Trials And Tribulations Of Expanded Health Coverage
News outlets report how, as the overhaul "chips away" at the nation's number of people without insurance, the law's solutions to the problem often come with challenges of their own.
The New York Times: Looking At Costs And Risks, Many Skip Health Insurance
Steve Huber, an affable salesman who is still paying off an unexpected medical bill, was not among the millions of Americans who signed up for health insurance under the Affordable Care Act during the enrollment period that ended March 31. After seeing television ads for Kentucky’s new online insurance marketplace, Mr. Huber, 57, made several attempts to explore the website but found it too complicated. Moreover, his income has dropped in recent years, he said, and he felt certain that he could not afford coverage. So he never priced plans or researched whether he qualified for financial assistance (Goodnough, 4/21).
The Associated Press: Affordable Care Act Only Chips Away At A Core Goal
Swan Lockett had high hopes that President Barack Obama’s health overhaul would lead her family to an affordable insurance plan, but that hasn’t happened. Instead, because lawmakers in her state refused to expand Medicaid, the 46-year-old mother of four from Texas uses home remedies or pays $75 to see a doctor when she has an asthma attack (4/21).
Kaiser Health News: Waiting For Medicaid To Kick In
For most of Teresa Martinez’s life, buying health insurance has been out of the question. She works at a Koreatown hair salon, earning about $10 per cut – not nearly enough to afford private coverage. With a long list of ailments including dizziness, blurry vision and leg pain, she eagerly applied last year for a county program that would cover her for free until Obamacare set in (Gorman, 4/21).
The Washington Post’s The Fact Checker: Spinning Obamacare Success: The President Highlights A Less Relevant Number
The Fact Checker was on break last week, but did manage to pass a TV set that aired images of the President’s announcement on April 17 that 8 million people had signed up for health insurance on the Affordable Care Act exchanges. We were struck by a headline in the TV ticker that amplified the president’s message that 35 percent of the enrollees were younger than 35. Why is that important? The “young invincibles” are considered a key to the health law’s success, since they are healthier and won’t requires as much health coverage as older Americans. If the proportion of young and old enrollees was out of whack, insurance companies might feel compelled to boost premiums, which some feared would lead to a cycle of even fewer younger adults and higher premiums (Kessler, 4/22).
Fox News: Congressional Budget Office Projections On Obamacare Raise Questions About Future Enrollment
President Obama and other officials like to point to projections by the Congressional Budget Office to show that ObamaCare "is working," as the president put it. He said 8 million have enrolled in the federal exchanges, but the CBO said in a recent report only 6 million are newly insured and some say even fewer than that did not have prior insurance…That is why the CBO showed that at the end of this year, there will still be 42 million uninsured and 31 million without insurance ten years from now (Angle, 4/22).
Detailing The Winners: Who Scored The Most Health Exchange Sign-Ups
In California, it was Anthem Blue Cross, while Kaiser Permanente, Rocky Mountain Health Plans and the Colorado HealthOP appeared to fare well through that state's online insurance marketplace. Meanwhile, reports also track how the small business exchanges did in Rhode Island and Connecticut.
Los Angeles Times: Anthem Blue Cross Signs Up The Most Californians Under Health Law
With open enrollment for Obamacare wrapped up, insurance giant Anthem Blue Cross stayed ahead of the pack in California sign-ups and widened its lead over rival Blue Shield of California. Anthem signed up 425,058 people through April 15, or 30.5% of Covered California's exchange market under the Affordable Care Act, new data show. Anthem is a unit of Indianapolis-based WellPoint Inc., the nation's second-largest health insurer (Terhune, 4/21).
The Miami Herald: Florida Blue Says ACA Enrollments Exceeded Expectations But Premiums May Rise In 2015
Most of the consumers who bought a private health plan from Florida Blue through the Affordable Care Act’s insurance exchanges between October and April were previously uninsured — one of many factors potentially leading to higher premium rates in 2015, according to a senior executive (Chang and Borns, 4/21).
