Next Stage Of Health Law Triggers Concern, Confusion


Obamacare Protest at Supreme Court

Obamacare Protest at Supreme Court (Photo credit: southerntabitha)

News outlets report on the confusion that continues to surround
the health law, especially as key provisions are about to take effect.
Meanwhile, officials and activists strategize about how to educate
consumers about their options.

Georgia Health News: Concern, Confusion Over The Next Stage Of Reform

In six months, Jimmy Rowalt will no longer have health insurance. For
the past two and a half years, the 25-year-old Athens resident has
worked at Highwire Lounge without worrying about the job’s lack of
health benefits. Now he’s a manager there, working 45 to 55 hours a
week. A rule allowing young adults to remain on their parents’ health
insurance policies until age 26 was one of the first provisions of the
Affordable Care Act to go into effect, in September 2010. … Rowalt’s
options will be meager after his October birthday, when he will be
dropped by his parents’ insurance company (Murphy, 4/22).

CT Mirror: Strategizing On Helping The Uninsured With Health Care Reform

As the country gears up to launch the Affordable Health Act, one of the
most difficult tasks will be to sell it to uninsured people who may have
never heard of the word “co-pay” or know what a primary care physician
is. That was the message of Alta Lash, a Connecticut community organizer
who was one of several speakers from across the nation at a daylong
roundtable discussion Monday on how to promote health equity through
“Obamacare.” The event attracted about 200 policymakers, social workers,
physicians and researchers to the Mark Twain House in Hartford for a
discussion of how to eliminate health disparities through the expanded
coverage that will take effect in January (Merritt, 4/22).

CNN Money: Millions Eligible For Obamacare Subsidies, But Most Don’t Know It

Nearly 26 million Americans could be eligible for health insurance
subsidies next year, but most don’t know it. That’s because relatively
few people are familiar with provisions in the Affordable Care Act, aka
“Obamacare,” that will provide tax credits to low- and middle-income
consumers to help them purchase health coverage through state-run
insurance exchanges (Luhby, 4/23).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Competition Key Ingredient To Success Of State Health Exchanges


Stateline reports that even some of the strongest health exchange
enthusiasts are concerned that some states will still only have limited
insurance choices for consumers. Meanwhile, in other news, the Arkansas
Medicaid expansion model gains momentum, Florida’s efforts face
continued complications, Arizona’s expansion standoff continues and the
Missouri Senate rejects the concept. Also, the shape of Ohio’s
compromise exchange is beginning to emerge.

Stateline: Lack Of Competition Might Hamper Health Exchange

The White House sums up the central idea behind the health care
exchanges in the new federal health law with a simple motto: “more
choices, greater competition.” But even some stalwart supporters of the
Affordable Care Act worry that in many states, people won’t have a lot
of health insurance choices when the exchanges launch in October. Health
economists predict that in states that already have robust competition
among insurance companies—states such as Colorado, Minnesota and
Oregon—the exchanges are likely to stimulate more. But according to
Linda Blumberg of the Urban Institute, “There are still going to be
states with virtual monopolies” (Vestal, 4/23).

Health News Florida: ‘Private Option‘ Plan, Florida Model, Passes In Ark.

Arkansas’ state legislature passed a model plan to expand Medicaid last
week, even though its Legislature is dominated by Republicans and the
measure had to pass by a three-quarters vote, the Associated Press
reports. The Arkansas plan is the model for Florida state Sen. Joe
Negron’s plan, which would accept an estimated $51 billion in federal
funds over 10 years to expand insurance to about 1 million of the
state’s low-income uninsured (Gentry, 4/22).

Miami Herald: Legislators Poised To Adjourn With No Medicaid Plan

As the clock winds down on the legislative session, Florida lawmakers
are sending signals that they are likely to adjourn without resolving
the issue of whether to accept federal Medicaid money to insure the
state’s poorest residents. “It’s not something you put together in a
week,”’ said Sen. John Thrasher, R-St. Augustine, chairman of the Senate
Rules Committee and a close adviser to Senate President Don Gaetz.
“It’s a very big, complicated issue and these issues take some time.” He
said he does not expect there would be political repercussions if the
Republican-led Legislature waits another year (Klash, 4/22).

