Some Boston Marathon Bomb Victims Will Face Insurance Coverage Limits


Boston Marathon

Boston Marathon (Photo credit: Wikipedia)

Payments for prosthetics, rehabilitation and a range of other
treatments may fall outside some insurance limits and could continue
long into the future.

The New York Times: For Wounded, Daunting Cost; For Aid Fund, Tough Decisions

Many of the wounded could face staggering bills not just for the trauma
care
they received in the days after the bombings, but for prosthetic
limbs
, lengthy rehabilitation and the equipment they will need to
negotiate daily life with crippling injuries. Even those with health
insurance may find that their plan places limits on specific services,
like physical therapy or psychological counseling (Goodnough, 4/22).

Politico: Coverage Limits Are Harsh Reality For Amputees

Those who lost limbs in the Boston Marathon bombings now need care to
learn to navigate the world in a new way — and navigate a thorny area of
health care coverage, too. In the case of the Boston bombings, pledges
and offers of support have poured in to help with the health care costs
of the 14 people who reportedly lost all or part of a limb. But for some
amputees, covering the staggering cost for prosthetics care can be a
struggle (Smith, 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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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)

Insurer Centene: We Can Do Arkansas-Style Medicaid


English: House Bill and Senate Bill subsidies ...

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

By Jay Hancock

April 23rd, 2013, 3:33 PM

Arkansas
is the latest and perhaps best hope for those who want states resistant
to the Affordable Care Act’s Medicaid expansion to reconsider.

Illustration by Darwinek via Wikimedia Commons

Last week the Arkansas legislature approved
a plan to give Medicaid beneficiaries money to buy individual policies
from private insurers on the state’s health insurance exchange — the
subsidized, online markeplaces due to be in business next year. The
governor signed the bill Tuesday — making it law.

The Department of Health and Human Services, which has said it “will consider approving a limited number” of such arrangements, still needs to negotiate details and sign off.

One insurer is already expressing interest.

“We
are very capable of doing an Arkansas-type model,” Centene Corp. CEO
Michael Neidorff said Tuesday. “That’s something that would be a sweet
spot for us.”

Centene sees opportunity in participating in the
health law’s coverage expansions, whether Arkansas-style or not. It
already runs Medicaid managed care plans for those with very low incomes
in several states, although not in Arkansas. Now it wants to offer
plans to individuals with slightly higher incomes through the exchanges.

“We
believe we can achieve increased profitability in 2014 upon the
commencement of the ACA,” Neidorff told stock analysts Tuesday. “The
exchange market represents the largest growth opportunity for Centene
over the next several years, estimated at $52 billion in our existing
markets.”

Policy analysts expect considerable “churn”
from members moving between the ACA’s expanded Medicaid program and
commercial policies sold on the exchanges as their incomes fluctuate.
Centene wants to be on both sides of the line, selling “a product that
offers people a comfortable transition,” said K. Rone Baldwin, chief of
the company’s insurance group.

Whether managed by Centene or some
other carrier, private, individual insurance in the Arkansas mode could
help Medicaid members keep the same doctor and otherwise minimize
disruptions when they graduate to a non-Medicaid exchange plan, some
have suggested.

The Arkansas model faces large questions. Not least are those about cost.
Commercial insurance of the type Arkansas sees covering Medicaid
members typically pays doctors and hospitals more than traditional
Medicaid or Medicaid managed care plans like Centene runs.

But the plan is being praised as a “conservative alternative” to Obamacare classic and is reportedly being eyed by Pennsylvania, Ohio and other states resisting the Medicaid expansion.

Centene
executives spoke to investment analysts on a conference call about the
company’s quarterly profits. Like other insurers, they were coy about
saying where they plan to offer exchange plans and on what terms.

“We
do expect to be on the exchanges in a subset of the places where we
have health plans today, and we’re entering into contracts with
hospitals,” said Baldwin. How well will Centene be paying those
hospitals to care for its exchange members? “It’s certainly not exactly
at [lower] Medicaid rates but I wouldn’t say it’s exactly at [higher]
commercial rates either,” he added.

The company earned $23 million for the quarter on revenue of $2.5 billion.

States Boost Laws, Regulations Governing Abortion


English: Histogram of abortions by gestational...

English: Histogram of abortions by gestational age for the United States in 2004. Horizontal axis is weeks and vertical axis is thousands of abortions. Data is taken from the Centers for Disease Control and Prevention.http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5609a1.htm#tab6 Updated version of Image:US abortion by gestational age 2002 histogram.svg, but data is almost identical. (Photo credit: Wikipedia)

Time series of induced abortions in Norway

Time series of induced abortions in Norway (Photo credit: Wikipedia)

Topics: Delivery of Care, Women’s Health, Politics, States

Apr 01, 2013

States have passed a record number of abortion bills since 2011, including curbs on clinics and chemically induced abortions, and in North Dakota, a ban on abortions as early as six weeks. On the other side, New York and Washington are weighing measures to ensure abortion rights.

