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
(4/22).

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,
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.

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.”

Wash. Bill To Mandate Abortion Coverage Awaits State Senate Vote


Texas Medical Center

Texas Medical Center (Photo credit: slight clutter)

Topics: States, Women’s Health

Mar 25, 2013

Washington’s Reproductive Parity Act would be the first state law to require insurance plans to cover abortion.

The Wall Street Journal: State Weighs Mandate On Abortion Insurance
Washington state may be on the verge of passing the nation’s first mandatory abortion-insurance law, which would require all insurers to reimburse women for abortion procedures as part of their maternity-care coverage. Legislation known as the Reproductive Parity Act has passed in the state House of Representatives but still must clear the Senate (Millman, 3/24).

The Associated Press/Washington Post: Wash., An Abortion Rights Trailblazer, Weighs Passing Nation’s 1st Abortion Insurance Mandate
With 21 states having adopted bans or severe restrictions on insurance companies from paying for abortions, Washington is alone in seriously considering legislation mandating the opposite (3/23).

Meanwhile in North Dakota and Texas:

Reuters: North Dakota Lawmakers Approve Measure That Could Ban Abortion
North Dakota lawmakers on Friday approved a proposed amendment to the state constitution that could make the state the first to define life as beginning at conception, which would effectively outlaw all abortions. If approved by voters, North Dakota would be the first state in the United States with such a provision in its constitution. Similar measures have been put before voters in several states, including Mississippi, and rejected (Thompson, 3/22).

The Texas Tribune: Bill Could Reduce Number Of Texas Abortion Facilities
A bill advancing through the Texas Legislature could drastically decrease the number of legal abortion facilities in the state. Supporters of Senate Bill 537, which would increase regulations for abortion facilities, say it will improve women’s safety (Aaronson, 3/25).

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.

Planned Parenthood In Texas Braces For End To State Funding


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

Aug 23, 2012

Officials are moving quickly to end state funding for Planned Parenthood, which for now remains a part of the Texas‘ Women’s Health Program despite a judge’s ruling that state funds can be stopped while a related lawsuit is pending.

The Associated Press/Houston Chronicle: Planned Parenthood Awaits Funding Cutoff In Texas
Planned Parenthood said Wednesday that Texas clinics are operating like normal for now, even as state officials move to quickly freeze funding after a federal court gave Republican lawmakers a victory in their efforts to punish health providers linked to abortion services. The court ruling allows the state to cut off funding to Planned Parenthood, the largest provider in the Texas Women’s Health Program, while a lawsuit over the issue moves forward. But just how fast Texas can sever funding remains unclear. The health program provides family planning and other health services to more than 130,000 low-income women and is designed for those who might not otherwise qualify for Medicaid (Weber, 8/22).

The Texas Tribune: For Now, Planned Parenthood In Women’s Health Program
One day after the 5th U.S. Circuit Court of Appeals‘ decision to side with Texas and overturn a temporary injunction that allowed Planned Parenthood clinics to remain in the Women’s Health Program, a spokeswoman for a Planned Parenthood provider said that the affiliates involved in the program are “still in the WHP.” Planned Parenthood had filed a lawsuit in order to stay in the Women’s Health Program. Tuesday’s court ruling overturned the injunction, pending a district court hearing in the fall (Tan, 8/22).

In other Planned Parenthood news —

The Oregonian: Providence Health Rejects Portland-Area Guide For The Poor Over Planned Parenthood Tie
Providence Health & Services has halted distribution of a Portland-area resource guide for people in poverty, saying a listing for Planned Parenthood violates policies for the religious-based health care organization. Last week, the newspaper Street Roots, which publishes the Rose City Resource guide, reported that Providence had rejected a shipment of the guide intended for distribution to the public in waiting rooms and other areas. “We were told that they couldn’t accept the guide because of Planned Parenthood,” said Israel Bayer, publisher of Street Roots. … Providence Health is headed by the Catholic order of the Sisters of Providence. Spokesman Gary Walker confirmed that the guide’s inclusion of “abortion services” explained the decision to stop accepting the guide (Budnick, 8/22).

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.

Supporters of Planned Parenthood

Supporters of Planned Parenthood (Photo credit: Wikipedia)

Judge Finds Texas Can End Planned Parenthood Funding Before Final Ruling


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

Aug 22, 2012

A federal judge ruled Tuesday that Texas can cut off funding to Planned Parenthood before a ruling is made on the legality of the Texas legislature’s law banning funding to the provider of women’s health services over its abortion services.

Los Angeles Times: Texas Can Cut Planned Parenthood Clinic Funding, Judges Rule
Texas can cut off funds for Planned Parenthood clinics before a trial concerning the legality of its ban on funding organizations tied to abortion providers, a federal appeals court ruled Tuesday. The U.S. 5th Circuit Court of Appeals in New Orleans lifted a federal judge’s temporary injunction that had protected the funding pending an October trial (Hennessy-Fiske, 8/21).

