Senate Finance Committee Chair Max Baucus (D-Mont.) on Tuesday said that the economic stimulus package likely will include subsidies to help recently laid-off workers pay to retain their health insurance through COBRA, the Boston Globe reports (Wangsness, Boston Globe, 1/7).COBRA -- which allows recently laid-off workers to retain their group health insurance for as long as 18 months, provided that they pay the full cost of the premiums -- on average costs such workers 84% of their unemployment benefits, according to a report scheduled for release on Friday by Families USA . David Lemmon, a spokesperson for Families USA, said that the group has provided copies of the report to Baucus and the transition team of President-elect Barack Obama (Clarke, CQ Today, 1/6). According to Senate Democratic aides, the Congressional Budget Office has not determined the cost of the COBRA subsidies, and the percentage of the premiums that the subsidies would cover also remains undetermined (Boston Globe, 1/7). The COBRA subsidies would expire after two years, aides said (Weisman, Wall Street Journal , 1/7). Aides said that the COBRA subsidies will account for part of the estimated $100 billion included in the stimulus package for health care provisions (Boston Globe, 1/7). Other health care provisions in the stimulus package likely will include an increase in federal Medicaid funds for states, an investment in health care information technology, and funds for medical research, prevention programs and community health centers (Frates, The Politico , 1/6). In addition, Obama has proposed a provision in the stimulus package that would allow workers who lose jobs that did not include health insurance to apply for Medicaid (Wall Street Journal, 1/7).The Senate Finance Committee plans to hold a closed meeting Thursday to determine the level of support for health care and other provisions in the stimulus package (Rogers, The Politico , 1/7). Congressional committees likely will begin to hold hearings and markup sessions on the stimulus package as early as next week (CQ Today, 1/6).

Comments In a statement, Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) said of the COBRA subsidies, "Congress has a responsibility to help the victims of this crisis keep their health insurance even when they lose their jobs," adding, "The stimulus needs to include both job support and health support." Senate Budget Committee ranking member Judd Gregg (R-N.H.) said that he might support the COBRA subsidies, provided that they remain temporary (Boston Globe, 1/7). However, House Budget Committee ranking member Paul Ryan (R-Wis.) said that the COBRA subsidies and additional federal Medicaid funds for states "aren't stimulus" and amount to "ideological accomplishments in the guise of economic stimulus" (Wall Street Journal, 1/7).

Health Care Groups Seek Additional Medicaid Funds In related news, a coalition of patient, hospital, physician and nursing home groups on Tuesday sent a letter to lawmakers asking for more than $125 billion in additional federal Medicaid funds for states, CQ HealthBeat reports. The groups said that the stimulus bill should link matching funds to local government contributions to the portion of Medicaid funded by states, as well as "a robust maintenance of effort to protect against adverse changes in eligibility, benefits, provider payments or access to care."The groups that signed the letter included the American Academy of Pediatrics , the American Hospital Association , the American Academy of Family Physicians , the American Health Care Association and the National Association for Home Care and Hospice (Reichard, CQ HealthBeat, 1/6).

Opinion Piece "As with the practice of medicine, the application of economic stimulus is as much art as it is science," and "it's imperative to get a clear idea of how proposals for new spending on health care" and other provisions "would work and why they should be part of this package," Washington Post columnist Ruth Marcus writes.She writes, "Much of what the Obama team proposes is more -- much more -- of the same," such as "giving states extra money for Medicaid," adding, "By contrast, launching a new 'green energy' plan or a program to computerize health records, is a newer, more complicated endeavor, one that calls for more consideration than up-or-down vote on the floor." According to Marcus, "It is incumbent on Obama's advisers to explain how these programs would contribute to the recovery." In addition, lawmakers "need to consider whether they are passing a temporary stimulus or paving the way for permanent spending," according to Marcus.She writes, "The next several weeks will be a test, for the new Congress as much as for the new administration," because the nation "cannot afford a 111th Congress as gridlocked as the 110th," adding, "Nor should it settle for a rubber-stamp Democratic Congress doing the bidding of the new Democratic president" (Marcus, Washington Post, 1/7).

Broadcast Coverage NBC's "Nightly News " on Tuesday reported on efforts to overhaul the U.S. health care system amid a worsening economy, as well as health care provisions expected to be included in the stimulus bill. The segment includes comments from Kaiser Family Foundation President and CEO Drew Altman; Karen Ignagni, president and CEO of America's Health Insurance Plans ; Obama; and Ron Pollack, executive director of Families USA . The segment is part of a series of special reports titled "America's Agenda" (Bazell, "Nightly News," NBC, 1/6).

