First Edition: September 16, 2013

Sep 16 2013

Today's headlines include reports about new polling indicating that the health law still faces an uphill climb.  

Kaiser Health News: States Balk At Terminating Medicaid Contracts Even When There's Fraud Or Poor Patient Care
Reporting for Kaiser Health News, in collaboration with The Washington Post, Jenni Bergal writes: "In Florida, a national managed care company's former top executives were convicted in a scheme to rip off Medicaid. In Illinois, a state official concluded two Medicaid plans were providing 'abysmal' care. In Ohio, a nonprofit paid millions to settle civil fraud allegations that it failed to screen special needs children and faked data. Despite these problems, state health agencies in these - and other states - continued to contract with the plans to provide services to patients on Medicaid, the federal-state program for the poor and disabled. Health care experts say that's because states are reluctant to drop Medicaid plans out of fear of leaving patients in a bind" (Bergal, 9/15). Read the story.

Kaiser Health News: The Overlooked Obamacare Sales Force: Hospitals
Kaiser Health News staff writer Jay Hancock, working in collaboration with The Washington Post, reports: "As community groups, brokers and insurers prepare to recruit members for medical plans that go on sale in October under the health law, nobody has a bigger financial stake in their success than hospitals. And few may work harder to sign consumers up for the Obamacare insurance marketplaces than hospitals themselves" (Hancock, 9/13). Read the story.

Kaiser Health News: Local Uninsured Programs Face Uncertain Times As Obamacare Ramps Up
Kaiser Health News staff writer Phil Galewitz, working in collaboration with McClatchy, reports: "Jennifer Webb works the deli counter at Publix supermarket and has thyroid problems. Her boyfriend, William May, is an artist recovering from colon cancer. The couple has relied on a county program that provides health coverage to the working poor. But their 'security blanket,' as Webb calls the Alachua County CHOICES program, is being taken away at the end of December. As new coverage provisions take effect Jan. 1 under the health law, local programs that offered barebones care to the uninsured are in flux – and with them, the lives of thousands who depend on them" (Galewitz, 9/13). Read the story.

Kaiser Health News: Individuals With Medical Conditions Will Not Pay A Penalty On Premiums (Video)
Kaiser Health News consumer columnist Michelle Andrews helps you navigate the new insurance marketplaces that are scheduled to launch on Oct. 1. In today's video, she answers a question about premium penalties (9/15). Watch the video or watch the other videos in this series.

Kaiser Health News: Long-Term Care Panel Releases Recommendations But Fails To Offer Plan To Help Pay For Services
Reporting for Kaiser Health News, Susan Jaffe writes: "A commission created by Congress to address the country's surging need for long-term health care released recommendations Friday but did not reach a consensus on how to pay for these often expensive services" (Jaffe, 9/13). Read the story.

Kaiser Health News: Gov. Corbett To Propose Big Changes to Pennsylvania Medicaid
The Philadelphia Inquirer's Amy Worden, Angela Couloumbis, and Harold Brubaker, working in partnership with Kaiser Health News, reports: "Pennsylvania Gov. Tom Corbett will announce his plan Monday to expand health coverage for the poor by using public dollars to finance commercial insurance for 500,000 uninsured Pennsylvanians" (Worden, Couloumbis and Brubaker, 9/15). Read the story.

Kaiser Health News also tracked weekend health policy headlines, including reports about the Obama administration's response to labor union's health law request (9/15) and President Barack Obama's comments about efforts to defund the overhaul (9/15).

The Wall Street Journal: Health Law Faces Skepticism
New poll results show the depth of the Obama administration's challenge on the eve of the rollout of the federal health law's core provisions, as many Americans say they don't understand the law and don't think it will help them. A Wall Street Journal/NBC News poll found that even those lacking health insurance, who are supposed to be the law's biggest beneficiaries, generally believe it wouldn't do them much good (Radnofsky, 9/16).

USA Today: USA Today/Pew Poll: Health Care Law Faces Difficult Future
Republican lawmakers have failed in dozens of attempts to repeal the Affordable Care Act, but a new USA TODAY/Pew Research Center Poll shows just how difficult they have made it for President Obama's signature legislative achievement to succeed. As the health care exchanges at the heart of the law open for enrollment in two weeks, the public's views of it are as negative as they have ever been, and disapproval of the president's handling of health care has hit a new high (Page, 9/16).