Health News Colorado: Kaiser, Other Nonprofits Score Majority Of Exchange Sign-Ups
Nearly three out of four people who bought private health insurance through Colorado’s exchange selected nonprofit carriers: Kaiser Permanente, Rocky Mountain Health Plans and the Colorado HealthOP. Nearly half picked Kaiser. Kaiser enrolled 58,344 of 127,233 people — or about 46 percent — of those who bought insurance through Connect for Health Colorado between Oct. 1 and the end of open enrollment on March 31 (McCrimmon, 4/21).
Politico Pro: Rhode Island Shines In The SHOP Spotlight
The smallest state in the nation may be able to boast the greatest progress in an Obamacare initiative aimed at, yes, small businesses. Many states pushed their small-business health options programs to the side amid the myriad problems that arose while they were gearing up for the law’s first enrollment season. But Rhode Island put SHOP front and center, and half a year later, its program has signed up a bigger percentage of the population than that of any other state (Villacorta, 4/21).
The CT Mirror: CT Obamacare Exchange Lags In Attracting Small Businesses
Access Health CT, the state’s health insurance exchange, drew national praise for its performance in enrolling more than 208,000 individuals in health care coverage as part of the law commonly known as Obamacare. But the small business side of the state’s exchange -- known as SHOP, for the Small Business Health Options Program -- hasn’t done so well. As of April 8, it had sold plans to 78 businesses, covering a total of 330 people (Becker, 4/21).
Polls Offer Competing Visions Of Electorate's Views On Health Law
A Fox poll finds more than half of voters are inclined to support candidates that oppose the health overhaul, but Democrats say that other polls show a band of independent voters who may not like the law but don't want it repealed.
Fox News: Fox News Poll: Independents More Likely To Back Anti-ObamaCare Candidates
Most voters say ObamaCare will play an important role in their vote in this year's elections, and over half are more inclined to back the candidate who opposes the health care law. That's according to a Fox News poll released Monday. The new poll asks voters what they would do if the only difference between two congressional candidates is that one promises to fight for the health care law and the other promises to fight against it (Blanton, 4/21).
The Wall Street Journal’s Washington Wire: Can Democrats Use Obamacare To Persuade Voters?
Are there any voters left who haven't made up their minds about the Affordable Care Act? Not many, but Democrats are counting on a few at the margins to come their way. Tracking polls by the Kaiser Family Foundation suggest that support for and opposition to the law have remained about the same over the last six months, even as the law’s impact began to be felt in people’s lives, for better and worse. But there remains a narrow band of voters whose attitude toward the law and whose political allegiance may still be up for grabs: Voters who don’t like the law but don’t want it repealed (Hook, 4/21).
In other news about the politics of the law -
Politico: Who Is Dr. Ben Carson?
In October, Carson made headlines again when he said that the Affordable Care Act’s framework of mandates, insurance exchanges and federal subsidies amounted to "the worst thing that has happened in this nation since slavery." He meant the comparison literally. "It is slavery in a way," Carson, who is African American, went on, "because it is making all of us subservient to the government, and it was never about health care. It was about control." That sense of loss of control over the practice of medicine is what has brought many doctors recently to become vocal in discussions of policy. Several dozen are even running for Congress this year, most as Republicans. But it's Carson who has become one of those curious media stars that often shoots through American politics nowadays—so suddenly popular among conservatives that he bested such 2016 hopefuls as Chris Christie, Scott Walker and Marco Rubio at the CPAC straw poll (Hamblin, 4/21).
Politico: Schwartz Ad Touts Obamacare In Pennsylvania
Most Democratic candidates in competitive races this year are avoiding talking about the Affordable Care Act, but a new ad from Rep. Allyson Schwartz — one of the four Democrats vying to take on Pennsylvania GOP Gov. Tom Corbett — embraces both President Barack Obama and his signature health care law. "I worked with President Obama on the Affordable Care Act and getting health coverage to all Americans," Schwartz says in the ad, shared first with POLITICO. "It was my legislation that said insurance companies can no longer deny coverage for kids with pre-existing conditions. It's something I’m proud of because it also closed the gap in prescription drug coverage for seniors" (Schultheis, 4/21).
