First Edition: January 27, 2014

Today's headlines include a report about a new Associated Press poll that found some negative views of the health law may be easing.  

Kaiser Health News: Florida County With Highest Uninsured Rate Sees Little Impact From Obamacare
Kaiser Health News staff writer Phil Galewitz, working in collaboration with USA Today, reports: "In the city that calls itself “America's Sweetest Town,” the smell of burning sugar cane pierces the 80 degree January air. Steam billows from the 12-story U.S. Sugar Corp. factory that dominates the landscape and the economy in this region, halfway between the Gulf of Mexico and the Atlantic Ocean. Some describe the aroma as sweet, others as sour -- a metaphor of sorts for the Affordable Care Act and its impact on this South Florida county that has the state’s highest uninsured rate" (Galewitz, 1/27). Read the story.

Kaiser Health News: The Clubfoot Correction: How Parents Pushed For A Better Treatment
Kaiser Health News staff writer Jenny Gold, working in collaboration with NPR, reports: "Mary Snyder found out during her pregnancy at her 19-week ultrasound that her baby had clubfoot; both of Alice’s feet were completely turned inward, forming the twisted U-shape typical of clubfoot. The condition is one of the most common birth defects, affecting about one out of every thousand babies, but that was little comfort to Snyder" (Gold, 1/27). Read the story.

Kaiser Health News: Capsules: HHS Releases Poverty Guidelines For 2014
Now on Kaiser Health News' blog, Jordan Rau writes: "The federal government has released slightly higher poverty level guidelines for 2014, but those won’t alter the income thresholds that are being used now to determine what kind of financial assistance is available to buy insurance under the health law" (Rau, 1/27). Check out what else is new on the blog

Kaiser Health News also tracked weekend health policy headlines, including reports about the most recent health law enrollment tallies offered by the Obama administration (1/24), the Supreme Court's temporary reprieve from the health law's birth control mandate for an order of nuns (1/24) and the outcome of a long saga in Texas regarding a brain dead, pregnant woman who was being kept alive on a ventilator (1/26).

The Associated Press/Washington Post: AP-GfK Poll: Negative View Of Health Rollout Eases
Memo to the White House: The website may be fixed, but President Barack Obama’s new health insurance markets have yet to win over most consumers. Negative perceptions of the health care rollout have eased, a new Associated Press-GfK poll finds. But overall, two-thirds of Americans say things still aren’t going well. Of those who’ve tried to sign up, or who live with someone who has, 71 percent have encountered problems. But the share reporting success jumped to 40 percent from a meager 24 percent in December (1/27). 

Politico: State Of The Union 2014: The Search For A Non-Awkward Obamacare Shout-Out
This time, President Barack Obama is going to have to actually talk about Obamacare in his State of the Union address. No more touch-the-base-and-keep-running treatments, the way he’s handled it the past couple of years. This time, he’ll be expected to linger on base a bit, at least long enough to acknowledge the launch of the biggest domestic achievement of his presidency — and do it in the least awkward way possible (Nather, 1/27). 

Politico: Direct Sign-Up For Obamacare Subsidy Enrollees Still Bumpy
Nearly two-thirds of the way through the Obamacare sign-up season, most insurers are still having trouble with direct enrollment of individuals who qualify for subsidies. Upgrades have been promised to the feature of HealthCare.gov designed to facilitate this process, and carriers and brokers are trying to stay optimistic that they’ll come in time to help enroll a rush of applicants ahead of the March 31 deadline for 2014 coverage. “They’ve made a lot of progress, but there’s still a lot to do. We’re told all of the critical changes will be completed during this open enrollment period,” said Michael Mahoney, a senior vice president with GoHealth, a private online insurance brokerage that is selling exchange plans (Norman, 1/24).

Politico: Deductibles May Create Obamacare Surprises
Skimpy, pre-Obamacare insurance plans are being phased out, but some of the more comprehensive plans being sold in the new marketplaces carry hefty deductibles consumers have to pay before all their benefits kick in. ... Granted, they’re just one part of what people end up paying, and the health law caps out of pocket spending. And not every new health plan carries higher deductibles than the old, individual market plans, despite claims by some Republicans hostile to the law.But deductibles — the amount a customer must generally spend before their policy kicks in — can still take a big unexpected chunk out of shoppers’ wallets (Winfield Cunningham, 1/26).

