First Edition: July 15,2013

Jul 15 2013

Today's headlines include reports about the health law's implementation and status checks on how the measure's online insurance marketplaces are taking shape. 

Kaiser Health News: 'Wildfire' Growth Of Freestanding ERs Raises Concerns About Cost
Kaiser Health News staff writer Phil Galewitz, working in collaboration with USA Today, reports: "In this fast-growing Houston suburb, six ERs are just a short drive away. She chose Texas Emergency Care Center, a facility that feels like a Western lodge with its earth-toned brick walls, leather chairs and coffee bar. The eight-bed ER that opened last year has almost everything -- except, that is, an attached hospital" (Galewitz, 6/15). Read the story.

Kaiser Health News: Kentucky's Rush Into Medicaid Managed Care: A Cautionary Tale For Other States
Reporting for Kaiser Health News, in collaboration with The Washington Post, Jenni Bergal writes: "Kaden Stone loves playing baseball, riding his bike and watching Duck Dynasty on TV at his red-brick ranch-style house in rural south central Kentucky.  Despite his energy, the tiny boy of eight with a crewcut and missing front tooth can't eat much, the result of congenital bowel problems that have required dozens of surgeries and procedures. He needs PediaSure, says his mother, who was shocked when Kaden's Medicaid managed care plan stopped paying last fall for the expensive nutritional drink, saying it was not 'medically necessary'" (Bergal, 7/15). Read the story.

Kaiser Health News: Capsules: 7 States, Governors Team To Tackle Hospital 'Frequent Flyers'; State Insurance Exchanges Launching TV Ads To Encourage Enrollment
Now on Kaiser Health News' blog, Kelsey Miller writes about hospital frequent flyers: "Seven states and the National Governors Association are teaming up to find ways to save money and better coordinate the care of Medicaid and uninsured patients who frequently use hospital emergency rooms and other costly health services" (Miller, 7/12).

In addition, Phil Galewitz reports on state insurance exchanges efforts to encourage enrollment: "A folk singer playing guitar in front of a mountain stream. A Disney-like animated video about how 'a new day is coming.' An announcer talking about "change is here." A woman jumping up and down in celebration in a baseball team locker room. These images are from the first television advertisements being aired by state-run health insurance exchanges created under the federal health law. Oregon, Kentucky, Colorado and Connecticut produced them. Several more states, including Hawaii and Vermont, are expected to launch ads in the coming weeks, ahead of the Oct. 1 start of open enrollment" (Galewitz, 7/15). Check out what else is on the blog.

Kaiser Health News also tracked weekend health policy headlines, including news about Texas' new abortion law (7/13) and Senate leaders' verbal sparring over the health law (7/14).

McClatchy/The Washington Post: Little Understanding Of Health-Care Law Opens Door For Scams
If a stranger claiming to be from the government calls to offer you an "Obamacare card" or threatens to throw you in jail unless you buy insurance, hang up the phone. It's a scam. Fraudsters are poised to take advantage of widespread confusion over the Affordable Care Act -; also known as Obamacare -; to steal Americans' credit cards, Social Security numbers and other personal information, consumer advocates and government officials say (7/14).

The Wall Street Journal: Insurers Test Drive New Health Plans
The federal health overhaul's big requirement that most people carry health insurance is still months away, but already insurers like Blue Cross & Blue Shield of Rhode Island have a sense of what will matter most to consumers: price. "To me, it's all about money," said Rob Roy, who compared plans in a consumer test for the insurer. Currently uninsured and working as a cook in a pub, Mr. Roy said he found the choices too expensive. He ended up opting for a competitor's plan instead of Blue Cross (Mathews, 7/14).

The Wall Street Journal: Insurers Seek Right Balance Of Risk, Reward
In the insurance business, some customers are more desirable than others-;and insurers will be seeking to woo them in preparation for the health law's new marketplaces. Customers not only bring revenue in the form of the premiums they pay. They also come with costs, since the insurer will be on the hook for medical expenses (Mathews, 7/14).

The Wall Street Journal's Corporate Intelligence: How Will Health Insurance Exchanges Work?
This fall, people in every state are supposed to be able to buy health insurance through new online marketplaces, or exchanges, instituted by the federal health-care law. Insurers have been preparing for the rollout with research, trying to figure out what products to offer and how to market them. For consumers, here are some important questions and answers about the exchanges (Mathews, 7/14).

Politico: Mandate Delay A 'Full Time' Headache For Employers
Restaurants and other employers essentially got an extra year to push for Obamacare changes when the administration delayed the law's employer mandate. But it isn't as good as it sounds. The decision to delay the mandate until 2015 left two big sticky issues standing in the way for employers: a lowered sense of urgency in Congress to enact the changes they want and sharp divisions among House Republicans over how to approach the law (Cunningham, 7/15).

Politico: Obamacare's Missing Mandate
The massive coast-to-coast campaign to get people to sign up for Obamacare is light on mentions of one central element: the widely disliked individual mandate. Poll after poll has found that Americans don't like being told they have to get insurance or face a penalty. So the groups doing outreach don't plan to draw much attention to it. ... The early stages of the enrollment push has been all honey and no vinegar (Millman, 7/13).