The Associated Press/New York Times: Women’s Clinics In Texas Lose Aid
A federal appeals court ruled on Tuesday that Texas can end financing for Planned Parenthood clinics that provide health services to low-income women before there is a trial over a new law that bars state money from going to organizations tied to abortion providers (8/21).

The Associated Press/Houston Chronicle: Court: Texas Can Cut Off Planned Parenthood Funds
Texas officials are vowing to cut off funding for Planned Parenthood after a federal court sided with the state in a challenge over a new law that bans clinics affiliated with abortion providers from getting money through a health program for low-income women. The 5th U.S. Circuit Court of Appeals in New Orleans late Tuesday reversed a federal judge’s temporary injunction that was allowing the funding to continue pending an October trial on Planned Parenthood’s challenge to the law. State officials are seeking to halt money to Planned Parenthood clinics that provide family planning and health services as part of the state’s Women’s Health Program because the Republican-led Texas Legislature passed a law banning funds to organizations linked to abortion providers (Weissert, 8/22).

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.

Texas Medical Center

Texas Medical Center (Photo credit: slight clutter)

Texas Doctors Oppose State Plans On Abortion


Topics: Delivery of Care, Public Health, Politics, Medicaid, States

Aug 07, 2012

The physicians are objecting to a proposed rule for the Texas Women’s Health Program that prohibits them from discussing abortion with patients. Meanwhile, the governor, who says he opposes an expansion of Medicaid, also says he will use such an expansion to justify his cut off of funds to Planned Parenthood.

Texas Tribune: Medical Groups Oppose Women’s Health Program Rule
A proposed state rule that would prohibit doctors in Texas’ Women’s Health Program from discussing the option of abortion with their patients — even if the patient asks about it — has drawn the opposition of Texas medical groups. The groups take issue specifically with a clause that states the provider must not “promote elective abortions.” The word “promote” as defined by the proposed rule includes counseling and referrals to abortion providers, as well as the display of any materials from abortion providers (O’Connor, 8/6).

The Dallas Morning News: Texas Medical Groups Protest Proposed Rules Prohibiting Abortion Counseling
Texas medical groups are revolting against a proposed state Health Department rule for the Women’s Health Program that would prohibit abortion counseling, saying the state is attempting to impose a “gag order” on physicians. In a nine-page letter released Monday, the Texas Medical Association — in conjunction with associations representing gynecologists, obstetricians, pediatricians and family practitioners — said that the state’s proposed rules are so onerous that many physicians, even though they may be morally opposed to abortion, may nevertheless refuse to participate in the Texas Women’s Health Program (Hoppe, 8/6).

The Hill: Perry Caught In Medicaid Contradition
Texas Gov. Rick Perry is facing a big contradiction as he pursues two policies important to conservatives — defunding Planned Parenthood and rejecting President Obama’s healthcare law. Perry has said he won’t implement the healthcare law’s Medicaid expansion. But his plan to cut off Planned Parenthood assumes that the Medicaid expansion will happen in Texas (Baker, 8/6).

And in Colorado –

Denver Post: Signatures Turned In For Colorado Anti-Abortion Measure
The Colorado Personhood Coalition Monday submitted more than 121,000 signatures to the secretary of state to get its anti-abortion measure on the November ballot. … This would be the group’s third try since 2008 to amend the state Constitution. Personhood USA founder Keith Mason said the ballot language this year is different. It would extend constitutional rights to all humans at any stage of development by stating that protections of life “apply equally to all innocent persons.” It would “prohibit the intentional killing of any innocent person” (Draper, 8/6).

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.

Businesses Will Push Perry to Rethink Medicaid Expansion


Texas Gov. Rick Perry says he rejects the “Obamacare power grab” and will block measures expanding health insurance to millions in his state. The country’s second-biggest health insurer is betting he won’t succeed.

The same day last week that Perry said expanding Medicaid would be like “adding a thousand people to the Titanic,” WellPoint Inc. disclosed an agreement to buy Texas’s biggest Medicaid managed care company for $4.9 billion. The purchase of Amerigroup, which operates in 12 other states besides Texas, is WellPoint’s attempt to cash in on the health act’s addition of 17 million Americans to Medicaid, the state and federal program for the poor.

The Supreme Court decision allowing states to block Medicaid growth without a penalty, however, threatens the profits of companies hoping to manage care for the new beneficiaries. Perry is one of more than half a dozen Republican governors resisting the federal Medicaid windfall set to begin in 2014.

But if there’s one thing more powerful than Republican governors’ dislike of the Affordable Care Act, many believe, it may turn out to be the business interests in their own states.

