Daily Health Policy Report

Friday, March 7, 2014

Last updated: Fri, Mar 7

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Health Care Marketplace

Quality

State Watch

Health Policy Research

Weekend Reading

Editorials and Opinions

KHN Original Reporting & Guest Opinion

IG Report Findings Could Strengthen Nursing Home Inspections

Reporting for Kaiser Health News in collaboration with The Washington Post, Susan Jaffe writes: "Federal efforts to strengthen inspections of the nation's nursing homes are gaining momentum after a government probe uncovered instances of substandard care. The March 3 report by the HHS Inspector General found that an estimated one-third of residents suffered harm because of substandard care and that the chances of nursing home inspectors discovering these 'adverse events' are 'slim to none,' said Ruth Ann Dorrill, a deputy regional director for the inspector general and the manager of the investigation" (Jaffe, 3/7). Read the story.

This Story: Print | Link to | Top

What Will Obamacare Really Cost? They Might Be First To Know

Kaiser Health News staff writer Jay Hancock reports: "Now that medical insurers must accept all applicants no matter how sick, what will these new customers cost health plans? How will they affect coverage prices for 2015 and beyond? Few questions about the Affordable Care Act are more important. How it all plays out will affect consumer pocketbooks, insurance company profits and perhaps the political fortunes of those backing the health law" (Hancock, 3/7). Read the story.

This Story: Print | Link to | Top

A Reader Asks: Can I Buy An Exchange Plan When My Policy Expires In May?

Kaiser Health News consumer columnist Michelle Andrews answers this readers question (3/7). Read her response.

This Story: Print | Link to | Top

Capsules: Obama Urges Latinos To Sign Up For Insurance Now

Kaiser Health News: Capsules: Obama Urges Latinos To Sign Up For Insurance Now
Now on Kaiser Health News' blog, Phil Galewitz reports: "President Barack Obama appealed directly to Latinos on Thursday, telling them time is running out to sign up for health coverage this year and that they should enroll now to avoid problems" (Galewitz, 3/6). Check out what else is on the blog.

This Story: Print | Link to | Top

Political Cartoon: 'Care-Free?'

Kaiser Health News provides a fresh take on health policy developments with "Care-Free?" by Len Chapman.

And here's today's health policy haiku:

TAILORING THE MESSAGE

"Asegúrate"
means "we need young enrollees,"
roughly translated.
-Anonymous 

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

 

This Story: Print | Link to | Top

Health Reform

Obama Gives Latinos Full Court Press

The president appeared at a town-hall-style event Thursday, hosted by Spanish-language media outlets, to urge Latinos to sign up for insurance options made available by the health law before open enrollment ends March 31.

NPR: Obama Pitches Health Care Law To Latinos In Bid To Boost Enrollment
Getting Latinos to sign up for health insurance under the Affordable Care Act is seen as critical to the law's success. The Latino population is disproportionately uninsured and relatively young, but enrollment hasn't been going well. This, in part, explains President Obama's appearance Thursday at a town-hall-style event hosted by the nation's two largest Spanish-language television networks, Univision and Telemundo. The tough questions he got only scratch the surface (Keith, 3/6).

The Associated Press/Washington Post: Obama To Latinos: Last Call For Health Care Signup
Facing fresh skepticism from one of his traditionally most loyal constituencies, Obama pushed back on the notion of some critics that he’s become America’s “deporter in chief,” insisting that Latinos know that “I’ve got their back.” In a virtual town hall meeting with Spanish-language media outlets, Obama disputed that his credibility had been undermined by the chaotic health care rollout and his failure to secure legal status for millions of Latinos in the U.S. illegally (3/6).

Kaiser Health News: Capsules: Obama Urges Latinos To Sign Up For Insurance Now
President Barack Obama appealed directly to Latinos on Thursday, telling them time is running out to sign up for health coverage this year and that they should enroll now to avoid problems (Galewitz, 3/6).

MSNBC: A Final Push For Insurance Sign-Ups?
National Council of La Raza’s Janet Murguia joins to discuss President Obama’s push for more Latin-Americans to enroll in Obamacare (Farrow, 3/6).

MSNBC: How Immigration Affects Latinos’ ACA Enrollment
The  number of uninsured Hispanics is nearly double the national rate. On Thursday, Pres. Obama pushed for Latinos to sign up for health care at a town hall. He also dodged the label of “Deporter-in-Chief.” Telemundo’s Jose Diaz-Balart discusses (3/6).

NBC News: Latinos Get Full-Court Press From Obama For Health Care Sign-Up
President Barack Obama sought to reassure families with a mixture of U.S. citizens and immigrants here illegally that their personal information would not be shared with immigration officials if they sign up for health care. With the March 31 deadline looming, the president said Thursday at a town hall directed at Latinos, "none of the information provided (to buy health insurance) is in any way transferred to immigration services." The administration has been concerned about the lag in enrollment by Latinos for insurance under the Affordable Care Act, also known as Obamacare (Gamboa, 3/6).

CBS News: Speaking to Latinos, Obama Defends Immigration, Obamacare
In an interview with reporters from the country's top Spanish-language media outlets Thursday, President Obama encouraged the nation's Latino community to sign up for health insurance in the coming weeks while insisting he won't push back the March 31 deadline or waive fines for people who fail to do so. But his health care law is becoming intertwined with the national debate about immigration reform, forcing the president to go on the defensive about those policies as well. One of the first questions for the president during the interview, which was conducted by anchors from Univision and Telemundo, was whether immigrants who came to the U.S. illegally but then had children who were born with citizenship should worry about being turned over to Immigration and Customs Enforcement if they tried to get healthcare for their children (Kaplan, 3/6).

This Story: Print | Link to | Top

Studies Find Share Of Uninsured People Signing Up For Coverage Remains Low

But some signals point to a pattern that may be emerging that suggests more uninsured people have been looking for information about plan options or seeking to buy insurance through the online marketplaces in these final weeks of open enrollment.

The Washington Post: New Health Insurance Marketplaces Signing Up Few Uninsured Americans, Two Surveys Find
The new health insurance marketplaces appear to be making little headway in signing up Americans who lack insurance, the Affordable Care Act’s central goal, according to a pair of new surveys. Only one in 10 uninsured people who qualify for private plans through the new marketplaces enrolled as of last month, one of the surveys shows. The other found that about half of uninsured adults have looked for information on the online exchanges or planned to look (Goldstein, 3/6).