The Wall Street Journal: Watch Out Insurers, This Obamacare Glitch May Be A Challenge
As part of the Affordable Care Act's goal of equalizing access to health care, insurers who offer plans on the new exchanges are prohibited from denying coverage to those applicants with a pre-existing conditions. But they are allowed to charge more based on age and tobacco use, with the oldest smokers receiving the most expensive plans, helping insurers better allocate risk. Obamacare regulations intended that older insurance enrollees could be charged up to three times more than younger people, while a smoker could be hit with a surcharge of up to 50 percent (Foley, 7/13).

The Wall Street Journal: A Cure For Student Health Woes?
Student health-insurance plans are getting better-;and pricier. Just a few years ago, such plans were under fire for skimpy annual benefit limits that often topped out well below $100,000. Some plans didn't cover prescription drugs or treatment for mental-health or substance-abuse problems. Those days are gone. Under the Affordable Care Act, the minimum annual benefits limit will jump to $500,000 for the 2013-14 school year, up from $100,000 in 2012-13 (Blumenthal, 7/13).

The Wall Street Journal: Slowdown In Health Spending Could Be At Risk
The long upward curve of U.S. health-care spending finally seems to be flattening. But is it temporary or the start of a lasting change? With health-care costs nearing 18% of the nation's gross domestic product-;$2.7 trillion in 2011-;the health of the economy itself is at stake. There have been plenty of hopeful signs. U.S. spending on health care rose at a 3.9% rate for the third consecutive year in 2011, about half the previous decade's pace and the lowest since the 1960s (Beck, 7/14).

The Washington Post: Reid Open To Vote On 20-Week Abortion Ban Senate
Majority Leader Harry Reid (D-Nev.) said Sunday that he was open to allowing a vote on a House bill that would ban abortions after the 20th week of pregnancy. But he also suggested Congress shouldn't be focusing on such "fringe issues."... Reid is one of a few Democrats in the Senate identifies as being against abortion rights (Blake, 7/14).

Politico: The Force Behind EMILY's List
Ask around about EMILY's List President Stephanie Schriock and two things become clear: She delivers results and isn't afraid to knock heads in the process. ... EMILY's List was a natural fit for Schriock: she said she first wanted to get involved in politics when she saw NARAL Pro-Choice America President Nancy Keenan, then the Montana Superintendent of Public Instruction, speak at her high school in Montana. (Schultheis, 7/13).

The Associated Press/Washington Post: Republicans Return Abortion To Front Burner For 2014 Elections, Democrats See Gain As A result
With no immediate hope of overturning the U.S. Supreme Court's decision legalizing abortion, Republicans around the country are increasingly pushing legislation to restrict the procedure, and Democrats say they'll make the GOP pay in coming elections. From statehouses to Congress, Republicans have advanced a range of ideas: banning nearly all abortions beyond the 20th week after conception; making abortion clinics follow regulations for surgical care; mandating that clinic physicians have admitting privileges at local hospitals; requiring women to get ultrasounds before terminating a pregnancy (7/15).

The Washington Post: Texas Abortion Vote Joins Growing Legal Frenzy
A sweeping set of abortion restrictions adopted by the Texas state Senate on Saturday is the latest in a series of state-level political fights triggering a frenzy of legal action that could determine how much access to abortion services American women have in the future. Abortion opponents hope that eventually some of cases will reach the U.S. Supreme Court (Eilperin, 713).

The New York Times: A Pill Available In Mexico Is A Texas Option For Abortion   
At the Whole Woman's Health center here [McAllen, Texas], a young woman predicted what others would do if the state's stringent new abortion bill approved late Friday forces clinics like this one to close: cross the border to Mexico to seek an "abortion pill." ... In Nuevo Progreso, only yards past the Mexican border, pharmacists respond to requests for a pill to "bring back a woman's period" by offering the drug, misoprostol, at discount prices: generic at $35 for a box of 28 pills, or the branded Cytotec for $175 (Eckholm, 7/13).

Los Angeles Times: California Prisons Sterilized 148 Women Without Approval, Report Says
Dozens of women in California prisons were sterilized without the required approval of a state medical committee, officials said Friday. Some of the women say they felt coerced to undergo the surgery, and now state lawmakers are calling for an investigation (McGreevy and Willon, 7/13).

Los Angeles Times: Six People Fired From Cedars-Sinai Over Patient Privacy Breaches
Five workers and a student research assistant at Cedars-Sinai Medical Center have been fired over privacy breaches involving patient medical records. Cedars-Sinai officials said in a statement that 14 patient records were "inappropriately accessed" between June 18 and June 24. Six people were fired over the breach: four were employees of community physicians who have medical staff privileges at the hospital, one was a medical assistant employed by Cedars-Sinai, and one was an unpaid student research assistant (Gorman and Sewall, 7/12).