Arizona Republic: Brewer, GOP In Medicaid Standoff

Three months after she stunned political observers and made her case for
expanding Medicaid coverage in Arizona, Gov. Jan Brewer is no closer to
reaching agreement with Republican legislative leaders on the issue,
which has driven a wedge through GOP ranks and is delaying work on the
state budget. By most accounts at the Capitol, Brewer has just enough
votes in the House and Senate to get expansion approved. Even some
lawmakers who oppose the plan predict it eventually will pass, owing in
large part to the power of the governor’s veto pen and her reputation
for tenacity, as well as pressure from top-flight lobbyists and
heart-tugging health-care crisis stories (Reinhart, 4/22).

The Associated Press: Mo. Senate Votes Down Federal Medicaid Expansion

Republican senators have made it clear that there will be no Medicaid
expansion in Missouri this session. The Republican-led Senate voted down
a Democratic attempt Monday night to insert $890 million of federal
funds into Missouri’s budget to expand Medicaid eligibility to an
estimated 260,000 lower-income adults (4/23).

Cleveland Plain Dealer: Ohio’s Medicaid Expansion Alternative Could Use Private Insurance

For the first time since Gov. John Kasich won national attention by
supporting Medicaid expansion, a clear picture is emerging on how the
Republican governor’s compromise with federal regulators could work.
Some uninsured Ohioans would be enrolled in the state’s traditional
Medicaid program, while others would sign up for private health
insurance using federal funding, said Greg Moody, director of Ohio’s
Office of Health Transformation. The proposal, which Kasich hopes to
sell to GOP lawmakers reluctant to support an outright Medicaid
expansion, has been dubbed “The Ohio Plan.” And it differs from the
standard federal expansion program on one crucial point: It puts some
enrollees in the private insurance market (Tribble, 4/22).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

John Kasich

John Kasich (Photo credit: Wikipedia)

Viewpoints: ‘Big Risks’ Of Buying Private Insurance With Medicaid Dollars; One Month Of Sequestration


US residents with employer-based private healt...

US residents with employer-based private health insurance, with self insurance, with Medicare or Medicaid or military health care and uninsured in Million; U.S. Census bureau: Income, Poverty, and Health Insurance Coverage in the United States: 2007 (Photo credit: Wikipedia)

Topics: Medicaid, Medicare, Health Reform, States, Health Costs, Women’s Health, Uninsured

Apr 01, 2013

The New York Times: Using Medicaid Dollars For Private Insurance
The Obama administration and Republican officials in several states are exploring ways to redirect federal money intended to expand Medicaid, the main public insurance program for the poor, and use it instead to buy private health insurance for Medicaid recipients. The approach could have important benefits for beneficiaries and for the future of health care reform. But the idea also carries big risks. Federal officials will need to enforce strict conditions before agreeing to any redirection of Medicaid dollars that were originally intended to enlarge the Medicaid rolls (3/31).

Forbes: The Arkansas-Obamacare Medicaid Deal: Far Less Than It First Appeared
When Arkansas Gov. Mike Beebe (D.) first announced that he had reached a deal with the Obama administration to use the Affordable Care Act‘s private insurance exchanges to expand coverage to poor Arkansans, it seemed like an important, and potentially transformative, development. … A Good Friday memo from the U.S. Department of Health and Human Services, however, splashes cold water on that aspiration. It’s now clear that the Beebe-HHS deal applies a kind of private-sector window dressing on the dysfunctional Medicaid program, and it’s not obvious that the Arkansas legislature should go along (Avik Roy, 4/1).

USA Today: ‘Sequester’ Still Looks Stupid, As Planned: Our View
Congress and the White House exempted some programs when they finalized the original deal, and the spending bill they agreed to last month to keep the government open to Sept. 30 spared some vital functions — food inspections, for example. But not enough. Nor does the sequester seriously address the major spending driver: health care costs. The best outcome would be for the sort of anger that forced Congress and the White House to re-open the government in 1996 to push Congress and the White House back to the table on a realistic budget deal this year. The outlines of that deal have been obvious for too long: Trim entitlement programs such as Medicare and Social Security, overhaul the hopelessly inefficient and corrupt tax code to bring in more money, and cut defense and domestic programs with a scalpel instead of an ax (3/31).