The Wall Street Journal: Number Of Uninsured Buying Coverage Under Health Law Is Rising
The number of previously uninsured consumers buying coverage under the health law has risen sharply in recent weeks, according to new research, a nascent signal of progress in the law's goal of reducing the ranks of the uninsured. The overall share of uninsured people gaining coverage remains low, but the trend suggests more people could get coverage as the enrollment period approaches its final weeks. Most people must pick health plans by the end of March (Weaver and Mathews, 3/6).

Fox News: ObamaCare Signing Up Few Uninsured Americans, Studies Show
ObamaCare appears to be making little progress in signing up uninsured Americans, one of the law's primary goals, according to two new surveys. Only one in 10 uninsured people who qualify for private plans through the new health insurance marketplaces enrolled as of last month, according to a survey by the consulting firm McKinsey & Co., The Washington Post reported on Thursday. The McKinsey survey found that only 27 percent of people who have selected a plan on the exchanges described themselves as having previously been without insurance (3/7).

Politico Pro: Study: More Obamacare Enrollees Were Uninsured
More people who were previously uninsured are signing up for health coverage as the country gets closer to the March 31 close of open enrollment, according to an updated enrollment snapshot by McKinsey & Company released Thursday. About 27 percent of those who bought a new plan this year said they had not been covered in a survey fielded from Feb. 4-13 and detailed Thursday at a conference of America’s Health Insurance Plans. While still only about a quarter of sign-ups, that compares with just 11 percent in surveys earlier in the enrollment period that the consulting firm conducted (Norman, 3/6).

This Story: Print | Link to | Top

Who Wins And Who Loses From Latest ACA Delays?

Media outlets look at the impact of the two-year extension of nonconforming plans, as well as of other regulatory changes that will affect unions and insurers.

Marketplace: Who Foots The Bill For An Obamacare Delay?
The latest delay in the Affordable Care Act means people enrolled in plans that don't meet Obamacare's stricter coverage standards can keep them for another two years. It could create a two-tiered system, because states will get to decide whether to allow the delay, says former Senator Ben Nelson, who now heads the National Association of Insurance Commissioners. And because people in the plans that don’t comply with Obamacare tend to be healthier, not having them in the broader insurance pool means insurers have to shell out more money, and that cost will be passed to consumers. How much more? Nelson says it's too soon to pin down a figure ... (Gorenstein, 3/6).

The Wall Street Journal: Obama Says Delays Don't Mean Health Law Was A Mistake
President Barack Obama on Thursday responded to criticism of his latest change to the Affordable Care Act, saying fixes to the program should be expected and don't amount to an implicit acknowledgment of the law's flaws. "No, No, No," Mr. Obama said when asked whether the delays and changes to the law suggest it was a mistake. "On a program like this that has so many people involved, and millions of people who are trying to find health insurance or get better health insurance, there are always going to be some smoothing out of the process" (Favole, 3/6).

The Seattle Times: Washington Won't Revive Canceled Insurance Plans 
Washington residents are not affected by President Obama’s announcement that canceled health insurance plans will be extended by an additional two years. Plans that expired at the end of 2013 will stay dead in Washington, the state’s insurance commissioner confirmed Wednesday (Stiffler, 3/6).

The CT Mirror: Latest Obamacare Tweak Could Revive CT Debate On Extending Health Plans
Thousands of Connecticut residents whose health insurance plans didn’t meet the requirements of the federal health law managed to keep their policies by renewing them in late 2013, before the new Obamacare regulations kicked in.The expectation was that they’d have to buy new, Obamacare-compliant health plans when their policies expire late this year. But now the federal government says those people could continue their noncompliant plans for another two years -- if their states and insurers allow it (Becker, 3/7).

The San Jose Mercury News: Obamacare Extension Of Nonconforming Health Plans Won't Affect Many Californians
The Obama administration's announcement Wednesday that allows a two-year extension for individual health insurance policies that don't conform to the health care law applies nationwide -- but only to states that agree to the plan, according to a spokeswoman with the federal Centers for Medicare & Medicaid Services. In California, even if the state Legislature and Gov. Jerry Brown approve the extension by changing current law, most of the 1.1 million Californians whose nonconforming plans were canceled last year wouldn't likely benefit, a state Insurance Department official said Thursday. Janice Rocco, deputy commissioner of health care policy, said there are "very few people left'' with pre-2014 policies who would be able to take advantage of Wednesday's decision because state law says that after Jan. 1, 2014, insurance plans that don't comply with the Affordable Care Act cannot be sold or renewed (Seipel, 3/6).

Kaiser Health News: What Will Obamacare Really Cost? They Might Be First To Know
Now that medical insurers must accept all applicants no matter how sick, what will these new customers cost health plans? How will they affect coverage prices for 2015 and beyond? Few questions about the Affordable Care Act are more important. How it all plays out will affect consumer pocketbooks, insurance company profits and perhaps the political fortunes of those backing the health law (Hancock, 3/7).

The size of the potential tax penalties facing consumers who go without health insurance, and how the latest regulatory changes affect unions and insurers also draw scrutiny -

The Wall Street Journal’s Washington Wire: Obamacare Penalty To Exceed $95 For Many Americans
For many individuals and families, the penalty for not having health-insurance coverage will run a lot higher than the $95 figure often cited — and it could run into the five figures in some cases. That’s according to the Tax Policy Center, which has just rolled out a tax penalty calculator — the ACA Tax Penalty Calculator. The calculator helps people figure out how large their tax penalty will be if they fail to obtain required health-insurance coverage (McKinnon, 3/6).

The Wall Street Journal’s Washington Wire: Some Unions Get Break From Health Law’s ‘Belly Button Tax’
The slew of regulations released by the Obama administration Wednesday to implement the federal health law included confirmation that some labor unions and businesses would get a break from the law’s so-called belly button tax. Federal officials signaled in November they were planning to let some organizations that offer health insurance off paying a reinsurance fee on each person they cover, which goes into a fund to compensate insurance carriers that end up paying big medical bills now they can no longer charge riskier people more (Radnofsky, 3/6).

CQ HealthBeat: Additional Funds For Insurers Through Risk Corridors Could Cost $8 Billion
Health plans could be eligible for $8 billion in extra funds to offset unexpectedly high claims this year under regulations finalized this week, a top federal official said after speaking to an insurer trade group on Thursday. The additional funds were provided because of the problems insurers have faced this year offering coverage to individuals and small businesses through health law exchanges. The money is intended to compensate insurers who may have greater-than-expected losses, in part because President Barack Obama said consumers could continue getting coverage through insurance policies that do not meet the benefit requirements of the health care law (Adams, 3/6).

