Proposal Would Require Insurers To Report Health Law Taxes

English: , member of the United States Senate....

English: , member of the United States Senate. Español: John Cornyn, un senador del Senado de los Estados Unidos (Photo credit: Wikipedia)

The measure’s sponsor, Sen. John Cornyn, R-Texas, bills it as a
way to educate consumers about how the health law’s benefits are funded.

The Hill: Insurers Would Report ObamaCare Taxes Under GOP Bill

A new bill from Sen. John Cornyn (R-Texas) would require health insurers
to disclose taxes they pay under ObamaCare to policyholders. In a
statement Monday, Cornyn touted the measure as a way to educate
consumers about how the Affordable Care Act’s benefits are funded

Also in the news, health law opponents are pressing for repeal of the
health law’s medical device tax, among other provisions, in
comprehensive tax reform legislation –

Roll Call: Health Law Tax Foes Find Hope In Overhaul Effort

Proponents of doing away with provisions such as the medical-device tax
and the annual fee on health insurance companies say they already have
bipartisan support for their repeal legislation. But the efforts still
will face health care politics and the need for significant offsets,
making their inclusion far from certain as lawmakers work toward
comprehensive tax legislation that can pass in both chambers (Attias,

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.


Stakeholders See Health Law Benefits, Challenges

insurance broker

insurance broker (Photo credit: Elva Keaton)

Topics: Health Costs, Insurance, Marketplace, Health Reform, Delivery of Care

Mar 26, 2013

News outlets explore issues emerging from the health law’s implementation, including how the costs of insuring full-time employees could be a boon for temporary staffing agencies, how nurse practitioners are seeking a greater role in primary care and how some clinics are fighting to benefit from the law’s changes.

Kaiser Health News: Temp Agencies See Opportunity In Health Law
The rush to implement the Affordable Care Act, which is generating billions for insurers, hospitals and technology vendors, also looks like a boon for staffing companies, whose share prices have soared. But some suggest that exceptions for temporary employees could leave holes in the health law’s expanded coverage (Hancock, 3/26).

Marketplace: The Nurse Practitioner Will See You Now
It can be tough to see a primary care physician today. Just wait till next year when another 30 million patients or so get insurance under Obamacare. “We need all hands on deck. We need more family physicians. We need more primary care nurse practitioners, we need more physicians assistants…we need pharmacists. Everyone with a focus on the patient,” says Dr. Wanda Filer, a physician in York, Penn., and board member of the American Academy of Family Physicians. The nation is facing a shortage of primary care physicians. Estimates range from several thousand today to 52,000 by 2050. Annual spending on primary care is approximately $200 billion (Gorenstein, 3/25).

HealthyCal: Feminist Clinic Fights To Be Included In Health Care Reform
As millions of Californians are projected to gain coverage over the next several years, the independent clinics that have traditionally served the uninsured are in for some big changes. Soon, many more low-income patients are expected to have private insurance, following the roll out of the Affordable Care Act’s signature reforms in 2014. That’s putting some clinics, like those in the Women’s Health Specialists network, in a quandary. They want to be a part of the system that’s creating a boon of paying patients – but in a way that allows them to hold onto their guiding principles (Bartos, 3/26).

The Hill: Study: Health Law Has Imposed 111 Million Hours Of Paperwork
In its first three years, President Obama’s healthcare law has imposed more than $30 billion in costs and 111 million hours of paperwork burdens, according to a new study from the American Action Forum. The forum, a conservative think tank led by former Congressional Budget Office Director Douglas Holtz-Eakin, said the law will raise premiums and hurt small businesses (Baker, 3/25).

The Hill: GOP Lawmaker Wary Of Voter Registration Questions In Obama Health Law Forms
A Republican lawmaker is concerned about voter registration questions buried in a draft application to receive benefits under President Obama’s healthcare law. Rep. Charles Boustany (R-La.), who leads a House subcommittee on oversight, said the questions’ placement could lead some to believe that voter registration is tied to eligibility for the law’s insurance exchanges (Viebeck, 3/25).