The Associated Press/Washington Post: Company Returns $800K 'Navigator' Grant As Obstacles To Implement Affordable Care Act Mount
A company that has for decades helped people enroll in Medicaid says it won't be able to sign up people for insurance under the new Affordable Care Act because there is too much scrutiny over a so-called navigator program. According to an email obtained by The Associated Press, Cardon Outreach's chief legal officer Charles Kable told the federal government it was returning more than $800,000 in federal grant money. The funds were supposed to be used to hire people in four states help explain the intricacies of health insurance to millions of people who aren't covered (9/15).

The Wall Street Journal: Kentucky Officials Promote Health Law Where Skepticism Runs Deep
As Kentucky prepares to implement the health law, public agencies and advocacy groups are devoting millions of dollars and scores of outreach workers to sign up a key group: uninsured people in the state's rural expanses. Of the roughly 640,000 Kentuckians who are uninsured, 45% live in nonmetropolitan counties, which are mainly rural, according to state data (Campo-Flores, 9/13).

Politico: Obamacare D-Day Becomes A Soft Launch
For months all eyes have been on October 1 -; the first day people can sign up for Obamacare. But as that day approaches, many people working on the nuts and bolts of the health law are tamping down any expectations of a sign-up stampede. Not everyone will enroll immediately. And that, they say, is the way they want it (Haberkorn, 9/14).

The Tennessean/USA Today: Health Law Offers Quandary For Youths
Whether he and millions of other young people buy coverage is crucial for the federal health law to reach the goal of making insurance affordable. Their participation is needed to offset the cost of guaranteed coverage for older people with pre-existing conditions. But with barely more than two weeks before enrollment begins on a newly created exchange for the uninsured, most young people know little or nothing about what's at stake for them, according to polls and surveys (Wilemon, 9/15).

Los Angeles Times: Insurers Limiting Doctors, Hospitals In Health Insurance Market
The doctor can't see you now. Consumers may hear that a lot more often after getting health insurance under President Obama's Affordable Care Act. To hold down premiums, major insurers in California have sharply limited the number of doctors and hospitals available to patients in the state's new health insurance market opening Oct. 1 (Terhune, 9/14).

The Washington Post: If Elected, Mcauliffe Faces Showdown With Va. House Republicans Over Obamacare
Terry McAuliffe has made Medicaid expansion central to his bid for governor, saying it would provide health insurance to 400,000 needy Virginians, create thousands of jobs and provide the state with a $2 billion a year windfall. Some Republicans say his push to expand the health-care program could lead to something less appealing: a government shutdown. "I will not sign a budget in Virginia unless it includes the Medicaid expansion," McAuliffe said this summer in an interview with AARP. ... Given overwhelming opposition to expansion in the GOP-dominated House of Delegates, that campaign promise amounts to a threat to hold the state budget hostage to McAuliffe's Medicaid goal, some Republicans say (Vozzella, 9/14).

NPR: Calling Obesity A Disease May Make It Easier To Get Help
Under the Affordable Care Act, more insurance plans are expected to start covering the cost of obesity treatments, including counseling on diet and exercise as well as medications and surgery. These are treatments that most insurance companies don't cover now. This move is a response to the increasing number of health advocates and medical groups that say obesity should be classified as a disease (Neighmond, 9/16).

The New York Times: On Campus, A Faculty Uprising Over Personal Data
Improving health while holding down health care costs is the kind of having-your-cake-and-eating-it combination that most people can get behind. In fact, both ideas are embedded in the Obama administration's Affordable Care Act. But an uprising among faculty members at Pennsylvania State University over a new employee wellness plan is challenging at least some of the methods designed to achieve those aims (Singer, 9/14).

Politico: Price, Van Hollen Spar Over Obamacare
Reps. Tom Price and Chris Van Hollen tore into each other on "Fox News Sunday" when asked whether stopping Obamacare implementation was worth shutting down the government. Price, a Republican from Georgia, when asked whether he supported a shutdown to stop the implementation of Obamacare, demurred twice, changing course from an earlier Fox interview in which he said that he would. Instead, he pointed to a proposal to delay the law's implementation for a year (Drusch, 9/15).

The Washington Post: Club For Growth Takes Aim At Obamacare As It Continues To Take On GOP From The Right
Now the [Club for Growth] is advocating disruption on a grander scale, urging Republicans to wage what some in the party are calling a suicidal campaign to shut down the government unless President Obama agrees to defund his signature health initiative. Last week, Boehner (R-Ohio) cancelled another vote -; this time on a plan to keep the government open past Sept. 30 -; after the Club and other outside groups complained that it failed to undermine Obamacare. "Every Republican ran on defunding or repealing Obamacare. This is a test of whether they're actually going to do what they say they're for," said Club President Chris Chocola, a former congressman from Indiana. "What's the more radical thing to do: Continue to spend more and borrow more from China? Or have the confrontation? It's never going to get any easier" (Montgomery, 9/14).