This Story: Print | Link to | Top

N.H. Senate, Led By GOP, Votes To Expand Medicaid

Seven Republicans joined Democrats to pass the bill, which now goes to the Democratic-controlled House. Meanwhile, tensions are rising in Virginia on the issue as Republicans in the House hold out against the governor's offensive, and in Pennsylvania, the Republican governor amends his requirements for an expansion.

The New York Times: New Hampshire Senate Votes To Expand Health Insurance Coverage
The state's Republican-dominated Senate voted Thursday to expand health care coverage to an estimated 50,000 adults using Medicaid funding made available through the Affordable Care Act. The bill moves to the House, which has passed similar legislation. Gov. Maggie Hassan, a Democrat, praised the bill, calling it "a New Hampshire-specific solution to making sure that we can have health care coverage for working men and women throughout the state who haven’t had it before" (Bidgood, 3/6).

Concord Monitor: N.H. Senate Approves Medicaid Expansion, 18-5
After more than two hours of debate and three failed attempts by opponents to amend the bill, the New Hampshire Senate yesterday voted, 18-5, to expand the state Medicaid program. Seven Republicans, including Senate President Chuck Morse of Salem, joined the entire Democratic Senate caucus in supporting the legislation. ... The bill goes next to the House Finance Committee on Monday. The Democratic majority there is supportive of the bill, as is Gov. Maggie Hassan, who would have to sign it before the state can begin submitting necessary paperwork to federal agencies (Palermo, 3/7).

New Hampshire Union Leader: Senate Passes Medicaid Expansion On Bipartisan Vote
Senate Bill 413 uses the current managed-care Medicaid program, an existing program that pays the private health insurance premium for those on employer plans, and private insurance through the state's health insurance exchange to provide health insurance for an estimated 50,000 state residents. Supporters said the bill would help those needing health care, providers and the state economy. But opponents argued it does little to protect taxpayers and will be unaffordable in coming years (Rayno, 3/6).

The Richmond Times-Dispatch: McAuliffe Presses Ahead On Medicaid
Gov. Terry McAuliffe will visit a Fredericksburg hospital today on his promotional tour for expanding health care to the uninsured, a day after House Republicans launched an unsuccessful attempt to extend the legislative session instead of having a special session to deal with the issue in the state budget. The Fredericksburg area is home turf for House Speaker William J. Howell, R-Stafford, who leads the opposition to a Senate plan for extending health coverage to uninsured Virginians as part of its proposed budget. "I’ll be in Fredericksburg … if the speaker would like to come with me," McAuliffe quipped Thursday in a news conference to celebrate the launch of a major Medicaid reform initiative (Meola and Martz, 3/6).

Norfolk Virginian-Pilot: McAuliffe Lambasts House Republicans On Medicaid
In some of his most forceful comments yet on Medicaid expansion, Gov. Terry McAuliffe condemned Republicans in the House of Delegates on Thursday for refusing to provide health care for the poor even though it is a "life and death" proposition. Speaking at a morning news event heralding a new state pilot program to better treat patients jointly eligible for Medicare and Medicaid, the Democrat denounced his GOP rivals for their unwillingness to even consider the matter (Sizemore and Walker, 3/6).

The Washington Post: In Va., Waiting For Someone To Blink On Medicaid
With two days to go before they are supposed to leave town, House Republicans and Gov. Terry McAuliffe showed no signs Thursday of budging in their standoff over expanding Medicaid, bringing Virginia closer to a historic budget stalemate. McAuliffe (D) continued making his case on behalf of expansion, accusing Republican opponents of ignoring those Virginians who stand to benefit the most from the program. Recounting wrenching stories from a tour of a health clinic in rural Wise County, the governor said: "Folks, this is about life and death. It is not a partisan political game" (Laris, 3/6). 

Philadelphia Inquirer: Corbett Shifts On Medicaid Work-Search Requirement
Gov. Corbett has backed off his insistence that a work-search requirement be included in any expansion of Medicaid coverage to hundreds of thousands of uninsured Pennsylvanians, lowering a major stumbling block for approval of his proposal. In a letter to Health and Human Services Secretary Kathleen Sebelius, Corbett suggested turning the work-search requirement into "a voluntary, one-year pilot program to positively encourage those who are able to work" by reducing premiums (Sapatkin and Worden, 3/7).

Politico Pro: Corbett Drops Employment Requirement For Medicaid Expansion
Pennsylvania Gov. Tom Corbett has agreed to back off the most controversial element of a proposal to expand Medicaid -- a requirement that able-bodied beneficiaries without full-time work participate in an employment program as a condition of their health coverage. Instead, he's requesting approval for a one-year pilot program that would be voluntary and offer reduced premiums for anyone who signs up. The concession, offered in a letter to HHS Secretary Kathleen Sebelius that was provided to Politico, may put the state in a stronger position as its waiver request is reviewed (Cheney, 3/6).

Pittsburgh Post-Gazette: Corbett Changes Course On Medicaid
The state will essentially drop a controversial work-search requirement it had sought to impose as part of its overhaul of Pennsylvania's Medicaid program, according to documents that became public Thursday. A letter from Gov. Tom Corbett to Kathleen Sebelius, U.S. Department of Health and Human Services secretary, says the governor wants to "move forward in good faith and work towards a reasonable compromise" on the matter. He is instead proposing a voluntary pilot program called "Encouraging Employment" (Giammarise, 3/6).

Health News Florida: 'It's All About Hope' -- and $51B
A lot of money -- $200 million a month or $7 million a day -- could be used to buy health coverage for Florida's poor. But it all could go to some other state, said advocates who held a Capitol press conference Wednesday with the message: "Take the Money!" The money in question is the estimated $51 billion over 10 years that is sitting in Washington D.C., to be sent to Florida to buy health coverage for the poor (Gentry, 3/6). 

The Arizona Republic: Insider: Battle Of Medicaid Bills Meets Predictable End
The battle of the Medicaid bills met a predictable end in the Arizona House of Representatives: Speaker Andy Tobin's bill passed, while a measure from his congressional opponent Adam Kwasman quietly disappeared. It wasn't supposed to be this way. Tobin last month pooh-poohed Kwasman's bill to repeal the Medicaid expansion Gov. Jan Brewer championed, but said he’d still let the 60 representatives decide its fate (Pitzl, 3/6).

This Story: Print | Link to | Top

Maryland's Health Exchange Continues To Be Hot Button Political Issue

News outlets report on developments regarding health exchanges in Maryland, Delaware and Oregon. 