USA Today: ‘Sequester’ Needed To Rein In Spending: Another View
Let’s get real on the “sequester.” One month in, not much has changed. Nor is it likely to. Rather than devastating the federal government, the sequester is necessary to rein in the unbridled growth of federal spending. The sequester is certainly flawed. It’s a blunt instrument leaving the biggest spending drivers, entitlements, virtually untouched (Alison Fraser, 3/31).

The Wall Street Journal: The Liberal Medicare Advantage Revolt
A big political story this year is likely to be Democrats turning on their White House minders as the harmful and unpopular parts of the Affordable Care Act ramp up. On the heels of the recent 79-20 Senate uprising against the 2.3% medical device tax, now comes the surge of Democrats pleading on behalf of Medicare Advantage. Liberals have claimed for years to hate this program, but by now Advantage provides private insurance coverage to more than one of four seniors. And those seniors like it (3/29).

The Chicago Tribune: Scrubbing Medicaid
In January, Illinois launched an effort to scrub ineligible people from the state’s Medicaid rolls. … The initial results of this audit are … astonishing: Of the first 20,500 recipients screened by an outside contractor, the auditors recommend that 13,709 be removed from the rolls. Yes, that’s two-thirds of the first group screened, flagged as ineligible to receive their current Medicaid benefits. How so? In some cases, the recipients make too much money to qualify. In other cases, they don’t live in Illinois (3/31).

The New York Times: The Campaign to Outlaw Abortion
Anti-abortion groups have been trying to re-impose restrictions on abortion rights for 40 years, but the Legislature and governor of North Dakota have taken this attack on women’s reproductive health and freedom to a shocking new low … The clear message is the need for a stepped-up effort to hold state officials electorally accountable for policies that harm women in states where right-wing Republicans control the machinery of government (3/29).

The Seattle Times: State Senate Health Care Committee Should Vote On Abortion Measure
After the Senate Health Care Committee hearing on the Reproductive Parity Act Monday, members should vote for it before a key deadline Wednesday. State lawmakers do not need to complicate this issue. House Bill 1044 would maintain insurance coverage for women seeking abortions after federal health reforms take effect (3/31).

Los Angeles Times: The Starbucks Syndrome In Healthcare
Medicare statistics, for example, reveal that Los Angeles leads the nation in the amount of medical services provided during the last six months of a person’s life. Healthy seniors here are also big consumers of healthcare, getting about 65% more MRI studies and utilizing ambulances three times as often as seniors elsewhere. Commercial insurance data point to similar patterns in the healthcare of the younger population in Southern California. What explains such avid use of medical services. … Part of the problem is that Angelenos approach healthcare as they do other kinds of consumption. They expect their CT scans, when they want them, in much the same way they expect their decaf caramel extra hot low-fat macchiatos. (Daniel J. Stone, 3/31).

Los Angeles Times: Bump In The Road For Healthcare Law
One figure in a new report neatly summarizes the potential pitfalls for Obamacare: 30.1%. That’s how much premiums could rise next year, on average, for the roughly 1.3 million moderate- and upper-income Californians who buy individual health insurance policies. Most of that increase is attributable to the insurance reforms in the 2010 law, also known as the Affordable Care Act. The bill’s title is not ironic — its provisions will slow the growth of healthcare costs and lead over time to a more rational and efficient system. But the transition will have some rough patches, and we’re about to hit one (3/29).

Houston Chronicle: The Affordable Care Act Is A Poor Solution
Senator Orrin Hatch has speculated that the Affordable Care Act was designed to fail. A close look at the Act’s contents and history suggests he may be right. The Affordable Care Act is nothing more than a political stopgap, a waypoint on the road to something that might work. Republicans could stand around complaining or we could seize this opportunity to determine what comes next (Chris Ladd, 4/1).

