7. Deductibles, Other Health Plan Costs May Surprise Consumers
News outlets report that, as more details become available, some people may find that their health insurance in 2014 will cost more than they hoped.
The Wall Street Journal: High Deductibles Fuel New Worries Of Health-Law Sticker Shock
As enrollment picks up on the HealthCare.gov website, many people with modest incomes are encountering a troubling element of the federal health law: deductibles so steep they may not be able to afford the portion of medical expenses that insurance doesn't cover. The average individual deductible for what is called a bronze plan on the exchange—the lowest-priced coverage—is $5,081 a year, according to a new report on insurance offerings in 34 of the 36 states that rely on the federally run online marketplace (Scism and Martin, 12/8).
The New York Times: On Health Exchanges, Premiums May Be Low, But Other Costs Can Be High
Until now, it was almost impossible for people using the federal health care website to see the deductible amounts, which consumers pay before coverage kicks in. But federal officials finally relented last week and added a “window shopping” feature that displays data on deductibles. For policies offered in the federal exchange, as in many states, the annual deductible often tops $5,000 for an individual and $10,000 for a couple (Pear, 12/9).
The Associated Press: Personal Stories Used As Spin Over New Health Law
When Jennifer Slafter first ran the numbers, she thought the new federal health care law would cost her family an extra $171 a month for an insurance plan with a higher deductible. So the 40-year-old stay-home mom from southeastern Minnesota felt compelled to go public with her frustration. … When it comes to the health law, spin is in. ... Democrats are rooting for its success and Republicans are craving to see it undone. Both sides have latched on to personal stories, with critics trumpeting experiences like Slafter's while its backers brandish more positive angles (Condon, 12/8).
The Philadelphia Inquirer: Frustrated By The ACA's 'Family Glitch'
Susan Rubinstein's optimism dissolved into tears when she learned the Affordable Care Act marketplace wouldn't help her…She is stuck in what is called the family glitch. Because she is offered insurance through her husband's company, despite the high cost, she is ineligible for discounts on the marketplace (Tyrrell, 12/8).
8. Implementation Issues: Optimism, Winners, Losers And What About Those Paper Applications?
A range of health law issues are examined, including a look at some of the consumers who approach the overhaul with a sense of relief and optimism. Meanwhile, while insurance agents are feeling left out, public relations firms see the law as a boon.
The New York Times: Amid The Uproar Over The Health Law, Voices Of Quiet Optimism And Relief
The rollout of the health care law has been plagued with problems so deep that even some of its strongest supporters have soured on its potential. The bottlenecks in the federal online insurance exchange, which serves 36 states; the cancellation of hundreds of thousands of policies that did not comply with the minimum requirements of the new law; and the high price of some plans sold through both federal and state-run exchanges have all cast a pall over President Obama's efforts to win support for the law (Goodnough, Thomas and Abelson, 12/8).
The Associated Press/Washington Post: Insurance Agents Feeling Left Out Of 'Obamacare'
When insurance agent Kelly Fristoe recently spent 30 minutes helping a client pick a mid-level health plan and the federal marketplace website froze, he called the government’s hotline and tried to finish the application. But the operator refused to credit Fristoe as an agent on the application, meaning he wouldn't get the commission or be listed as the follow-up contact if his client needed help again later (12/8).
The Associated Press: Feds Curtail Paper Applications For Health Care Law
Federal health officials, who encouraged alternate sign-up methods amid the fumbled rollout of their online insurance website, began quietly urging counselors around the country this week to stop using paper applications to enroll people in health insurance because of concerns those applications would not be processed in time (12/7).
Politico: Website Woes, PR Firms Boon
It may be have been a debacle, but there is one upside to the glitch-plagued rollout of the health care website: It’s become a powerful case study for crisis management consultants and their clients of what not to do. … Far from the world of government and politics, the botched launch of Healthcare.gov has become an instant classic. It has replaced such notorious bungles as New Coke and the BP oil spill as a real time example in the crisis management world of how not to respond when everything goes wrong. Experts are eagerly cashing in on the administration's missteps, offering critiques in private interactions with clients, as well as publishing blog posts and op-eds on the basic rules of crisis management that were not followed (Gold, 12/8).
