First Edition: June 24, 2013

Today's early morning highlights from the major news organizations, including articles about the 100-day sprint toward opening the online health insurance marketplaces. 

Kaiser Health News: Officials Prepare For ‘Biggest Open-Enrollment Season We’ve Ever Seen’
Kaiser Health News staff writers Phil Galewitz and Jay Hancock report: "At the Silver State Health Insurance Exchange in Carson City, Nev., workers have been counting down the days until Oct. 1 on an office corkboard. Sunday is a big milestone --- 100 days to the deadline for opening the online marketplaces that are a linchpin of the federal health law known as Obamacare. 'We certainly will need every one of the days that we have left,' said Jon Hager, executive director of the Nevada exchange. 'But I am confident we will be ready to go.' ... Opening the marketplaces on time represents the Obama administration’s biggest opportunity to fulfill the law’s promise to extend coverage to uninsured Americans, including those who have been denied coverage in the past because of health conditions" (Galewitz and Hancock, 6/23). Read the story.

Kaiser Health News: Blue Cross-Blue Shield Bets Big On Obamacare Exchanges
Kaiser Health News staff writer Jay Hancock, in collaboration with The Washington Post, reports: "At a closed White House meeting in April, President Barack Obama told corporate insurance bosses 'we’re all in this together' on implementing his signature health law. But some insurance companies seem to be more in than others. At least five Blue Cross and Blue Shield executives sat at the table of about a dozen CEOs with the president, according to those knowledgeable about the session, first reported by the New York Times. Just as significant is who wasn’t there: chiefs of the country’s biggest and third-biggest health insurers, UnitedHealth Group and Aetna" (Hancock 6/21). Read the story.

Kaiser Health News: Better Hospital Food Brought To You By The Federal Health Law
Kaiser Health News staff writer Phil Galewitz, in collaboration with USA Today, reports: "When Lauren Heath learned she had to spend an extra day in Rex Hospital after delivering her baby girl in May, she wasn’t complaining. 'It means I get three more, really good meals,' said Heath, 29, of Wake Forest, N.C. 'The food is amazing.' ... Rex, part of the University of North Carolina Health System, is one of a growing number of hospitals nationwide that are tossing out their fryers and adopting hotel-style “room service” where patients can order food anytime from a large menu.  Many are also setting up gardens to grow their own vegetables, inviting local farmers to sell produce in their lobbies and turning food presentations into works of art -- even when made puree style" (Galewitz, 6/24). Read the story.

Kaiser Health News: Political Fight Jeopardizes Mississippi’s Entire Medicaid Program
Mississippi Public Broadcasting's Jeffrey Hess, working in partnership with Kaiser Health News and NPR, reports: "Medicaid and controversy are welded together in many states lately, but for the most part, the wrangling is about 'new' Medicaid -- the Obamacare expansion of the health program for the poor and disabled. Mississippi, though, is raising the stakes. Democrats and Republicans in the state are in the middle of a game of political chicken that could threaten the very existence of the entire Medicaid program by the end of the month (Hess, 6/22). Read the story.

The New York Times: Employers Test Plan To Cap Medical Spending
Hoping to cut medical costs, employers are experimenting with a new way to pay for health care, telling workers that their company health plan will pay only a fixed amount for a given test or procedure, like a CT scan or knee replacement. Employees who choose a doctor or hospital that charges more are responsible for paying the additional amount themselves. Although it is in the early stages, the strategy is gaining in popularity and there is some evidence that it has persuaded high-priced hospitals to lower their prices (Abelson, 6/23).

Related, earlier KHN story: Companies Steering Workers To Lower Priced Medical Care (Appleby, 9/22/11)

The New York Times: A Louisville Clinic Races To Adapt To The Health Care Overhaul
One morning last month, a health clinic next to a scruffy strip mall here had an unlikely visitor: a man in a suit and tie, seeking to bring a dose of M.B.A. order to the operation. ... For doctors and their staffs, this is a period of fevered preparation for the far-reaching changes that are soon to come as the law moves out of the realm of political jousting and into the real world. To follow how the historic law is playing out, The New York Times will look periodically at its impact in Louisville, a city of 600,000 that embodies both the triumphs and the shortcomings of the medical system in the United States (Goodnough, 6/22).

The New York Times: Why A Health Insurance Penalty May Look Tempting
Once new health insurance exchanges are up and running in October, companies with 50 or more full-time employees will face a choice: Provide affordable care to all full-time employees, or pay a penalty. But that penalty is only $2,000 a person, excluding the first 30 employees. With an employer’s contribution to family health coverage now averaging $11,429 a year, taking that penalty would seem to yield big savings. Yet there may be costs in employee satisfaction, especially if companies don’t raise pay enough to keep workers whole when they buy insurance on the exchanges (Bernasek, 6/22).

The Washington Post: Obamacare Starts In 100 Days
There are, arguably, two big things that need to happen between now and October. The first is technical: The federal government needs to finish building the infrastructure that allows multiple government agencies to transmit information, determining whether an individual should qualify for tax subsidies. This is a really big lift ... Also in the technical arena, the federal government needs to finish building the federal exchange, an online portal that most states will have their residents use to purchase health insurance (Kliff, 6/23).