Meanwhile, the New York Times looks at how employers are using worker’s health care premiums on incentives programs –

The New York Times: Companies Get Strict On Health Of Workers
Employers are increasingly trying to lower health care costs by using incentives to persuade workers to make better lifestyle choices, a new survey shows, but what remains less clear is whether a reward is better than a punishment — or whether the programs work at all (Thomas, 3/25).

More Workers Covered By Bosses’ Self-Insured Plans

By Ankita Rao

November 28th, 2012, 5:25 PM

The number of U.S. workers covered by self-insured health plans—in which their employer assumes the financial risk for health costs rather than paying insurance companies to do that—has grown steadily in recent years. But such plans are still primarily used by large companies, not small employers, a new study finds.

As of 2011, more than half of U.S. employees were covered under these self-insured plans, compared to about 41 percent in 1998, according to a report by the Employee Benefit Research Institute. These plans can lower costs for employers by reducing administration, exempting them from state-mandated services, and allowing them to provide uniform coverage across state lines.

Sometimes workers do not even know that their employer is self-insuring because the company will hire a traditional insurance plan to administer the program.

Businesses with less than 50 employees have not followed the same trend, with only 10.8 percent of private sector enrollees in self-insured plans in 2011. The number has remained generally around 12 percent since 1998, according to EBRI.

The analysis also found that the rates varied by state — Hawaii was on the lower end with 30.5 percent of workers enrolled in self-insured plans, and Indiana and Minnesota were on the higher end with more than 70 percent enrolled. Massachusetts, the only state to have enacted universal health care coverage, saw more medium and large firms choose self-insurance.

The report’s author, Paul Fronstin, director of EBRI’s Health Research and Education Program, says the research was prompted by speculation that smaller firms increasingly may move to a self-insured model because of their concerns about rising insurance costs under the 2010 federal health law.

Employers generally, and small employers particularly, concerned about the rising cost of providing health coverage may view self-insurance as a better way to control expected cost increases,” notes Fronstin. “This new analysis provides a baseline against which to measure future trends.”

In a separate issue brief, researchers from The Urban Institute said the health law will make self-insurance plans more attractive to small employers because of less price discrimination against small groups.

But since the federal regulations don’t apply to self-insurance, authors said a small business migration to the plans could “undermine the effectiveness of the Affordable Care Act’s small-group reforms and to destabilize the market.” But the brief describes ways that federal or state regulation can help mitigate that problem.

This sign, displayed at all credit unions, inf...

This sign, displayed at all credit unions, informs members that their savings are insured by the NCUA. (Photo credit: Wikipedia)

Raising – And Answering – Questions About Health Law’s Future

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

Nov 09, 2012

Kaiser Health News: After The Election: A Consumer’s Guide To The Health Law
Now that President Barack Obama has won a second term, the Affordable Care Act is back on a fast track. … Here’s a primer on parts of the law already up and running, what’s to come and ways that provisions could still be altered: … I get my health coverage at work and want to keep my current plan. Will I be able to do that? How will my plan be affected by the health law? (Carey and Gold, 11/9).

The New York Times: With Obama Re-Elected, States Scramble Over Health Law
After nearly three years of legal and political threats that kept President Obama’s health care law in a constant state of uncertainty, his re-election on Tuesday all but guarantees that the historic legislation will survive. Now comes another big hurdle: making it work. … Will the administration, for example, try to address the concerns of insurers, employers and some consumer groups who worry that the law’s requirements could increase premiums? (Goodnough and Pear, 11/8).

The Associated Press: Obama’s Health Care Overhaul Turns Into A Sprint
[N]ot all hurdles have been cleared. Republican governors who opposed the law have to decide whether it’s better for their states to now help carry it out. The administration could stumble carrying out the complex legislation, or get tripped up if budget talks with Congress lead to scaling back the plan (Alonso-Zaldivar, 11/9).