Fox News: Just A PR Problem? Obamacare Architect Claims 'Big PR Campaign' Needed
The federal health care overhaul was central to President Obama's two campaigns for the White House, and has been the defining achievement -- for better or worse -- of his presidency. But one of the architects of Obamacare, in a heated interview on "Fox News Sunday," argued that the reason young people are not signing up in droves for coverage under the law is the administration hasn't promoted it. Ezekiel Emanuel, a former health adviser to the president (and the brother of former White House Chief of Staff Rahm Emanuel), argued the administration has been too caught up with fixing HealthCare.gov to give the law the proper promotional push (12/8).
9. State Insurance Exchanges Wrestle With Rollout Issues
In Iowa, an insurer uses sarcasm to woo consumers to buy policies away from the federal website. In Minnesota, insurers list problems which may keep consumers who think they've enrolled in a plan from being covered on Jan.1. Developments in Oregon and Colorado are also scrutinized.
The Associated Press: Iowa Insurer Pokes Fun At Federal Website In Ads
The television ads show a series of medical mishaps: a man kicking the wrong leg in a reflex check, a urine sample bottle that won’t open for a frustrated patient and a blood pressure cuff letting out a strange noise when the doctor presses the plastic bulb. After each scene, a narrator says: "Things don’t always work like they’re supposed to. Good thing the government exchange website isn’t the only place to buy health insurance" (Lucey, 12/8).
Kaiser Health News: Minnesotans Who Think They Signed Up For Health Insurance May Not Be Enrolled
In the most vivid detail yet, Minnesota's top insurers have laid out a list of technological problems that they say may keep people who've enrolled in a health plan from being covered on Jan. 1. Insurance carriers selling plans on the state's insurance marketplace say enrollment information they're getting from MNsure, is inaccurate and incomplete - and that time is running out to fix these problems (Richert, 12/8).
The Oregonian: Cover Oregon: Take Care In Applying Those Advanced Premium Tax Credits
So if all goes as state officials hope, Oregonians who've applied for insurance through Cover Oregon will receive enrollment packets in the mail this week. If you're among them, and you want coverage by Jan. 1, you'll have until Dec. 15 to finalize some fairly complicated choices. You'll have to pick which insurance plan (or plans) best suits you or your family. You'll also have to decide – if you're eligible - how much of a tax credit to take and when to take it (Hunsberger, 12/7).
The Oregonian: John Kitzhaber Says Extending Oregon Insurance Plans To 2014 Is Legal
Gov. John Kitzhaber said Friday that Oregon’s legislative lawyers got it wrong when they ruled the state’s insurance commissioner was out-of-bounds in allowing insurers to extend some health plans into 2014. More than 140,000 Oregonians faced Dec. 31 cancellations of their health insurance until Oregon Insurance Commissioner Laura Cali announced that insurers could extend those policies until the end of next year (Gaston, 12/6).
Health Policy Solutions (a Colo. news service): Exchange Boss Withdraws Request For Pay Hike
The head of Colorado’s health exchange is withdrawing a request for a raise. … The news came after the Denver Post reported that Rep. Cory Gardner, R-Yuma, planned to introduce legislation in Congress barring CEOs of state health exchanges from getting taxpayer-supported bonuses or raises. … [Patty Fontneau, the CEO and executive director of Colorado’s health exchange] gets paid $190,550 a year and received a 10 percent bonus last December (Kerwin McCrimmon, 12/6).
Health Policy Solutions (a Colo. news service): ‘Don’t Give Up,’ Commissioner Urges Angry Ski Resort Residents
Colorado Insurance Commissioner Marguerite Salazar wants to reduce high health costs in mountain resort communities, but can’t fix anything until 2015. Salazar met with a standing-room crowd of irate Summit County residents on Thursday to hear their concerns and explore solutions for health insurance rates that are up to three times higher than other parts of the state. The area is home to several of Colorado’s premier ski resorts including Keystone, Breckenridge, Copper Mountain and Arapahoe Basin (Kerwin McCrimmon, 12/6).
10. Maryland's Online Insurance Marketplace Plagued By Technical Problems, Discord
The director of the state exchange resigned Friday. Meanwhile, the Web portal continues to be marked by operational difficulties that are undermining enrollment efforts.