The United Nations Population Fund is partnering with a local Pakistani nongovernmental organization in an effort to educate female commercial sex workers in the city of Karachi -- where thousands of such women are at high risk for contracting HIV and other sexually transmitted infections through unprotected sex -- on prevention methods and condom use, IRIN/PlusNews reports. Mizra Alim Baig, president of the Gender and Reproductive Health Forum, said the organization has been able to distribute hundreds of UNFPA-provided condoms daily "in the hope that somewhere a life might be saved." Baig also said that it "used to be a thankless job" but that he is "happy" female commercial sex workers have the "tools and knowledge to better protect themselves against HIV/AIDS, STIs and hepatitis." The forum also utilizes a group of outreach workers that includes former sex workers. "These women know what these [female sex workers] are going through and can relate to them in a better way," Baig said. According to a 2007 UNFPA survey, 1,015 out of 11,324 female sex workers in Karachi had taken HIV tests, and two tested positive for the virus. IRIN/PlusNews reports that the first reported case of an HIV-positive female sex worker in Karachi "created a scare in the city's brothels," and although many sex workers tried to insist on condom use, "the customers mostly refused." Baig said that women in Pakistani society are "regarded as second class citizens" and the "situation is worse" for female sex workers, who often have unprotected sex with members of other high risk groups, such as injection drug users and male sex workers who also have sex with men. He added, "We may not be on the brink of an epidemic when it comes to [female sex workers], but the facts remain that these women are vulnerable" (IRIN/PlusNews, 1/6).

An HIV-infected taxi driver had indiscriminate sexual relations with scores of women, police in Jecheon, South Chungcheong Province, said yesterday. Though the 26-year-old man “Jeon” is simply an HIV carrier and does not have AIDS, the incident has ...

In 2006, a local gynecologist reported that she treated more cases of herpes and human papillomavirus at The Villages than she did when she worked in Miami. ...

By Rebecca C. Espera Davao City (18 May) -- Tomorrow will be observed World Hepatitis Day under the auspices of the Philippine Hepatology Society in coordination with World Hepatitis Alliance. The event aims is to give attention to hepatitis virus just ...

Experts on Thursday during a Senate Health, Education, Labor and Pensions Committee hearing discussed a number of state programs that have helped residents quit smoking, lose weight and improve their health, CQ HealthBeat reports.During the hearing, part of an ongoing series held by the committee to discuss efforts to improve the U.S. health care system, L. Allen Dobson, chair of North Carolina Community Care Networks , said that the state Community Care program, which provides Medicaid and SCHIP beneficiaries and other low-income residents with important parts of a medical home and community-based care management, has improved care for asthma, reduced hospitalizations by 35% and resulted in savings of more than $100 million annually since 2003. Iowa state Sen. Jack Hatch (D) said that the Health Care Reform Act, a state law approved in May 2008 that seeks to expand health insurance to all eligible children by 2011, has led to the creation of medical homes, a statewide electronic health record system, and local and private-sector prevention programs.According to JudyAnn Bigby, secretary of Massachusetts' Health and Human Services , a state smoking cessation program that makes group or individual counseling and nicotine lozenges, patches and other medications available for Medicaid beneficiaries has helped more than 15,000 beneficiaries quit smoking since July 2006. Jonathan Fielding, director of the Los Angeles County Department of Public Health , said that states should focus on smoking prevention efforts among teens, establish nutrition standards for school meals and promote physical activity to help prevent childhood obesity.Committee Chair Tom Harkin (D-Iowa) said, "As we draft health reform legislation at the federal level, it is important that we capture the excellent ideas and practices that are being pioneered by the states and coordinat[e] our initiatives" (Attias, CQ HealthBeat, 1/22).

Some teenagers and young adults might overestimate how often they use condoms during sex, according to a study published recently in the Archives of Pediatrics and Adolescent Medicine, Reuters Health reports. Eve Rose of Emory University and colleagues conducted the study among 715 black women and girls ages 15 to 21 who were enrolled in an HIV prevention program. Researchers asked the participants how many times in the past two weeks they had sex and how many times they used a condom. The participants also provided vaginal fluid samples to be screened for Y chromosome DNA, or evidence of sperm. The researchers found that among the women who had sex during the past two weeks, 186 reported condom use every time. However, of the women who reported consistent condom use, 34% had Y chromosome DNA in their fluid samples. According to the researchers, the reasons for the discrepancy -- including that the participants were mistaken, had misused the condoms or had provided the "socially desirable" response -- are not known. They add that "regardless of whether the problem is condom user error or misreporting, the unfortunate result, in terms of risk for [sexually transmitted infections] and HIV, is the same." The study's findings also have implications for young people's sexual health and studies on the issue, the researchers said. They added that studies using both self reports and objective measures of condom use might provide a more accurate understanding of young people's sexual behavior and their STI risk (Reuters Health, 1/14). An abstract of the study is available online .