Kaiser Health News Bloggers Parse What Happens Next On Health Law
Bloggers are focusing on how the law will be implemented, what the role of states may be, how patient care will be affected and how the work left to be done will shake out. Here’s a sampling (Villegas, 11/8).

CQ HealthBeat: Berwick Pleased That Implementation Of Law Is Proceeding, But Worried About Funding
Former Centers for Medicare and Medicaid Services Administrator Donald M. Berwick said Thursday he fears that House Republicans might still try to deny funding for health care law implementation, particularly for the insurance exchanges. Berwick, who is now a senior fellow at the Center for American Progress and spends a good deal of his time visiting health systems around the country, said that just because the electoral results protect the health care law from repeal, “that doesn’t automatically mean it can be implemented” (Adams, 11/8).

Politico: ACA Opponents Scramble For A Plan B
What’s the plan for Obamacare’s opponents now? Judging from Republicans’ mixed messages Thursday, the plan is: disarray. … The best hopes of resistance, for now, are coming from the states — where some governors are saying they may just not move ahead to set up the health exchanges. But even then, all that happens is that the feds would set up the exchanges for them (Norman and Millman, 11/8).

Politico Pro: U.S. Lawyers Defend Health Law In ‘Blue Slip’ Case
Once again, the Obama administration is defending the health reform law in court. And this time it’s arguing that there is no reason for a court to strike the individual mandate — which the Supreme Court in a separate lawsuit considered a tax — just because the bill originated in the Senate. This lawsuit alleges that the health law violates the Constitution’s requirement that all revenue-raising bills start in the House. It’s a technical claim that its backer — Iraq war veteran Matt Sissel — hopes will put a significant dent in the law (Haberkorn, 11/9).

English: Barack Obama signing the Patient Prot...

English: Barack Obama signing the Patient Protection and Affordable Care Act at the White House (Photo credit: Wikipedia)

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.

States Get Extra Time On Health Insurance Exchanges

Topics: Health Reform, Insurance, States

Nov 10, 2012

News organizations covered the late-afternoon Friday development – a letter from Health and Human Services Secretary Kathleen Sebelius.

Kaiser Health News: Obama Administration Extends Deadline For State Exchanges
The Obama administration on Friday gave states more time to submit plans to set up state-based health insurance exchanges, a concession to the reality that many states had delayed planning until they saw who won the presidential election (Galewitz, 11/9).

NBC News: States Get 3 More Weeks For Health Exchange Plans
“The deadline for a Declaration letter for a State-based exchange remains Friday, November 16, 2012,” [Sebelius] wrote in a letter to governors. “However, today, in order to continue to provide you with appropriate technical support if you are pursuing a State-based exchange, HHS is extending the deadline for State-based Exchange Blueprint application submissions to Friday, December 14, 2012.” (Fox, 11/9).

KHN has a pdf of the letter from Secretary Sebelius to governors.

The Hill: HHS Offers States Extra Time On Exchanges
The [Affordable Care Act] envisions each state running its own exchange, but authorizes a federal fallback in states that don’t move to set up their own marketplace. … even some conservative governors have been quietly studying how an exchange would work, preferring to set their own rules rather than defer to HHS (Baker, 11/9).

Los Angeles Times: Obama Administration Extends Health Law Deadline
These exchanges are designed to allow Americans who don’t get coverage through work to buy insurance on Internet-based marketplaces much as they shop for airline tickets today. They were to be operated by states starting next fall so consumers could get insurance starting in 2014. But just 15 states, including California, Maryland and Connecticut, as well as the District of Columbia, have established an exchange, according to the nonpartisan Kaiser Family Foundation (Levey, 11/9).

The New York Times: U.S. Extends a Deadline for States on Coverage
The White House has repeatedly said that states were making excellent progress toward creation of the exchanges, even as Republican governors and state legislators expressed ambivalence or outright opposition. In addition, state officials who want to establish exchanges said they were having difficulty because Mr. Obama had yet to issue crucial regulations and guidance (Pear, 11/9).