The Baltimore Sun: Maryland Health Exchange Director Resigns After Questions About Vacation
The director of Maryland's troubled health insurance exchange resigned Friday amid ongoing technical problems and questions about a Caribbean vacation she took while the online marketplace faltered. Rebecca Pearce, hired two years ago to build a $107 million exchange, leaves her post as officials struggle to repair the system that launched Oct. 1 (Cox, 12/7).
The Washington Post: Rebecca Pearce, Director Of Maryland's Health Insurance Exchange, Resigns
The Maryland official who directly oversaw the rollout of Maryland’s health insurance exchange resigned Friday amid continuing technical problems that have hampered the state’s online enrollment efforts. After an emergency session Friday night, the board of the Maryland Health Benefit Exchange accepted the resignation of Rebecca Pearce, its executive director, and thanked her in a statement for working “tirelessly and with tremendous dedication” for more than two years (Wagner and Sun, 12/6).
The Wall Street Journal: Health-Site Snafus Plague Maryland
Maryland is struggling to fix its troubled health-insurance website more than two months after it opened, showing how technology woes are affecting more than just the federal system. The official in charge of Maryland's insurance marketplace, Rebecca Pearce, resigned late Friday after criticism of her decision to take a vacation in the Cayman Islands during Thanksgiving week. New statistics released Friday showed just a trickle of customers signing up for private coverage in the state (Dooren, 12/8).
The Baltimore Sun: Technical Problems, Discord Plagued Health Care Site
Although state officials have provided the public scant detail about the troubled launch of Maryland's version of Obamacare, emails and documents show that the project was beset behind the scenes for months by an array of technical issues, warring contractors and other problems (Cohn and Walker, 12/7).
The Baltimore Sun: No E-mails From Brown On Health Exchange
As Maryland officials touted their implementation of the Affordable Care Act, Lt. Gov. Anthony G. Brown was front and center — proudly describing the state as a national leader in preparing for the overhaul. But even though Brown was helping to lead the health care effort, he wrote no emails to the state workers overseeing development of the state's online health insurance marketplace — at least none that his office deemed fit for public release (Cohn and Walker, 12/7).
11. California Exchange Shares Consumers' Names Without Their Consent
Officials with Covered California said they gave insurance agents the contact information of thousands of people who went online but didn't enroll in coverage as part of a pilot program to help people sign up by Dec. 23.
Los Angeles Times: Covered California Gave Consumers' Contact Information To Agents
Raising concerns about consumer privacy, California's health exchange has given insurance agents the names and contact information for tens of thousands of people who went online to check out coverage but didn't ask to be contacted. The Covered California exchange said it started handing out this consumer information this week as part of a pilot program to help people enroll ahead of a Dec. 23 deadline to have health insurance in place by Jan. 1 (Terhune, 12/6).
The Associated Press/Washington Post: Calif. Health Exchange Shares Data Without Consent
Peter Lee, executive director of Covered California, says the information was shared to ease the process for consumers. The exchange was set up in response to the federal Affordable Care Act. It has been struggling with a surge in applications ahead of a Dec. 23 deadline to have insurance in place by Jan. 1 (12/7).
In related news -
California Healthline: Forum Explores Other States’ Handling Of Exchange, Medicaid Enrollment
But California is not the only success story. Other states have established robust exchanges and yesterday officials from some of them talked about what they've been accomplishing in their own exchanges. "With Affordable Care Act-related enrollment, states have had nine weeks of experience," said Catherine Hess, managing director for coverage and access at the National Academy for State Health Policy, a co-sponsor of yesterday's online forum. … Hess pointed out that a big part of the open enrollment period, among the states that have created exchanges, includes successful expansion of Medicaid -- Medi-Cal in California (Gorn, 12/6).
12. New Federal Exchange Hiccup: Sending Unqualified People To Medicaid
USA Today reports that the National Association of State Medicaid Directors may release more information this week about how the federal exchange may be mislabelling people as Medicaid-qualified.
USA Today: Federal Exchange Sends Unqualified People To Medicaid
The federal health care exchange is incorrectly determining that some people are eligible for Medicaid when they clearly are not, leaving them with little chance to get the subsidized insurance they are entitled to as the Dec. 23 deadline for enrollment approaches. State and industry officials haven't quantified the problem yet, but the National Association of State Medicaid Directors may release information next week after following up on reports from around the country, says Executive Director Matt Salo (O'Donnell, 12/8).