Richmond Times-Dispatch: Moving Forward On Medicaid: More Important Than Ever
As a community physician for more than eight years, I’ve seen how medical care helps keep families strong and secure. When parents and their kids can access health care — and have a way to pay for it — they are much less likely to face unpaid bills or have to put off doctor visits. Instead of worrying about how their family is going to survive, they can focus on how their family is going to thrive. Unfortunately, too many Virginians — more than a million, in fact — find that getting health care is a real challenge because they don’t have insurance (Dr. Christopher Lillis, 4/1).

The Wall Street Journal: The Skinny On Anti-Obesity Soda Laws
New York Mayor Michael Bloomberg’s anti-obesity campaign to ban the sale of certain sugary drinks in large servings, especially sodas, was struck down last month in state court. A proposal for a penny-per-ounce excise tax on sweetened beverages also floundered in Vermont’s House of Representatives in February. … As an economist, I have two big gripes with such paternalistic public-health initiatives: The proposals aren’t grounded in data or compelling economic models, and soda taxes might catalyze a dismal chain reaction, with escalating government intrusions on personal freedom (Michael L. Marlow, 3/31).

Oregonian: Don’t Take Portland’s Sick-Leave Mistake Statewide: Agenda 2013
By voting to mandate paid sick leave last month, Amanda Fritz and her city council colleagues furthered Portland’s reputation as a place where businesses fear to tread. One way to protect city employers burdened by this mandate is to adopt a similar requirement statewide, erasing a competitive advantage a restaurant in, say, Beaverton might have over one in Portland. In other words, bail out Portland by making things tougher all over (3/31).

USA Today: ER Key To Curb Painkiller Abuse
Most opioids are prescribed in the doctor’s office, which has prompted some states to restrict primary care physicians like myself from prescribing them and to encourage referrals to pain specialists. New York City Mayor Michael Bloomberg has taken these curbs a step further by focusing on emergency departments. In January, he announced a voluntary initiative to limit prescription of opioid painkillers in the emergency rooms of the city’s 11 public hospitals. This approach should be expanded across the nation. From 2004 to 2009, the number of emergency visits in New York City hospitals related to opioid abuse or misuse more than doubled (Dr. Kevin Pho, 3/31).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

GOP Opposition To Health Law Hurts Efforts To Court Hispanics


Obamacare Protest at Supreme Court

Obamacare Protest at Supreme Court (Photo credit: southerntabitha)

Topics: Health Costs, Insurance, Medicaid, Politics, Health Reform, States

Apr 01, 2013

The Los Angeles Times reports that Latinos, who have the lowest rates of health coverage in the country, are among the strongest supporters of the health law. Meanwhile, AP examines the hard opposition to the overhaul in the South, led by Republican governors representing some of the poorest and least healthy states.

Los Angeles Times: Healthcare An Obstacle As Republicans Court Latinos
As Republican leaders try to woo Latino voters with a new openness to legal status for the nation’s illegal immigrants, the party remains at odds with America‘s fastest-growing ethnic community on another key issue: healthcare. Latinos, who have the lowest rates of health coverage in the country, are among the strongest backers of President Obama’s healthcare law (Levey, 3/31).

The Associated Press: The South: A Near-Solid Block Against ‘Obamacare’
As more Republicans give in to President Barack Obama’s health-care overhaul, an opposition bloc remains across the South, including from governors who lead some of the nation’s poorest and unhealthiest states…So why are these states holding out? The short-term calculus seems heavily influenced by politics (Barrow, 3/31).

The Hill: GOP Seeks To Benefit From Sebelius Admission On Healthcare Cost Hikes
Republican campaign officials are claiming new momentum for 2014 after the Obama administration admitted that some consumers could see their health insurance premiums rise under healthcare reform. This week’s surprise concession from federal Health secretary Kathleen Sebelius played into the GOP’s No. 1 message against the Affordable Care Act — that it will raise healthcare costs. The remark triggered a rush of campaign messaging against vulnerable Democrats who supported healthcare reform (Viebeck, 3/31).

Examining ‘A Glitch’ In The Health Law’s Tax Credits


English: Official portrait of US Senator Marco...

