First Edition: May 1, 2014

Today's headlines include news about a GOP report on health exchange sign-ups as well as coverage of the interaction between the health law and WellPoint's first-quarter results.   

Kaiser Health News: New Medicare Procedures Seek To Stop Overpayment Of Drugs For Hospice Patients
Reporting for Kaiser Health News, in collaboration with The Washington Post, Susan Jaffe writes: “New Medicare guidance taking effect today aims to stop the federal government from paying millions of dollars to hospice organizations and drug insurance plans for the same prescriptions for seniors. But the changes may make it more difficult for dying patients to get some medications, senior advocates and hospice providers say” (Jaffe, 5/1). Read the story.

Kaiser Health News: Capsules: WellPoint Softens Forecast For Obamacare Rate Hikes
Now on Kaiser Health News’ blog, Jay Hancock reports: “Welcoming a surge of young, last-minute enrollees, the biggest player in the health law’s insurance marketplaces on Wednesday tempered its prediction for substantial 2015 rate increases” (Hancock, 4/30). Check out what else is on the blog.

The Washington Post’s Wonkblog: The Obamacare Change That’s Unpopular In Blue States
State-run health insurance exchanges are squabbling with the Obama administration over who should be responsible for deciding who deserves a free pass from Obamacare’s unpopular individual mandate. At least seven state exchanges have sharply criticized an administration proposal that would shift responsibility for determining eligibility for mandate exemptions onto the state-run marketplaces in the 2015 enrollment period, scheduled to open Nov. 15. The states warn they don’t have the technical ability or funding to handle requests from people seeking a pass from the Affordable Care Act’s requirement to obtain insurance coverage or pay a fine. Some states have urged the Department of Health and Human Services to dump the proposal, while others are asking to delay its implementation by at least a year (Millman, 4/30).

The Wall Street Journal’s Washington Wire: Obamacare Ratings Steady Despite Busy Month – WSJ/NBC Poll
Some 36% think the law is a good idea – the same as in March 2010, when the law passed – but up a bit from the 31% who supported it last September just before the law’s rollout. A steady 46% think the law is a bad idea, down slightly from the 50% peak in December 2013, but up a bit from 44% in September. Americans still feel that even if they don’t like the law, they don’t want it repealed. Only 21% of respondents thought it should be totally eliminated. Instead, 40% wanted to see “minor modifications to improve it” and another 28% said it needed a “major overhaul” (Radnofsky, 5/1).

The New York Times: Not All Health Care Premiums Are Paid Up, House Panel Says
A House committee said Wednesday that only two-thirds of people signing up for private health insurance in the federal exchange had paid their premiums by April 15. Without payment, consumers will not have coverage. The Obama administration questioned the accuracy of the numbers, but provided none of its own. Republican leaders of the panel, the House Committee on Energy and Commerce, said they had obtained the data from all insurance companies participating in the federal marketplace (Pear, 4/30).

The Wall Street Journal: Report: Two-Thirds of Insurance Exchange Enrollees Paid Premiums
Around two-thirds of people who had picked insurance plans through HealthCare.gov paid their first month's premium by April 15, according to a report released Wednesday by Republican lawmakers using data from insurers. The GOP-led House Energy and Commerce Committee asked for payment data from 160 health plans selling policies in the Affordable Care Act's federal insurance exchange. The committee's leaders said that responses showed that across the 36 states served by the federal exchange, 67% of people who had finished the sign-up process had made the premium payment to insurers and had been enrolled in coverage as of April 15 (Radnofsky and Mathews, 4/30).

The Associated Press: GOP: Health Signups Lagging
House Republicans issued a report Wednesday saying that one-third of people who signed up for health insurance through new federal exchanges hadn’t paid their first month’s premium as of mid-April, which could undermine the Obama administration’s claims of robust enrollment under the new health law (4/30).

The New York Times’ The Upshot: Implications For Employers In New Health Care Law
As the Affordable Care Act goes from thousands of pages of legalese to actual, real-life public policy, the future of employer-provided health insurance is one of the most fascinating questions. Will employers call for — and their workers accept — the practice of buying health insurance through government exchanges? How much will companies save, and will they pass those savings onto employees? Will it make workers more mobile and ready to shift jobs, or will employer-paid health insurance become a sought-after perk? (Irwin, 5/1).

