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.

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Louisiana Health Secretary Submits Resignation


, member of the United States House of Represe...

, member of the United States House of Representatives. (Photo credit: Wikipedia)

Topics: States, Medicaid, Politics

Apr 01, 2013

Louisiana Gov. Bobby Jindal‘s health secretary — Bruce Greenstein — is resigning amid a probe into a Medicaid contract he awarded to a former employer.

The Associated Press: La. Gov. Jindal’s Health Secretary Resigns As Probes Continue Into Medicaid Contract
Louisiana Gov. Bobby Jindal’s health secretary and close ally, Bruce Greenstein, is resigning amid ongoing state and federal investigations into the awarding of a Medicaid contract to a company where Greenstein once worked, officials said Friday. The Jindal administration canceled the nearly $200 million contract with Maryland-based CNSI last week after details leaked of a federal grand jury subpoena involving the contract award (3/29).

New Orleans Times Picayune: DHH Secretary Bruce Greenstein Resigns In Wake Of Federal Investigation
Louisiana Department of Health and Hospitals Secretary Bruce Greenstein has resigned, a statement from Gov. Bobby Jindal’s office confirmed Friday. Speculation Greenstein would resign was rampant after news broke he allegedly used his influence as department head to secure a contract for a former employer. … Asked whether the hospitals secretary was forced out, Jindal spokesman Sean Lansing said in an email, “The governor did not ask Bruce to resign.” He later added that no one in the administration or among Jindal’s advisers asked Greenstein to resign (McGaughy, 3/29).

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.

Supporters Of Medicaid Expansion Fight To Be Heard In Some Statehouses


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

Apr 01, 2013

Mississippi House Democrats blocked passage of the state’s Medicaid budget Sunday to force a vote on expanding the program, while supporters and critics do battle in Missouri, Montana and Arkansas.

Clarion Ledger: Mississippi House Democrats Block Medicaid Budget
House Democrats on Sunday night blocked passage of the $840 million Medicaid budget, a move to try to force a vote on expanding the program and to block Gov. Phil Bryant from running it by executive order. “The federal government is offering venture capital to expand the largest industry we’ve got in this state, and we can’t even get a vote and debate on it,” said Rep. Steve Holland, D-Plantersville. “So we’re doing what we have to do. We are going to have an up-or-down vote on Medicaid expansion — it may be in a special session — or we are not going to have Medicaid” (Pender, 3/31).

The Associated Press: FACT CHECK: Corbett And The Medicaid Expansion
For now, (Pennsylvania) Gov. Tom Corbett has decided against embracing an expansion of Medicaid that could extend taxpayer-paid health care coverage to hundreds of thousands of low-income adult Pennsylvanians. The 2010 Affordable Care Act pledges to shoulder the lion’s share of the cost of the expansion, but Corbett says he is still concerned about the cost to Pennsylvania taxpayers and cautions that the federal government cannot always be trusted to deliver on its funding promises to states. Here is a look at the validity of some of his claims about the Medicaid expansion (Levy, 3/31).

The Associated Press/Kansas City Star: Medicaid Debate In Missouri Gets Hyperbolic
If Missouri expands Medicaid health coverage for lower-income adults, could it create a crisis for public schools? If Missouri fails to expand Medicaid, could it result in millions of Missourians‘ tax dollars going to health care in other states? In the tense Medicaid debate at the Missouri Capitol, both assertions have been put forth as plain facts by opponents or supporters of a plan that could add as many as 300,000 adults to the Medicaid rolls. But they might best be labeled as hyperbole (Lieb, 3/31).

Helena Independent Record: Democrats Vow To Pass Medicaid Expansion As Republicans Say It Will Blow State Budget
Last week, Republicans on two legislative committees used their majorities to kill Democrat-sponsored bills to expand the program starting in 2014. Gov. Steve Bullock and fellow Democrats vow to keep searching for a way to pass the expansion, although it could be difficult, as long as Republican majorities at the Legislature oppose it (Dennison, 3/31).

The Associated Press: Health Care, Tax Cuts Issues Colliding (AP Analysis)
How do you convince Republicans who took over the Arkansas Legislature by vowing to fight “Obamacare” to support government-subsidized health insurance? The same way you convince a Democratic governor who has said his budget can’t include more tax cuts to agree to a large package of reductions. As Arkansas lawmakers approach what could be the final weeks of this year’s session, it’s becoming clearer that proposals to expand health insurance to low-income workers and to cut $100 million in taxes are colliding (DeMillo, 3/31).

Baltimore Sun: Health Reform’s Changes Stir Worries As They Take Shape In Md.
State lawmakers put finishing touches last week on plans to apply federal health care reforms in Maryland come Jan. 1. But who becomes newly insured — and at what cost —still worries stakeholders as the state speeds toward becoming one of the first to adopt a revamped system. Under legislation passed by the House of Delegates and Senate, more low-income Marylanders would qualify for government-funded health care through Medicaid, and an existing tax on health insurers would sustain a new insurance marketplace once federal support wanes (Dance, 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.

