and Kevin Sack of The New York Times reported Jan. 19.

"The news was so welcome that the company’s chief executive quickly relayed it to investment analysts," the Times reported. "But it is projected to cost Medicare up to $500 million over that period. Dennis J. Cotter, who studies the cost and efficacy of dialysis drugs, told the newspaper, “Everybody is carving out their own turf and getting it protected, and we pass the bill on to the taxpayer.”

McConnell spokesman Robert Steurer said the senator did not push for the provision. The Times story did not focus on McConnell, saying "Supporters of the delay, primarily leaders of the Senate Finance Committee who have long benefited from Amgen’s political largess, said it was necessary to allow regulators to prepare properly for the pricing change." And it noted the firm "also has worked hard to build close ties with the Obama administration." It did note that former McConnell chief of staff Hunter Bates is among "a small army of 74 lobbyists for Amgen, which was "the only company to argue aggressively for the delay, according to several Congressional aides of both parties."

According to the Center for Responsive Politics, which analyzes lobbying and campaign contributions, Amgen's political action committee gave McConnell $7,000 during the 2011-12 election cycle, an amount exceeded by only seven other senators, none of them in the Senate leadership. McConnell was the main negotiator on the fiscal-cliff deal with Vice President Biden.

UPDATE, Jan. 25: Writing on BillMoyers.com and then on Salon, Bill Moyers and Michael Winship report that since 2007, "Amgen employees and its political action committee have contributed $73,000 to Senator McConnell’s campaigns," almost $68,000 to Sen. Max Baucus, D-Mont., chairman of the Finance Committee, and $59,000 to Sen. Orrin Hatch, R-Utah. They also note that Republican Rep. Richard Hanna R-N.Y., and Democratic Reps. Peter Welch of Vermont and Jim Cooper of Tennessee have introduced a bill "to repeal the half billion-dollar giveaway to Amgen. The story includes Moyers' video interview with Welch.

Senate Republican Leader Mitch McConnell of Kentucky, whose public statements usually emphasize the need to cut federal spending on entitlement programs, as they did in Lexington Friday, apparently passed up an opportunity to rein in Medicare spending when he signed off on a big favor for a significant campaign contributor in the fiscal-cliff deal.

The deal delayed for two years price controls on a class of drugs including Sensipar, used by kidney-dialysis patients and manufactured by Amgen, "the world's largest biotechnology firm," Eric Lipton and Kevin Sack of The New York Times reported Jan. 19.

"The news was so welcome that the company’s chief executive quickly relayed it to investment analysts," the Times reported. "But it is projected to cost Medicare up to $500 million over that period. Dennis J. Cotter, who studies the cost and efficacy of dialysis drugs, told the newspaper, “Everybody is carving out their own turf and getting it protected, and we pass the bill on to the taxpayer.”

McConnell spokesman Robert Steurer said the senator did not push for the provision. The Times story did not focus on McConnell, saying "Supporters of the delay, primarily leaders of the Senate Finance Committee who have long benefited from Amgen’s political largess, said it was necessary to allow regulators to prepare properly for the pricing change." And it noted the firm "also has worked hard to build close ties with the Obama administration." It did note that former McConnell chief of staff Hunter Bates is among "a small army of 74 lobbyists for Amgen, which was "the only company to argue aggressively for the delay, according to several Congressional aides of both parties."

According to the Center for Responsive Politics, which analyzes lobbying and campaign contributions, Amgen's political action committee gave McConnell $7,000 during the 2011-12 election cycle, an amount exceeded by only seven other senators, none of them in the Senate leadership. McConnell was the main negotiator on the fiscal-cliff deal with Vice President Biden.

UPDATE, Jan. 25: Writing on BillMoyers.com and then on Salon, Bill Moyers and Michael Winship report that since 2007, "Amgen employees and its political action committee have contributed $73,000 to Senator McConnell’s campaigns," almost $68,000 to Sen. Max Baucus, D-Mont., chairman of the Finance Committee, and $59,000 to Sen. Orrin Hatch, R-Utah. They also note that Republican Rep. Richard Hanna R-N.Y., and Democratic Reps. Peter Welch of Vermont and Jim Cooper of Tennessee have introduced a bill "to repeal the half billion-dollar giveaway to Amgen. The story includes Moyers' video interview with Welch.

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