The Baltimore Sun: Republicans Continue Push To Scrap Health Exchange Website
Republicans in Annapolis continue their push to get more information about what went wrong with the state's troubled health exchange website, and to scrap the site entirely. Maryland Senate Minority Leader David Brinkley called for an independent investigation, but was told in a letter from Attorney General Douglas Gansler that his office lacked the authority (Cohn, 3/6).

The Washington Post: Gansler Decries ‘Mismanagement’ Of Maryland Health Exchange In Letter To GOP Senator
Attorney General Douglas F. Gansler (D) offered fresh criticism Thursday of the way that Gov. Martin O’Malley’s administration has handled Maryland’s online health insurance exchange, saying in a letter to a Republican senator that “the taxpayers ... have been poorly served by the Executive Branch’s mismanagement.” Gansler, a Democratic candidate for governor, wrote that he is “deeply troubled” by the tens of millions of dollars that have been “wasted while hard-working Marylanders have suffered from the botched rollout” (Wagner, 3/6).

The Associated Press: Del. Officials Report 7K Enrollees In Exchange
With the open enrollment period set to expire in about three weeks, the number of Delawareans who have chosen private insurance plans under the federal Affordable Care Act remains far below the initial goal set by state officials. The number determined to be eligible for health care coverage under the ACA’s Medicaid expansion also remains a fraction of what state officials had estimated last year, according to figures presented to the Delaware Health Care Commission on Thursday (3/6).

The Oregonian: Cover Oregon Health Exchange Considers Web-Based Insurance Seller, ehealth, Inc
The Cover Oregon health insurance exchange is in discussions with eHealth, Inc, the online health insurance seller. The company, which operates the website ehealthinsurance.com, takes over the role of insurance agent, posting information on prices and plans similar to the vision of health care exchanges. News of possible discussions was broken by CNBC, which noted eHealth is close to a deal with Maryland for a pilot program in which the site would provide consumers with preliminary subsidy estimates and forward their application to that state's exchange, getting credit for a sale (Budnick, 3/6).

This Story: Print | Link to | Top

Head Of Federal Insurance Marketplace Resigning

Gary Cohen says he will return to California, where he was once an insurance executive, regulator and head of an advocacy group. 

The New York Times: Official At Helm Of Federal Health Marketplace Is Resigning
Gary M. Cohen, the official in charge of the federal health insurance marketplace, who repeatedly told Congress before its troubled rollout that it would work well, said on Thursday that he was resigning. Mr. Cohen is the chief architect of federal rules regulating the operations of private health insurance under the new health care law (Pear, 3/6).

Bloomberg: U.S. Health Insurance Regulator Gary Cohen To Resign
Cohen will step down as director of the Center for Consumer Information and Insurance Oversight at the end of the month, when the first enrollment period for the health-care law concludes, Marilyn Tavenner, the administrator of the Centers for Medicare and Medicaid Services and Cohen’s boss, said yesterday in an e-mail to employees. Cohen and Tavenner said his departure is voluntary. ... Cohen said he hasn’t begun looking for a new job in part because of federal conflict-of-interest rules (Wayne, 3/6).

This Story: Print | Link to | Top

Capitol Hill Watch

House GOP To Vote On 'Doc Fix' Bill That Repeals Health Law Individual Mandate

The bill could put House Democrats in an awkward spot, but would be a nonstarter in the Democrat-controlled Senate and could kill prospects this year to get rid of the sustainable growth rate formula. Meanwhile, a right-leaning advocacy group unveils a $1 million ad campaign against congressional Democrats over the administration's proposed reductions in funding to private Medicare Advantage plans.

Politico: House To Vote On 'Doc Fix' – With Obamacare Funds
House Republicans are planning to bring up a permanent "doc fix" bill next week — paid for by repealing the individual mandate in Obamacare. It puts House Democrats in an awkward position. They have to either vote against repealing a Medicare payment formula that has long vexed doctors — or against a key, but unpopular piece of the Affordable Care Act. And because the bill isn't likely to come up in the Democratic-led Senate, the problem will still be unsolved (Haberkorn, 3/6).

Politico: $1 Million In Ads To Target Democrats On Medicare
Seizing on proposed Medicare Advantage cuts, the right-leaning American Action Network will unveil a $1 million ad campaign on Friday against three vulnerable Democratic senators and six House Democrats. Over the next two weeks, TV buys will be accompanied by mailings to swing voters and online ads directing voters to DontCutOurMedicare.com (Hohmann, 3/6).

McClatchy: Do GOP Rep. Ellmers' Claims Of Cuts To Medicare Advantage Plans Hold Up?
Rep. Renee Ellmers this week joined fellow Republicans who say the Obama administration is slashing Medicare Advantage to pay for the health care law. Ellmers and other House Republicans sent a letter to the administration this week, calling for "immediate reversal of their plans to make painful cuts to Medicare Advantage to pay for Obamacare." The recent spate of political warnings about Medicare Advantage stem from a Feb. 21 announcement of preliminary figures used to compute the rates Medicare will pay to private providers for Medicare Advantage plans in 2015 (Schoof, 3/6).

Still, the Republicans are weighing how to deal with the health law, which many had expected to make the key foil in their midterm campaigns. But some are rethinking that strategy as public attitudes on the law evolve.

Fox News: Republican Proposes Hiring Official Watchdog For ObamaCare
A Republican congressman is calling for the federal government to hire a full-time watchdog for ObamaCare, amid ongoing concerns about fraud and mismanagement. Rep. Peter Roskam, R-Ill., introduced a bill on Thursday that would create a "Special Inspector General for Monitoring the Affordable Care Act (SIGMA)." He told Fox News the position is needed to follow the money. "There's very specific criteria that the special inspector general is required to produce and follow up on," Roskam told Fox News. "But the point is it needs to be done holistically and in a larger context. It's just a common sense approach to government and oversight” (Emanuel, 3/6).

The Fiscal Times: Divided GOP Searches for 'One Voice' On Obamacare
Are Republicans fumbling their anti-Obamacare message ahead of the midterm elections? During the first months of the law's disastrous rollout -- plagued with website problems, cancelled policies and numerous delays -- it seemed as if Obamacare would be an easy target for the GOP. However, now that the majority of the website's glitches have been resolved and enrollment has increased, the Republicans seem to be at an impasse over how to deal with Obamacare (Ehley, 3/7).