Politico: Getting Obamacare To The Hardest-To-Reach Americans
While Obamacare’s botched rollout made enrollment difficult for many Americans, certain groups continue to face coverage barriers that extend far beyond a troubled website. In fact, the individuals involved — from homeless people and recently paroled inmates to former foster-care children — often aren’t even aware they are eligible for benefits. Reaching underserved populations who are newly qualified for coverage under the law’s Medicaid expansion remains a major concern and challenge, according to advocates speaking Saturday at the Families USA Health Action conference in Washington, D.C. (Kalter, 1/26).

NPR:  The Healthy, Not The Young, May Determine Health Law's Fate
Now that the problems with the balky HealthCare.gov website are largely fixed, the Obama administration is finally feeling comfortable enough to launch some of the outreach it planned for last fall. Its top target: young adults, specifically those between 18 and 35. ... The theory has been that without young and healthy people in the insurance pools, premiums will spiral upward in future years. But people have started to wonder just how critical those young people really are to making the health exchanges operate smoothly  (Rovner, 1/24).

The Associated Press: Health Overhaul Law Gets Tricky When Kids Might Be Eligible For Medicaid But Parents Are Not
Families shopping for health insurance through the new federal marketplace are running into trouble getting everyone covered when children are eligible for Medicaid but their parents are not. Children who qualify for Medicaid, the safety-net program for the poor and disabled, can't be included on subsidized family plans purchased through the federal marketplace, a fact that is taking many parents by surprise and leaving some kids stuck without coverage (Ramer, 1/26).

The Wall Street Journal: New Benefits Come With Obamacare
Coverage for pregnancy and childbirth? Check. Mental-health care? Prescription drugs? Check and check. People who buy health insurance as on their own are seeing big changes as their coverage gets more comprehensive this year. The Affordable Care Act, also known as Obamacare, requires that all new plans offered in 2014 cover a set of "essential health benefits," some at no cost to enrollees. The benefits are modeled after those typically offered by large employers and fall into 10 broad categories (Gerencher, 1/26).

The Texas Tribune/The New York Times: Local Governments Pursue Obamacare Enrollment
While no one believed carrying out the Affordable Care Act in Texas would be easy, a series of additional obstacles has impeded efforts to help the 6.2 million uninsured Texans find health coverage. The launch of the federal marketplace, healthcare.gov, was a technical disaster. The state’s Republican leadership, saying Medicaid is broken, has refused to expand the program for impoverished adults. And last week, the Texas Department of Insurance issued state regulations that added further training and other requirements for the navigators hired and trained by recipients of federal grants to help people enroll in the health marketplace. Still, government officials and community-based organizations are working together to incorporate new rules, maximize their resources and educate uninsured Texans on how to take advantage of the federal law (Aaronson, 1/26).

The Wall Street Journal: H&R Block Tackles Health-Care Opportunity
It is said that the only two certainties in life are death and taxes. A third might be that someone will try to make a buck off the first two. After all, the Grim Reaper doesn't show up absent some illness or injury, while Uncle Sam requires lots of paperwork to assess his take. Both usually involve professional assistance. And the Affordable Care Act means the $2.8 trillion health-care and $19 billion tax-preparation industries just got much more complicated. Having faced uncertainty, health insurers and hospitals looked like winners in the overhaul. But tax preparers such as H&R Block could be surprise beneficiaries of the law's heretofore messy implementation (Jakab, 1/26). 

Politico: In Target’s Wake, Businesses Plot Obamacare Paths 
Target became the latest big company to follow the old drill: drop health coverage for some workers, blame Obamacare and watch Republicans pounce. Home Depot and Trader Joe’s made similar changes to their health plans last year, and UPS limited coverage for spouses. ... While each situation was a little different, the initial conclusion that Obamacare was leaving consumers worse off starts to gets squishy when the details are unpacked. ... since many employers are still figuring out how to respond to the new law, it’s worth discerning lessons from Target’s announcement this week (Nather and Winfield Cunningham, 1/24).

The Associated Press: Carney: Obamacare Worth It, No Matter Political Consequences
Days before President Obama is set to deliver the annual State of the Union during, White House Press Secretary Jay Carney told ABC News that passing and implementing the president's signature health care law is worth any political consequences, including losing the Democratically-controlled Senate to the Republicans. "This is not about politics. So the answer is, it is absolutely worth it, no matter what happens politically," Carney said when asked about the possibility of losing the Senate during an interview at the White House for "This Week" (Bell, 1/26).

The Washington Post: Doctors Cut From Medicare Advantage Networks Struggle With What To Tell Patients
Thousands of primary-care doctors and specialists across the country have been terminated from privately run Medicare Advantage plans, sparking a battle between doctors who say patient care is being threatened and insurers that insist they have to reduce costs and streamline their operations. Medical associations, which describe the dismissals as the largest in the program’s history, say the cuts are forcing some patients to leave their doctors in mid-treatment  (Cha, 1/25).

