The U.S. health-care system is full of things that don't make much sense. A lot of them are extremely profitable.

One of these, recently highlighted by legendary short-seller Jim Chanos,is dialysis, a market largely split in the U.S. between two large firms,DaVita Inc. andFresenius Medical Care AG & Co KGaA.If the Senate passes a health-care bill similar to one the House of Representatives passed last month, then it may become easier for private insurance plans to stop covering dialysis, cutting off a big source of profit for these companies.

This is just one of the more extreme risks, of many, looming over health-care companies these days. And yet shares of the two biggest dialysisfirms have outpaced the broader stock market since the election, and the rest of health care is keeping up.

Holding Up

Health care stocks, including the two biggest dialysis providers, have held up well to the threat of Republican health care reform

Source: Bloomberg

Dialysis is a costly procedure that is mostly paid for by government programs -- people with end-stage kidney disease become eligible for Medicare, regardless of age. Trouble is, those programs reimburse dialysis companies at a significantly lower rate than private insurers. According to a Bloomberg Intelligence analysis, DaVita made 95 percent of its Ebitda from patients with private insurance from 2013 to 2016. The profit margin for these patients is 77 percent, versus 2 percent for government patients.

Doing the Splits

A DaVita slide deck shows how much more profitable commercially covered patients are for the dialysis firm

Source: DaVita

Though eligible for Medicare, some dialysis patients prefer private insurance because it can be more flexible. The Affordable Care Act made that insurance easier to get. It requires insurers to cover such patients, says insurers can't charge those patients more, caps out-of-pocket expenses and helps less-wealthy patients cover premiums.

The Republican replacement for the ACA, the American Health Care Act, seems designed to be a pain for dialysis firms. The law may let states apply for waivers of the regulations that have made private insurance more attainable.If given the opportunity, insurers would likely make plans covering dialysis patients prohibitively expensive, to help keep such people out of their risk pool.

Dialysis companies have already been curtailed in their ability to nudge patients toward commercial insurance by funding third-party charities that help pay for it. The AHCA has the potential to enhance theirwoes by pricing patients out of the private insurance market, charity or no.

Not Dead Yet

Trumpcare

Not every part of the health-care sector is quite as exposed to the AHCA as dialysis is. But most companies have similar risks, for which stock prices have failed to fully account.

Drugmakers, for example, also spend significant amounts of money funding charities that help cover out-of-pocket drug costs for patients on expensive medicines. Those costs are expected to rise substantially if the ACA is repealed, hitting revenue and increasing the political and public pressure over high drug prices.

A Kaiser Family Foundation analysisfound that 75 percent of individual insurance plansin the pre-ACA era didn't cover maternity care, 45 percent didn't include substance-abuse services, 38 percent didn't include mental and behavioral health services, and 17 percent had prescription-drug restrictions. The ACA brought those percentages down significantly. Under the AHCA, the individual insurance market is likely to head back to those bad old days in some states, pricing people out of comprehensive coverage -- and hurting companies that provide these services and products.

That will have widespread and unpredictable knock-on effects throughout health care. People who don't get mental-health care also don't get prescribed medication, and so on.

This is not a small-scale or narrowly concentrated problem. Twenty-three million people are expected to lose health coverage outright under the AHCA, according to the Congressional Budget Office. An unknown number will have substantially skimpier coverage or higher out-of-pocket costs that may dissuade them from getting care. Millions of Americans with employer-sponsored coverage may once again face annual and lifetime coverage limits.

Yet health-care stocks in the Russell 3000 index of the largest U.S. companies are outperforming the index as a whole since the election.A few stocks with ACA exposure are down since the election, but many more are up.

Giddy

Health care stocks have outperformed the Russell 3000 since Donald Trump's election, despite the threat of GOP health care reform

Source: Bloomberg

It's become increasingly clear health-care investors can't rely on the Senate to save them. The Senate has gone from publicly decrying the House bill to reportedly working on something that copies it in many respects. There's not all that much room to soften the House bill, anyway, despite President Donald Trump apparently having come to believe the House bill is "mean."The revised bill is being designed in secrecy and hastened to a vote (again) for a reason.

The consequences aren't always as obvious as they are for dialysis firms. But they're there, and health-care investors appear to be in some denial about it.

Peter Grauer, the chairman of Bloomberg LP, the parent company of Bloomberg News, is a member of DaVitas board.

This column does not necessarily reflect the opinion of Bloomberg LP and its owners.

To contact the author of this story: Max Nisen in New York at mnisen@bloomberg.net

To contact the editor responsible for this story: Mark Gongloff at mgongloff1@bloomberg.net

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Health-Care Investors Are in Denial - Bloomberg

Sen. Elizabeth WarrenElizabeth WarrenTrump probe puts spotlight on Justice's No. 3 Conway blames lawmaker shooting on 'personal attacks' against Trump Warren rips Senate GOP for secretive work on healthcare bill MORE (D-Mass.) on Friday ripped Senate Republicans in an interview with "CBS This Morning" for drafting their version of the bill to repeal and replace ObamaCare behind closed doors without any input from Democrats.

"Right now, the Senate Republican leadership has 13 men locked behind doors, negotiating what they're going to do on a healthcare bill won't let Democrats in the room to even see the bill," Warren said.

Prompted by CBS host Jeff Glor that President Trump had called the House bill "mean," Warren responded by blasting the president for holding a Rose Garden celebration with GOP lawmakers following its passage.

"This is a bill that's going to touch every American family," Warren continued. "Everybody who's got an elderly relative in a nursing home, everybody who has a child with special needs, these cuts to Medicaid will touch millions of families."

On Sunday, Republicans announced that they saw a path to repealing ObamaCare through the Senate. If the Senate bill passes, the two bills will go through a reconciliation process.

Warren, one of the most liberal members of the Senate, ripped the House bill shortly after it passed.

"A health care bill that destroys care & affordable coverage for millions seriously? What planet are these guys living on?!" Warren tweeted in March.

Original post:

Warren rips Senate GOP for secretive work on healthcare bill - The Hill

BEAVER -- The Sister of St. Joseph organized a pray-in event for health care in front of the Beaver County Courthouse on Friday.

About 20 community members and sisters were there, standing up against federal health-care legislation that they say could negatively impact senior citizens, the disabled and children if passed.

It's not a political issue. It's a moral issue, said Sister Jeanette Bussen, who spoke in front of the group with signs and posters.

There are more than 160 members at Sister of St. Joseph in Baden. About 80 of those women use Medicaid as their health insurance.

Our mission is to serve God and the dear neighbor without distinction, said Sister Barbara Czyrnik, who is on the leadership team of the Sisters of St. Joseph. We found out that this moment in our history, probably one of the greatest needs right now, is to advocate for health care for everyone.

Many residents at Villa St. Joseph rely on self-pay or Medicaid, as well as other senior-care facilities. In Pennsylvania, nearly 75 percent of Medicaid funding is spent on care for seniors and people with disabilities.

According to the Pennsylvania Department of Human Services, more than 35,000 Beaver Countians were enrolled in Medicaid as of December 2015, which is more than 20 percent of the county's population.

Following prayers and speeches, the sisters urged that others contact U.S. Sens. Pat Toomey and Bob Casey to speak out against the American Health Care Act.

The bill was passed in the House of Representatives in May and awaits a Senate vote.