Meanwhile, there are updates on Medicaid expansion in South Dakota and Pennsylvania -
The New York Times: Pennsylvania Wants to Use Federal Funds to Cover Poor
The governor of Pennsylvania, Tom Corbett, released details on Friday of his proposal to use federal Medicaid funds to buy private health insurance for low-income people — a plan similar to one being carried out by Arkansas and considered by other Republican governors who oppose expanding Medicaid under President Obama’s health care law. Like the Arkansas plan, which the Obama administration formally approved in September, Mr. Corbett’s proposal would use federal funds available for expanding Medicaid under the Affordable Care Act to instead buy private coverage for an expanded Medicaid population (Goodnough, 12/6).
The Associated Press: Pa. Medicaid Plan Panned By Health Care Advocates
Health care advocates who began reading Gov. Tom Corbett's detailed proposal Friday to bring billions of federal health care dollars to Pennsylvania criticized it as unnecessarily punitive toward potential enrollees and laden with red tape. On top of that, the proposal that Corbett calls fiscally responsible also contains a long list of requests for the federal government to waive rules that would otherwise apply to the health care coverage that a state Medicaid program must provide (Levy, 12/6).
The Associated Press: South Dakota Lawmakers Urged To Expand Medicaid
Some lawmakers and health care groups plan to ask the South Dakota Legislature next month to expand the state's Medicaid program to cover the medical costs of 48,000 more poor people, despite resistance from Gov. Dennis Daugaard. Daugaard last week told state lawmakers that he is not recommending the Medicaid expansion, available to states as an option under the federal health care overhaul, as part of next year's state budget (12/9).
13. Two Governors Go 'All In' With Health Law's Trials And Tribulations
In a pair of stories, Politico takes a look at how decisions made by governors in two very different states are playing.
Politico: Nevada's Republican Governor Is 'All In'
In a Republican party that’s gone all out against Obamacare, Nevada Gov. Brian Sandoval went all in. Sandoval is the only Republican governor whose state is both running its own health insurance exchange this year and expanding its Medicaid program under the health law. ... in fully implementing Obamacare, Sandoval faces a double-edged sword: He's helping bring health care coverage to a state with the second highest uninsured rate in the country, while he may be hurting his national ambitions because he’s not actively blocking the president’s law (Haberkorn, 12/7).
Politico: Kentucky's Unlikely Health Care Heartthrob
As the only governor of a Southern state who has both set up a state insurance exchange and green-lighted an expansion of the Medicaid program, [Steve] Beshear represents a painfully rare bright spot in the landscape of Obamacare implementation. The state exchange, dubbed Kynect, has been a model of smooth enrollment compared with the federal government’s version, and has absorbed 550,000 Web visitors and 180,000 phone inquiries so far. The final verdict on the program — nationally and on the state level — is far from decided, but Beshear says his mind is entirely made up on both the merits and the politics of health care (Burns, 12/7).
14. GOP Uses Weekly Address To Reignite Obamacare Debate Ahead Of Election Season
In the GOP's weekly address, Rep. Renee Ellmers, R-N.C., said the health law amounts to the Obama administration telling Americans what's best for them and that it is also an example of the "war on women." Elsewhere, the health law is figuring prominently in early election politics.
Politico: GOP Returns To Obamacare In Weekly Adddress
Rep. Renee Ellmers (R-NC) focused on how she said the Affordable Care Act is hurting families whose existing insurance plans have been canceled because they didn't meet the health law's coverage requirements. "The Obama administration is essentially saying it knows what’s best for you and your family," Ellmers said, charging that many people also will lose longtime, trusted doctors because of Obamacare (Villacorta, 12/7).
McClatchy: Rep. Ellmers Calls Obamacare A 'War On Women'
The Affordable Care Act is an example of a "war on women," Rep. Renee Ellmers, R-N.C., said Saturday in the Republicans' weekly address. Women make many of their families' health care decisions, Ellmers said, emphasizing that she was speaking not only as a congresswoman and chairwoman of the Republican Women's Policy Committee, but also as the mother of a college student. Ellmers said that the cancellations of some insurance policies showed that "the Obama administration is essentially saying it knows what's best for you and your family" (Schoof, 12/7).