English: Official portrait of US Senator Marco Rubio of Florida. (Photo credit: Wikipedia)

Topics: Health Costs, Insurance, Marketplace, Politics, Health Reform

Mar 27, 2013

Reuters reports on a health law consequence that Families USA says needs to be fixed: that millions of “modest earners” could be priced out of health insurance. The Fiscal Times analyzes the current state of play regarding the measure’s new taxes and other moving parts.

Reuters: Little Hope Seen For Millions Priced Out Of Health Overhaul
Millions of Americans will be priced out of health insurance under President Barack Obama’s healthcare overhaul because of a glitch in the law that adversely affects people with modest incomes who cannot afford family coverage offered by their employers, a leading healthcare advocacy group said on Tuesday. Tax credits are a key component of the law and the White House has said the credits, averaging about $4,000 apiece, will help about 18 million individuals and families pay for health insurance once the Affordable Care Act takes full effect, beginning in January 2014 (Brown, 3/26).

The Fiscal Times: $1 Trillion In New Taxes From Health Reform Is Coming
Three years after enactment of the landmark legislation extending health care coverage to 27 million uninsured people, many in Congress and a majority of Americans are coming face to face with a daunting reality. Consumers will face higher insurance premiums, insurers will see a 32 percent increase in medical claims costs, and almost everyone in the upper middle class or higher will pay a slew of new taxes (Pianin, 3/27).

Also in the news, the latest developments regarding efforts to repeal the health law’s medical device tax.

Roll Call: McConnell To House: Move Device Tax Repeal Soon
The top Senate Republican is calling on the House to send over legislation to repeal the health care law’s tax on medical devices, following a bipartisan vote among senators in favor of such a move last week. Appearing Monday evening on the Hugh Hewitt radio show along with Florida GOP Sen. Marco Rubio, Minority Leader Mitch McConnell, R-Ky., said he thought House Republicans should pass a stand-alone repeal of the medical-device tax to see how the Senate would handle it (Lesniewski and Attias, 3/26).

Urban Institute: Medicaid Expansion Will Benefit Veterans


Topics: Medicaid, Politics, Health Reform, States

Mar 27, 2013

Overall, the health law could help as many as 40 percent of uninsured veterans gain access to health coverage. News outlets also report on Medicaid expansion news from Tennessee, Missouri and Louisiana.

The Hill: Analysis Finds Medicaid Expansion Will Benefit Veterans
Veterans stand to benefit substantially from President Obama’s healthcare law, particularly in states that choose to expand their Medicaid programs, a new analysis found. Researchers with the Urban Institute reported that as many as 40 percent of uninsured U.S. veterans would be eligible for healthcare under the law’s insurance exchanges or its expanded Medicaid program (Viebeck, 3/26).

The Associated Press: Haslam To Announce Medicaid Decision
Republican Gov. Bill Haslam will address a joint session of the Tennessee General Assembly on Wednesday about his decision on whether to expand Medicaid to cover more uninsured people under the federal health care overhaul, according to a person familiar with the plans. Lawmakers plan to authorize the gathering during regular floor sessions Wednesday morning, the official told The Associated Press on the condition of anonymity because the joint assembly hadn’t yet been publicly announced (Schelzig, 3/26).

The Associated Press: Mo. House Defeats Medicaid Expansion Effort
Missouri’s Republican-led House dealt a resounding defeat Tuesday to Democratic attempts to expand Medicaid, refusing to add more than $900 million to the state budget to cover 260,000 lower-income adults because of concerns about a future drag on state finances. The largely party-line votes against the Medicaid expansion marked the climax of a daylong House debate on Missouri’s budget but were almost a foregone conclusion (Lieb, 3/26).

New Orleans Times Picayune: Louisiana State Analysis Of Medicaid Expansion Shows State Could Financially Benefit
An analysis by the state Department of Health and Hospitals shows that accepting the Medicaid expansion envisioned in the federal health law would likely save Louisiana millions in 2014 and possibly for years beyond that. Under a “low-impact” scenario that envisions 577,329 new enrollees in the program, the state could save as much as $367 million over the course of a decade. In a “high-impact” scenario, the state could end up spending $1.71 billion over a decade, but that not only factors in 76,000 more people getting coverage but the state also drastically ramping up reimbursement rates for doctors and hospitals who accept Medicaid (Maggi, 3/26).