Katy Wilcox of South Beaver Township attended the event with her husband, David, in solitary with the sisters message about health care. Three years ago, her adult son Dan had serious complications following surgery, which led to him being in a seven-week coma. She held a large poster with photos of her son during his lengthy hospital stay and a recent photo of him doing well.

She credits the Affordable Care Act and prayer as the reasons her son is alive. She said she feels certain that he wouldnt be if the American Health Care Act were law instead.

He now works part time, but his health insurance could be at stake if the AHCA is signed into law.

I'm here for his sake, but our story is just one story, Wilcox said. We understand now, on a personal level, how health problems can devastate your savings. Our life savings has been just about wiped out. We do have retirement and Social Security, but our means are not what we anticipated they would be at this part of our life. And we're very proud of our son ... and the work he's done and the progress he's made.

Its stories like hers that further motivate the sisters.

When you take it to a personal level, it always affects you in terms of motivation to do more, Bussen said. Because that makes it real, and when it becomes real, then you're in the position of wanting to do something about it and to work with people. Otherwise, they become statistics and they become news briefs and they become something that people are doing in Congress, but they don't affect us. ...

"This particular bill is going to affect us greatly. And hearing those stories should motivate people to really want to take some action and make phone calls.

Wilcox said she hopes that both sides of the political health-care argument can unite, quoting one of her favorite Bible verses.

"Let justice roll down like a river. Righteousness, like a mighty stream, she said.

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Sisters of St. Joseph stand up against federal health-care legislation - Timesonline.com

U.S. Sen. Pat Toomey isn't sure any issue in modern American politics has been as publicly litigated as Obamacare.

Now working on a bill to replace the existing health care law, the Lehigh County Republican spoke Friday about those efforts, alleged Russian tampering with U.S. elections, congressional security and other issues at WFMZ-TV. He took questions from anchor Rob Vaughn, other reporters and social media.

People submitting questions were most interested in health care, Vaughn said, and Toomey's one of about a dozen senators working on replacing the Affordable Care Act. Specifically, he's been tasked with working out changes to Medicaid, which covers low-income, elderly and disabled individuals.

Toomey noted that health care discussions revolve around changes to Medicaid and the individual markets created under Obamacare, and not the employer-provided health insurance or Medicare that cover the bulk of America. Given Democrats won't support a bill that repeals the heart of Obamacare, the Republican authors must hold the support of virtually every member of their party to be successful.

The group has been criticized for working in private, but Toomey said he can't imagine the bill his group produces wouldn't become a public document that would be evaluated by the Congressional Budget Office before the Senate votes on it. The House voted last month on its own health care bill without waiting for CBO.

Funding for the Medicaid program is one area where the Senate bill is likely to differ from the House's. The outcome is important for Pennsylvania, which is among 31 states that expanded Medicaid under Obamacare, allowing a new category of adults to access coverage beyond the traditional program.

The federal government has been paying the full cost for the new category, but those payments will drop to 90 percent by 2020. While both the House and Senate are looking to reduce how much the federal government kicks toward Medicaid, the House wants to make the change abruptly, Toomey said, while the Senate wants that change to be more gradual. Toomey said the federal government should eventually pay the same percentage for the the new category of the Medicaid population as it does the old, which in Pennsylvania is 52 percent.

Getting there would cost some recipients coverage, critics warn. Under Obamacare 700,000 more Pennsylvanians signed up for coverage, and the state is running a deficit.

Toomey said a measure of the new bill's success will be whether premiums decline, something he said wasn't seen under Obamacare. He noted some people under Obamacarehave one choice of insurer.

There has to be a viable health insurance market, Toomey said, and the new bill will have to make sure people aren't "gaming the system" by only signing up for health care after they have a problem.

"Let's get the policy right," he said. "If we get it right, people are going to want to have health insurance and they will and it will be available and affordable."

Toomey also spoke Friday about the investigation into alleged Russian interference with the United States elections. Addressing a comment he'd made previously on CNN, Toomey said the "media obsession" with the idea that the Trump campaign colluded with the Russians was "overblown," noting two Democrats close to the investigation have said there's no evidence of it. Toomey said he's not aware of evidence of obstruction of justice, either.

But, he said, Russia's actions are a problem and their behavior has been "outrageous."

"I don't have any doubt that Russia tried to interfere with our elections," he said. "They are generally trying to discredit western democracies in the United States particularly."

Speaking to reporters after the televised interview, Toomey called the Wednesday shooting incident during a GOP baseball practice that injured House Majority Whip Steve Scalise, two Capitol Police officers and two others, "extremely concerning." He said there's reason to believe this was an isolated action of a "deranged individual."

"If that's the case then hopefully this sort of thing will remain exceedingly rare and we don't have a lot to worry about," he said.

The interview came a few hours after President Donald Trump fired off a series of tweets about reports of an investigation into whether he colluded with the Russians, calling it a "witch hunt."

Toomey was asked what he thought of such Twitter activity.

"Generally, I think we'd be better off if there were fewer tweets. I don't think it's helping to advance the agenda I want to get [done]," he said. "Fewer tweets wouldn't hurt."

mmerlin@mcall.com

twitter @michellejmerlin

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Pat Toomey talks health care, Russia, and security during Lehigh Valley stop - Allentown Morning Call

On May 4, 2017 the U.S. House of Representatives passed a bill seeking to repeal and replace the Affordable Care Act (ACA). The debate is now in the U.S. Senate. The Affordable Care Act (ACA), at this time, remains the law of the land with all of its consumer protections for people with pre-existing conditions, women, and small businesses. DC Health Link is established in District law, locally managed and controlled, financially sound and going strong. Legislative action on May 4 doesnt impact your ability to enroll in affordable quality health insurance for 2017. You may also be eligible for premium reductions. DC Health Link has 20 private health insurance options to choose from for residents and their families from CareFirst and Kaiser Permanente. For 2017 small businesses have 151 health plan options from Aetna, CareFirst, Kaiser and United. Individuals and families can enroll if they qualify for a special enrollment due to a change in their life like getting married. Small businesses can sign up throughout the year. Residents can apply for Medicaid throughout the year.

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DC Health Link - Welcome to DC's Health Insurance Marketplace

At least 20 million Americans with employer-provided health insurance could find themselves one devastating accident or diagnosis away from financial ruin if the Senate health care bill is passed as expected, according to a report released Thursday by the Center for American Progress.

Lawmakers have been working behind closed doors on their American Care Act (ACA) replacement bill, whose primary focus is reshaping the individual insurance market and rolling back the ACAs expansion of Medicaid. Yet the bill may also include a provision that would weaken protections for millions of Americans with employer-sponsored health coverage, Axios reports.

Senators havent released a draft of their legislation, and media reports have said they dont intend to ahead of a vote that could happen before Congress breaks for July 4. The Center for American Progress assumed that the bill would include a waiver provision that could weaken patient protections and used survey and census data to estimate the number of workers and dependents in large company plans who would be affected.

The waiver was also included in the House version of the health care bill, the American Health Care Act, which passed on May 4.

This provision would allow employers to bring back annual and lifetime caps on health coverage. In 2009, before the ACA, 59% of workers with employer-provided health insurance were in a plan with a lifetime limit on how much the plan would cover. That cap could be set as low as $1 million, which wouldnt be hard for certain patients to hit. For example, a baby who spent months in the neonatal intensive care unit or someone who was born with hemophilia, developed an aggressive form of cancer, or got paralyzed in a car accident would all easily reach that sum.