The Washington Post: For Hurried States, Obama Administration Extends Health Law Deadline
Many states, however, have already made a decision not to play any role in setting up their exchanges: Florida, Kansas and Virginia all announced Thursday that they would leave the task to the federal government. States have cited their opposition to the health care law as one reason they won’t move forward. Others also see logistical challenges: If they rush to set up the marketplace, it may not have a smooth launch (Kliff, 11/9).

The Associated Press: States Get More Time To Work On Health Care Plans
In a concession to procrastinators, Sebelius said states considering a partnership with the federal government to run their exchanges can now have until mid-February to make a decision and submit their blueprints (Alonso-Zaldivar, 11/9).

Politico Pro: HHS Pushes Back Exchange Decision Deadline
The new HHS deadline … also gives the Obama administration more time to issue rules that have been on hold in the months leading up to the election. State officials — Republican and Democrat alike — have complained that the administration hasn’t provided key details on ground rules for exchanges, benefits that health plans must provide and the health law’s now-voluntary Medicaid expansion, among other new requirements in the health care law (Millman, 11/9).

Official portrait of United States Health and ...

Official portrait of United States Health and Human Services Secretary . (Photo credit: Wikipedia)

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.

States, Feds Confront Health Law P.R. Challenges, Exchange Implementation

Centers for Medicare and Medicaid Services (Me...

Centers for Medicare and Medicaid Services (Medicaid administrator) logo (Photo credit: Wikipedia)

Official photographic portrait of US President...

Official photographic portrait of US President Barack Obama (born 4 August 1961; assumed office 20 January 2009) (Photo credit: Wikipedia)

Topics: Health Reform, States, Insurance, Marketplace

Oct 05, 2012

States are dealing with the ramifications of the health law’s federally or state-run health insurance exchanges and the essential health benefits. Also, officials confront the challenge of educating the public on the health law’s provisions.

The Washington Post: Small Businesses Push Back On DC Insurance-Exchange Mandate
The District’s small businesses may have to buy their employee health insurance through a city-run exchange come 2014, following a controversial vote by a city board. The D.C. Health Benefit Exchange Authority, charged with implementing the federal health care overhaul, voted Wednesday evening to accept a recommendation that all health-insurance plans sold in the city for 50 members or fewer must be purchased through the exchange (DeBonis, 10/4).

Politico Pro: Louisiana May Try To Stop EHB In Its Tracks
Plenty of states, almost exclusively Republican-led, say they don’t have enough guidance from the feds to select an essential health benefits benchmark plan. But they seem willing to accept the federal default plan taking effect in their states. Louisiana, however, is taking it one step further. The state — at the front lines of opposing the Affordable Care Act — is looking to stop the EHB from taking effect within its borders (Millman, 10/4).

Kaiser Health News: Capsules: Berwick: Debate Underscores Challenge Explaining Health Law
More than two and a half years after he signed the most far reaching health care legislation into law, President Barack Obama showed in his Wednesday debate with Mitt Romney that explaining the law is still no easy job (Galewitz, 10/5).

Politico Pro: Panelists Agree: ACO Push Likely To Survive
The political winds are at the back of accountable care organizations, no matter who wins the election, and economic pressure to make “integrated care” work will continue to push the health care system away from fee-for-service, panelists agreed at a Politico Pro briefing Thursday. Bruce Fried of SNR Denton compared the health care system to a “battleship” that may not be able to turn around in time to achieve the savings Medicare needs — making it that much more urgent to double down on ACO-like reforms (Norman, 10/4).

