OVERNIGHT HEALTH: The public doesn't understand health law

Three years after it became law, Democrats have made almost no progress explaining the Affordable Care Act to the public. The latest monthly tracking poll from the Kaiser Family Foundation shows dramatic confusion over what is and isn't included in the law, as well as deep uncertainty over its effects.

As a rule, the more likely voters were to say they liked a particular policy, the less likely they were to know it is part of the ACA. Awareness of unpopular provisions like the individual mandate was high, while voters were unaware of more popular elements such as small-business tax credits.

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It's an indication that the White House and other supporters haven't done a very good job explaining the healthcare law — much less making a strong case for it. (Approval of the ACA remained closely divided, as always.)

More troubling for the administration, knowledge was most lacking among the people who stand to benefit most from the law — the uninsured and the poor.

Healthwatch has more from the poll.

HELP passes HOPE: The Senate Health, Education, Labor and Pensions (HELP) Committee today passed a bipartisan bill that would end a 1988 federal ban on research into organ donations between people with HIV. The measure, known as the HOPE Act, would encourage studies on the transplants and, if they are proven safe, allow donations to begin. The senators behind the bill, Barbara Boxer (D-Calif.) and Tom Coburn (R-Okla.), said it could be life-saving for people with HIV. The American Medical Association and a variety of other groups back the measure, and Rep. Lois Capps (D-Calif.) is behind the House version. 

Long-term savings: If Congress could make a mandatory long-term-care program work, it could save the government nearly $50 billion, according to a new analysis from Avalere Health. The consulting firm said a mandatory system for long-term care — requiring taxpayers to pay into a long-term-care program — would save $49 billion over 15 years by reducing Medicaid's spending for long-term care. A voluntary system would save roughly $5.6 billion, Avalere said.

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The Affordable Care Act attempted to set up a new program for long-term-care coverage, known as the CLASS program. But the administration shelved the program after determining that it couldn't be implemented in an economically feasible way. 

Opting out: A Republican bill to toss the requirement that businesses automatically enroll new workers in the company health plan is winning praise from industry. Reps. Richard Hudson (R-N.C.) and Robert Pittenger (R-N.C.) are warned that the auto-enroll provision of President Obama's healthcare law would bury employers of 200 workers or more in paperwork — a particular threat for industries that experience high employee turnover.

U.S. retailers quickly backed the bill along with the restaurant industry, which said auto-enroll would lead to "financial hardship" and "confusion." Angelo Amador, a vice president with the National Restaurant Association, pointed to young people employed in food service who often shift jobs or receive insurance through their parents.

"Many are likely to inadvertently miss opt-out deadlines ... causing significant, unexpected financial hardship when they learn their paycheck has been reduced to cover the new premium," Amador said in a statement. Read more at Healthwatch. 

SCOTUS strikes state Medicaid law: The Supreme Court on Wednesday struck down a North Carolina law allowing the state to garnish payments in medical malpractice cases. 

If a patient is harmed by medical malpractice, and a state Medicaid program covers injuries that resulted from the malpractice, the state can reimburse itself out of the patient's malpractice award. North Carolina took one-third of malpractice awards to recoup its Medicaid losses. But the court said that's an arbitrary amount, and states don't have a right to take more than what they paid out in medical care.

"If a State could arbitrarily designate one-third of any recovery as payment for medical expenses, it could arbitrarily designate half or all of the recovery in the same way," Justice Anthony Kennedy said in the court's 7-2 decision

Mental illness tied to smoking: The Substance Abuse and Mental Health Services Administration (SAMHSA) reported Wednesday that people experiencing mental illness are more likely to smoke, and smoke heavily. A new study found that the rate of smoking is 94 percent higher among people with mental illness or substance abuse issues, and that this population accounts for about 40 percent of all cigarettes smoked, though it is only about 25 percent of the population.

SAMHSA Administrator Pamela S. Hyde vowed to further study the nexus of tobacco use and mental health.

"It has long been a public health priority to develop effective smoking prevention and cessation programs,” Hyde said in a statement. "This report highlights a clear disparity.  It shows that people dealing with mental illness or substance abuse issues smoke more and are less likely to quit."

Read the report here


Thursday's agenda

The Republican Doctors Caucus and House Democrats will mark the Affordable Care Act's birthday with press conferences.

House members will hold a bipartisan press conference to introduce the Common Sense Nutrition Disclosure Act, a bill limiting regulations on nutrition disclosure.

Analysts, including Bruce Lesley from First Focus, will hold a Capitol Hill briefing on children and the federal budget.

The New England Healthcare Institute (NEHI) will hold a summit on accountable care organizations.

The National Association of Community Health Centers will continue its annual policy conference.

The Alliance for Health Reform will hold a briefing on the future of the healthcare workforce.


State by state

Michigan panel OKs budget without Medicaid expansion

LePage wants more funding, flexibility before expanding Medicaid

Will Arkansas's Medicaid math add up?


Lobbying registrations

International Premium Cigar & Pipe Retailers / self-registration

International Hearing Society / self-registration

Emmer Consulting / self-registration


Reading list

CVS Caremark demands workers disclose weight, health info

Grieving doc regrets he didn't ask depressed patient about gun

Our coming deficits are driven by old people, not health inflation

CDC: Autism diagnoses on the rise

UK: Public OK with creating babies from three parents


What you might have missed on Healthwatch

Congress moves to put protections on painkiller

Durbin: Grand bargain odds less than 50-50

Catholic bishops renew fight over Ryan budget

Hatch: Medicare office using health law funds for treadmill desks

Poll: Voters still don't know what's in Obama health law

House Republican delays vote on asbestos bill



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Sam Baker: sbaker@thehill.com / 202-628-8351

Elise Viebeck: eviebeck@thehill.com / 202-628-8523

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