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).

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Sebelius: Some Insurance Costs Could Increase When Law Is Implemented


Portrait of United States Health and Human Ser...

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

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

Mar 27, 2013

The HHS secretary’s remarks came as insurers are becoming increasingly jittery about how sweeping health law changes will impact the marketplace and on the same day that the Society of Actuaries released a study that predicted increased medical claims costs.

The Wall Street Journal’s Washington Wire: Sebelius: Some Could See Insurance Premiums Rise
Some people purchasing new insurance policies for themselves this fall could see premiums rise because of requirements in the health-care law, Health and Human Services Secretary Kathleen Sebelius told reporters Tuesday. Ms. Sebelius’s remarks come weeks before insurers are expected to begin releasing rates for plans that start on Jan. 1, 2014, when key provisions of the health law kick in (Radnofsky, 3/26).

Reuters: Some Healthcare Costs May Rise When ‘Obamacare’ Implemented: Official
President Barack Obama’s top healthcare adviser acknowledged on Tuesday that costs could rise in the individual health insurance market, particularly for men and younger people, because of the landmark 2010 healthcare restructuring due to take effect next year. U.S. Health and Human Services Secretary Kathleen Sebelius said definitive data on costs will not be available until later this year when private health plans become authorized to sell federally subsidized coverage on new state-based online marketplaces, known as exchanges (Mason and Morgan, 3/26).

She also spoke about Medicare –

USA Today: White House Warns Cutting Medicare Will Shift Costs
If Congress addresses the nation’s budget deficit by cutting Medicare, that will simply shift health care costs to the private sector and not address the underlying issues, Obama administration officials said Tuesday at a White House briefing. “If you only focus on Medicare, you shift the costs,” Health and Human Services Secretary Kathleen Sebelius said, adding that Medicare and Medicaid are not the reason health costs are going up (Kennedy, 3/26).

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 Continue Sorting Out Choices About Health Exchanges, Medicaid Expansion


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

Dec 05, 2012

Kansas, South Dakota and Texas are among the states still making decisions — or reconsidering old ones — about the health law’s insurance exchanges and the Medicaid expansion.

Kansas Health Institute News: ACA Opponent Says Brownback Should Reconsider Stand On Insurance Exchange
Like Kansas Gov. Sam Brownback, Bob Laszewski is a staunch opponent of the Affordable Care Act. Despite that, the Washington, D.C. consultant said at a meeting here today that Brownback is making a mistake by refusing to partner with the federal government to run the Kansas health insurance purchasing exchange that the law requires to be operational by 2014. … Brownback last year blocked Kansas Insurance Commissioner Sandy Praeger‘s attempts to establish a state-operated exchange, returning a $31.5 million federal grant in the process. Last month, the governor told Praeger, who also is a Republican, that he would not support her efforts to partner with the federal government to operate and fund the Kansas exchange (McLean, 12/4).

Politico Pro: South Dakota Governor: ‘No’ On Expansion For Now
South Dakota Gov. Dennis Daugaard says the state won’t expand Medicaid for now — but he’s not ruling it out for the long term. Daugaard, a Republican, included no funding for the optional expansion in his proposed budget for fiscal year 2014, which he released Tuesday. But he said in an address to the state Legislature that expansion is not “a now-or-never decision” — and left the door open for an expansion or partial expansion in the future (Smith, 12/4).

The Texas Tribune: Interactive: Comparing State Medicaid Expansions
If Texas lawmakers decide to expand Medicaid, as called for in the federal Affordable Care Act, the spending, savings, enrollment growth and reduction in the number of uninsured residents are poised to be greater in Texas than in most other states. This interactive compares the expansion of Medicaid in each state using data from a report by the Kaiser Family Foundation, a nonpartisan health care think tank (Aaronson, 12/5).