Image representing Associated Press as depicte...

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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).

Federal Officials Look To Mass Marketing To Sell Health Law


Pete Souza, Official White House Photographer

Pete Souza, Official White House Photographer (Photo credit: Wikipedia)

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

Apr 01, 2013

The administration faces a tough challenge to get the public to understand and accept the health law — and, then, to sign up the millions without coverage.

The Associated Press: Can Mass Marketing Heal The Splits On ‘Obamacare’?
How do you convince millions of average Americans that one of the most complex and controversial programs devised by government may actually be a good deal for them? With the nation still split over President Barack Obama’s health care law, the administration has turned to the science of mass marketing for help in understanding the lives of uninsured people, hoping to craft winning pitches for a surprisingly varied group in society (Alonso-Zaldivar, 4/1).

Kaiser Health News: Why Uninsured Might Not Flock To Health Law‘s Marketplaces
With almost one in five of its residents lacking health insurance, officials in Palm Beach County thought they had hit on a smart solution. The county launched a program that offered subsidized coverage to residents who couldn’t afford private insurance, but made too much to qualify for Medicaid, the state-federal program for the poor. Enrollees would be able to buy policies for about $52 a month — far cheaper than what private insurers were offering. But a year after the program began, fewer than 500 people had signed up — less than a third of the number expected (Galewitz, 4/1).

NPR: Three Years On, States Still Struggle With Health Care Law Messaging
It is hard to imagine that after three years of acrimony and debate we could still be so confused about President Obama’s Affordable Care Act. … There are essentially three big pieces to the Affordable Care Act: the insurance reforms (also known as the patients’ bill of rights), quality and cost measures, and the health care mandate. …. For consumers, however, it doesn’t matter if you’re in Texas or California or anywhere else in the country, the law is clear: The uninsured are expected to get coverage by January. Whether those folks will be informed and ready by then is not so clear (Sullivan, 3/30).

The Medicare NewsGroup: Obama’s 2014 Budget Could Mean Significant Change For Medicare
On April 10, President Obama will enter the ongoing 2014 budget battle when the White House releases its budget blueprint, joining Senate Democrats and both parties in the House in a partisan scuffle over the nation’s fiscal future. If it’s anything like what the president put forth last year, the Medicare-related parts of the White House budget will focus on containing costs by reforming the Medicare payment system and reducing fraud and waste while maintaining the Traditional Medicare structure (Adamopoulos, 3/31).

Meanwhile, federal officials released rules Friday reiterating their plans for expanded Medicaid funding under the health law –

Modern Healthcare: CMS Considering Waivers For Private Coverage Medicaid Alternative
The Obama administration is showing willingness to let some states steer new Medicaid funding to private coverage in the new individual insurance marketplaces in order meet the coverage goals of the healthcare reform law. The CMS will consider granting a “limited number” of state waivers for demonstration that test what happens when states give Medicaid enrollees the option of taking a subsidy to buy a private plan, according to new guidance issued Friday (Blesch, 3/31).

Bloomberg: Some U.S. States Can Shift Medicaid Funds To Exchanges
Low-income people may get Medicaid money to buy health insurance from private plans such as UnitedHealth Group Inc. (UNH) or Humana Inc. (HUM) in a “limited number” of states, U.S. officials said. Arkansas and Ohio have asked President Barack Obama’s administration to allow them to adjust how Medicaid dollars are used (Wayne, 3/30).

The Hill: Obama Administration Finalizes Key Affordable Care Act Rule
The federal government will reimburse states for 100 percent of the costs for some newly eligible Medicaid patients, under new regulations finalized Friday as part of the Obama administration’s implementation of the Affordable Care Act (ACA). The healthcare law authorizes states to expand Medicaid to adults under 65 with incomes up to 135 percent of the federal poverty level — roughly $15,000 for a single adult in 2012 (Goad, 3/29).

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.

No Rate Shock Seen In Proposed 2014 Premiums In Vermont


English: Barack Obama speech "Fighting fo...

English: Barack Obama speech “Fighting for Health Insurance Reform” delivered 8 March 2010 (Photo credit: Wikipedia)

By Phil Galewitz

April 1st, 2013, 12:55 PM

After years of anticipation, Vermont became the first state Monday to publish proposed 2014 individual health insurance rates under the federal health law. Despite Republican and insurers’ predictions, there was no “rate shock” in the new premiums, according to the Vermont governor’s office and insurance representatives.