New Painkiller, With Fewer Side-Effects, Up For FDA Approval
The drug, Moxduo, allows patients to take lower doses of other painkillers. Elsewhere, a Food and Drug Administration official talks about another painkiller, Zohydro.
NPR: Powerful Narcotic Painkiller Up For FDA Approval
The Food and Drug Administration is trying to decide whether to approve a powerful new prescription painkiller that's designed to relieve severe pain quickly, and with fewer side effects than other opioids. While some pain experts say the medicine could provide a valuable alternative for some patients in intense pain, the drug (called Moxduo) is also prompting concern that it could exacerbate the epidemic of abuse of prescription painkillers and overdoses. An FDA advisory committee is holding a daylong hearing Tuesday to decide whether to recommend that the agency approve the drug (Stein, 4/22).
CQ Healthbeat: FDA Official Urges Reassessment Of Painkiller Use
While defending the approval of the controversial painkiller Zohydro, the top U.S. drug regulator is calling for a reversal of the trends that have triggered excess use of narcotics in the United States and unleashed an epidemic of prescription drug abuse (Young, 4/22).
McAuliffe Renews His Push To Expand Virginia's Medicaid Program
Medicaid expansion news from Virginia and Kansas as well as a report about how some CHIP advocates are now concerned about how the expansion could impact the insurance program for children.
The Associated Press: Va. Gov. McAuliffe Touts First 100 Days In Office
Gov. Terry McAuliffe celebrated his first 100 days in office Monday by highlighting his work to improve the state’s economy and by renewing his call to expand Medicaid eligibility to low-income residents (4/21).
The Washington Post: Medicaid Expansion In Kansas On Hold Until At Least 2015
If Kansas opts to expand Medicaid, it won’t happen until at least next year. A new measure, signed into law late last week by Gov. Sam Brownback (R), requires that any expansion of Medicaid be explicitly approved by the state legislature, which has finished its regular session for the year (Chokshi, 4/21).
CQ Healthbeat: CHIP Advocates Cast Wary Eye on the Calendar
Champions of the Children’s Health Insurance Program are starting to worry about its future with federal funding set to expire in 18 months and new coverage alternatives available under the health law. A central question is whether advocates can convince Congress the program covering 8.5 million children is worth keeping even though states now have the option of expanding their Medicaid programs to help cover that population. Lawmakers also authorized hundreds of billions of dollars in subsidies to buy coverage on insurance exchanges (Reichard, 4/21).
Supreme Court Weighs Truth-In-Labeling Issue In Case Involving Juice Product
The makers of a pomegranate juice called Pom Wonderful ask the court to rule that Coca-Cola is falsely labeling its Pomegranate Blueberry juice that is 99.4 percent apple and grape juice.
Los Angeles Times: Supreme Court Seems Inclined To Bolster Truth-In-Labeling Laws
In a case that could strengthen truth-in-labeling laws, Supreme Court justices on Monday voiced deep skepticism about Coca-Cola's Pomegranate Blueberry juice that is 99.4% apple and grape juice, saying the name would probably fool most consumers, including themselves. The high court is hearing an appeal from Stewart and Lynda Resnick of Los Angeles, makers of a rival pomegranate juice called Pom Wonderful, who complained that the name of the Coca-Cola product, sold under the Minute Maid brand, is false and misleading. … At issue is whether federal law permits selling a product with a name or a label that is almost sure to mislead consumers, and how much latitude manufacturers have in marketing (Savage, 4/21).