Once a person hit his lifetime cap, the health plan would stop paying his expenses. Someone who hit his annual cap would have to wait until the following year for coverage. To a lot of people, it probably came as a surprise, says Emily Gee, a health economist at the left-leaning Center for American Progress and co-author of the report.

The Senate bill could expose workers to these caps by allowing states to apply for a waiver to define their own list of essential health benefits. The Affordable Care Act required most plans to include a robust list of 10 essential benefits, including prescription drug coverage, mental health and maternity care. The law banned annual and lifetime limits for essential health benefits, which in effect meant that most care wasnt subject to any caps.

But if states could pick and choose their essential health benefits, then employers could do the same, bringing back caps for any care that doesnt fall under their new definition of "essential." Individual and small group (generally, under 50 workers) plans in a particular state would be bound by their local regulationsso if their state mandated a full slate of essential health benefits, then they wouldnt have the option of choosing a health plan that excluded one.

By contrast, regulations allow large employers to base their benefit structure on any given states. Since essential health benefits are standard under the Affordable Care Act, this ability isnt currently that meaningful. However, if variations in essential health benefits become the norm, then employers that want to cut health costs could gravitate toward the state that offers them the most flexibility to do so.

To be sure, not all large employers will choose to set caps. Plenty of companies see comprehensive health insurance as a way to attract and keep talented employees, says Zack Pace, senior vice president of CBIZ, a benefits consulting firm. But the relentlessly rising cost of medical care and prescription drugs means that some firms may have no choice but to limit their workers coverage, Gee says.

The Center for American Progress based its estimates on a survey by Willis Towers Watson in which 20% of large employers said they would impost annual limits and 15% would impose lifetime limits if the ACA protections were repealed. Authors then used U.S. Census data to estimate the number of large-company workers and their dependents who would be affected: nearly 27 million would be subject to annual limits, and about 20 million would be subject to lifetime limits.

This worries advocates for people with pre-existing conditions. Imagine being the individual in active cancer treatment, says Anna Howard, principal in policy development at the American Cancer Society Cancer Action Network, and being told that, in effect, were not going to be paying for the products and services that are keeping you alive.

Excerpt from:

The Senate Health Care Bill Could Hurt You Even If You Get Insurance Through Work, Report Says - Money Magazine

The Republican-controlled U.S. Senate has received constant waves of criticism over its secret tinkering with the controversial and widely panned American Healthcare Act (AHCA)even from President Donald Trump, who reportedly said it was mean and asked that it be more generous.

Trumps characterization of the bill, which passed the House of Representatives last month, could very well be correct, and may even affect one of his top campaign promises: boosting the economy and jobs.

A study examining how each state could be affected if it passes the Senate and is written into law, published Wednesday by The Commonwealth Fund,found that by 2026 nearly one million jobs could be lost, state gross domestic product could shrink by $93 billion and businesses could suffer a $148 billion bite.

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When the House passed the bill on May 24, critics focused in particular on the Congressional Budget Offices estimate that 23 million Americans would be uninsured by 2026 and Medicaidwould see $880 billion in cuts during the same eight years.

But the new study appears to be focusing directly on the presidents main concernthe economyone of the few places hes claimed success after five months in office.

Should the bill be passed this year and enacted in 2018, there would be initial job growththat would gradually taper off. The bill ultimately would result in the loss of jobs in as many as 10 states, according to the study.

Initially, the repeal of Obamacare would raise the federal deficit following a tax cut, and then lead to the creation of 864,000 jobs by 2018. But due to the rising costs of health care, coupled with the bills tax cuts, over time more sectors of the economy would be affected, and eventually 924,000 jobs would be lost.

Combined, tax repeal and coverage-related changes lead to initial economic and employment growth but eventual losses, the study reads.

Coverage and spending-related policies are directly related to funding for health services (e.g., Medicaid, premium tax credits, high-risk pools). The reductions directly affect the health sectorhospitals, doctors offices or pharmaciesbut then flow out to other sectors.

Thus, about two-fifths of jobs lost due to coverage policies are in the health sector, while three-fifths are in other sectors. Tax changes affect consumption broadly, spreading effects over most job sectors, the study said.

If the current version of the bill passes, job losses could significantly hit 10 states, some of which went with Trump in the Electoral College last year. Florida, Pennsylvania and New York would be affected the worst, with upwardof 80,000 jobs or more lost, while Michigan could dip by 51,000, and New Jersey, Illinois, Ohio and North Carolina by more than 40,000 each.

It also appears the entire country could have serious problems with the AHCA. ANew York Times composite of eight national polls found that on average, only 29 percent of Americans support the bill and not a single state is in favor of its passage.

Link:

Republicans' 'Mean' Health Care Plan: The Real Cost of Trump's AHCA Is Jobs, Study Finds - Newsweek

The CDC released a Morbidity and Mortality Weekly Report (MMWR)(www.cdc.gov) and an accompanying Vital Signs report on June 6 that analyzed the prevalence of Legionnaires' disease in the U.S. health care system and found that 76 percent of facilities studied reported health care-associated cases of the disease.

Seventy-two health care facilities in 16 of the 21 U.S. jurisdictions the CDC studied reported definite health care-related cases of Legionnaires' disease, which is known to kill one-quarter of patients who are infected.

Legionnaires' disease is a severe pneumonia typically acquired through inhalation of aerosolized water containing Legionella bacteria. Legionella can grow in the complex water systems that supply many buildings, including health care facilities, when those systems are not well managed. Thus, effective water management programs could prevent the growth of Legionella in these building water systems.

Most healthy patients who are exposed to Legionella don't develop Legionnaires' disease. Some patients, however, are at increased risk for the disease, including those 50 or older and those who have certain risk factors, such as being a current or former smoker or having a chronic disease or weakened immune system.

Legionnaires' disease in hospitals is widespread, deadly and preventable," said CDC Acting Director Anne Schuchat, M.D., in a June 6 news release.(www.cdc.gov) "These data are especially important for health care facility leaders, doctors and facility managers because it reminds them to think about the risks of Legionella in their facility and to take action.

"Controlling these bacteria in water systems can be challenging, but it is essential to protect patients."

All 50 states, two large U.S. metropolitan areas and five territories report basic demographic information to the CDC's National Notifiable Diseases Surveillance System (NNDSS) for all cases of legionellosis, which manifests as one of two distinct clinical presentations: Pontiac fever (a mild influenza-like illness) and Legionnaires' disease. NNDSS makes no distinction between the two presentations.

In 2015, a total of 6,079 cases of legionellosis were reported to NNDSS, although the CDC noted that this estimate may be low due to underdiagnosis. The Supplemental Legionnaires' Disease Surveillance System (SLDSS) receives additional epidemiologic information, including whether patients were exposed to health care facilities, and distinguishes Legionnaires' disease from Pontiac fever, but reporting to SLDSS is less widespread.

The MMWR analysis aimed to define which Legionnaires' cases were associated specifically with health care facilities using data from the 21 U.S. jurisdictions. Definite health care-associated disease was defined as including hospitalization or long-term care facility residence for 10 days preceding symptom onset; possible health care-associated disease was defined as including any exposure to a health care facility for a portion of the 10 days preceding symptom onset. All other cases were considered unrelated to health care.