In the meantime, Health and Human Services Secretary Kathleen Sebelius will meet with state lawmakers on health law implementation Wednesday —

Politico Pro: Sebelius To Meet With State Lawmakers On ACA
State legislators are scheduled to meet with HHS Secretary Kathleen Sebelius at the department headquarters Wednesday to discuss implementation of the health care law. Sebelius asked for the meeting with the members of the National Conference of State Legislatures‘ Federal Health Reform Implementation Task Force, who are in town for the group’s fall forum. She is scheduled to meet with the legislators for 30 minutes Wednesday afternoon. Joy Johnson Wilson, who directs health policy for NCSL, said she wants to hear Sebelius talk about state flexibility. That’s a message that governors stressed during a White House meeting with President Barack Obama on Tuesday (Millman, 12/4).

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.

Portrait of United States Health and Human Ser...

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

States Detail Questions About Their Exchange Options


Official portrait of United States Health and ...

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

Governor of New Jersey at a town hall in Hills...

Governor of New Jersey at a town hall in Hillsborough, NJ 3/2/11 (Photo credit: Wikipedia)

By Ankita Rao

November 19th, 2012, 3:03 PM

Iowa Gov. Terry Branstad said Friday that he will build a health exchange in his state – as soon as the Obama administration can explain exactly what that means. The Republican governor submitted 50 questions to Health and Human Services Secretary Kathleen Sebelius about how the state-built online insurance markets are supposed to be set up.

“As a former governor, I trust you know the challenges states face when trying to navigate the murky waters of implementing a federal mandate without clear guidance,” he wrote in a Nov. 16 letter  intended to meet a now-extended deadline for states to decide whether to build their own insurance markets. “We continue to struggle with too many unanswered questions on topics critically important to the final development of an exchange that meets the needs of Iowans, including the cost of building and operating an exchange.”

Branstad and New Jersey Gov. Chris Christie, also a Republican, are more public than some other state leaders in their criticism of  the health law, but they are not the only ones demanding answers on how the exchanges must be set up. A National Association of Insurance Commissioners committee is compiling a working document of state queries about exchange regulations, which had 40 questions as of Monday afternoon. The nonpartisan group said it will also post answers as the questions are answered by the administration.

Exchanges are websites where individuals and small businesses will be able to shop for coverage and find out if they are eligible for federal subsidies or Medicaid beginning in 2014. Under the law, the federal government must set them up in states that don’t build them.  As of Friday, 18 states and the District of Columbia had indicated they planned to go ahead with state-based markets.

States have until mid-December to inform federal regulators if they will build their own markets and until mid-February to say if they want to partner with the federal government.

Will Sebelius Stay At HHS?


Topics: Politics, Health Reform

Nov 09, 2012

CQ HealthBeat says there is little talk of her moving on but even so, four years is a long tenure in the job.CQ HealthBeat: Health Team May Stay Steady In Key Phase Of Overhaul Implementation
There’s little or no talk thus far that Health and Human Services Secretary Kathleen Sebelius is on her way out, particularly with the possibility that her legacy would be burnished by seeing through the job of implementing the health law if she does stay. But four years as HHS secretary is a long time. Staying through a second term would be highly unusual. “Only one HHS secretary has stayed on that long, and the job was much easier then,” said a former administration official, referring to the tenure of Donna Shalala as head of HHS during the eight years of the Clinton administration. “As for Sebelius, it’s hard to say,” the former official adds. “She’s got a helluva lot of energy and wants to see things through, so I expect she’ll stay for at least part of a second term” (Reichard, 11/8).

Meanwhile, some of President Barack Obama’s political advisers say the health law played a role in his re-election.

The New York Times: Don’t Credit Us, Obama’s Tacticians Say
But less than 48 hours after Mr. Obama clinched re-election, his aides were becoming wary that the first draft of history on the campaign was turning into a story about how smart campaign tactics had delivered victory to an embattled president rather than one about how it was all due to the president himself and his policies. … Jim Messina, the campaign manager who oversaw the creation of the system that surprised Republicans by getting more Obama supporters to the polls than Republicans had expected, argued that the results should be viewed as vindication for the president’s call for higher taxes on the rich as part of any deal to reduce the deficit. And Mr. Obama’s aides noted that exit polls showed that only a minority want to see the president’s health care plan entirely repealed (Rutenberg, 11/8).