The Wall Street Journal: Is This The Hardest Job In America?
The health law has reshaped the way insurers do business. Before the law, consumers often had to tell insurers if they had health conditions that might require pricey care, such as diabetes. Insurers could typically boost those consumers' premiums or refuse to cover them. Now, insurers must accept all comers and they get no health information on enrollees. That means that actuaries have little to go on when predicting medical costs—and setting premiums. What's more, frequent regulatory tweaks from policy makers have forced actuaries to rejigger their projections and strategies on the fly. This is raising the stakes for actuaries, a word traced back to the Latin root for bookkeeper (Mathews, 5/30).

The Washington Post: Bill Clinton Assails Media Coverage Of Obamacare
Former president Bill Clinton on Wednesday criticized the media in stark terms -- particularly for its coverage of Obamacare. In a lecture at Georgetown University, in Washington, D.C., Clinton said the media does the country a disservice by building a narrative and never straying from it, regardless of the facts (Rucker and Blake, 4/30).

The Associated Press: WellPoint Falls 21%
WellPoint's first-quarter net income fell 21 percent as the nation's second-largest health insurer adjusted to coverage changes introduced by the health care overhaul. But the Blue Cross Blue Shield insurer touted the underlying strength of its business and once again raised its 2014 forecast after reporting on Wednesday quarterly earnings that topped Wall Street expectations. Its stock climbed in premarket trading after it released results. The federal overhaul expanded coverage to millions of people starting this year, but the law also enacted taxes and fees, as well as changes to how insurers write their coverage (4/30).

The Washington Post’s Wonkblog: Major Obamacare Insurer Backs Away From Double-Digit Rate Hike Prediction
Company officials were more cagey about expectations Wednesday. Several analysts asked about expected rate increase for next year, including one analyst who asked specifically whether the insurer expects double-digit rate increases and if it felt any pressure to keep down rates after a meeting with President Obama this month. “Rates will vary by market, but given this information, they may not be what we thought from previous reports,” Wellpoint said Wednesday in an e-mailed statement (Millman, 4/30).

The Wall Street Journal: WellPoint Reports Lower Profit But Growth In Membership
WellPoint said it had enrolled around 400,000 new members through the health-law marketplaces, and expected the total would be above 600,000 when sign-ups through mid-April are added. The insurer said its marketplace sign-ups had gotten younger as the enrollment period progressed, and it reiterated that it expected margins of around 3% to 5% on the business. Chief Financial Officer Wayne DeVeydt said factors including the ramp-up in the fee the government is charging insurers under the health law would impact marketplace premiums next year, but he said the overall pricing trend would vary by market. The insurer's experience is being closely watched because of its big position in the new government marketplaces (Mathews and Rubin, 4/30).

The Associated Press: WellPoint Helps Investors Breathe Easy On Overhaul
Investors pushed WellPoint shares closer to their all-time high price on Wednesday after the company raised its 2014 forecast again and became the latest health insurer to ease some worry about a key health care overhaul coverage expansion. The Blue Cross Blue Shield insurer estimates that it will add more than 600,000 customers through state-based public insurance exchanges that started accepting enrollment last fall, and it said it still expects to make money from that business (4/30).

The Wall Street Journal: Cigna Profit Surges On Improved Group Disability, Life Operations
Cigna Corp. said its first-quarter profit surged as the company posted higher revenue, particularly from its group disability and life operations. The results easily topped analysts' expectations. … The health insurer said in February that it expected to lose money on health-care exchanges this year as enrollment numbers looked soft in the early going, particularly after a series of technical glitches in the federal HealthCare.gov site that slowed registration (Calia, 5/1).

USA Today: House Panel Seeks Improved Medicare Fraud Efforts
Improper Medicare payments cost about $50 billion last year, a Health and Human Services official told a House panel Wednesday, testimony that prompted a rare display of bipartisanship in a usually divided House. The traditional Medicare fee-for-service program lost $36 billion, while Medicare Advantage lost $11.8 billion, said Gloria Jarmon, HHS' deputy inspector general. Improper payments in the fee-for-service program made up 10% of all payments in 2013, up for 8.5% in 2012, she said (Kennedy, 4/30).

Los Angeles Times: Senate Panel Backs Health Coverage For Those In The Country Illegally
A proposal to have the state fund an expansion of healthcare to cover low-income residents in the country illegally was advanced Wednesday by the state Senate Health Committee. Sen. Ricardo Lara (D-Bell Gardens) introduced SB 1005, which would use state money to expand Medi-Cal eligibility to those with an annual income of about $15,000 or less for one person but who have not been able to qualify because of their immigration status. People in the country illegally are prohibited from participating in the federal Affordable Care Act program providing subsidized care (McGreevy, 4/30). 

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