The Obama administration and the Congressional Budget Office have indicated that Social Security beneficiaries will not receive a cost-of-living increase in 2010 or 2011, which would have "major implications for Medicare," the New York Times reports. Social Security typically increases benefits annually to keep up with rising prices of consumer goods; however, the current economic recession, coupled with other factors, has resulted in low inflation, which likely will result in the lack of a cost-of-living increase. Federal law stipulates that most Social Security beneficiaries cannot have their Medicare Part B premiums increase by more than the dollar amount of the cost-of-living increase in their Social Security checks. As a result, about 75% of beneficiaries' Medicare Part B premiums will remain the same. However, about 25% of Medicare beneficiaries are not protected by this law and could see their premiums increase. According to the Times, most Medicare beneficiaries pay a monthly Part B premium of $96.40. CBO estimates the basic premium will rise to $119 next year and to $123 in 2011 for those not protected by the law. In addition, the Times reports that millions of beneficiaries also could experience higher premiums for drug coverage under Medicare Part D because there are no laws that prevent such an increase.David Certner, legislative counsel at AARP , said, "If, as expected, there is no COLA in Social Security next year but premiums for drug coverage increase, as expected, millions of beneficiaries will see their Social Security checks reduced for the first time" (Pear, New York Times, 5/3).

The Mayor's Office of Health Policy in New Orleans on Tuesday told the City Council that it has made efforts to expedite the distribution of Ryan White Program funding for 2009, the New Orleans Times-Picayune reports. City Council member Arnie Fielkow called on officials to begin the 2009 distribution process earlier in the year to avoid a delay similar to what was seen in 2008, when the distribution of Ryan White grants was delayed by six months. Fran Lawless, director of the Office of Health Policy, told the council's Housing and Human Needs Committee that she believes it is "doable" to come up with grant awards for select local service providers by March 15 -- two weeks after HHS will have announced the allocation of Ryan White funding. After the meeting, Lawless said that although she expects contracts to be written by March 15, there are too many intervening factors in the process to expect final executed contracts by that date. Lawless also told the council committee that under a new policy, the health department will check the progress of contracts daily as they move through the city's grant approval process, the Times-Picayune reports. In terms of the reason behind the delay in distribution last year, Lawless said that the wait in part was because six city departments have to sign off on each contract with a selected provider before they can be approved by the mayor. She also said the delay was because of larger providers failing to submit their invoices on time. According to Lawless, the office is unable to set up contracts with providers -- and providers cannot set a budget for the contract -- until the full amount of Ryan White funding is announced March 1. She added that the New Orleans City Charter bans her office from executing any contract prior to this announcement. However, City Council member Stacy Head said she does not agree with Lawless' interpretation, adding that the city can enter into provisional contracts with service providers in advance of the federal announcement and tie the exact value of each contract to the future available grant. Lawless acknowledged that final grant amount is not difficult to insert into provisional contracts, according to the Times-Picayune (Hammer, Times-Picayune, 1/14).

IRIN News on Wednesday examined the stigma and discrimination faced by HIV-positive people in Iraq. According to Ihsan Jaafar, head of the Ministry of Health's public health directorate, Iraq has a relatively low HIV prevalence, and 44 people are confirmed to be living with the virus in the country. Wadah Hamed -- head of Iraq's national HIV/AIDS prevention program and the country's AIDS Research Center -- said HIV first entered Iraq in 1985 through the importation of contaminated blood. Since 1986, the country has detected 482 cases of the virus, of which 272 have occurred among Iraqis and the rest among foreigners. Treatment in the late 1980s was "tough and arbitrary," Hamed said, adding that those who tested HIV-positive often "were placed in segregated medical facilities." According to IRIN News, people living with HIV in Iraq often face "social isolation and even death at the hands of religious extremists who believe the virus is proof that an HIV-positive person must have engaged in indecent acts." In addition, some Muslim extremists believe that people with HIV are "'sinners who should be killed," IRIN News reports. Iraqi officials do not have data on HIV-positive people gunmen have killed, according to IRIN News. Iraq's health ministry in response to the stigma associated with HIV/AIDS in the country is launching a campaign to raise awareness about the disease by working with local media outlets, distributing posters and holding workshops. Secondary school curricula also will include HIV/AIDS awareness programs, and officials have established a hotline for people seeking advice about the disease. According to Hamed, the campaign intends to stay "low-key, because our country is still not open to such subjects." He added that he does not want the campaign to "trigger panic and anxiety among the public."According to IRIN News, Iraq's government currently provides the equivalent of about $85 monthly plus a clothing allowance for people in the country living with HIV. In addition, those who contracted the disease in 1985 receive an extra $200 monthly. The government also provides no-cost monthly checkups for all HIV-positive people, partner examinations every three months and additional examinations for other family members every six months. At least 11 medical centers in Baghdad provide these services, IRIN News reports. In addition, the health ministry in coordination with the World Health Organization provides no-cost antiretroviral drugs for HIV-positive people in the country (IRIN News, 1/14).