English: Kathleen Sebelius speaking after her ...

English: Kathleen Sebelius speaking after her official nomination as Secretary of Health and Human Services. President Barack Obama is standing behind Sebelius (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.

Houston Hit Hard In Latest Medicare Fraud Bust


By Carrie Feibel, KUHF

October 17th, 2012, 6:00 AM

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When federal law enforcement agents swept through seven U.S. cities earlier this month to arrest more than 91 doctors, nurses and others for Medicare fraud, one of their targets was Houston. For the Bayou City, it was the latest in a disturbing series of revelations about health care fraud there.

A picture has emerged in Houston of kickbacks and schemes to steer patients between group homes and outpatient mental health clinics offering “partial hospitalization” programs that bill Medicare.  The clinics often operate out of strip-mall storefronts or even single-family suburban homes.

A Houston Chronicle investigation last year noted that more than 75 percent of all Medicare spending in Texas on outpatient psychiatric programs is flowing into just one county: Harris County, where Houston is located.

Private ambulance companies in Houston also bill Medicare to ferry the patients back and forth. The Chronicle questioned the lack of oversight for the clinics and the medical necessity of the ambulance rides. Series reporter Terri Langford revealed that private ambulance operators in Harris County billed Medicare in 2009 almost nine times as much as companies in New York City.

“I’m more struck by why didn’t someone catch these things in the first place,” said Vivian Ho, a health economist at Rice University’s James A. Baker III Institute for Public Policy. “When you find so many additional ambulance rides going on. Or how is it that a home health care agency can bill for several million dollars and no one realizes the care isn’t legitimate?”

The October arrests ensnared leaders of an historic hospital that once served Houston’s African American community. Riverside General Hospital was once the Houston Negro Hospital – but now specializes in the treatment of mental illness and substance abuse.

The CEO of Riverside was arrested, along with his son and five other people. Earnest Gibson III has led the hospital for 30 years. The government alleges that Gibson and his employees bilked Medicare out of $158 million over more than seven years.

Riverside had already suffered the arrest of a top administrator in February, on charges of using patient recruiters to steer group home residents into its programs.  In June, Medicare stopped reimbursing Riverside for its partial hospitalization programs at four mental health sites.

While federal agents trumpet the arrests as victories in rooting out health care fraud, it’s unclear how it plays politically.

“The other side effect of all this fraud is it leads to people being less confident that their taxpayer dollars are being spent well and they end up being less supportive of government provision of health care,” Ho said.

“I think on the margin this Medicare fraud can lead people to become more cynical about supporting the Medicare program.”

Still, Ho says the answer is not giving up on Medicare but cracking down even more, especially using data mining and other digital tools.

Ho says it’s hard to know for sure, but some studies estimate that up to 10 percent of Medicare spending is actually lost to fraud and abuse.

“To that extent, 10 percent savings would be wonderful in terms of trying to deal with the deficit we’re facing because we spend so much on Medicare. So when we’re talking about fraud, if we can address it effectively, it’s not a drop in the bucket, it’s actually a tremendous amount of savings that would make us all better off.”

Ho says investigations of medical fraud slowed down after Sept. 11, 2001, when the government investigations shifted to terrorism.

But investigations and arrests have picked up over the past two years.

They often focus on organized crime rings that steal the identity of seniors and bill for services at non-existent clinics.

Criminals also use home health care, ambulance services, and medical equipment to defraud the system.

A report from the Health and Human Services Department indicates that for every dollar spent in recent years on investigating medical fraud, the government recovers more than $7.

Map of Florida marking the area first affected

Map of Florida marking the area first affected (Photo credit: Wikipedia)

This story is part of a reporting partnership that includes KUHF, NPR and Kaiser Health News.