The MMWR analysis aimed to define which Legionnaires' cases were associated specifically with health care facilities using data from the 21 U.S. jurisdictions. Definite health care-associated disease was defined as including hospitalization or long-term care facility residence for 10 days preceding symptom onset; possible health care-associated disease was defined as including any exposure to a health care facility for a portion of the 10 days preceding symptom onset. All other cases were considered unrelated to health care.

Of the more than 6,000 confirmed legionellosis cases reported to NNDSS in 2015, 3,516 (58 percent) were also reported to SLDSS, including 3,459 Legionnaires' disease cases. Of those Legionnaires' disease cases, 2,809 (81 percent) were reported by the 21 jurisdictions included in the MMWR analysis, including 553 (20 percent) that were health care-associated (either definite or possible).

Of the 85 Legionnaires' disease cases that were determined to be definitely health care-associated, 80 percent were associated with long-term care facilities, 18 percent with hospitals and 2 percent with both.

Definite health care-associated Legionnaires' disease cases were reported in 72 facilities -- 15 hospitals and 57 long-term care facilities -- and included one to six cases per facility. Almost 90 percent of these definite cases occurred in patients 60 or older.

Of the 468 possible health care-associated cases, 49 percent were thought to be associated with hospitals, 26 percent with clinics, 13 percent with long-term care facilities, 3 percent with other settings such as outpatient laboratories, and 9 percent with more than one setting.

The MMWR report's authors said preventing the first case of Legionnaires' disease from arising in any health care facility should be the goal, and that is best achieved by establishing and maintaining an effective water management program. To this end, the CDC and its partners have created a best practices guide(www.cdc.gov) for these facilities to use.

In general, the CDC said the principles of effective water management include maintaining water temperatures that are not conducive to Legionella growth; preventing water stagnation; ensuring adequate disinfection; and maintaining equipment to prevent scale, corrosion and biofilm growth, which provide a habitat and nutrients for Legionella.

"Safe water at a health care facility might not be on a physician's mind, but it's an essential element of health care quality," said Nancy Messonnier, M.D., director of the CDC's National Center for Immunization and Respiratory Diseases, in the agency's release. "Having a water management program that focuses on keeping facility water safe can help prevent Legionnaires' disease."

In related news, CMS released a survey and certification memo(www.cms.gov) on June 2 that requires health care facilities to develop and adhere to policies and procedures to reduce the risk of disseminating Legionella and other waterborne pathogens.

According to the CDC, health care professionals play a critical role in preventing and responding to Legionnaires' disease by rapidly identifying and reporting cases.

Unfortunately, Legionnaires' disease is clinically indistinguishable from other causes of pneumonia. But failing to diagnose a health care-associated case could result in a missed opportunity to prevent subsequent cases.

Therefore, "Legionella should be considered as a cause of health care-associated pneumonia, especially for groups at increased risk, when other facility-related cases have been identified, or when changes in water parameters might lead to increased risk for Legionnaires' disease," the MMWR report advised.

The preferred diagnostic procedure for Legionnaires' disease is to concurrently obtain a lower respiratory sputum sample for culture and perform a Legionella urinary antigen test.

The CDC said ideally, sputum should be obtained before antibiotics are administered and shouldn't be rejected based on specimen quality (e.g., lack of polymorphonuclear leukocytes or contamination with other bacteria), because sputa produced by patients with Legionnaires' disease might not be purulent, and contaminating bacteria will not negatively affect isolation of Legionella on selective media.

"This report demonstrates that Legionnaires' disease continues to result from exposures to health care facility water systems," said the MMWR report. "The high case fatality rate of health care-associated Legionnaires' disease underscores the need for effective prevention and response programs.

"Implementation and maintenance of water management programs, combined with rapid case identification and investigation, could reduce the number of health care-associated Legionnaires' disease cases."

More From AAFP American Family Physician: Recreational Waterborne Illnesses: Recognition, Treatment, and Prevention

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Legionella Poses Risk for Patients in Health Care Facilities - AAFP News

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SALEM, Ore. (AP) A $670 million health care tax package designed to help sustain Medicaid services for the next two years and avoid the shuttering of a newly-built psychiatric hospital passed the Oregon House Thursday.

The 36-23 decision vote exceeded the constitutionally-required supermajority by just one vote.

House Bill 2391 is among the most high-profile pieces of legislation in Salem this year. Without it, lawmakers would have less than a month to solve a large chunk of the state's upcoming $1.4 billion shortfall, a psychiatric hospital in Junction City, Ore. with 100 beds and 400 workers would be on the chopping block and more than 350,000 low-income Oregon residents could lose health insurance under the federal Medicaid expansion almost immediately.

The package is among Gov. Kate Brown's top priorities she wants lawmakers to get done before the required July 10 adjournment. In a briefing with the state capitol press Wednesday, Brown noted she'd continue to fight the GOP minority's efforts in Congress to derail the Medicaid expansion and repeal President Barrack Obama's legacy legislation, the Affordable Care Act.

"The conversation, at least from what I've been able to read and in my conversations most recently with Sen. (Jeff) Merkley, is that the proposal will likely starting kicking people off after the 2020 elections," Brown said. "I find that appalling that we would keep people on for a year or two to get past the 2018 election cycle and then devastate 23 million Americans."

Passage of the so-called "provider" tax is also essential for the Oregon Health Authority's nearly $20 billion budget, proposed as a companion bill, for the 2017-19 biennium. House lawmakers approved the OHA budget, House Bill 5026, immediately following the provider tax, which squeaked by on a narrow three-fifths vote after Republican Rep. Sal Esquivel broke with his party to help majority Democrats advance the bill the next stage.

Both health care bills now head for final approval to the state Senate. The provider tax has broader support among Republicans in the Senate than it did in the House, so it's expected to clinch supermajority support more easily.

The package includes raising an existing tax on hospitals' net patient revenue 4 percent on small, rural hospitals and 6 percent on large hospitals and imposes a new 1.5 percent tax on health plans provided by some insurers as well as coordinated-care organizations that facilitate the state's Medicaid program, called the Oregon Health Plan.

The proposal has been several months in the making among Democrats, Republicans and key health care industry players, who worked in good faith toward the common goal of ensuring that billions of federal Medicaid matching-dollars, which begin tapering off next year, continue flowing into Oregon's local economy.

But negotiations were ongoing up until hours before the vote, with House Republicans opposing the premium tax as being too high.

"The inclusion of a tax on insurance premiums will result in higher health care costs for small businesses, college students and everyone in between," said Republican Rep. Cedric Hayden, who played a key role in negotiating the provider tax package. "It's disappointing that bipartisan alternatives were not given the consideration they deserved by the majority party."

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Oregon House advances $670M health care provider tax - KATU

Apple has been in talks with hospitals and other healthcare organizations to explore the possibility of bringing health records together via iPhones, media outlets reported.

The effort to make all personal health information available via its devices would be a first for Apple, which until now has focused it healthcare work on fitness and wellness with its Apple HealthKit. Apple has been typically mum on the developments and CNBC, which first reported Apples latest intentions for healthcare, said the works has thus far been secretive.