The New York Times: Three Senators Try To Hold Off G.O.P. In South
Next year, Democrats will face not only a general hostility to the national party among Southern white voters, but also a keen dislike of President Obama's Affordable Care Act. Representative Bill Cassidy, one of the Republicans opposing Ms. Landrieu, has an attack ad that calls her "Barack Obama's rubber stamp." She and her two Southern colleagues in the Senate voted for the health plan and have reiterated their support, though they have also rushed to criticize the administration's handling of the rollout and pushed for modifications. Republicans are trying to exploit the opening, insisting that each of the incumbents muttered the decisive "aye" that allowed the law to pass, which was approved 60 to 39 (Robertson and Peters, 12/8).
NBC News: Races To Watch: Will Obamacare Sink Democrats In 2014?
As the hobbled website becomes more functional, the president is offering more vocal praise for his signature domestic achievement. But some Democrats are keenly aware that the program’s poor debut could weigh them down in November. It’s already helped drag Obama's approval ratings to a new low and distracted from perceived GOP failures during the shutdown. As the key battles for that control begin to unfold, here are seven contests to watch in 2014 (Taylor, 12/9).
CBS News: Poll: After Rough Debut, Views On Obamacare Barely Budge
Buffeted by terrible headlines since its online insurance marketplace debuted with a host of glitches on October 1, Obamacare is proving surprisingly resilient in the court of public opinion. According to a new Gallup poll, a slim majority of Americans – 52 percent – believe the law should be repealed entirely or scaled back. It’s a stout number, but not much changed since mid-October, when 50 percent voiced the same opinion (Miller, 12/6).
15. Former Obama Aide Phil Schiliro Returns To Help Oversee Obamacare
Schiliro is the president's former congressional liaison.
The New York Times: Obama Recalls An Aide To Guide Health Care Law
As the Obama administration continues the aggressive public defense of the Affordable Care Act it began this week, the president will get some help from his former chief congressional lobbyist, Phil Schiliro, who is returning temporarily to the White House almost exactly two years after he left. Mr. Schiliro’s job, which is expected to last a few months, is to help protect the health care law from legislative attacks by repeal-minded Republicans in Congress, and to quiet dissent from politically vulnerable Democrats seeking to distance themselves from the law and the president ahead of the midterm congressional elections (Calmes, 12/6).
Politico: Ex-Obama Aide Phil Schiliro Returns To White House As Obamacare Strategist
Schiliro’s assignment, which will last several months, is Obama’s first personnel move at the White House since the disastrous rollout of HealthCare.gov. ... Schiliro left the White House in December 2011 after serving as an architect of Obama’s top legislative achievements of his first term, including Obamacare, the economic stimulus program and the Dodd-Frank financial overhaul law (Budoff Brown, 12/6).
Bloomberg: Ex-Obama Aide Schiliro To Return To Oversee Health Law Rollout
“We are focused like a laser on reducing health-care costs implementing the Affordable Care Act, and Phil will be vital to ensuring it is done right,” White House Chief of Staff Denis McDonough said in a statement. “Anyone who has worked with him knows Phil has the expertise, the wisdom, and the relationships to tackle any project -– large or small. We are blessed to have him back.” (Goldman, 12/7).
USA Today: Sibling Rivalry? Zeke Vs. Rahm Emanuel On Obamacare
When Rahm Emanuel was White House chief of staff and Ezekiel Emanuel was helping draft the Affordable Care Act, the famously combative brothers clashed over the health care law. "He thought we should have done something more incremental," ... Zeke Emanuel said in an interview … But now, the prominent health policy analyst says the technical problems that have dogged the website are being solved and "will soon be forgotten" (Page, 12/9).
CAPITOL HILL WATCH
16. Capitol Hill Experiences Same Online Insurance Exchange Successes, Failures As All Americans
Members of Congress are a microcosm of what's happening for people trying to sign up for health coverage in the health law's online insurance exchanges across the nation -- some are getting through, some are seeing glitches still and some are avoiding it altogether.
Politico: Members' Obamacare Sign-Up Headaches
Staring down a deadline to sign up for Obamacare, some lawmakers are getting hit by technical glitches or sticker shock. Others are breezing through the website, elated by lower premiums and better health services. And at least one won't sign up at all -- opting to pay a penalty instead. In short, the Obamacare experience is the same mixed bag on Capitol Hill as it is across the nation (Kim and Haberkorn, 12/9).