In the meantime, the Department of Health and Human Services has hired a PR firm to educate the public about the federal health insurance exchanges —

CQ HealthBeat: Federally-Paid PR Firm To Help Market Federal Exchanges
The Centers for Medicare and Medicaid Services has hired public relations firm Weber Shandwick to help promote the health insurance exchanges the administration will operate in states in 2014. With the $3.1 million contract, the New York City-based firm will help with a strategic plan to raise awareness about the exchanges, educate consumers and conduct outreach. “This will help our educational effort to ensure more Americans have access to quality, affordable health insurance,” said a CMS spokesperson. States have until Nov. 16 to tell the administration about whether they will operate the insurance exchanges on their own, run a hybrid model with federal assistance, or rely on the federal government to operate the exchange (Ethridge, 10/4).

The Hill: HHS Signs $3 million PR Contract To Promote Federal Exchange
The new $3.1 million award is tied to the fallback exchange that the Health and Human Services Department will operate in states that don’t set up their own exchanges. Only a handful of states have taken concrete steps to set up an exchange, and some states that want to handle the task themselves won’t be ready by the Jan. 1, 2014, deadline (Baker, 10/4).

And in other health law news —

St. Louis Beacon: Appeals Court Affirms Decision To Dismiss Kinder Suit Against Health Care Law
The 8th Circuit Court of Appeals has upheld a lower court decision to dismiss Lt. Gov. Peter Kinder’s challenge to the Affordable Care Act.The Republican officeholder, who is seeking re-election Nov. 6, filed a federal suit against President Barack Obama’s signature domestic achievement in 2010, taking particular aim at the mandate requiring most Americans to buy health insurance. A lower federal court earlier threw out the suit, stating that Kinder didn’t have standing because he has health insurance (Rosenbaum, 10/4).

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.

The Postive Or Negative Impact Of Health Law Is In Eye Of Beholder

English: Arizona Governor Jan Brewer meeting w...

English: Arizona Governor Jan Brewer meeting with President Barack Obama in June 2010 in the wake of SB 1070, to discuss immigration and border security issues. Español: La gobernadora de Arizona Jan Brewer reuniéndose con el presidente Barack Obama en junio de 2010 tras la aprobación de SB 1070 para discutir las cuestiónes de la inmigración y la seguridad fronteriza. (Photo credit: Wikipedia)

Heather Wooten (Public Health Law & Policy) mo...

Heather Wooten (Public Health Law & Policy) moderates a policy priority breakout session on retail food environments in front of a giant map of all the organizations represented at the California Convergence. (Photo credit: heacphotos)

Topics: Insurance, Marketplace, Health Reform, States

Sep 24, 2012

Some businesses are taking advantage of the health law’s requirements as states prepare to implement it.

The New York Times: Liking It Or Not, States Prepare For Health Law
Like many Republican governors, Jan Brewer of Arizona is a stinging critic of President Obama’s health care law. … Yet the Brewer administration is quietly designing an insurance exchange — one of the most essential and controversial requirements of the law. Officials in a handful of other Republican-led states say they are also working to have a framework ready by Nov. 16, the deadline for states to commit to running an exchange or leave it to the federal government to run it for them (Goodnough, 9/23).

USA Today: Health Care Law‘s Impact On Businesses Varies
Companies specializing in driving down spending on health care, whether through electronic records, preventive care or consolidating services, are turning out to be the biggest winners from the 2010 health care law. … Health care information technology spending for the second quarter hit $293 million, up from $86 million for the same period last year (Kennedy, 9/23).

And on the topic of essential health benefits –

Politico Pro: Exchange Week: Wrapping Up Essential Benefits
States continue to wrestle with their essential health benefit decisions, as many aim to have their picks in by the suggested date of Oct. 1. Meanwhile, Nebraska looks to get its Web portal going, and California starts to figure out who will come, now that they’ve built it (Millman, 9/24).

Politico Pro: Advocates See State Confusion Over EHB
T]he health law’s strongest supporters in some fierce anti-“Obamacare” states are facing ample confusion about what the governors are planning. … consumer groups in states that are most opposed to the federal health law say there is not much clarity about the EHB decision. Nor is it exactly clear how much more time HHS will really allow them to finalize plans (Millman, 9/24).

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.