[Also:Will Apple buy athenahealth? Jonathan Bush calls rumor baseless]

Unnamed sources told CNBC Apple is looking at startups in the cloud-hosting space to give it a foothold in healthcare.

The company has already acquired personal health data startup Gliimpse, which has a secure platform for consumers to manage and share their own medical records.

The entrepreneur Anil Sethi, who built Gliimpse and sold it to Apple three years later, is now working at Apple. His title, according to his LinkedIn page, is Director, Apple Health.

More recently, Apple recruited Sumbul Desai, MD, from Stanford, where she has been involved in several successful digital projects. Apple executives have not released what role Desai will play, whether she might join the team working on ResearchKit, HealthKit and CareKit, or work on another project altogether.

Also, Apple insiders reportedly talked with people at The Argonaut Project, which is promoting the adoption of open standards for health information, and to "The Carin Alliance," an organization that advocates for giving patients a central role in controlling their own medical data.

Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com

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Apple reveals plans to put health records on the iPhone - Healthcare IT News

President Donald Trump hosts a working lunch with members of Congress, including Sen. Lisa Murkowski (left), at the White House on June 13. | Getty

President Donald Trump directed Senate Republicans to pass a generous health care bill at a meeting with more than a dozen GOP senators on Tuesday, arguing that the austere House health care bill is difficult to defend, according to people familiar with the meeting.

The president also said Republicans risk getting savaged in the 2018 midterms if they fail to repeal Obamacare after a seven-year campaign against the law.

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But he made clear that the Senate needs to pass a bill that Republicans are able to more easily defend and is not viewed as an attack on Americans from low-income households, as the House bill has been portrayed by critics, the sources said. He also advocated more robust tax credits for people who buy insurance on the individual market, a move that would increase the bills cost.

Sen. Rob Portman (R-Ohio), who is pushing the Senate to slow the repeal of Medicaid expansion, indicated Trump is concerned about the people who are enrolled in the program for low-income Americans.

He talked about the need to take care of people, Portman said of the president.

The gathering included 13 GOP senators of varying ideological stripes, from the moderate Sens. Susan Collins of Maine and Lisa Murkowski of Alaska to the conservative Mike Lee of Utah and Ted Cruz of Texas. The meeting left some Republicans on Capitol Hill with the impression that Trump is siding with more moderate Republicans, particularly when it comes to winding down Obamacares Medicaid expansion, which brought insurance coverage to millions of people.

Trump has told associates that news coverage of the House health care bill was terrible, in the words of one associate who has spoken with him.

Trump threw a party in the Rose Garden celebrating the passage of the House bill and has publicly called it terrific.

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But aides and associates said he has not liked the news coverage and has shown little interest in what is in the bill but wants it to be received well.

Conservatives want to wind down the expansion quickly and curtail future Medicaid spending, while more centrist senators are trying to preserve as much coverage as possible. Republicans said Trump spent a significant portion of the meeting observing senators disagreeing over the matter.

Murkowski, who, like Portman, is from a state that expanded Medicaid, said she made it clear to the president that she is concerned about repealing the expansion.

I reinforced that I think Medicaid expansion has been very important to the state of Alaska, she said.

Sen. Pat Toomey (R-Pa.), who is arguing to constrain future Medicaid spending to a rate lower than the House bill provides, said finding the sweet spot remains a challenge.

It feels like were making a little bit of progress. Its slow, but it was always going to be a tough slog, said Toomey, who attended the meeting.

A White House official said Trump did not take a firm position on Medicaid, which is the subject of much deliberation within the Senate Republican Conference. Seema Verma, administrator of the Centers for Medicare and Medicaid Services, attended both the White House meeting and a subsequent GOP lunch on health care, playing point for the administration on the matter.

And rather than instructing senators to meet hard deadlines, Trump urged Republicans to have a more orderly process than the chaotic one in the House. Senate Majority Leader Mitch McConnell is trying to call for a vote this month, though it may slip until July due to ideological disagreements and the difficulty of drafting such a complex bill.

The president asked Republicans to set aside their vast policy differences and find consensus.

The message really was, I know you have your differences, but work through them and lets figure out a way to get it done, said Sen. John Thune (R-S.D.). We have to get a product.

He wants us to pass this bill and improve this House bill, Senate Finance Chairman Orrin Hatch of Utah told reporters.

Republican senators believe it will be at least a week before a coherent blueprint emerges for the GOP to chew over. Leaders are still going back and forth with the Congressional Budget Office to lay out options for Medicaid and tax credits and how much each option would cost.

Hatch told reporters that he doesnt think there will be a bill this week. If that prediction holds, it would be difficult for the Senate to vote on legislation before the Fourth of July recess.

McConnell refused to tell reporters when a bill might be released or how long it would be available to the public before a vote.

Well let you see the bill when we finally release it, McConnell said. Nobodys hiding the ball here.

Trump has taken a much more hands-off approach to the Senate bill than he took with the House version. Many senators expect the president to weigh in with more one-on-one or group lobbying as the GOP gets closer to moving a bill to the Senate floor.

Hell be a big help, but I think the timing is important. And hell be an important part of this, said Senate Majority Whip John Cornyn (R-Texas). We need to consult among ourselves and come up with a consensus.

Adam Cancryn contributed to this report.

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Trump knocks House health care bill as too harsh - POLITICO

Donald Trump looks to House Speaker Paul Ryan of Wis., and other House congressmen in the Rose Garden after the House pushed through a health care bill.

By Jabin Botsford/Getty images.

Last month, after weeks of browbeating and cajoling wary lawmakers, Donald Trump threw a party on the White House lawn to celebrate the passage of the American Health Care Act through the House. A brass band was on hand for the Rose Garden ceremony as dozens of Republicans lined up behind the president to take turns praising each other for crafting a bill that would slash subsidies for the sick and elderly and was estimated to cover 24 million fewer people. More than a dozen politically vulnerable congressmen in swing districts ultimately changed their votes and went out on a limb for the president, who was then eager to score a legislative win in the wake of his 100th day in office. But now, as Senate Republicans deliberate in secret as they race to hold a vote ahead of their July 4 recess, Trump appears to be having second thoughts about the G.O.P. health-care plan, which is supported by just 24 percent of voters.

In a lunch meeting with more than a dozen Republican senators at the White House on Tuesday, Trump started off with praise. I really appreciate what youre doing to come out with a bill thats going to be a phenomenal bill for the people of our country: generous, kind, with heart, he said, according to The New York Times. He then went on to suggest that the Senate should actually put additional money into the House plan, which he described as mean. CNNs Jim Acosta reported that the president went on to call the legislation cold-hearted and a son of a bitch.

While it is unclear what aspects of the repeal bill the president was specifically referring to, his private comments mark a sharp departure from his public approval last month. At the time of the health-care bills slim 217-213 passage in the House, Trump seemed blissfully unaware of what was in the bill or the potential impact it could have on his own supporters, reportedly viewing the vote primarily as the fulfillment of his campaign promise to dismantle Obamacare. But the fierce backlash to its passage, as well as the Congressional Budget Offices estimate that the G.O.P. plan would cover 24 million fewer people than current law, reportedly changed his view. Politico reports the president has told associates that the coverage of the bill was terrible and wants the Senate to pass a bill that will be better-received by the public.

