First Edition: January 7, 2014

Today's headlines include a range of reports about state developments related to the health law's online marketplaces as well as details regarding the latest Centers for Medicare & Medicaid Services' figures on health costs.  

Kaiser Health News: Nonprofit Health Centers Go Into For-Profit Insurance Business
Kaiser Health News staff writer Phil Galewitz, working in collaboration with USA Today, reports: "The nation's 1,200 nonprofit community health centers receive strong federal support to treat millions of uninsured residents, but still face financial challenges. Some are responding with an unusual strategy -- starting for-profit insurance plans. In 2008, the Jessie Trice Community Health Center in Miami invested $120,000 to start Prestige Health Choice, a for-profit Medicaid health plan that the state pays a flat monthly fee per enrollee to provide care. Fourteen other community health centers also participated" (Galewitz, 1/7). Read the story.

Kaiser Health News: Readers Ask: Are Premium Subsidies Permanent; Do I Have To Meet An Asset Test For Medicaid? 
Kaiser Health News consumer columnist Michelle Andrews answers questions about provisions of the health law (Andrews, 1/7). Read her responses.

Kaiser Health News: Capsules: Detailed Report Delivers Good News On Health Costs, But Will It Last?; How Much Does A New Hip Cost? Even The Surgeon Doesn't Know
Now on Kaiser Health News' blog, Jay Hancock reports on the latest health cost figures: "Definitive 2012 numbers show continued, historically low increases in medical prices and the use of medical services. Health spending rose 3.7 percent, up slightly from 2011 but far below the 8 percent increases of the early 2000s, according to figures released Monday by the Centers for Medicare & Medicaid Services” (Hancock, 1/6). 

Also on the blog, Jenny Gold reports on a new survey that examines what orthopedic surgeons know and don’t know about how they contribute to health spending: "They were only able to correctly estimate the cost of a device 21 percent of the time, according to a survey of 503 physicians at seven major academic medical centers published this week in Health Affairs. Their guesses ranged from 1.8 percent of the actual price to 24.6 times the actual price. Researchers could not release the actual costs, because they signed nondisclosure agreements with the hospitals" (Gold, 1/6). Check out what else is new on the blog.

Politico: The 2014 Obamacare Tax Wave
Tanning salons, colonoscopy scopes and prescription drugs like Xanax — they're all items hit by taxes in recent years to fund President Barack Obama's health care law. Starting in 2014, the Obamacare tax man is coming for insurance companies — who contend a good chunk of these costs will be passed on to consumers in the form of higher premiums. And with those now in effect, almost all of the taxes that will be used to offset the cost of Obamacare are in place (Bade, 1/6).

Los Angeles Times: Hiccups Persist In California Health Insurance Exchange
Paperwork and computer glitches are still tripping up some eager consumers who are seeking coverage through California's insurance exchange and its 11 health plans. On Monday, the Covered California exchange said that all the applications it received online for coverage starting Jan. 1 have been sent to participating insurers, but that it is still sorting through an unspecified number of paper applications for that time period. In light of that delay, last weekend the state exchange extended the payment deadline for January premiums by nine days to Jan. 15 (Terhune, 1/6).

The Wall Street Journal's Washington Wire: Maryland Congressman: Can We Switch To Federal Health Site? 
A Maryland congressman has asked the state whether it’s feasible to consider temporarily switching to the federal Healthcare.gov site while the state continues work fixing its own health insurance site. Rep. John Delaney (D., Md.) said he’s concerned the state isn’t keeping pace with enrollment goals. As of Dec. 28, 18,257 people enrolled in private health plans through Maryland’s insurance exchange, which Mr. Delaney says is 12% of the state’s enrollment goal of 150,000 for private health plans. Nationwide, about 2.1 million have enrolled in private health plans, which represents about 30% of a White House goal of seven million (Corbett Dooren, 1/6).

The Washington Post: Democratic Hopeful Mizeur Decries 'Failure Of Leadership' On Maryland's Health Exchange
Democratic gubernatorial hopeful Heather R. Mizeur on Monday called the rollout of Maryland’s online health insurance exchange a "debacle" and said the General Assembly needs to "step in and make it right." "Our current situation has been a twin failure of leadership being asleep at the wheel when the program was being designed and then overpromising that everything was fixed when it wasn't," said Mizeur, a state delegate from Montgomery County (Wagner, 1/6).

The Washington Post: Governor Candidate David Craig: Md. Should Stop Promoting Its Troubled Health Exchange
A leading Republican candidate for Maryland governor wants the state to stop spending millions of dollars marketing and promoting its problem-plagued health insurance marketplace and instead point residents directly to private insurance carriers and other options. Harford County Executive David R. Craig (R) released a plan on Monday that calls on the administration of Gov. Martin O’Malley (D) to obtain a waiver from the U.S. Department of Health and Human Services to divert money away from promoting the state’s health exchange and toward a "public awareness campaign informing consumers of their right to obtain health insurance directly through carriers" (Johnson, 1/6).