CNN: Now Who's Having Trouble With Health Care Signup? Ask Congress
Congress itself is now having so much trouble signing up for the Obamacare exchanges that late Friday the top administrator in the House of Representatives laid out a backup plan in case lawmakers and staff can't get through the process by the time their enrollment ends Monday. The red flags started reaching critical mass Thursday and Friday, when some staff and members of Congress told House administrators they were having trouble enrolling through the Washington health exchange, known as DC Health Link. The D.C. exchange is the official signup portal for Congress, where members must go to get health care through their job (Desjardins, 12/7).
17. Lawmakers Close In On 'Cease-Fire' Budget Deal
Lawmakers are close to finding accord on a budget that would undo only a few parts of the government cuts known as "sequester." In addition, the proposed budget wouldn't lower the debt or change the costs involved with health care programs in addition to leaving other programs intact.
The Washington Post: Budget Deal Expected This Week Amounts To A Cease-fire As Sides Move To Avert A Standoff
House and Senate negotiators were putting the finishing touches Sunday on what would be the first successful budget accord since 2011, when the battle over a soaring national debt first paralyzed Washington. The deal expected to be sealed this week on Capitol Hill would not significantly reduce the debt, now $17.3 trillion and rising. It would not close corporate tax loopholes or reform expensive health-care and retirement programs. It would not even fully replace sharp spending cuts known as the sequester, the negotiators' primary target (Montgomery, 12/8).
The Wall Street Journal: Congress Readies A Year-End Dash
Because Republicans have refused to raise taxes and Democrats have declined to consider major cuts to Medicare or other entitlement programs, any deal is likely to mitigate only a modest chunk of the sequester. To permit spending to rise above levels set in 2011, lawmakers would need to agree on ways to trim the federal budget deficit elsewhere, potentially by increasing fees for airport security and federal guarantees of private pensions. An agreement would mark a rare moment of bipartisan accord brokered without the specter of a government shutdown or financial chaos. However, even a deal reached by two lawmakers popular within their own parties would still have to secure the support of a GOP caucus unafraid to buck its leadership and a Democratic caucus concerned about other expiring programs. In recent weeks, Democrats have pushed to extend emergency benefits for the long-term unemployed past their Dec. 28 expiration, but Mr. Durbin said Sunday he didn't expect it would become a make-or-break issue in the budget talks (Peterson and Crittenden, 12/8).
Lawmakers are also contemplating a change in how Medicare pays doctors, and a group of senators voice their support for a set of rule exemptions allowing doctors to self-refer for some in-office procedures --
JAMA: Fixing The (Un)Sustainable Growth Rate Formula: Shifting From Volume To Value
Although much media coverage around health care reform recently focused on the Obamacare rollout, another profound but far less publicized change could be coming. Congress is closer than ever to correcting the sustainable growth rate (SGR) formula, an ill-conceived policy that annually threatens physicians with indiscriminate cuts in fees to control Medicare spending (Sanghavi, O’Shea and McCelallan, 12/6).
Medpage Today: Docs In Senate Back Stark Law Exemptions
The physician members of the Senate wrote to congressional leaders this week backing the current Stark Law exemptions for in-office self-referrals. Sens. Tom Coburn, MD (R-Okla.), John Barrasso, MD (R-Wyo.), Rand Paul, MD (R-Ky.), and John Boozman (R-Ark.) said they support physicians referring for services such as radiation therapy, diagnostic imaging, pathology, and physical therapy within their respective practices. The Stark Law prohibits physicians from making self-referrals for certain services but allows self-referral for advanced diagnostic imaging, radiation therapy, anatomic pathology, and physical therapy (Pittman, 12/6).
18. Drugmaker Pushes New Drug Over Cheaper Equivalent At Medicare's Expense
The Washington Post explores the public impact of two equivalent drugs that both prevent blindness but which have very different prices. Other media report on the federal court decision in Connecticut that temporarily blocks UnitedHealthcare from dropping more than 2,000 doctors from its Medicare Advantage network in that state.
The Washington Post: An Effective Eye Drug Is Available For $50. But Many Doctors Choose a $2,000 Alternative.