The Fiscal Times: Americans Want to Fix, Not Repeal Obamacare
Though the majority of Americans have an unfavorable view of Obamacare—most say they would prefer to see the law fixed instead of repealed. That's according to a survey by Hart Research Associates and Public Opinion Strategies that found 54 percent of respondents say they want lawmakers to repair Obamacare, while 28 percent say they want to eliminate it. Another 17 percent say they want the law to remain as is (Ehley, 3/6).

This Story: Print | Link to | Top

Health Care Marketplace

Companies Test Private Exchanges, Other Ways To Cut Health Costs

Some companies are turning to private exchanges to cut costs while a team of three programmers use data to help people wade through their coverage choices.

The New York Times: Companies Test Plans To Cut Their Health Costs
As health care costs continue their steady climb, employers are looking for ways to slow the pace. A survey of large employers released on Thursday showed that companies were shifting more costs onto their employees but were also experimenting with concepts like private exchanges that allow companies like Walgreen to offer their workers more choices in health care plans (Abelson, 3/6).

The New York Times: More Than One Way To Buy A Plan
When the federal online marketplace for the Affordable Care Act stumbled out of the gate last fall, leaving would-be applicants unable to sign up for care or even to view their plans, three young programmers thought they might be able to help frustrated users. In October, they packaged reams of publicly-available data into a website, healthsherpa.com, that allowed users to immediately view exchange plans in their area. But the site was intended for research only; users still had to purchase them through the federal and state health exchanges or, in some cases, directly through insurers (Bidgood, 3/6). 

This Story: Print | Link to | Top

Quality

Privately Run Long-Term Care Gets High Scrutiny

Other news includes a report that could mean better inspections of nursing homes and a study that examines the burden many poor women face in caring for an aging parent.

The New York Times: Pitfalls Seen In A Turn to Privately Run Long-Term Care
Even as public attention is focused on the Affordable Care Act, another health care overhaul is underway in many states: an ambitious effort to restrain the ballooning Medicaid cost of long-term care as people live longer and survive more disabling conditions (Bernstein, 3/6).

Kaiser Health News: IG Report Findings Could Strengthen Nursing Home Inspections
Federal efforts to strengthen inspections of the nation's nursing homes are gaining momentum after a government probe uncovered instances of substandard care. The March 3 report by the HHS Inspector General found that an estimated one-third of residents suffered harm because of substandard care and that the chances of nursing home inspectors discovering these 'adverse events' are 'slim to none,' said Ruth Ann Dorrill, a deputy regional director for the inspector general and the manager of the investigation (Jaffe, 3/7).

Reuters: Financial 'Vicious Cycle' Traps Poor Women Caregivers
Caring for aging parents can be a burden for anyone, but poor women are more likely to need to take it on and to enter a financial downward spiral as a result, a recent study suggests. Women with better financial resources can afford paid health care for an aging parent, which allows those women to remain in the workforce, the authors found (Jegtvig, 3/6).

This Story: Print | Link to | Top

State Watch

Highlights: Calif. Retiree Health Costs Rise; More Abortion Clinic Closings In Texas; Wash. Insurance Bills Roadblock

A selection of health policy stories from California, Texas, Washington state, Illinois, Virginia and Georgia.

Los Angeles Times: Estimate Of How Much State Owes For Retiree Health Care Keeps Rising
While lawmakers begin discussing ways to fix California's cash-strapped teacher pension system, another long-term financial problem continues to fester. The cost of providing health care to retired state workers is $64.6 billion more than state leaders have set aside to pay, an increase of $730 million from the previous year (Megerian, 3/6).

The New York Times: Abortion Law Pushes Texas Clinics To Close Doors
Shortly before a candlelight vigil on the sidewalk outside, employees of the last abortion clinic in the Rio Grande Valley in South Texas shut the doors early Thursday evening, making legal abortion unavailable in the poorest part of the state in the wake of tough new restrictions passed last year by the Texas Legislature (Fernandez, 3/6).

Los Angeles Times: Two More Abortion Clinics Close In Texas Under New Restrictions
Two more Texas abortion clinics closed on Thursday because of restrictions in a state law that is being fought in the federal courts. Amy Hagstrom Miller, who owns the Whole Woman's Health Clinic, told reporters on Thursday that Republican lawmakers have made it impossible to keep her clinics open in Beaumont and McAllen. The McAllen clinic is the last in the Rio Grande Valley in southern Texas, and the Beaumont clinic is the only one between Houston and the Louisiana border (Muskal, 3/6).

The Seattle Times: Bills Designed To Aid Consumers With Insurance Run Into Opposition 
Two bills in the state Legislature aimed at increasing transparency for consumers and helping them make savvy decisions about insurance are now missing key elements, primarily because of concerns that companies’ proprietary information might be revealed. One bill was designed to protect consumers from being blindsided by their insurer’s potential collapse because of financial instability of their larger holding company (Ostrom, 3/6).

Los Angeles Times: Computers With L.A. County Patients’ Personal Data Are Stolen
A Torrance office of Sutherland Healthcare Solutions, which handles billing and collections for the county's Department of Health Services and Department of Public Health, was burglarized Feb. 5 and computer equipment was stolen, according to a county statement issued Thursday (Sewell, 3/6). 

The Associated Press: Report: Fewer Illinois Kids Lack Health Insurance
While a child advocacy group's report shows that more Illinois kids now have health insurance, it also warns that health disparities related to income and race could intensify if there are program cuts to Medicaid and social services as the state faces a large dip in revenues next year. The yearly report released Thursday by Voices for Illinois Children shows children that are black, Latino or from low-income families have less access to health care and insurance (Koop, 3/6).

The Richmond Times-Dispatch: McAuliffe, Citing Coordinated Care Program, Urges Lawmakers To Close 'Coverage Gap'
Gov. Terry McAuliffe today used the launch of an ambitious pilot project for coordinating care of elderly and disabled Virginians to call again for the state to extend health insurance coverage to hundreds of thousands of uninsured residents. The Commonwealth Coordinated Care program began enrolling people on Monday in Central Virginia and Tidewater in an effort to manage services they receive from both the federal Medicare program and the state-federal Medicaid program. The program eventually will cover five regions of the state and an estimated 78,000 people who are “dually eligible” for both programs (Martz, 3/6).

Georgia Health News: Bill Would Nudge More HIV Patients Into Treatment
More than half of Georgians with HIV are not currently in treatment, health officials say. A Senate bill aims to bring thousands more of these patients into care. If enacted, SB 342 would allow the state’s Department of Public Health to alert a physician of a patient’s HIV or AIDS status (Miller, 3/6).