The Associated Press: Promise Of Price Cut On Hospital Bills Is In Limbo
Huge list prices charged by hospitals are drawing increased attention, but a federal law meant to limit what the most financially vulnerable patients can be billed doesn't seem to be making much difference. A provision in President Barack Obama's health care overhaul says most hospitals must charge uninsured patients no more than what people with health insurance are billed. The goal is to protect patients from medical bankruptcy, a problem that will not go away next year when Obama's law expands coverage for millions (Alonso-Zaldivar, 6/24).

Politico: Multistate Affordable Care Act Plans May Not Spur Competition
A program meant to beef up competition on Obamacare exchanges may not add much to the mix of insurance options after all. The Multi-State Plan Program — which was the closest thing to a watered-down “public option” that made it into the final health law — is eventually supposed to provide at least two new insurance options in every state. The problem is that the only insurers likely to be able to quickly scale up coverage across the country are already doing just that: selling their plans from coast to coast (Norman, 6/24).

USA Today: Government Begins Education Blitz For Uninsured
A week after a Government Accountability Office report said new health insurance exchanges may not be fully ready to launch in October, the government Monday began a 100-day public education blitz by releasing a new website, call center and publicity campaign. The campaign is designed to educate those who do not have insurance about how the marketplaces will work and how to obtain health insurance (Kennedy, 6/24).

NPR: Proposed Changes In Organ Donation Stir Debate
The nation's organ transplant network will consider a controversial proposal Monday to overhaul the guidelines for an increasingly common form of organ donation. The board of directors of the United Network for Organ Sharing will open a two-day meeting at the organization's headquarters in Richmond, Va., to consider new guidelines for donation after cardiac death. Donation after cardiac death involves removing organs minutes after life-support has been stopped for patients who still have at least some brain activity (Stein, 6/24).

The Associated Press: Texas Lawmakers Approve Abortion Restrictions
Republicans used their majority to cut short debate and give preliminary approval early Monday to some of the toughest abortion restrictions in the country as time was running out on the Texas Legislature's special session. ... The measure would ban abortions after the 20th week of pregnancy, require doctors to have admitting privileges at nearby hospitals and limit abortions to surgical centers. Supporters say the bill will raise the standard of women's health care, but opponents point out the bill would shut down 37 out of 42 abortion clinics in the state (Tomlinson, 6/24).

Los Angeles Times: Hospitals Cut Some Surgery Prices After CalPERS Caps Reimbursements
When the California Public Employees’ Retirement System told its Anthem Blue Cross members it would pay only up to $30,000 for a knee or hip replacement surgery, some patients shopped around for a cheaper hospital. What may be more surprising is that about 40 higher-priced hospitals in the state cut their surgery prices significantly to avoid losing patients. That response accounted for about 85% of the $5.5 million CalPERS saved over two years, researchers at UC Berkeley found, with the rest of the savings coming from patients opting for lower-cost hospitals (Terhune, 6/23).

The New York Times: California Pushes For Immigrant Health
When Congress passed President Obama’s health care overhaul, a critical compromise provision was that immigrants living in the United States illegally would not be allowed access to publicly subsidized health insurance. Even now, as lawmakers in Washington are debating an overhaul of immigration laws, leaders from both parties are arguing that no federal money should be spent on health care for immigrants on their way to obtaining citizenship. But not in California, where there are an estimated 2.6 million illegal immigrants (Medina, 6/23).

The New York Times: State Rewards Home Care Firms Once Rebuked
Hunting for ways that the incoming governor could close a $2 billion budget deficit late in 2010, New York State officials scrutinized Medicaid spending on home health care, and made some startling discoveries. The cost of caring for frail elderly and disabled people at home had more than doubled from 2003 to 2010, to $1.3 billion, even though fewer people were being served. And that huge cost increase had been driven by just a half-dozen certified home health agencies out of 140, most located in Brooklyn (Bernstein, 6/23).

The Texas Tribune/New York Times: A Policy Keeps Some Texas Doctors From the Delivery Room
But Dr. Alling no longer has a place to deliver babies in the county. The community hospital in Bridgeport that he helped found in 2008 merged its obstetrics unit with the Wise Regional Health System in Decatur in March. That hospital, where Dr. Alling delivered babies before he left for Bridgeport, instituted a policy in 2009 that allowed physicians to deliver babies only if they had undergone a three-year residency program specializing in obstetrics and gynecology. ... As a result, Dr. Alling and three other family physicians were denied obstetrics privileges at Wise Regional and are in legal mediation with the hospital. They estimate that 50 to 100 pregnant patients, the majority of whom live in rural areas and are covered by Medicaid, have been affected by Wise Regional’s refusal to grant them obstetrics privileges (Aaronson, 6/22).

The Washington Post: Federal Employee Dental And Vision Insurance Program To Expand
More insurance companies will participate in the dental and vision insurance program for federal employees and retirees in 2014, the first expansion since the program was created in 2006, the Office of Personnel Management announced Friday. ... In the FEDVIP program, federal employees and retirees can purchase one or the other type of coverage or both, and can cover certain family members (Yoder, 6/21).

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This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from major 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.