Politico: RNC Radio Ads Target Democrats On Obamacare
The Republican National Committee will this week release its first paid media hitting Democratic candidates of 2014, POLITICO has learned. The committee’s radio ads, which will run Tuesday and Wednesday in 12 states, focus on Obamacare and tie Democratic candidates across the country to President Barack Obama’s faulty promise that citizens could keep their existing insurance plans (Shultheis, 1/7).

The Wall Street Journal's Washington Wire: Sen. Ron Johnson: Obamacare Suit Not A 'Stunt'
Sen. Ron Johnson and Rep. Jim Sensenbrenner, both Wisconsin Republicans, both want the Affordable Care Act repealed. But the lawmakers disagreed Monday about a lawsuit (PDF) Mr. Johnson filed related to the law. Mr. Johnson filed a lawsuit Monday in the U.S. District Court Eastern District of Wisconsin against the Obama administration that would set aside a policy aimed at allowing Congress and employees to continue receiving employer-sponsored health insurance (Corbett Dooren, 1/6).

The Washington Post’s The Fact Checker: Harry Reid’s Claim That Under Obamacare 9 Million People ‘Have Health Care That Didn’t Have It Before’
There have been lots of numbers tossed around about enrollment under the Affordable Care Act, a.k.a. Obamacare, but Reid’s figure certainly jumped out at us, given the administration is backing away from its initial target of 7 million enrollees on the exchanges (Kessler, 1/7).

The New York Times: Another Modest Rise For Health Costs
As a share of the economy, health spending declined slightly, to 17.2 percent in 2012, from 17.3 percent in the prior year. For decades, health spending has grown faster than the economy, taking a bigger bite out of workers’ wages and the federal budget. Health spending averaged about $8,900 a person in 2012, according to the annual report issued Monday by the government (Pear, 1/6).

NPR: Health Care Costs Grew More Slowly Than The Economy In 2012
Health care spending grew at a record slow pace for the fourth straight year in 2012, according to a new government report. But the federal officials who compiled the report disagree with their bosses in the Obama administration about why (Rovner, 1/6).

Los Angeles Times: U.S. Healthcare Costs Keep Rising But At Slower Pace
The relentless rise in healthcare spending — which had threatened government budgets and helped pave the way for President Obama's health law — continued to moderate in 2012, the fourth year of a historic slowdown, newly released federal data show. … For only the third time in the last 15 years, health spending grew more slowly than the overall economy as measured by the non-inflation-adjusted U.S. gross domestic product. That meant that healthcare shrank slightly as a share of the U.S. economy, from 17.3% in 2011 to 17.2% in 2012 (Levey, 1/6).

The Washington Post’s Wonkblog: Good News! Health Spending As A Share Of The Economy Is Shrinking.
The share of the economy devoted to health care fell in 2012, according to federal data released Monday. The decline -- the largest in more than a decade -- comes after four years of unprecedentedly slow growth in health care spending. And it has economists puzzling, yet again, over whether the slackening merely reflects the short-term impact of the recession or shows a larger, more structural change in the medical industry (Kliff, 1/6).

The Wall Street Journal: Health-Care Spending Grew at Modest Pace in 2012
Economists say health-care costs are the biggest driver of the nation's long-term fiscal problems, and until the economic shocks of 2008 those costs seemed to be growing unstoppably. Since 2010, however, health spending has risen roughly in line with economic growth, and in 2012 it accounted for 17.2% of gross domestic product, down from 17.3% in 2011 (Schatz and Morath, 1/6).

USA Today: Growth Of Spending On Health Continues To Slow
The researchers would not comment on 2013 or trends moving forward, saying they have to wait for the data. However, they did explain why the growth spending rate seems to be stabilizing after the recession years. Anne Martin, lead author on the report, said that both consumers and employers make decisions about health care based on what's happening at the time, but those decisions can affect costs for years to come (Kennedy, 1/6).

The New York Times: Faulty Websites Confront Needy In Search Of Aid
While the nation’s attention was focused on the troubled rollout of the federal health care site under the Affordable Care Act, the problems with the unemployment sites have pointed to something much broader: how a lack of funding in many states and a shortage of information technology specialists in public service jobs routinely lead to higher costs, botched systems and infuriating technical problems that fall hardest on the poor, the jobless and the neediest (Robles, 1/7).

The Washington Post: Deeds Returns To Richmond Determined To Reform Mental Health System
State Sen. R. Creigh Deeds, determined to rebound from a personal tragedy that left him gravely injured and his son lost to suicide, returns to the Capitol this week on a mission to fix the state’s mental health system. Deeds (D-Bath) has proposed two bills intended to address what went horribly wrong in November, when his 24-year-old son, Austin, known as “Gus,” stabbed the senator and then fatally shot himself (Vozzella, 1/6).

Politico: Shifting Strategies For State Abortion Battles In 2014
Conservative states that ran into legal trouble passing some of the most restrictive abortion laws in the nation last year have shifted their approach for 2014: smaller instead of sweeping. Rather than bans that directly challenge Roe v. Wade, many states are again going for more incremental measures that address the physical space requirements of clinics, physicians’ qualifications and the use of certain procedures. The move is hardly a retreat, abortion opponents say, but rather a strategic decision that they expect could be nearly as effective in less time. Compared to broader moves, restrictions that are more narrowly drawn often pass judicial muster (Villacorta, 1/6). 

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