Humoring the president is presumably not a top priority for Republicans, who already have their hands full. The Senate G.O.P. has been locked in back-room negotiations for weeks over the Republican bill, which they began rewriting immediately after receiving it from the House. I dont know how we get to 50 [votes] at the moment, Senate Majority Leader Mitch McConnell conceded last month. It was only in the last few days that Republican senators began putting the finishing touches on their version of the bill, which they have so far refused to make public (We arent stupid, one aide recently said, by way of explanation). And they dont appear particularly amenable to starting over just because Donald Trump, who has admitted that health-care policy is much more complicated than he originally assumed, is expressing doubts. The Times reports that senators are growing increasingly indifferent to Mr. Trumps policy interests and did not seem moved by his entreaties.

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Trump Throws His Own Health-Care Plan Under the Bus - Vanity Fair

Executive Summary

Most data-driven healthcare IT (HCIT) providers arent going to survive. Their business models are at serious risk of failure as health data becomes more widelycollected and freely shared. To beat those odds, they need to evolve dramatically, and fast, to a point where they are not selling data but providing insight. There are two common ways to provide insight: one is to focus on specific use cases, and the other is to focus on particular patient populations.The marketplace is rapidly moving in this direction. For example, Proteus Digital Health is engaging with health systems to provide insights into health patterns and treatment effectiveness for patients with uncontrolled hypertension and diabetes.The late economist and marketing professor Theodore Levitt famously said People dont want to buy a quarter-inch drill, they want a quarter-inch hole. In health care, providers dont want data, they want solutions that lower costs and improve outcomes. HCIT firms that deliver those solutions are the ones that will be around in five years time.

Most data-driven healthcare IT (HCIT) providers arent going to survive. Their business models are at serious risk of failure in the next three to five years. To beat those odds, they need to evolve dramatically, and fast, to a point where they are not selling data at all.

Like any number of industries, healthcare is being transformed by the explosion of low-cost data. In healthcare, the transformation is driven in large part by electronic medical record adoption and digitization. There have been many benefits. End users can take advantage of quantities of newly available information to solve problems in population health, clinical decision support, and patient engagement, among other applications. And ease of access means ease of market entry: Emerging data providers can get on their feet quickly and create new sources of competition. For example, AiCure and Propeller Health are using very different methods to generate patient medication adherence data. Competition leads to better offerings and more choice. What could go wrong?

Plenty, actually. End users can be overwhelmed by the flood of raw data and reports that may not fit well with their existing workflow or answer their specific question. And for data providers, ubiquitous availability of information and low barriers to entry means that the competitive advantage gained from the data itself can be quickly eroded.

Yet too many HCIT providers are still pursuing that data-centric advantage. The bulk of HCIT investment supports startups that sell data clinical or operational information that is otherwise difficult for clients to obtain or to organize. These firms regard data as the source of business value. But as more data and more data providers flood the market, a competitive position based solely on data becomes impossible to defend. Consider the move by the Centers for Medicare and Medicaid Services to publish extensive Medicare enrollment and utilization data, and to make it accessible and easy to interpret via the CMS website. Information that would once have been proprietary and premium-priced is now widely available, for free. CMSs move illustrates a broad trend. Increasingly, for most HCIT firms, data is a commodity.

Whats a data provider to do?

One solution is to become the authoritative source for a particular kind of information. Some firms have managed it, in healthcare and in other arenas think of QuintilesIMS as a source of pharmaceutical sales data, Nielsen as the authority on TV viewer habits, and the U.S. Census for information about U.S. demographics. In theory, a healthcare IT provider can follow their lead and try to corner the market on a data set. But to do this in todays landscape is a tall order. The same dynamics weve described widespread access, low costs, low barriers to entry, commoditization of data sets mean its an open question whether this strategy can work.

A better option is to evolve from providing data to providing insight.

Companies moving this direction aim to solve problems within a use case, for example, decision support. They might focus on a specific population such as cancer, diabetes, or Alzheimers patients and a specific insight about disease progression, pain management or treatment options. They address an underlying stakeholder need such as managing the total cost of care. Clients get whats really needed raw data transformed to support better decisions. And HCIT providers escape the commodity trap.

The marketplace is rapidly moving in this direction. IBM established its Watson Health business unit to apply cognitive computing analyses to healthcare and in 2016 announced plans to acquire Truven Health Analytics for $2.6 billion. IBM plans to leverage Truvens vast data collection sourced from more than 8,500 insurers, hospitals and government agencies to support specific use cases, using Watsons analytical capabilities. For example, some Watson Health initiatives focus on improving oncology diagnostics and identifying the most effective treatment protocols for specific cancer patient subgroups.

Another solution provider, Proteus Digital Health, is engaging with health systems to provide insights into actual medication use and resulting health patterns. Understanding treatment effectiveness for at-risk patients in particular for patients with uncontrolled hypertension and diabetes is a priority for many health plans. Proteus analytics support patient and family engagement and care-team coaching to drive clinical improvement. Other data analytics services based on accurate medication-intake information, in combination with physiological measures, also promise to improve clinical decision-making, reduce doctors workload, and improve outcomes.

The transformation from data provider to data analytics services is hard. It requires significant changes in business models, staffing and management approach. But we believe its the only option. The late economist and marketing professor Theodore Levitt famously said People dont want to buy a quarter-inch drill, they want a quarter-inch hole. In health care, providers dont want data, they want solutions that lower costs and improve outcomes. HCIT firms that deliver those solutions are the ones that will be around in five years time.

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To Survive, Health Care Data Providers Need to Stop Selling Data - Harvard Business Review

Forbes

How About This Health Care Act That Both Democrats And Republicans Support Forbes Think Democrats and Republicans can't agree on anything healthcare related? Well, here's something that has a good amount of bipartisan support in Congress: the ''Personal Health Investment Today Act'', otherwise known as the ''PHIT Act.'' You know ...

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How About This Health Care Act That Both Democrats And Republicans Support - Forbes

University of Great Falls Pivots to Health Care Inside Higher Ed The University of Great Falls in Montana is shifting to emphasize training for the health-care field and will be renamed the University of Providence at the beginning of July, following an investment by the multistate Providence St. Joseph Health system. and more »

Originally posted here:

University of Great Falls Pivots to Health Care - Inside Higher Ed

As Attorney General Jeff Sessions testimony before the Senate Intelligence Committee on Tuesday fanned the flames of the Russia scandal that hangs over Donald Trumps presidency, the White House appeared eager to change the subject to health care.

And that appears to be just fine with Democrats amid a messaging war over the Republicans crafting of a replacement for the 2010 health care law that Trump claims will be far better than the Obama-era system.

Sessions tussled with Democrats on the Intelligence panel Tuesdayduring dramatic testimony as Trump was en route to Wisconsin aboard Air Force One. The attorney generaldeclined to answer questions about conversations with Trump, citing the potential that the White House could assert executive privilege which has not yet happened.

And he denied meeting with the Russian ambassador to the United States following a foreign policy speech last April by then-candidate Trump at Washingtons Mayflower Hotel. Sessions defiantly pushed back on notions that his attending the same event as the ambassador, Sergey Kislyak, would constituteproof of collusion.

The attorney generalclashed with Sen. Ron Wyden over the Oregon Democrats contention that hewas stonewalling the panel. Sessions hit back, accusing Wyden and others of besmirching him with secret innuendo. As the dramatic scenes played out on Capitol Hill, Air Force One was touching down in Milwaukee.