The Wall Street Journal: Justices Skeptical Of Coke's Pomegranate Juice Label
Los Angeles-based Pom, which sells juices and juice blends with high content of costly pomegranate juice, claims that Coke is misleading consumers with a Minute Maid product it calls Pomegranate Blueberry Blend of Five Juices. The product, which contains about 0.5% of pomegranate and blueberry juices, highlights the words Pomegranate Blueberry, features a pomegranate and blueberry on its label, and is colored a bluish-purple, altering the natural hue of the less pricey apple and grape juices that make up more than 99% of the beverage (Bravin, 4/21).
The high court will also consider a case Tuesday involving abortion and free speech -
Politico: Abortion At Heart Of Ohio Speech Case
The Supreme Court will consider Tuesday whether an anti-abortion group can challenge an Ohio law that could have restricted it from publicly accusing a political candidate of voting for taxpayer-funded abortions in Obamacare. The justices aren’t likely to decide whether the law chills free speech—although Susan B. Anthony List and even the Ohio attorney general say that it does. They’re instead being asked to decide whether SBA List has standing to challenge the law since the group was never prosecuted under it (Winfield Cunningham, 4/22).
Novartis To Buy GlaxoSmithKline's Oncology Unit
The deal, worth billions, will also see Novartis sell its vaccines unit to Glaxo and partner with Glaxo on their consumer divisions. Novartis also said it will sell its animal health division to Eli Lily.
The Wall Street Journal: Novartis Buys GlaxoSmithKline's Oncology Unit For $14.5 Billion
Basel-based Novartis said it is acquiring the oncology unit of Britain's GlaxoSmithKline for around $14.5 billion. The Swiss pharmaceutical giant is also selling its vaccines unit to Glaxo for $5.25 billion. Both deals include provisions for milestone payments that could raise the total values. Novartis and Glaxo are also planning to combine their consumer divisions, which sell medicines that don't require a prescription (Falconi and Plumridge, 4/22).
Bloomberg/Los Angeles Times: Novarits To Buy GlaxoSmithKline Cancer Unit For Up To $16 Billion
Novartis AG agreed to buy GlaxoSmithKline Plc’s cancer-drug business for as much as $16 billion, form a consumer-health venture with Glaxo and sell its animal-health operation to Eli Lilly & Co. for $5.4 billion in an overhaul of the Swiss drugmaker. Novartis also will sell its vaccines business, excluding the flu operations, to Glaxo for $7.1 billion, the Basel, Switzerland-based company said in a statement today. That includes royalties and as much as $1.8 billion payments based on the achievement of certain business goals (4/21).
USA Today: Glaxo, Novartis, Eli Lilly In ‘Major 3-Part’ Deal
British drug giant GlaxoSmithKline announced Tuesday that it will sell its cancer-products business to pharmaceutical giant Novartis, in a deal that will see the firm's Swiss rival pay $14.5 billion for its oncology unit. Basel-headquartered Novartis said separately that it will sell its animal health division to U.S. firm Eli Lilly for $5.4 billion (Hjelmgaard, 4/22).
The Wall Street Journal: Novartis, GlaxoSmithKline Consumer-Health Business Unites Big Brands
The new over-the-counter drug and food-supplement business, with sales of around $11 billion, will be called GSK Consumer Healthcare. As the name suggests, Glaxo will control the business, with a 63.5 percent stake and seven of 11 board directors. Glaxo Chief Executive Andrew Witty will chair its board (Plumridge, 4/22).
State Highlights: Tenn. May Send Addicted Moms To Jail; Hawaii Autism Coverage; Florida Medical Marijuana
A selection of health policy stories from Tennessee, Hawaii, Florida, Minnesota, Wisconsin and Kansas.
NPR: Tennessee Bill Could Send Addicted Moms To Jail
Pregnant women addicted to illegal narcotics or prescription pain pills could soon be jailed in Tennessee under a bill awaiting the governor's signature. The strict proposal enjoys bipartisan support — despite objections from doctors (Farmer, 4/21).