The San Francisco Chronicle: Prisoners Lose In Damage Claim Over Lack Of Health Care
Prisoners can't sue for damages when they are denied health care because the state has failed to provide enough funding for medical staff or supplies, a divided federal appeals court ruled Thursday. In the case of a Southern California inmate whose treatment for a painful dental condition was delayed because the prison was short of dentists and technicians, the Ninth U.S. Circuit Court of Appeals in San Francisco ruled 6-5 that prison employees are immune from damage claims when the cause is a lack of state funds. "A prison medical official who fails to provide needed treatment because he lacks the necessary resources can hardly be said to have intended to punish the inmate," Chief Judge Alex Kozinski said in the majority opinion (Egelko, 3/6).

This Story: Print | Link to | Top

Health Policy Research

Research Roundup: Health Care And Prisoners; Hospitalized Patients' Surrogates; Suicides In The Army

Each week, KHN compiles a selection of recently released health policy studies and briefs.

Health Affairs: The Critical Link Between Health Care And Jails
As a group, jail-involved individuals, which we define here as people with a history of arrest and jail admission in the recent past, carry a heavy illness burden, with high rates of infectious and chronic disease as well as mental illness and substance use. Because these people have tended to also be uninsured, jail frequently has been their only regular source of health care. ... The Urban Institute estimated as much as 30 percent of some local corrections budgets is allocated to inmate health care services. This investment is largely lost when people are released back into the community, where they typically do not get treatment. ... With the expansion of Medicaid eligibility under the Affordable Care Act, there is now a critical opportunity to bring the jail-involved population into the mainstream health care system (Marks and Turner, 3/3).

Health Affairs: What The Affordable Care Act Means For People With Jail Stays
[The Affordable Care Act's] provision of better access to care before and after people are incarcerated could have positive long-term effects on both the health of those individuals and overall health care costs. Achieving these results will require careful planning and coordination among jail health care programs, Medicaid, and Marketplace health plans. The use of electronic health records by jails and community providers could help ensure that treatments are consistent no matter where a patient resides. Policy makers and health plans could also ensure continuity of care by including in their networks some of the same safety-net providers that are under contract to furnish care to jail inmates (Regenstein and Rosenbaum, 3/3).

JAMA Internal Medicine: Scope And Outcomes Of Surrogate Decision Making Among Hospitalized Older Adults
Our observational study found that 67.8% of hospitalized older adults face at least 1 major decision in the first 48 hours of hospitalization. Surrogate decision makers were involved in these decisions for nearly half of these older adults (47.4%). Most patients who required a surrogate faced decisions about life-sustaining care, and nearly half faced decisions about procedures and operations or discharge placement. ... there are substantial barriers to communication for surrogate decision makers. In the hospital, family members are considered "visitors" rather than crucial participants in their family member's care. ... surrogates often have trouble contacting hospital staff and struggle for information about the patient (Torke et al., 3/3).

JAMA Internal Medicine: Sociodemographic Differences In Fast Food Price Sensitivity
Fiscal food policies (eg, taxation) are increasingly proposed to improve population-level health, but their impact on health disparities is unknown. ... We found greater fast food price sensitivity on fast food consumption and insulin resistance among sociodemographic groups that have a disproportionate burden of chronic disease. Our findings have implications for fiscal policy, particularly with respect to possible effects of fast food taxes among populations with diet-related health disparities (Meyer, 3/3).

JAMA Psychiatry: Predictors Of Suicide And Accident Death In The Army Study To Assess Risk And Resilience In Servicemembers (Army STARRS)
To our knowledge, this is the first report of suicide trends by deployment category during a period when the Army suicide rate increased above the civilian rate. While we found suicide risk to be highest during deployment, the rise in the suicide rate was found not only among the currently and previously deployed but also among the never deployed. We also found suicide risk to be significantly associated with a number of sociodemographic characteristics and Army experiences. ... Other associations reported herein are new, including the disproportionate increase in suicide risk among deployed women soldiers, soldiers demoted in the past 2 years, and soldiers without either a high school diploma or general equivalency diploma (Schoenbaum et al., 3/3).

JAMA Psychiatry: Prevalence And Correlates Of Suicidal Behavior Among Soldiers
The lifetime prevalence estimates of suicidal ideation, suicide plans, and suicide attempts [representative cross-sectional survey of 5428 nondeployed soldiers] are 13.9%, 5.3%, and 2.4%. Most reported cases (47.0%-58.2%) had pre-enlistment onsets. Pre-enlistment onset rates were lower than in a prior national civilian survey (with imputed/simulated age at enlistment), whereas post-enlistment onsets of ideation and plans were higher, and post-enlistment first attempts were equivalent to civilian rates (Nock et al., 3/3).

JAMA Psychiatry: Thirty-Day Prevalence Of DSM-IV Mental Disorders Among Nondeployed Soldiers In The US Army
Although high rates of current mental disorder are known to exist in the US Army, little is known about the proportions of these disorders that had onsets prior to enlistment. ... Thirty-day DSM-IV internalizing (major depressive, bipolar, generalized anxiety, panic, and posttraumatic stress) and externalizing (attention-deficit/hyperactivity, intermittent explosive, alcohol/drug) disorders were assessed with validated self-report scales. Age at onset was assessed retrospectively. ... A total of 25.1% of respondents met criteria for any 30-day disorder (15.0% internalizing; 18.4% externalizing) and 11.1% for multiple disorders. A total of 76.6% of cases reported pre-enlistment age at onset of at least one 30-day disorder (49.6% internalizing; 81.7% externalizing). Also, 12.8% of respondents reported severe role impairment (Kessler et al., 3/3).

American Journal of Managed Care/Commonwealth Fund: Trends In The Financial Burden Of Medical Care For Nonelderly Adults With Diabetes, 2001 to 2009
Despite the increased prevalence of diabetes over the past decade, the financial burden borne by patients for treatment of the disease has actually decreased. ... Diabetes is a large and growing public health issue in the United States. From 2000 to 2010, the proportion of the adult population with this chronic condition increased from 6 percent to 9 percent, or to about 21 million people. In addition to its serious health consequences, diabetes presents a major financial challenge for individuals and the health system. In 2007, the estimated medical costs associated with diabetes were $116 billion, with average medical expenses 2.3 times higher for people with the disease compared to those without. The high cost and intensity of treatment, combined with the prevalence of comorbid conditions, can often act as a barrier for patients (Cunningham and Carrier, 2/28).