The two drugs have been declared equivalently miraculous. Tested side by side in six major trials, both prevent blindness in a common old-age affliction. Biologically, they are cousins. They’re even made by the same company. Avastin costs about $50 per injection. Lucentis costs about $2,000 per injection. Doctors choose the more expensive drug more than half a million times every year, a choice that costs the Medicare program, the largest single customer, an extra $1 billion or more annually (Whoriskey and Keating, 12/7).
Kaiser Health News: Judge's Medicare Advantage Order Could Have National Impact
In a decision that could have national implications, a federal judge in Connecticut temporarily blocked UnitedHealthcare late Thursday from dropping an estimated 2,200 physicians from its Medicare Advantage plan in that state. While the judge’s decision affects only the physicians in Fairfield and Hartford Counties who brought suit, several other medical groups are considering filing similar actions (Jaffe, 12/6).
The CT Mirror: Judge Blocks UnitedHealthcare Medicare Advantage Doctor Cuts
A federal judge has temporarily blocked UnitedHealthcare’s move to terminate Connecticut physicians from its Medicare Advantage network. U.S. District Judge Stefan R. Underhill granted a preliminary injunction requested by the Fairfield County Medical Association and the Hartford County Medical Association. The two medical groups took legal action after UnitedHealthcare notified about 2,200 doctors that they would be dropped from its Medicare Advantage network as of Feb. 1 (Becker, 12/6).
19. State Highlights: Union, Calif. Hospital Assn. At Odds Over Organization, Ballot Issues
A selection of health policy stories from California, Indiana, North Carolina, Florida and Minnesota.
Los Angeles Times: Health Care Union Abusing Initiative Process, Critics Say
Duane Dauner, president of the California Hospital Assn., emailed the group's board in September with a warning: The leader of the state's largest health care workers' union had told him that if hospitals did not pave the way for the organizing of 20,000 workers, the union would launch ballot measures taking aim at hospital pricing and executive pay. But negotiations on organizing agreements between the two sides stalled. In November, the union, SEIU-United Healthcare Workers West, filed two initiatives for the 2014 ballot that would limit hospital prices and cap executive compensation at nonprofit hospitals (Mason, 12/6).
The Associated Press: Indiana Hospital Cuts Create Uncertain Future For Nurses
Recent staffing cuts at hospitals in Indiana and around the country are forcing nurses and other health workers to shift the focus of their job searches and leaving them wondering about their futures (12/8).
The Associated Press: Scope Of N.C. Medicaid Overhaul Proposal Changes
Several months ago, Gov. Pat McCrory's administration proposed a dramatic overhaul of what he's repeatedly called a "broken" Medicaid system -- one beset annually by hundreds of millions of dollars in shortfalls (Robertson, 12/8).
Kaiser Health News: Capsules: Does Knowing Medical Prices Save Money? CalPERS Experiment Says Yes
In an effort to raise awareness and rein in what can seem like the Wild West of health care, the California Public Employees' Retirement System (CalPERS), the second largest benefits program in the country, and Anthem Blue Cross started a 'reference pricing' initiative in 2011. The initiative involved a system to guide their enrollees to choose facilities where routine hip and knee replacement procedures cost less than $30,000 (Rao, 12/6).
Health News Florida: Record Fees Going Up
Patients and their lawyers face a potentially steep increase in the cost of obtaining copies of their medical records following action by the Florida Board of Medicine on Friday. The board, meeting in Orlando, voted unanimously to raise the cap on charges for copying to $1 a page "or actual cost," whichever is less. It makes no difference whether the copies are paper or electronic (Gentry, 12/6).
Fox News: States Restore, Add To Mental Health Spending As Sandy Hook Anniversary Nears
Though Congress has done little to increase spending or enact laws to improve mental-health care after the 2012 Sandy Hook school shootings, dozens of states have increased or restored such funding. States struggling to make ends meet during the recent recession cut more than $4 billion from their mental-health budgets from 2009 through 2012. Now with the one-year anniversary of the Dec. 14, 2012, Sandy Hook elementary school shootings just days away, a new report shows at least 37 states have increased spending on mental health programs (12/8).