The Associated Press: Hawaii Considers Mandated Autism Care Coverage
Hawaii lawmakers continue to work out the details of Senate Bill 2054, which would require insurance companies to cover applied behavioral analysis and other treatment options. Applied behavioral analysis is widely viewed as the most effective treatment for autism spectrum disorders. But the Hawaii Medical Services Association, one of the state's largest insurance companies, opposed the bill, saying it would be too expensive to provide the services (Bussewitz, 4/21).
The Miami Herald: Florida Gov. Rick Scott’s Medical Czar Opposes Marijuana Bill
Efforts to legalize a specific strain of marijuana to help children with intractable epilepsy faced a new hurdle Monday as the governor’s chief medical advisor said he opposed the bill because it will allow untested drugs into the market, raising the specter that the governor may veto the bill (Klas, 4/21).
Modern Healthcare: Healthways To Pay $9.4 Million To Minn. Blues Over Telehealth Fraud
Tennessee-based health services firm Healthways has agreed to pay $9.4 million to Blue Cross and Blue Shield of Minnesota to resolve a contract dispute, the company announced last week. Under the settlement, Healthways agrees to pay BCBSMN a total of $4 million by the end of this month and a second payment of $5.5 million in January 2015. The settlement amount will be incurred as a charge within Healthways' first quarter 2014 results, the company said in a statement (Johnson, 4/21).
The Milwaukee Journal Sentinel: Wisconsin Nursing Homes Are Becoming More Home Than Nursing
Gerri Bussey loves to sleep in, and she does so nearly every day. She loves a big breakfast. Once a week she takes a bubble bath in style with a glass of wine. The vivacious 79-year-old isn't on holiday. She's been living at an Oconomowoc nursing home, Shorehaven, rehabilitating from a fall that happened a few months ago. Far from the traditional nursing home with sterile hallways and fluorescent lights, Shorehaven is one of a new breed popping up in the state, and a sign that life for Wisconsin's most vulnerable residents is transforming (Mulvany, 4/21).
The Pioneer Press: Dane County (Wis.) Dementia Program Could Expand Statewide
When Arkady Grinblat would try to go outside of his assisted-living facility, an alarm would go off. Staff told him he couldn't walk into other people's rooms. ... Like other people with behavior problems related to dementia, he risked being sent to Mendota Mental Health Institute. But Dane County's Dementia Support Team arranged for Grinblat to move to a smaller assisted-living facility instead, paying to hire an extra caregiver and put up a fence so Grinblat could get fresh air. The Dementia Support Team, formed in 2009 after a dementia patient from the county lingered at Mendota for more than two years, could expand through a state effort to reform dementia services (Wahlberg, 4/21).
The Associated Press: Gov. Walker Announces Plan To Expand Family Care Program
Wisconsin health officials are ready to begin expanding the Family Care program that provides in-home care to seven additional counties, but it could take as long as three years to get things ramped up. Gov. Scott Walker said Monday his administration is ready to start work on extending Family Care to Brown, Door, Kewaunee, Marinette, Menominee, Oconto and Shawano counties. The expansion would include 2,434 people who use similar county-based care programs, 977 people on waiting lists for county services and anyone else who resides in the counties and meets the eligibility requirements (Richmond, 4/21).
Kansas Health Institute: Waitlist Problems Delay Services For About 400 Disabled Kansans
State officials say they are prepared to move almost 400 physically disabled Kansans off the waitlist for Medicaid-funded, in-home services but cannot, chiefly because they’re having problems contacting the right people. And they say they have concluded the number of people awaiting services actually might be significantly less than they previously thought (Ranney, 4/21).
Viewpoints: The Case Against Jenny McCarthy's Vaccine Stand; Apathy On HIV; Defeating Alzheimer's
The New York Times: Autism And The Agitator
What do you call someone who sows misinformation, stokes fear, abets behavior that endangers people's health, extracts enormous visibility from doing so and then says the equivalent of "Who? Me?" I'm not aware of any common noun for a bad actor of this sort. But there’s a proper noun: Jenny McCarthy (Frank Bruni, 4/21).