The Kaiser Family Foundation: Adding An Out-of-Pocket Spending Maximum To Medicare: Implementation Issues And Challenges
Adding an out-of-pocket maximum to traditional Medicare would strengthen financial protections under Medicare for the beneficiary population and mitigate beneficiaries’ need for supplemental coverage. Varying the out-of-pocket maximum by income could achieve the policy goal of targeting resources to those most in need, but at the same time would add to the complexity of administering Medicare benefits. This brief describes the options for adding an out-of-pocket spending limit to Medicare and examines the operational issues that could arise in implementing both a uniform and an income-based out-of-pocket spending limit. Because the implementation of an income-related out-of-pocket maximum would pose somewhat greater complexity for Medicare, the operational issues associated with this approach are discussed in greater detail (Cubanski, Neuman and Levinson, 2/27).

Health Affairs/Robert Wood Johnson Foundation: Geographic Variation In Medicare Spending
While geographic variation in Medicare spending per beneficiary is itself well documented, the causes of that variation, whether it is appropriate, and what can be done to reduce spending in high-cost areas are less clear. This brief describes the research on geographic variation in Medicare spending and different interpretations of what it suggests for Medicare payment policy. ... Spending patterns are specific to Medicare ... Studies indicate that there is no single answer to addressing variation in Medicare spending by region (Cassidy, 3/6).

Mathematica/Agency for Healthcare Research and Quality: How Are CHIPRA Quality Demonstration States Designing And Implementing Caregiver Peer Support Programs?
This Evaluation Highlight is the seventh in a series that presents descriptive and analytic findings from the national evaluation of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program. ... Maryland, Georgia, Utah, and Idaho are using different approaches to test and refine caregiver peer support programs as a vehicle for improving the quality of care for [children with special health care needs (CSHCN)]. ... States have also learned that peer support caregivers themselves lead a complex life. To be effective, they need comprehensive training on their roles and responsibilities, a clear understanding of the time commitment required, and access to a support system. The experiences of the four States profiled in this Highlight suggest that implementing a peer support program can be challenging, especially with regard to financing and reimbursement (Ferry et al., February 2014).

Here is a selection of news coverage of other recent research:

The New York Times: Birth By C-Section May Raise Obesity Risk
A large review of studies has found that birth by cesarean section is associated with being overweight and obese in adult life. Researchers pooled data from 15 studies with a combined population of 142,702 for their analysis. The studies classified overweight as a body mass index of 25 or higher and obesity as 30 or higher, and covered various types of vaginal and cesarean deliveries. Compared with babies delivered vaginally, those delivered by C-section were 26 percent more likely to be overweight and 22 percent more likely to be obese. ... The analysis, published in the February issue of PLOS One, included a large sample from 10 countries, which gives it considerable strength (Bakalar, 3/3).

The Washington Post: Hospital Antibiotic Use Can Put Patients At Risk, Study Says
Doctors in some hospitals prescribe up to three times as many antibiotics as doctors at other hospitals, putting patients at greater risk for deadly superbug infections, according to a federal study released Tuesday. In addition, about one-third of the time, prescriptions to treat urinary tract infections and prescriptions for the drug vancomycin were given without proper testing or evaluation, or prescribed for too long, according to the Centers for Disease Control and Prevention (Sun, 3/4).

Time: Doctors' Stethoscopes Are Germ-Ridden And Disgusting
A new study says doctor’s stethoscopes carry lots of bacteria that can be transferred from patient to patient during appointments. Researchers from University of Geneva Hospitals collected and studied bacteria from the fingers, palms, and stethoscopes of three doctors who had 71 patient appointments. They looked specifically for a deadly bacteria called methicillin-resistant Staphylococcus aureus (MRSA). They found the most bacteria on the finger tips of the doctors’ dominant hand. However, stethoscopes–specifically the part that comes in contact with patients–came in second, with more bacteria than doctors’ palms. There was a decent amount of MRSA identified (Sifferlin, 2/28).

Reuters: Spine Surgery Patients Mostly Unaware Of Costs, Compensation
Orthopedic surgery patients go in and out of the operating room "blind" to the cost of their procedures, ... The misperceptions among spinal surgery patients are emblematic of a major barrier to controlling healthcare costs, according to the authors, which is that nobody knows what the costs are. ... 62 percent believed their surgeons earned thousands of dollars more for the procedures than they did, according to the results published in The Spine Journal. For minor procedures, patients estimated reimbursement was between $5,000 and $10,000, whereas the highest reimbursement for any minor procedure from Medicare was $1,363 and from a private insurer, $2,038 (Cohen, 2/27).

This Story: Print | Link to | Top

Weekend Reading

Longer Looks: Health Care In Jail; Preventing Medicare Drug Fraud; New Medical Codes

Every week, KHN reporter Marissa Evans selects interesting reading from around the Web. 

Health Affairs: To Improve Public Health And Safety, One Sheriff Looks Beyond The Jail Walls
"Sheriff Ashe," [the waitress] began. "My daughter is in your jail." She then told me her daughter's story. "Laura," as I’ll call her here, was a bright and sociable girl who, after graduating from high school, went on to community college. There, she began using drugs with the new friends she made. Things got worse: She became addicted to heroin and landed in the Hampden County Correctional Center before she was even twenty. ... we aim to provide every inmate with the tools he needs to return to the community and build a new life. This is how we think of reentry. One way we support reentry is through the After Incarceration Support Systems Program, established in 1996 in downtown Springfield. The program office houses organizations and social service agencies that provide recently released inmates with assistance in getting jobs, housing, counseling, help with drug and alcohol abuse problems, and other supportive services. Health care is also a major component of our approach to reentry. Jails are “reservoirs” of under- or untreated illness, including many communicable diseases such as HIV/AIDS, hepatitis, sexually transmitted infections, and tuberculosis (Michael J. Ashe, 3/5). 

Time Magazine: When Not To Arrest An Abuser In A Domestic Violence Case
Almost half the states in America have mandatory arrest provisions in domestic violence cases, and it's widely accepted as an important step in protecting the mostly female victims of spousal or partner violence. Just last month, the legislature in Madison County, Alabama,  passed a bill that would strengthen police's ability to make such arrests. But a new research paper raises some questions about whether mandatory arrests in every case is the right approach. It’s possible arresting an alleged abuser may be really bad for some victims'  long-term health (Belinda Luscombe, 3/5).

