States' refusal to expand Medicaid will prevent millions from getting coverage

The New York Times reports that the decision by about half the states to not expand Medicaid coverage will prevent two-thirds of poor black consumers and single mothers and more than half of low-wage workers from getting insurance.

The New York Times: Millions Of Poor Are Left Uncovered By Health Law
A sweeping national effort to extend health coverage to millions of Americans will leave out two-thirds of the poor blacks and single mothers and more than half of the low-wage workers who do not have insurance, the very kinds of people that the program was intended to help, according to an analysis of census data by The New York Times. Because they live in states largely controlled by Republicans that have declined to participate in a vast expansion of Medicaid, the medical insurance program for the poor, they are among the eight million Americans who are impoverished, uninsured and ineligible for help (Tavernise and Gebeloff, 10/2).

The New York Times: Despite Criticisms, Health Care Law's Impact On Jobs Is Still Unclear
To Speaker John A. Boehner, it is "job-killing." To Senator Ted Cruz, it is "hurting the American people." To Senator Mitch McConnell, it is a "big reason we are turning into a nation of part-time workers." But to many independent economic analysts, it remains too early to tell how the sweeping Affordable Care Act will affect the jobs market (Lowrey and Harwood, 10/2).

In other news about the policy effects of the law --

The Wall Street Journal's Washington Wire: U.S. Citizens Abroad Avoid Health-Law Mandate
The Affordable Care Act requires most Americans to carry health insurance or pay a tax penalty–and there's a reason we say "most" rather than "all." Americans who live abroad at least 330 days of the year will be treated as if they have qualifying insurance coverage and won't owe any tax penalty, according to the Internal Revenue Service. That's true regardless of whether the U.S. citizen actually has health insurance in the country where he or she lives (Schatz, 10/2).

USA Today: Is Health Law Really To Blame For Plan Changes?
A handful of big-name firms and many small ones are making major changes to their health care plans this fall, and while some big companies are blaming the Affordable Care Act, insurance and economic experts call those claims an exaggeration. Making health insurance changes, including big premium and deductible hikes when the rate of increase in health care costs has slowed, creates a "messaging issue," says University of Michigan business economics professor Thomas Buchmueller, "That's not an easy conversation," says Buchmueller. "It's convenient to say, 'the ACA is raising our costs'" (O'Donnell and McGinnis, 10/2).

The New York Times: Conversations: The Landscape Of Small-Business Health Insurance
Five years ago, a start-up called Liazon began offering businesses a new way to provide health insurance to employees. On Liazon's Bright Choices, an online marketplace, a company can specify how much money it wants to spend on each employee's benefits, and employees can use that contribution to buy the plan of their choice (Mandelbaum, 10/2).

The Wall Street Journal's Venture Capital Dispatch: Psilos Partner Sees Opportunity in ObamaCare Exchanges
The state and federal health-insurance exchanges central to ObamaCare have been getting a bad rap this week, as millions of consumers flocking to websites have caused crashes and delays. But when the dust settles, the exchanges will present opportunities for businesses to save money, for entrepreneurs to develop new technologies and for investors to reap returns, said venture capitalist Lisa Suennen, whose firm Psilos Group has made a number of investments over the years in startups that do business with or alongside the insurance industry (Hay, 10/2).

USA Today: Some Physicians Still Charge Co-Payments Banned By Law
Some doctors' offices are still charging patients co-payments for preventive exams, such as annual physicals and well-baby checkups, even though the Affordable Care Act prohibits the practice (Kennedy, 10/3).

CNN: Fact Check – Premiums Will Go Up
On CNN's Crossfire Tuesday night, Senator Tom Coburn (R-Okla.) took issue with the context in which new health insurance premiums under Obamacare are being described. The presentation of states' new premium data has been all over the map (pardon the pun). States whose leaders are opposed to the ACA have presented their data in a way that makes new premiums look overly burdensome to consumers. Democratic governors in favor of the ACA have presented their state's premiums in a way that makes them sound like a great benefit to consumers. The Department of Health and Human Services has chosen to use the nonpartisan Congressional Budget Office's and the Kaiser Family Foundation's predictions that, as Coburn notes, project that the premiums will be less costly than previously estimated. But that doesn't help compare new plans to ones available before the health care law took effect. So where's the truth? (10/2).

CNN: Doctor Shortage, Increased Demand Could Crash Health Care System
Dr. Ryan A. Stanton is worried that this coming flood of newly insured patients may crash the U.S. health care system as well. Stanton works at the emergency room at the busy Georgetown Community Hospital right outside of Lexington, Kentucky. While he sees trauma cases often, a good number of the patients he sees don't involve trauma. They're the uninsured who can't afford to pay for a regular doctor's visit -- so they use the emergency room instead. "People turn to the ER because they have no other place to go after hours or they don't have access to a level of appropriate primary care," Stanton said. "The ER has become the safety net of our health care system. We can't turn anyone away like a doctor's office could. ... I worry though with (Obamacare) this will significantly increase patient volume" (Christensen, 10/2).

Fox News: Obamacare Reg On Digital Patient Records Raises Security Concerns
A provision in ObamaCare requiring medical providers to switch from paper patient charts to electronic records is intended to reduce costs and improve care. But privacy advocates fear the transition is too fast for security measures to keep pace.  "The thing I worry about is not that we are doing it, but that we're doing it without the right safeguards," said Lee Tien, a senior staff attorney with the Electronic Frontier Foundation. "We have been giving (medical providers) incentives to move into the electronic-health-records era. But we haven't been giving them enough guidance on how they're supposed to do it" (Serrie, 10/2).

Martketplace: Obamacare Costs Jobs: Insurance Brokers
Like it or not, buying health insurance online is the future. And while that may be convenient consumers, it's not such great news for the more than 100,000 insurance agents and brokers who depend on commissions for a living. As the curtain comes up on the new health exchanges, Virginia-based insurance broker Jonathan Katz reports business has been hopping. "In the last two days, I've received over 40 calls and 50 emails a day," he says. "Current clients asking 'what are we going to do with my current plan? What's my situation?'" Katz knows that questions and sales aren't the same thing. And with millions of new customers shopping for insurance under Obamacare, a lot of future sales are going to happen on line without a broker (Gorenstein, 10/2).

CQ HealthBeat: Health Law's Impact On Part-Time Work Murky
Perhaps one of the sharpest attacks on the health law is that it's causing a big shift to part time work. But is that really true? A survey released Wednesday by the Mercer consulting firm lends credence to the charge. It says 11 percent of large employers next year are considering cutting back hours for at least part of their work force. They're taking that step to avoid triggering the overhaul's requirement that they provide health benefits to employees who work 30 or more hours per week (Reichard, 10/2).

CQ HealthBeat: Conservative Study Highlights High Exchange Premiums For The Young
A conservative think tank is questioning whether the very group of Americans that the Obama Administration needs to sign up for insurance coverage in the health law marketplaces - the so-called young invincibles - will actually enroll because premiums for that group are so much higher than they now pay (Bunis, 10/3).