“Once the headlines die down, every hospital in Texas is going to look at Perry and say, ‘Please tell me why we’re not taking money from the federal government to offset my uncompensated care,'” said Thomas Carroll, who follows health insurance stocks for investment firm Stifel Nicolaus. “That is a question that Rick Perry absolutely cannot answer.”

A higher portion of Texans lack coverage than residents of any other state. A Texas Medicaid expansion would generate $100 billion in federal money for the state over a decade, according to the state Health and Human Services Commission, and furnish coverage to an estimated 2 million Texans.

At the same time it would generate nearly $1 billion in annual Texas revenue for Amerigroup and WellPoint, calculates Carroll.

Quiet for now, insurers are expected to join hospitals and patient advocates to fight for Medicaid expansion and what are enormous amounts of money, even by Washington standards. Nowhere are the dollars bigger than in Perry’s state, where one in four lacks health coverage.

“Fights seem to follow the money, and there is a lot of money at stake in Texas on this,” said Phil King, a Republican state representative from outside Fort Worth who opposes the Medicaid expansion. “Maybe you need to rename this ‘The Full-Employment Act for Lobbyists.'”

With world-renowned medical institutions such as the University of Texas and a large part of its Medicaid coverage handled by private insurers such as Amerigroup, the state’s health industry is “just behind oil and gas” in size and influence, said Vivian Ho, a health economist at Rice University. “Given how much Amerigroup has to gain from a Medicaid expansion in Texas, they may be one of the most effective organizations to lobby Perry and the state legislature to fund the expansion.”

Founded in the mid-1990s in Virginia Beach, Va., Amerigroup contracts with 13 states to manage Medicaid care, generally for a fixed fee per member. Now grown to Fortune 500 size, the company had twice as many Texas members last year — 632,000 — as in any other state.

Amerigroup and merger partner WellPoint both have strong ties to Texas politicians.

Amerigroup’s Texas political action committee donated $20,000 to Perry’s 2010 gubernatorial campaign, has given thousands more to numerous legislators and had $89,000 in the bank as of June 25, public records show. Two years ago Amerigroup’s foundation presented its “Champion for Children” award to Texas Sen. Judith Zaffirini, a Democrat from Laredo who sits in the senate’s Medicaid subcommittee.

An Amerigroup spokeswoman declined to comment on Texas politics. Officials from WellPoint and the Texas Association of Health Plans did not return phone calls.

After years of rapid growth, managed care plans such as Amerigroup cover most Texas Medicaid beneficiaries. While patient advocacy groups say for-profit plans such as Amerigroup and UnitedHealthcare prompt more caregiver and patient complaints than not-for-profit rivals, they’re primarily concerned with achieving any coverage for Texas’s 6 million uninsured.

“In Texas we’re operating fairly low on the pyramid in the hierarchy of needs,” said Anne Dunkelberg, associate director of the Center for Public Policy Priorities in Austin. “If we don’t do the Medicaid expansion we’re going to be leaving somewhere in the neighborhood of 1.5 to 2 million adults without access to affordable coverage.”

Perry and his allies, however, argue that Medicaid is damaged beyond repair. Even though Washington will pay for all of the health act’s Medicaid expansion for three years and eventually 90 percent, they say, the move will prove too expensive for Texas.

“It is such an inefficient system,” said King, who like many Republicans wants Washington to cede control so Texas can design Medicaid to its own needs. “It is exceptionally ridden with fraud, and it doesn’t provide a very high quality of health care.”

But not all Republicans are falling immediately in line with the governor.

“The legislature will be very much involved in the decision making on this,” House Speaker Joe Straus told reporters after emerging from a budget hearing last week. “We will listen to all the stakeholders.”

“We will hold hearings soon to evaluate our options,” said Jane Nelson, chairwoman of the Senate Health and Human Services Committee.

On Thursday, the Texas Health and Human Services Commission slashed estimates of what Medicaid expansion would cost the state by 40 percent, undercutting those who say Texas can’t afford it. The old estimate was $26 billion to $27 billion over a decade; the new one is $15 billion to $16 billion.

The lobbying has only begun. Many believe that Perry and other governors will eventually accept Medicaid expansion, that their stance is only a prelude to bargaining with Washington for flexible terms.

Winning the expansion is “priority one,” said John Hawkins, a lobbyist for the Texas Hospital Association, adding that his group has approached insurers to discuss joint efforts.

WellPoint and Amerigroup, too, seem confident that gubernatorial resistance is only temporary.

“When you step back from all this, there are billions of dollars in federal money that are going to flow to the states,” Amerigroup CEO Jim Carlson told financial analysts on a conference call to discuss the merger. “We think states are going to need to take it.”