Blue Cross and Blue Shield of Vermont and MVP Health Care submitted plans with monthly premiums that range from an average of $265 for catastrophic coverage for young adults to $609 for platinum coverage, which has the lowest cost-sharing among four categories of plans.

“We think this is a positive development for folks who were worried about what rates would look like in 2014,” said Kevin Goddard, spokesman for Blue Cross and Blue Shield of Vermont, which is the state’s dominant commercial carrier, controlling about two-thirds of the market. He confirmed rates are similar to what the company now offers.

“These rates are comparable to what’s on the market today and that’s good news,” said Robin Lunge, director of health reform in the Vermont governor’s office. She said it’s difficult to do an apples-to-apples comparison because of the many benefit changes required under President Barack Obama’s health overhaul.  These changes, which take effect Jan. 1, include an end to annual lifetime limits in policies and a prohibition on denying coverage to people with medical problems.

Vermont may not be the best barometer of the impact of the heath overhaul on premiums, however,  because the state already prohibits insurers from using health status to determine an individual’s premiums. It is one of only seven states in the country which have so-called community rating regulations.

Vermont also requires prices to be the same regardless of person’s age. Two of the health law’s biggest changes include prohibiting insurers from using health status to determine premiums and prohibiting insurers from charging older people more than three times the rates of younger people.

Insurance industry predictions of rate shock are more likely in the majority of states that currently allow insurers to set premiums based on an individual’s health status, Goddard said.

Starting Oct. 1, individual and small group coverage in the state will be sold on a new online health insurance marketplace as required under the Affordable Care Act. Health insurers nationwide have just begun submitting their pricing and benefit information to states and the federal government for policies which will be sold in the marketplaces, or exchanges. Most people who buy on the new marketplaces are expected to be eligible for government subsidies.

Vermont insurance regulators still must approve the insurers’ proposed rates. In January 2013, the state approved about a 10 percent rate increase on the individual market after carriers asked for about a 13 percent increase, Lunge said.

All the health plans in the new marketplaces are standardized into platinum, gold, silver and bronze categories depending on their actuarial value so consumers have an easier time comparing.

The Vermont 2014 annual premiums for bronze plans range from $4,200 to $4,440, compared to a Congressional Budget Office estimate of $4,500 for an individual, according to Carolyn Pearson of consulting firm Avalere Health.

Mary Eversole, executive director of the Vermont Insurance Agents Association, said she was surprised the rate increases were not higher. At first blush, she said the 2014 proposed rates appear to be about 10 percent higher than this year. Premiums for the gold and platinum  policies appear lower than similar products, but silver and bronze policies are higher.

Officials from MVP were not available for immediate comment.

Tight Medicaid Eligibility Leads To More Adults Delaying Care


English: House Bill and Senate Bill subsidies ...

English: House Bill and Senate Bill subsidies for health insurance premiums. (Photo credit: Wikipedia)

By Ankita Rao

March 27th, 2013, 5:01 PM

Hidalgo is a county in southern Texas just across the Rio Grande from Mexico. It’s also home to the highest prevalence of U.S. adults – about 40 percent of the population– delaying necessary medical care because of cost, according to data in the March 28 New England Journal of Medicine.

The research letter in the March 28 issue of the journal found this number to vary significantly across the country and to be lower in places with less restrictive eligibility criteria for Medicaid, the federal-state insurance program for low-income citizens.

Authors found that people with incomes between 67 percent and 127 percent of the federal poverty line, which is $23,550 for a family of four, had up to a 16 percent chance of delaying care. The odds went up to 42 percent for those with lower incomes.

The findings come at a time when states are deciding whether to pursue the Affordable Care Act’s Medicaid expansion, which would extend eligibility to adults with incomes at or below 133 percent of the poverty level.

Norfolk, Mass., with a 6.5 percent prevalence of adults delaying care, was at the opposite end of the spectrum from Hidalgo, researchers said. Massachusetts’ adoption of state health reforms since 1990, including Medicaid expansions, and the state’s history of investing in health care were likely reasons, said one of the authors, Dr. Cheryl Clarke from Brigham and Women’s Hospital in Boston.

“We were surprised by the depth of variation between states,” she said. “It’s important these trends continue to be monitored.”

The study’s authors looked at county-level data of about 289,000 adults to determine the relationship between Medicaid eligibility and adults delaying care. They also took into account the sociodemographic and clinical characteristics at hand.

Researchers found that the counties with residents most vulnerable to delaying care were also likely to have more Hispanic residents and high rates of chronic diseases commonly associated with low-income communities. Texas and Florida were among the states with the highest prevalence.

But Clarke said the study shows that it is possible to develop health infrastructure – through Medicaid, community clinics and more primary care doctors – to combat an issue that might be taking a toll on the country’s health. And she said federal investments are moving in that direction.

“This seems to be a strategy that is feasible,” she said. “We’ll see how that plays out over time.”