In other news, an ad campaign is launched in Florida, to urge the state to turn down federal Medicaid expansion funding.

Health News Florida: Ad Urges FL To Turn Down Federal $$
A small-business lobbying group has launched a TV and online ad campaign to do the seemingly impossible: Persuade Floridians to turn down an estimated $51 billion in federal funds over the next decade — money that would provide health coverage to about 1 million of the state’s uninsured. The sponsor of the ad is the Florida arm of The National Federation of Independent Business. It is the same group that partnered with Florida in a failed effort to get the Patient Protection and Affordable Care Act declared unconstitutional after President Obama signed it into law in 2010 (Gentry, 3/27).

Obama greets Harkin the day after healthcare b...

Obama greets Harkin the day after healthcare bill passed (Photo credit: Wikipedia)

Arkansas’ ‘Third Option’ For Medicaid Expansion Draws Attention


Earl Ray Tomblin

Earl Ray Tomblin (Photo credit: Wikipedia)

Topics: Medicaid, Politics, Health Reform, States

Mar 26, 2013

The approach, which is under consideration by state lawmakers, has attracted the interest of conservative governors and legislators in other states who had previously opposed the program’s expansion. Meanwhile, news outlets track Medicaid expansion news from Iowa and West Virginia.

NPR: Arkansas Medicaid Expansion Attracts Other States’ Interest
Since the Supreme Court made the Medicaid expansion under the federal health law optional last year, states’ decisions have largely split along party lines. States run by Democrats have been opting in; states run by Republicans have mostly been saying no or holding back. But now Arkansas – at the suggestion of the federal government – has suggested a third option: Enroll those newly eligible for Medicaid in the same private insurance plans available to individuals and small businesses. And some think that could shake things up. A lot (Rovner, 3/26).

The Associated Press: Ark. GOP Leader Floats Special Session On Medicaid
The top Republican in the Arkansas House on Monday said lawmakers should delay taking final action on a proposal to expand health insurance to low-income residents so state officials can answer questions about how the program would operate. Democratic Gov. Mike Beebe quickly dismissed the idea, repeating his call for lawmakers to vote on the proposal before the end of this year’s legislative session (3/25).

The Associated Press: Iowa Senate Backs Medicaid Expansion Legislation
Lawmakers in the Democratic-controlled Senate approved an expansion of Iowa’s Medicaid program Monday, though Republican Gov. Terry Branstad remains firmly opposed to growing the program in the state. In a 26-23 vote, split down party lines, the Senate backed the legislation. During the 90-minute debate, Democratic lawmakers argued that expanding Medicaid will provide care to more low-income Iowans with little cost to the state (3/26).

Des Moines Register: Senate Approves Medicaid Expansion Plan
The Iowa Senate approved legislation Monday night to add more than 100,000 low-income Iowans to the state-federal Medicaid health insurance program, setting up a showdown with Gov. Terry Branstad. Senate File 296 was approved 26-23 on a straight party line vote with Democrats in favor and Republicans against (Petroski, 3/25).

The Associated Press: W. Va. Diocese Joins Call For Expanding Medicaid
The leader of West Virginia’s Roman Catholic community has joined the chorus urging Gov. Earl Ray Tomblin to expand Medicaid to cover more low-income residents. Bishop Michael J. Bransfield wrote the governor Friday, citing deep concerns about the health and wellbeing of West Virginians he’s developed in his eight years with the Diocese of Wheeling-Charleston and its 83,000 or so Catholics (3/26).

And, on the topic of health exchanges –

The Associated Press/Washington Post: Maryland House Passed Bill Further Implements Health Care Reform
A measure to further implement federal health care reform in Maryland passed the House of Delegates on a 93-43 vote Monday with little debate. The measure creates a dedicated funding stream for the Maryland Health Benefit Exchange, which is a new insurance market that will offer residents a choice of private health plans. While the exchange is on track to be up and running by Jan. 1 with federal help in the first year, the state will begin paying roughly $24 million in fiscal year 2015. The money will come from an existing 2 percent tax on insurance plans that are state-regulated (3/25).