The Wall Street Journal: States Harden Views Over Laws Governing Abortion
States are becoming increasingly polarized over abortion, as some legislatures pass ever-tighter restrictions on the procedure while others consider stronger legal protections for it, advocates on both sides say. … At the same time, Washington state is weighing a measure that would require all insurers doing business in new health insurance exchanges created by the Affordable Care Act to reimburse women for abortions. And New York Democratic Gov. Andrew Cuomo is seeking to update his state’s laws to clarify that women can obtain an abortion late in pregnancy if they have a medical reason (Radnofsky, 3/31).

The Associated Press: Abortion Clinics Need License, Check For Coercion
Michigan abortion clinics will need a state license and must check to make sure women are not being bullied or pressured into getting an abortion under a new law that took effect Sunday. Other regulations make clearer the proper disposal of fetal remains, after anti-abortion advocates expressed concern some were not disposed of with dignity (Eggert, 3/31).

In Montana, lawmakers are seeking to cut funding to some organizations that provide women’s health care.

The Associated Press: Women’s Health Funding Faces Cuts: House Budget Excludes $4.5M For Title X Funds
When Jennifer Strickley first learned she had ovarian cancer, it was Planned Parenthood that detected the disease. She had been going to a clinic in Billings (Montana) for about a decade, as the discounts on Pap tests, contraception and regular checkups provided an essential break for the single mom working without health insurance as a waitress to support her two kids … Strickley is one of 26,000 Montanans who rely upon clinics that receive federal family planning and preventive health funds in the form of Title X. … But the Montana House unanimously passed a state budget that excludes these funds — some $4.5 million — accounting for 30 percent of the budgets for 20 community clinics and five Planned Parenthood Clinics in the state (4/1).

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...

Image via CrunchBase

Va. Gov. Seeks To Bar Abortion Coverage From The Federal Exchange That Will Serve The State


English: Governor of Virginia at CPAC in .

English: Governor of Virginia at CPAC in . (Photo credit: Wikipedia)

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

Mar 27, 2013

Gov. Bob McDonnell added the provision Monday to recently passed legislation. Meanwhile, in other news, the Maryland Senate could vote as early as today on a bill that implements the state’s new insurance marketplace and Louisiana insurers and nonprofits form group to help consumers understand new insurance options.

The Associated Press: McDonnell’s Amendment Would Bar Abortion In Va. Federal Health Care Exchange
Insurance policies that cover abortions couldn’t be purchased through the federally run health care exchange that will serve Virginia under an amendment Gov. Bob McDonnell offered Monday to recently passed legislation. The Republican governor’s action, which reproductive rights organizations had warned for weeks was imminent, would forbid policies providing abortions to be sold through the exchange that is authorized by President Barack Obama’s health care overhaul (3/26).

The Washington Post: McDonnell Aims To Block Abortion Coverage
Health plans offered to Virginians through federal insurance exchanges could not cover most abortions under amendments that Gov. Robert F. McDonnell has proposed to two General Assembly bills. The Republican governor’s recommendations, which the legislature could accept or reject along with McDonnell’s other amendments when it reconvenes April 3, does not represent a shift in state policy (Vozzella, 3/26).

Baltimore Sun: Final Vote Expected In Senate On Health Bill
The Maryland Senate could vote as early as Wednesday on a bill that would qualify more Marylanders for government health care and pay for a new health insurance marketplace, both part of advancing the rollout of federal health reform. The House of Delegates approved an identical bill Monday, clearing the way for the legislation to make its way to Gov. Martin O’Malley for his signature. Initiatives in the bill spell out changes in the way poor or uninsured residents and small businesses would access health care once the federal law becomes effective next year (Dance and Cox, 3/26).

New Orleans Times Picayune: New Coalition Hopes To Provide Public With Information About Federal Health Law
Anticipating widespread consumer confusion as the Affordable Care Act mandates kick in next year, a group of nonprofits and businesses led by Blue Cross and Blue Shield of Louisiana are forming a coalition to help people wade through the complicated new marketplace. The Louisiana Healthcare Education Coalition will hold news conferences across the state this week. Over the coming months, the group wants to disseminate information about the federal law’s implementation by helping educate members, attending health fairs and other efforts (Maggi, 3/26).