NPR: Getting Personal With Your Health Insurance Exchange Questions
With the launch of new health insurance exchanges just about two weeks away, many of the questions in this month's mailbag focused less on the big picture and more on exactly how the law will operate for individuals. We can't answer every question we get. But here is a sampling of questions that were really popular, or that would apply to a lot of people (Rovner, 9/16).

The Wall Street Journal: U.S. Faces Long-Term Care Crisis, Report Says
The U.S. is facing a long-term-care crisis and needs to do a better job of preparing for it, a new congressional report says. Government agencies should work quickly to better harness public and private resources to best provide and pay for long-term care as 78 million baby boomers, born from 1946 to 1964, head into old age at the same time many of their parents are living into their 80s and 90s, according to the federal Commission on Long-Term Care, which released a series of recommendations Friday for dealing with the problem (Greene, 9/13).

Politico: Rift Exposed Over Long-Term Care Proposals
Democrats picked to serve on a special long-term care commission organized by Congress in the aftermath of Obamacare's discarded CLASS Act mostly rejected the panel's recommendations -; arguing that the commission failed to consider the key question of how to finance long-term care for an aging population. The special commission issued recommendations Friday for tackling the persistent policy challenge of reforming long-term care. The recommendations were approved, 9-6, but five of the nine Democratic appointees voted against the commission's final recommendations (Millman, 9/16).

The New York Times: In State Records, Little Evidence To Back Stricter Abortion Law
In their successful push this summer for strict new regulations on abortion facilities and the doctors performing them, proponents said the legislation was needed because conditions at existing facilities made it unsafe for women seeking to terminate pregnancies. But a Texas Tribune review of state inspection records for 36 abortion clinics from the year preceding the lawmakers' vote turned up little evidence to suggest that the facilities were putting patients in imminent danger. State auditors identified 19 regulatory violations that they said presented a risk to patient safety at six licensed abortion clinics that are not ambulatory surgical centers in Texas. None of the violations was severe enough to warrant financial penalties, according to the Department of State Health Services, which deemed the facilities' corrective action plans sufficient to protect patients (Aaronson, 9/14).

The Wall Street Journal: When To Consider In-Home Care
Nine out of 10 Americans say they want to grow old at home and keep living in their communities as long as possible, according to AARP. Home-health providers are rushing in to meet the demand. But there are things to consider when looking into care at home-;including the number of limitations a person is struggling with, whether they have supports in the community and whether the home itself is suitable. New advances in home care are allowing more people to remain in their homes because of telehealth and apps designed to keep track of an elder person's medication compliance and comings and goings, says Steve Landers, chief executive of VNA Health Group, which provides home-health services. Meanwhile, there are different types of at-home options to draw on. Maybe you need to see a doctor or nurse regularly, and these professionals do pay house calls. Personal-care assistants can help with nonmedical tasks like bathing. Assistance shopping, cooking or cleaning are also options (Forman, 9/15).

The New York Times: Fraud Investigation Unsettles Mental Health Care In New Mexico
For weeks now, New Mexico has been in the midst of a sweeping criminal investigation into 15 of its largest mental health providers, suspected of defrauding Medicaid of $36 million over three years. Arizona companies have been hired to fill in, but many patients are struggling without regular treatment. The state behavioral health system is in turmoil, with the administration of Gov. Susana Martinez under sharp attack (Frosch, 9/13).

Los Angeles Times: Bills Would Give State New Powers To Fight Prescription Drug Abuse
Last week, state lawmakers passed an ambitious slate of reforms aimed at giving authorities better tools and broader powers to crack down on doctors who recklessly prescribe narcotic painkillers and other commonly abused drugs. The three bills, which garnered strong bipartisan support, await a signature from Gov. Jerry Brown that would make them law (Glover and Girion, 9/15).

The Associated Press/Wall Street Journal: NY Building Low-Cost Housing Under Medicaid
New York plans to create low-income housing for 5,000 Medicaid recipients with significant health care needs. The housing units are planned for Manhattan and the Bronx; Monroe, Broome and Erie counties; and in the Finger Lakes Region as well as in Long Island's Suffolk County (9/15).