Los Angeles Times: AIDS At 30: Apathy Plus HIV Kills
In the 30 years since we discovered HIV, the stigma surrounding it has lessened, but it has never completely dissipated. And new threats loom: apathy and ignorance. AIDS advocacy groups are suffering from "prevention fatigue." The waning interest in prevention has propelled rising HIV infections in adolescents and young adults in comparison with other age groups. Of the estimated 1.1 million Americans living with HIV, the Centers for Disease Control and Prevention suggests that 16 percent do not know their HIV status. ... And in December, the White House announced a $100-million initiative toward finding a cure for HIV. This investment has the potential to make an enormous difference. But research is only one piece of the puzzle. Our ability to treat and cure HIV in the future is threatened by the continued stigma, apathy and ignorance surrounding the virus (Nathalia Holt, 4/21).
The Wall Street Journal: How Congress Can Fight The Alzheimer's Epidemic
Not many people know it, but one of the best ways to curb future health-care spending is with a drug that slows the progression of Alzheimer's disease. Alzheimer's affects more than five million seniors today and last year cost Medicare and Medicaid almost $150 billion. ... If we are to have any chance of mitigating this epidemic, we must find ways to encourage the development of drugs that slow the progression or delay the onset of the inevitable brain failure that characterizes Alzheimer's. Specifically, we need to find incentives for the development of drugs that alter the course of the disease (Kenneth Davis, 4/21).
The Washington Post’s The Plum Line: The Next Anti-Obamacare Talking Point You Can Safely Ignore
In the past few days, health care wonks have noted with some concern that after a period of years when total health care spending in America was slowing, it looks like it has begun to accelerate again. Republicans will probably begin to argue that this uptick is evidence that the Affordable Care Act has failed in one of its key goals, bringing down overall costs. But is this actually something to worry about? With some important caveats I’ll explain in a moment, the answer is no. In fact, in some ways it's a reason to celebrate (Paul Waldman, 4/21).
Bloomberg: Are Obamacare's Latest Numbers Good News Or Bad?
The good news is that pretty soon, we'll find out what the insurers are thinking; they'll start filing some of their preliminary rate increases in a couple of weeks. My guess would be that those increases will be modest in places such as New York, which had a lot of signups -- and had also nearly destroyed its private insurance market, so that almost any reform would have been an improvement. My guess would be that in other places, where the signups are too old or too few, premiums will jump sharply. I’d also guess that the backdoor bailouts the administration has been arranging through the risk corridors will be enough to keep existing insurers in the market, though maybe not enough to lure many new ones (Megan McArdle, 4/21).
Bloomberg: Why Voters Won't Turn Out For Obamacare
Successful programs guarantee their own success, regardless of subsequent elections. That's very likely to be the case with health-care reform, no matter how people feel about "Obamacare." It’s hard for politicians to take away benefits people like. What successful programs almost never do -- especially those that are targeted widely and don't put pressure on specific groups to realign -- is win elections. And Obamacare, with its largely invisible and abstract benefits, is particularly poorly designed to achieve that particular goal (Jonathan Bernstein, 4/21).
St. Louis Post-Dispatch: Medicaid Expansion Argument Is Winning In Missouri
In Missouri, that economic impact of expansion could be profound, creating more than 24,000 jobs and actually adding money to Missouri’s general revenue budget. That’s according to studies that the opponents have failed to counter in any meaningful way (4/21).
The Journal of the American Medical Association: CMS -- Engaging Multiple Payers In Payment Reform
The Affordable Care Act created the Center for Medicare and Medicaid Innovation (Innovation Center) to test innovative payment and service delivery models to reduce program expenditures under Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) ... All of these models share a common pathway for success: they hinge on getting clinicians and health care organizations to manage the health of populations and to act as good stewards of health care resources. ... However, for these models to succeed in the long term, "value-based payment and patient incentives to reward clinicians and health care organizations that offer more real value to patients must spread rapidly to other payers" (Rahul Rajkumar, Patrick H. Conway and Marilyn Tavenner, 4/21).