The president first met with what the White House often calls Obamacare victims, then appeared with some to tell their tales of being slighted by the 2010 health care law. The president, sounding energized to be talking about health care again in a state he won in November, said American citizens deserve so much better.

[Sessions: Suggestions of Collusion a Detestable Lie]

He then pivoted to bashing congressional Democrats, telling an audience at General Mitchell International Airport that the Democrats have let you down big league. As he did earlier Tuesdayin the White Houses Cabinet Room during a health care meeting with 15 Senate Republicans, Trump said the GOP push for a new law will get no obstructionist Democratic votes.

Trump and his top aides are ramping up their health care messaging as Senate Republicans accelerate their work, aiming to vote before a July 4 recess. But Republicansare finding an opposition party that appears up for a messaging fight.

Senate Minority Leader Charles E. Schumertook aim at Vice President Mike Pence and Senate Majority Leader Mitch McConnellon Tuesday.

He noted his relationship with McConnell since he became the Democratic leader is going fine, but he blasted the Kentucky Republicanfor legislative malpractice worse than he has seen during his 18-year Senate career by any leader. He was especially harsh on Pence, who huddled with the Senate GOP caucus on Tuesday after the White House meeting.

Schumer noted that Pence, during the 2009 health care debate when he was a member of the House GOP leadership team, urged Democrats that the American people deserved time to read the legislation, and that every member of Congress should commit to reading such a consequential bill.

Today, no member of Congress can read the [GOP] bill because we dont know what it is, Schumer said, adding that Democrats had 160 hours of floor debate and adopted more than 150 GOP-crafted amendments.

Thats what the process should look like, he said. It should be open, it should be fair, and not happen behind closed doors. The Republicans are so ashamed of this bill, they cannot even let a little sunshine light it up. Theyre ashamed of the bill.

Sen. Christopher S. Murphy, D-Conn., said the focus should be on the GOPs health care legislation.

My advice today: focus 10% of your attention/outrage on Sessions testimony, 90% on the secret health care bill that is speeding to a vote, he tweeted.

Hours earlier, House Minority Whip Steny H. Hoyer, D-Md., told reporters that based on conversations he has had with senators, the possibility of that chamber passing a health care bill before the July 4 recess is very, very small.

Schumer and Hoyers comments come as Democratic campaign entities are hammering Republicans with what is largely a one-issue attack: health care.

Trump would like the Senate to reach a consensus sooner rather than later. But at the start of his lunch meeting on the subject with the GOP senators, the president seemed more patient than normal he did not give the senators a hard deadline to finish a version that would have to be reconciled with a House-passed version before reaching Trumps desk.

As glasses of iced tea with large lemon wedges affixed to the rims sat mostly untouched before the midday meal was served, Trump told reporters he merely wanted the GOP senators to finish their version of the legislation as soon as we can.

The often-demanding president praised Republican senators for working very, very hard. Without getting into specifics, Trump predicted the Senate will pass a phenomenal bill that will feature a great health care plan that will be far better than the Obama-era law.

Meanwhile, as the Capitol prepared for Sessions testimony about Russia and former FBI Director James B. Comeys firing, White House aides were eager to to cast Tuesday as just another day in the West Wing.

Aides were seen carrying lunches back to their desks or notebooks to their next meeting. Workers moved boxes of sodas around, and a crew loaded furniture into a white box truck through the same door used by Trump to welcome world leaders to the White House.

A black squirrel paused around 1 p.m. after dropping something on a driveway, scooped it up, and sprinted toward a tree on the edge of the North Lawn.

A reporter climbed a small ladder and watched what appeared to be some of the Republican senators leaving after the lunch meeting via a side door on West Executive Drive. As they did, Marine One roared into sight and landed on the South Lawn near the Oval Office to ferry Trump to Joint Base Andrews in Maryland for his flight to Wisconsin.

In many ways, it was like any other day at the executive mansion. Only, for the second time in five days, it was anything but. Not only did the day feature more high-profile testimony related to the Russia matter, it came as the White House refused to deny that the president is considering firing special counsel Robert Mueller, whos now leading the FBIs Russia probe.

White House aides also pressed forward with what is being called workforce development week at the executive mansion.

As part of this theme, Trumpleft Washington just before Sessions began to testify on a trip that served several purposes not just to talk about health care but workforce issues.

[Will GOP Settle for a Clean Debt Limit Win?]

So Trump not only talked health care in Wisconsin. He toured a community college and held a roundtable on workforce development. He also participated in a fundraiser for Wisconsins Republicangovernor, Scott Walker.

But even as the White House was eager to cast Trump as a getting-things-done president, the Russia matter just wouldnt go away back in Washington.

His attorney general aggressively denied any involvement in any possible collusion with Russian officials as they interfered in the 2016 presidential election.

I was your colleague in this body for 20 years, at least some of you, and the suggestion that I participated in any collusion, that I was aware of any collusion with the Russian government to hurt this country, which I have served with honor for 35 years, a clearly angry Sessions sharply told his colleagues, or to undermine the integrity of our democratic process, is an appalling and detestable lie.

But even amid that passionate denial, Democrats appear eager for a fight.

Attorney General Jeff Sessions testimony left far too many questions unanswered, House Democratic Caucus Chairman Joseph Crowleysaid. It is abundantly clear there was inappropriate contact between President Trumps campaign and the Russians that must be investigated and explained in detail to the American people.

Get breaking news alerts and more from Roll Call on your iPhone or your Android.

Continued here:

White House Changes Subject to Health Care - Roll Call

Rising health care costs are projected to be the most burdensome expenses in retirement, but minimal behavioral change can significantly lower the price tag. These conclusions are from HealthView Services 2017 Retirement Health Care Costs Data Report, which draws from 70 million health care cases as well as actuarial, government and economic data.

According to a HealthView case study cited in the report, a 50-year-old with Type II diabetes who follows doctors orders can potentially add eight additional years to life expectancy and save an average of $5,000 annually in out-of-pocket costs before retirement. The firm notes that if the same individual invests that sum into a fund that earns a 6% return, that person would have more than $120,000 by age 65 or an extra $14,000 per year (assuming the person lives to the actuarial projected age of 80). With another $2,750 per year in health care savings in retirement, this individual would have generated almost $17,000 more in annual retirement income.

These findings emphasize the importance of communicating effective benefits packages in order for employees to make the most out of the offerings most beneficial to them. Adding a health component to financial wellness programs or adopting programs that incentivize healthy behavior may help as well.

But participants who dont address their health issues through behavior modification could be looking at a very expensive retirement, as could employers enduring higher health care costs.

According to HealthView, retirement health care cost inflation is expected to increase at an annual rate of 5.47% for the next decade. This translates to triple the rate of inflation between 2012 and 2016, and more than double the projected Social Security cost-of-living-adjustments (COLAs).

The study indicates that a healthy 65-year old couple retiring today is expected to need $321,994 to cover total health care costs in retirement, when factoring in projected expenses for Medicare Part B and D premiums, as well as supplemental and dental insurance. When accounting for deductibles, copays, hearing, vision, and cost sharing, that number jumps to $404,253 in todays dollars or $607,662 in future dollars.

Medicare Part B premiums alone jumped by 16% in 2016. So far in 2017, they have increased by 10% despite a 24% decrease predicted by the Medicare Board of Trustees.