The Wall Street Journal: The Pitfalls Of Applying For Medicare 
Roughly 3.65 million Americans will turn 65 this year and become eligible for Medicare. But be warned: There's nothing simple about signing up for the government's health-care insurance program. "Medicare is complicated," says Paula Muschler, operations manager of the Allsup Medicare Advisor, a Medicare advisory-services company. "There is a lot seniors can do either right or wrong that can have a lasting impact on their health-care costs for the rest of their lives."  ... Get a Medicare adviser, who, like a lawyer or a financial planner, can put you on the right track to finding the package that works best for your health and your pocketbook (Waters, 1/26).

The New York Times: Doctors Abusing Medicare Face Fines And Expulsion
The Obama administration is cracking down on doctors who repeatedly overcharge Medicare patients, and for the first time in more than 30 years the government may disclose how much is paid to individual doctors treating Medicare patients. Marilyn B. Tavenner, the administrator of the Centers for Medicare and Medicaid Services, said that “recalcitrant providers” would face civil fines and could be expelled from Medicare and other federal health programs. In a directive that took effect on Jan. 15 but received little attention, Ms. Tavenner indicated that the agency was losing patience with habitual offenders. She ordered new steps to identify and punish such doctors (Pear, 1/26).

The Associated Press/Wall Street Journal: Feds Urge More Talks On NY Medicaid Application 
New York has revised its request for a $10 billion Medicaid adjustment, which would allow using that money in related health care programs, after federal officials concluded capital investment and some other programs are ineligible. The application was first filed 18 months ago, prompting Gov. Andrew Cuomo and Health Commissioner Dr. Nirav Shah last week to publicly blame the federal delay for threatening financially distressed New York hospitals (1/26).

The Associated Press/Washington Post: House To Review Insurance, Cyberbullying Bills
Maryland’s House of Delegates will likely vote Tuesday on a plan to help residents who have struggled with the state’s health insurance exchange online. The bill would let customers sign up for retroactive coverage in the Maryland Health Insurance Plan, a separate safety net plan. Private insurance companies in the health exchange opened similar retroactive coverage options, but a deadline to register was last week (1/27).

NPR: Silencing Many Hospital Alarms Leads To Better Health Care
Alarms are good and necessary things in hospital care, except when there are so many of them that caregivers can't keep track of the ones that signal a crisis that requires immediate attention. Then it may be that less technology can actually be more effective (Knox, 1/27). 

The Washington Post: Medical Advocates Decry Insurance Rules In Wash. State On Waiting Period For Transplants
Newly insured consumers in Washington state who purchased health plans through the online exchange might find a surprise when they comb through the fine print in their policies: They’ll have to wait 90 days from when their insurance begins before coverage for transplants will kick in. The waiting period, a holdover from the days when insurers were able to impose restrictions on coverage for all sorts of preexisting conditions, has become the latest flash point in the often tense negotiations between insurers, regulators, doctors and consumers over the design of the new individual and small-group health plans that went into effect Jan 1 (Cha, 1/26).

Los Angeles Times: Brain-Dead, Pregnant Texas Woman Taken Off Life Support
After a bitter legal battle that became a touchstone in the abortion debate, a pregnant, brain-dead woman was removed from life support Sunday as a Texas hospital agreed to comply with a court order. Marlise Munoz's body was to be turned over to her family, said attorneys for her husband, Erick Munoz. She had been on life support for about two months at John Peter Smith Hospital in Fort Worth after falling unconscious in her home Nov. 26 with a possible blood clot in her lung. At the time, she was 14 weeks pregnant (Pearce, 1/26).

Los Angeles Times: Judge Kills Measure For Separate L.A. Health Department
A judge has preemptively struck down a ballot measure that would force the city of Los Angeles to launch its own health department separate from the county's. Los Angeles County Superior Court Judge Michael P. Linfield ruled Friday that the measure scheduled for the June ballot would conflict with state law if passed and would "impermissibly interfere with essential government functions." The measure was advocated by the nonprofit AIDS Healthcare Foundation, which is a major provider of AIDS- and HIV-related health services for the county's health department, but has also frequently butted heads with county leaders (Sewell, 1/24).

Politico: Creigh Deeds Talks Of Son’s Attack
Virginia state Sen. Creigh Deeds says he hopes his son’s death will be used to help address “inequity” in the way the country views mental health issues. Deeds, who was stabbed multiple times by his bipolar son, Gus, on Nov. 19, 2013, told CBS’s “60 Minutes” that the health system had failed his family (Drusch, 1/26). 

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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.