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California Cuts Back On Kids Insurance While New Hampshire Expands
California cuts back on health insurance for children, while New Hampshire expands state insurance to young adults. Meanwhile, a regional health commission in Missouri hopes to help the uninsured, and an Iowa report concludes that minorities face discrimination in the health care system.

Washington Post Details Six Senators To Watch On Health Care; Politics Of Fear Gain Prominence
The battle over health care reform will happen in the Senate, even though President Obama keeps getting all the attention, The Washington Post"s The Fix reports.
News of the day
CDC Prioritizes H1N1 Vaccinations For Pregnant Women
When the H1N1 flu vaccine becomes available in the fall, pregnant women should be among the first groups vaccinated because of their high risk for serious complications, a Centers for Disease Control and Prevention expert panel said on Wednesday, the Washington Post reports. The 15-member committee advises CDC on vaccine policy. The priority list also includes caretakers of infants, health care workers, children and young adults, and older people with chronic conditions. Anthony Fiore, a physician and epidemiologist at CDC, told the committee that about 6% of H1N1 deaths and hospitalizations are among pregnant women (Brown, Washington Post, 7/30). According to a CDC study published online Wednesday in the journal Lancet, pregnant women who contract the H1N1 virus -- also known as "swine flu" -- are at least four times more likely to be hospitalized than other people with the virus, the AP/Google reports. The study analyzed the first 34 U.S. cases, including six deaths, in pregnant women from April to mid-June of 2009. Although it is not clear if pregnant women are more susceptible to the virus, they have a higher risk of complications after becoming infected. The study"s authors said pregnant women suspected of having H1N1 should be administered Tamiflu as soon as possible, prior to the completion of diagnostic testing. CDC"s Denise Jamieson, the lead author of the study, said that Tamiflu appears relatively safe for pregnant women, despite limited safety data on its use in that population.Most pregnant women who contract H1N1 have mild flu symptoms like a cough or fever, according to the World Health Organization. Jamieson said that CDC does not recommend specific precautions for pregnant women but that doctors should act quickly -- preferably within 48 hours -- if a pregnant woman shows symptoms. She added that the pregnant women who died were basically healthy, and nearly all had viral pneumonia before experiencing acute respiratory problems prior to their death (Cheng, AP/Google, 7/29).CDC"s priority groups include about 159 million people out of a total U.S. population of more than 300 million, the Chicago Tribune reports. The agency expects to have about 120 million doses of the vaccine by the end of October. Officials are confident there will be enough for their target groups because only 20% to 50% of those recommended to receive seasonal flu vaccines seek them out. However, if supplies of the vaccine are unexpectedly restricted, the panel recommended that a smaller group -- about 41 million of the most susceptible to adverse side effects from infection or most likely to spread the virus -- be given priority for the vaccine. This smaller group also includes pregnant women (Maugh, Chicago Tribune, 7/30).
Endocrinology

RNs Praise House Vote To Permit State Single-Payer Laws

The nation"s largest union and professional association of registered nurses hailed passage of a key amendment in the House Education and Labor Committee to the national healthcare reform bill this morning that would enable individual states to go a step farther and adopt single-payer, Medicare-for-All style reforms. Introduced by Rep. Dennis Kucinich of Ohio, the amendment would remove potential legal impediments for states to pass single-payer bills by waiving federal exemptions that apply to employer-sponsored health plans. The amendment passed on a bi-partisan vote of 25-19, with the support of both progressive, single-payer Democrats and many Republicans who endorsed the ability of individual states to pass their own versions of health care reform. "This is a historic moment for patients, for American families, and for the tens of thousands of nurses and other single-payer activists from coast to coast who can now work in state capitols to pass single-payer bills, the strongest, most effective solution of all to our healthcare crisis," said Rose Ann DeMoro, executive director of the California Nurses Association/National Nurses Organizing Committee. "There are many models of health care reform from which to choose around the world - the vast majority of which perform far better than ours. The one that has been the most tested here and abroad is single-payer," said Kucinich in urging passage of the amendment. "Under a single-payer system everyone in the U.S. would get a card that would allow access to any doctor at virtually any hospital. Doctors and hospitals would continue to be privately run, but the insurance payments would be in the public hands. By getting rid of the for-profit insurance companies, we can save $400 billion per year and provide coverage for all medically necessary services for everyone in the U.S.," Kucinich said. The nurses noted there is a long road ahead for the amendment. It will still need approval from the full House and in a final version from the Senate. Nurses and other healthcare and community activists made numerous calls to legislators in support of the amendment, and will continue to press for its enactment in the final bill. For those who have opposed the proposal, DeMoro called it "a very modest amendment that simply protects choice for residents of individual states who favor more comprehensive reform." Recent reports from both the Department of Health and Human Services and the prestigious medical journal Health Affairs have documented that compared to people with private insurance, Medicare enrollees have greater access to care, fewer problems with medical bills, and greater satisfaction with their health plans and the quality of care they receive. The reason for improved access, quality, and lower costs under Medicare, said DeMoro, "is that under Medicare, insurance companies, whose central focus is profits for their shareholders not delivery of care, don"t have the ability to deny care, limit coverage, or continually raise prices that endanger the health and financial security of patients." "The successes and standards of Medicare should be the model for reform for all Americans," said DeMoro. "If the final national bill will not meet that test by establishing Medicare for all, then let"s give Americans the tools to pass it in individual states." Currently, if states were to pass single-payer laws, as California, for one, has twice, only to have the bill vetoed by Gov. Arnold Schwarzenegger, it could be subject to immediate legal challenge due to the federal Employee Retirement Income Security Act (ERISA) which applies to all employer-paid health plans. The Kucinich amendment would provide an ERISA waiver. California Nurses Association


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