Minnesota Public Radio: 'Dental Therapy' Takes Root Where Dentists Are Scarce In Minnesota
A new, mid-level dental profession is slowly taking root in Minnesota. Over the past two years universities have trained, and the state has licensed, 28 dental therapists, practitioners who perform many basic dental procedures that previously only a dentist would do. They work in places where dentists won't go, or are unwilling to accept Medicaid coverage (Benson, 12/9).
EDITORIALS AND OPINIONS
20. Viewpoints: Optimism About Obamacare; 834 Errors; Can-You-Keep-Your-Doctor Debate
The New York Times: Obamacare Turns a Corner?
This was the week when liberals decided that it was safe to feel optimistic about Obamacare again. ... A worst-case scenario, in which the website remained unusable well into the new year, seems to have been averted, and with it the danger that insurers or Congressional Democrats would begin to bail on Obamacare entirely. And liberals have apparently decided that just getting things moving in the right direction makes all the difference (Ross Douthat, 12/7).
The New Republic: Exclusive: The Obamacare Error Rate Has Fallen Dramatically
These days it seems like everybody following Obamacare is talking about the 834s. Those are the personal data files that healthcare.gov sends insurance companies, in order to notify them of new enrollees. The data has been prone to errors and that's a real problem. You can't get new coverage if the insurer doesn't have some basic information about you—your full name, Social Security number, and so on. ... But the 834 problem is fixable and, according to multiple sources in the public and private sectors, it is being fixed (Jonathan Cohn, 12/6).
The Wall Street Journal: ObamaCare In Translation
President Obama promised that if you like your doctor you can keep your doctor. But now comes an architect of ObamaCare to explain that this needs some translating. Former White House official (and our sometime contributor) Ezekial Emanuel has taken on the thankless task of defending the unpopular law he helped to write, and on "Fox News Sunday" he told host Chris Wallace what the President really meant (12/8).
The Washington Post's Wonkblog: Obamacare’s Real Promise: If You Lose Your Health-Care Plan, You Can Get A New One
Almost everyone in the country can lose their health insurance at any time, for all kinds of reasons — and every year, millions do. ... Health insurance isn't such a fraught topic in countries such as Canada and France because people don't live in constant fear of losing their ability to get routine medical care. A decade from now, that will be true in the U.S., too. But it's not true yet, and paradoxically, that's one reason health reform is so difficult. The status quo has left people rightly fearful, and when people are afraid, change is even scarier (Ezra Klein, 12/7).
The New York Times: When Bishops Direct Medical Care
Beyond new state efforts to restrict women’s access to proper reproductive health care, another, if quieter, threat is posed by mergers between secular hospitals and Catholic hospitals operating under religious directives from the nation’s Roman Catholic bishops. These directives, which oppose abortions, inevitably collide with a hospital’s duty to provide care to pregnant women in medical distress. This tension lies at the heart of a federal lawsuit filed last week by the American Civil Liberties Union (12/8).
Los Angeles Times: Fiscal Idiocy: What States Refusing Medicaid Will Cost Their Citizens
One ever-popular piece of political theater is for governors to go to Washington to demand a fair return on the money their citizens pay to the federal government. You know the drill: Governor calculates that his or her state receives only 80 or 90 cents back on every dollar the people pay, throws conniption, takes junket to DC, accompanied by TV cameras. When he was governor of California, Arnold Schwarzenegger made this a big part of his fiscal reform program (Michael Hiltzik, 12/6).
The New York Times: How the Government Gives
The government does its own charitable giving, in the form of tax deductions. When an individual makes a donation to a qualifying organization, the federal government essentially pays a portion of that donation: ... The federal government too often provides the deduction for donations that offer little or no benefit. Consider three examples: Nonprofit hospitals are among the largest recipients of charitable donations. Yet their activities are often indistinguishable from those of for-profit hospitals (Ray D. Madoff, 12/7).
The Atlantic: How Obamacare Lost Its Soul
The president has replaced the moral case for reform with a transactional one. That's a mistake. ... For supporters of the Affordable Care Act, President Obama’s new push to "sell" the law is a welcome sign that Healthcare.gov is on the mend, but it also risks devolving into transactionalism—a narrative of “Democrats delivering benefits on one side, and Republicans trying to deny them on the other,” as Politico puts it. To make the case, Obama needs to strike the sustained, emotional moral clarity—consistent claims that go beyond economic benefits—that helped bring him to the Washington in the first place (Michael Zuckerman, 12/6).