The Weekly Standard: Code Chaos
Ever considered suicide by jellyfish? Have you ended up in the hospital after being injured during the forced landing of your spacecraft? Or been hurt when you were sucked into the engine of an airplane or when your horse-drawn carriage collided with a trolley? Chances are slim. But should any of these unfortunate injuries befall you after October 1, 2014, your doctor, courtesy of the federal government, will have a code to record it. On that date, the United States is scheduled to implement a new system for recording injuries, medical diagnoses, and inpatient procedures called ICD-10​—​the 10th version of the International Classification of Diseases propagated by the World Health Organization in Geneva, Switzerland. ... The coming changes are vast. The number of codes will explode​—​from 17,000 under the current system to 155,000 under the new one, according to the Centers for Medicare and Medicaid Services (CMS) (Stephen F. Hayes, 3/5).

NewsHour: Teaching Students How To Combat Traumas Of Poverty On The Yoga Mat
At Cesar Chavez Academy in East Palo Alto, Calif., 7th graders are learning yoga as a way to cope with the stress of life in a community rife with homelessness, shootings and gang war trauma. By teaching these children to pay close attention to their breathing and movements, Stanford University researchers are hoping they will focus better in school and beyond (Jeffrey Brown, 3/4).

ProPublica: Medicare's Drug Program Needs Stronger Protections Against Fraud, Watchdog Says
Medicare has failed to adequately track fraud in its massive prescription drug program, according to a new report today from the agency's watchdog. In particular, the inspector general of the U.S. Department of Health and Human Services found that fewer than half of the insurance companies paid to administer Medicare's drug program reported data to the federal government about potential fraud and abuse cases between 2010 and 2012. Two large insurers with 4 million members collectively appear not to have reported a single incident of fraud in 2012 (Charles Ornstein, 3/4).

This Story: Print | Link to | Top

Editorials and Opinions

Viewpoints: New Delay On Policies: Cover For Dems Or Just Smoothing The Bumps Of Health Law?

The New York Times: Keeping Your Insurance Policy
The Obama administration announced a new policy on Wednesday that will allow many people to renew their existing insurance policies for two more years even though the policies don't provide the comprehensive coverage and consumer protections required by the Affordable Care Act. The move is designed to provide political cover for Democratic senators facing tough re-election campaigns in Republican-leaning states where the president is especially unpopular. ... This policy change had the immediate, unfortunate effect of giving Republicans another convenient excuse to bash the Affordable Care Act as a failure that should be repealed. In truth, it poses no threat to health care reform and will have no impact on the vast majority of Americans (3/6). 

USA Today: Obamacare Delays Not Created Equal: Our View
Another day, another Obamacare delay? Really? On Wednesday, the administration announced it would allow some people two more years to keep insurance policies that don't fully comply with the Affordable Care Act, feeding the impression that the White House changes the law whenever it feels like it for political reasons. That's a cartoon version of what's really happening, but it gave critics another chance to pounce. ... What's really going on is that Obamacare, like the Clean Air Act and other big changes before it, is such a large transformation that there were bound to be problems and delays (3/6).

USA Today: Mitch McConnell: Political Games Prompt Delays
Every week, it seems, we learn of some new way the administration and its congressional allies plan to put political imperatives ahead of the rule of law and the rights of ordinary citizens. We've seen it with the IRS scandal, and we saw it yet again this week with another politically motivated Obamacare delay. ... It's essentially all smoke and mirrors, because as long as Obamacare remains law, Americans will continue to face the threat of losing their plans. It's simply how the law was written; there's no "glitch" to be ironed out (Sen. Mitch McConnell, R-Ky., 3/6).

Bloomberg: Will Obama Ever Enforce His Health Law?
The Barack Obama administration announced yesterday that it was extending the "grandfathering" of noncompliant health-care plans for two more years. ... This latest maneuver is supposed to help midterm Democrats, who are facing a very tough landscape in November. But there will always be an election coming that Democrats will want to win. The longer this goes on, the harder it will be to activate the unpopular parts of the law. Especially if Republicans gain the trifecta -- House, Senate, presidency -- they are going to have no incentive to save Obamacare by sacrificing their own political fortunes (Megan McArdle, 3/6).

In other views on the health law -

The Washington Post: A Bipartisan Solution To Va.'s Medicaid Standoff
Virginia Republicans and Democrats are talking past each other on Medicaid expansion. GOP leaders bristle at federal bureaucratic demands regarding Medicaid. We get it; we don't like to be pushed around either. Democrats bristle at suggestions they are willing to cut and run on President Obama. We get that; no one likes being charged with cowardice under fire (Norman Leahy and Paul Goodman, 3/6). 

The Washington Post: Virginia Republicans' Stand Against Medicaid Funding Defies The Facts
The year 2014 is only 66 days old, yet already Virginia has forfeited $330 million in federal funds — funds already paid to Uncle Sam by taxpayers — as a result of its delay in expanding Medi­caid to cover up to 400,000 lower-income and uninsured Virginians. With each passing day, the state leaves another $5 million in federal funds unclaimed. It has also passed up another $32 million so far this year in lost savings, as well as tax revenues that would be generated by the creation of some 20,000 health-care jobs (3/6).

Bloomberg: The Obamacare Placebo Effect?
Gallup has new numbers today showing that the Affordable Care Act continues to be quite unpopular. In this reading, 40 percent of Americans approve of the law and 55 percent disapprove. ... We need better questions. First, how about some open-ended ones that ask how people have been helped or hurt? Second, how about some insurance information. People who have kept their employer-linked insurance may perceive that Obamacare has helped or hurt them. But that doesn't tell us anything about those who have had policies canceled or who have obtained insurance for the first time (Jonathan Bernstein, 3/6).

And on other health issues -

The Fiscal Times: Employers' Health Care Push: Play by Our Rules, or Pay
In Las Vegas, the house always rules. The same maxim may apply to how you obtain health benefits through your employer. Under a growing employer insurance option called "house money/house rules," employers are increasingly calling the shots on how employees receive their benefits — and workers may be penalized or rewarded depending upon how they take care of themselves. That means they may be subject to regular monitoring and told to enroll in health care management programs (John F. Wasik, 3/6).

Bloomberg: Unvaccinated Kids Make Everyone Sick
One of America's essential national defense shields is under attack from within, and the aggressors are people you wouldn't normally consider dangerous: parents of young children. As more and more resist having their school-age kids vaccinated, they are destroying the herd immunity that everyone relies on for protection against whooping cough, measles and other dangerous, sometimes fatal, infectious diseases (3/6).

This Story: Print | Link to | Top


EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Marissa Evans
Lisa Gillespie
Shefali Luthra

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.