HealthView Services reports that the main driver behind these rising expenses is the increase in retirement health care inflation.

The report notes that Through a short-term lens, the average 65-year-old couple that retires in 2017 will pay $11,369 in their first year for health care$670 more than the same couple retiring in 2016. By age 85, those 2017 retirees will spend $39,208 (or $1,915 more for the same coverage than last years retirees).

Women in particular may face a larger burden due to increased life expectancy. HealthView finds that women live on average two years longer than men. The firm projects that expected health care costs for a healthy 63-year-old woman retiring this year (living to age 89) would need $362,607 in future dollars or 29.9% more than a 65-year-old male.

But regardless of age or gender, the firm finds that minimal behavioral change can reduce health care expenses and boost savings as well as longevity.

Although these numbers may seem out of reach, the savings required to cover health care when meeting retirement savings goals are often more modest than might be expected, says HealthView President and CEO Ron Mastrogiovanni. A 55-year-old can increase 401(k) contributions by as little as $17 per paycheck to address their retirement health care premiums, assuming a company match of 50% and they are meeting an 85% incomer replacement ratio savings goal.

The full 2017 Retirement Health Care Costs Data Report can be found at HVSFinancial.com

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Reducing Health Care Costs Through Behavioral Modification - PLANSPONSOR

JUDY WOODRUFF: This is an important week for the fate of a bill designed to replace and potentially overhaul the health care law often referred to as Obamacare.

Republican senators are trying to finish drafting key portions of their own bill affecting coverage and costs. But Democrats say the entire battle over repealing the law is quite different from standard operating procedure, and not nearly transparent enough.

Lisa Desjardins looks at how its playing out in the Senate.

LISA DESJARDINS: Right now the debate over health care is red hot in Congress, but only behind closed doors, as Republicans privately try to craft a Senate bill.

And that is something Democrats, like Senator Claire McCaskill last week, have been raising publicly.

SEN. CLAIRE MCCASKILL, D-Mo.: We have no idea whats being proposed. Theres a group of guys in a backroom somewhere that are making these decisions. There were no hearings in the House. I mean, listen, this is hard to take, because I know we made mistakes on the Affordable Health Care Act, Mr. Secretary.

And one of the criticisms we got over and over again, that the vote was partisan. Well, you couldnt have a more partisan exercise than what youre engaged in right now. Were not even going to have a hearing on a bill that impacts one-sixth of our economy.

LISA DESJARDINS: McCaskill wants something called regular order. What is that? Well, it used to be the normal process. A bill goes through committee hearings, where experts and those affected by an issue ring in.

Then senators on the committee can vote to change the bill with amendments. And then, when a bill gets to the Senate floor, regular order means another chance to change it with amendment votes there too.

In 2009, with the Affordable Care Act, two Senate committees held three months of hearings and went through weeks of voting on amendments.

More recently, Senate Leader Mitch McConnell said he wanted regular order when Republicans took over in 2015.

SEN. MITCH MCCONNELL, Majority Leader: We need to open up, open up the legislative process in a way that allows more amendments from both sides.

LISA DESJARDINS: But thats not how Republicans so far have planned this health care debate. Again, in regular order, bills go through committees and amendment votes. Instead, this time around, Senate Republicans have indicated they may send their health care bill straight to the Senate floor with little, maybe no chance to amend it. And they have held no hearings on the bill so far.

Leading this process is Republican Senate Finance Chairman Orrin Hatch.

SEN. ORRIN HATCH, R-Utah: Well, I dont know that theres going to be another hearing, but we have invited you to participate.

LISA DESJARDINS: Who stressed to McCaskill that he wants Democratic ideas, if not more hearings and votes. But that differs from Hatch in 2009, when Republicans were the minority, and he thought Democrats were moving too fast on health care.

SEN. ORRIN HATCH: We at least ought to take the time to do this right.

LISA DESJARDINS: In the end, it took Democrats 14 months to pass their health care bill in 2009 and 2010. Thats why this moment is critical. The Senate will make or break health care reform. And Senate leaders, including Hatch, have said they want to pass a full health care bill by the end of this month. Thats just nine or 10 legislative days away.

For the PBS NewsHour, Im Lisa Desjardins.

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Republican senators are privately crafting a health care bill, raising alarm from Democrats - PBS NewsHour

Several Republican senators have indicated that they would be willing to support a health care bill that funds Planned Parenthood or some abortion services, Fox News has learned.

The GOP is worried that any bill to repeal and replace ObamaCare would have to be carefully structured to hold the support of moderate and conservative Republicans. However, the apparent concession by conservatives might give leadership more room to maneuver.

The pressure is on Senate Republicans to try to move a bill to repeal and replace ObamaCare before the Fourth of July recess. The House of Representatives passed its own bill, the American Health Care Act, last month.

Fox News has also learned that Senate GOP leaders have been sending policy proposals to the Congressional Budget Office for evaluation and scoring. However, a full bill was not expected to be presented at the weekly Republican luncheon Tuesday.

Senate Republicans are winnowing down policy options in an effort to get the necessary 51 votes to pass any health care legislation. Some believe any bill will only get 50 votes, necessitating a tie-breaking intervention by Vice President Mike Pence.

Meanwhile, the government said Monday thatabout 16 percent of consumers who signed up for coverage this year through Healthcare.gov and its state counterparts had canceled their plans by early spring.

Figures released from the Health and Human Services department show that 10.3 million people were signed up and paying their premiums as of March 15. That's 1.9 million fewer than the 12.2 million who initially signed up during open enrollment season, which ended Jan. 31.

In the first part of last year, the dropout rate was similar, about 13 percent. It increased as the year went on. Monthly enrollment averaged about 10 million people in 2016.

Some of the main reasons for dropping out include finding job-based insurance, problems paying premiums, and becoming eligible for Medicare.

A new analysis from HHS also found higher dropout rates in areas where insurers have left the program. About one-third of U.S. counties only had one participating insurer this year, and next year there may be areas with no available carrier.

The Trump administration said the numbers are a sign of continuing problems with Obamacare, such as sharp premium increases and the departure of some major insurers that suffered financial losses.Democrats have accused Trump of trying to "sabotage" Obama's signature domestic achievement

Fox News' Chad Pergram and Mike Emanuel contributed to this report. The Associated Press also contributed to this report.

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GOP senators may be willing to back health bill that funds Planned Parenthood - Fox News

A majority of likely voters in Georgias sixth congressional district hold an unfavorable impression of the Republican plan to repeal and replace ObamaCare, according to a new poll by The Atlanta Journal-Constitution.

While 62 percent hold an unfavorable impression of the legislation, 25 percent have a favorable impression of the plan, the poll said. Thirteen percent did not know or did not provide an answer.

The results of the poll come with the district about a week away from going to the polls for the special election that has drawn both funds and attention throughout the country.

Republicans in the Senate have said a vote on the legislation could come in July.

Abt Associates conducted the poll from June 5 through June 8, surveying 1,000 registered voters. It has a margin of error of 4 percentage points.

Democrat Jon Ossoff and Republican Karen Handel will face off on June 20 in the special election for the seat vacated by Health and Human Services Secretary Tom Price.

See the article here:

Majority in Georgia 6th have unfavorable view of GOP healthcare bill: poll - The Hill