First Edition: January 3, 2014

Today's headlines include coverage of a new study examining how Oregon's ER usage increased after expanding Medicaid.

Kaiser Health News: Obamacare Comes To Skid Row
Kaiser Health News staff writer Sarah Varney, working in collaboration with NPR, reports: "If you were led blindfolded from Los Angeles' grand city hall a few blocks east, you would know when you entered Skid Row. There is the pungent smell of urine and burning marijuana smoke, and the sound of music and easy laughter. A carnival rising out of misery. This is the chaos that Chris Mack plunges into on most days. Once homeless himself, Mack is an outreach worker for the JWCH Institute's Center for Community Health, a free clinic that sits at the heart of Skid Row" (Varney, 1/2). Read the story. 

Kaiser Health News: Many Spanish Speakers Left Behind In First Wave Of Obamacare
Kaiser Health News staff writer Daniela Hernandez reports: "In Silicon Valley, the executives and engineers who've helped build the Apple, Google and Facebook empires earn high salaries and enjoy a slew of perks, including stellar health benefits. The clients of the Ravenswood Family Health Center, a community clinic in East Palo Alto just two miles away from Facebook's sprawling headquarters, live in a very different Silicon Valley. They're the gardeners, nannies, factory workers and service staff who keep Silicon Valley homes and offices humming, the lawns manicured and the families comfortable" (Hernandez, 1/3). Read the story. 

Kaiser Health News: A Reader Asks: If I Don't Use All My Subsidy Credit, Will I Get It When I Do My Taxes?
Kaiser Health News consumer columnist Michelle Andrews answers this question from a reader (1/3). Read her response. 

Kaiser Health News: Six Things That May Move Public Perception Of Obamacare
Kaiser Health News staff writer Phil Galewitz reports: "Now, though, most of its major provisions are in effect, and arguments may hinge less on ideology and more on how the law is actually working for millions of people – for instance, how many get coverage through online marketplaces; whether they're able to see doctors when they need them; how they rate that care; and perhaps most important, whether having that coverage improves their lives in tangible ways. … No question that partisans on both sides will keep spinning, especially in the run-up to the 2014 midterm elections. To help make sense of the challenges ahead, here are six things that are likely to be important measuring sticks of the law in 2014 and beyond" (Galewitz, 1/3). Read the story. 

Kaiser Health News: Capsules: Missouri Governor Pushes GOP-Led Legislature On Medicaid Expansion; 
Now on Kaiser Health News' blog, the St. Louis Post-Disptach's Virginia Young, working in partnership with KHN, reports on Missouri's Medicaid expansion: "Missouri Gov. Jay Nixon, a Democrat, is intensifying his effort to persuade Republican lawmakers to expand Medicaid with a pitch that uses some of the same themes that Republicans favor. At a news conference in his Capitol office this week, Nixon praised states such as Iowa and Arkansas for designing "common-sense, market-based approaches" that encourage personal responsibility on the part of Medicaid participants" (Young, 1/2).

Also on Capsules, Oregon Public Broadcasting's Kristian Foden-Vencil reports on how one health plan is working with elementary schools to encourage good health: "Behaving well in elementary school could reduce smoking in later life. At least, that's what Trillium Community Health Plan hopes, and it's putting money behind the idea. Danebo Elementary in Eugene, Ore., is one of 50 schools receiving money to teach classes while integrating something called the "Good Behavior Game." Teacher Cami Railey sits at a small table, surrounded by four kids. She's about to teach them the "s" sound and the "a" sound. But first, as she does every day, she goes over the rules" (Foden-Vencil, 1/2). Check out what else is on the blog.  

The Wall Street Journal: Consumers Hit Snags As Health Law Kicks In
Consumers began test-driving insurance coverage under the federal health-care law Thursday, seeking care at pharmacies and clinics, and in some cases running into hiccups as their policies took effect. Doctors' offices, hospitals and pharmacies said they saw a limited number of people with the new insurance, which kicked in at the beginning of the year (Mathews, Martin and Weaver, 1/2).

Politico: Quiet Start To Noisy Health Law
For a law that's inspired a lot of noise, the start of Obamacare coverage has been quiet. The health care industry is still trying to diagnose the depth of any implementation issues with the president's health care program since coverage took effect Jan. 1. Providers, insurers and patient advocates say it's too early to know whether people are rushing to get care or running into problems when they try to use their new insurance for the first time (Millman, 1/2) .

The Washington Post's The Fact Checker: The White House's Claim That 7 Million Enrolled In Obamacare 'Was Never Our Target Number'
The White House this week crowed about the fact that, as of the end of the year, 2.1 million Americans have signed up for insurance either through the federal health care exchange or state-run exchanges. The message was that the Affordable Care Act Web site, which had a troubled launch, was turning a corner. At the same time, the administration has backed away from the idea that it suggested that it had a "target" of 7 million enrollees when the enrollment period for 2014 ends in March. As Schiliro put it, "that was never our target number." Let's explore this figure and the administration's enrollment claims (Kessler, 1/3). 

The New York Times: New Ad Campaign Criticizes Senators For Support Of Health Law
A conservative advocacy group backed by the billionaire Koch brothers said Thursday it will spend $2.5 million on television advertisements targeting three vulnerable Democratic senators who supported President Obama's health care law. Americans for Prosperity, which last year spent more than $16 million on television ads attacking the law popularly called "Obamacare," is running the ads against Senators Kay Hagan of North Carolina, Mary L. Landrieu of Louisiana and Jeanne Shaheen of New Hampshire, all Democrats who face tough re-election fights this year. They will air on cable and broadcast networks in the three states (Stolberg, 1/2). 

Politico: Americans For Prosperity Launches Obamacare Blitz
The deep-pocketed Americans for Prosperity on Thursday morning unveiled a major Obamacare air offensive against three Democratic senators up for reelection in November. The group will begin airing 30-second ads this week targeting Sens. Mary Landrieu of Louisiana, Kay Hagan of North Carolina and Jeanne Shaheen of New Hampshire. The total ad buy is north of $2.5 million and the spots will run for three weeks in each state's major media markets, AFP said (Everett, 1/2). 

Los Angeles Times: Next Phase Of The Obamacare Battle: Dueling Personal Stories
Those sorts of dueling stories are the next phase of the battle over Obamacare, and the question of which version Americans will find most compelling could tip the balance in a dozen or so Senate races this year that will determine the balance of power in Washington (Reston, 1/2).

Politico: Eric Cantor Plans Vote On Obamacare
House Majority Leader Eric Cantor said Thursday that he plans to schedule a vote next week on a measure placing more security requirements on the new Obamacare insurance exchanges. He said he'll draw from legislation that's been introduced by Reps. Diane Black of Tennessee, Kerry Bentivolio of Michigan and Gus Bilirakis of Florida (Cunningham, 1/2). 

NPR: Medicaid Expansion Boosted Emergency Room Visits In Oregon
Giving poor people health insurance, the belief was, would decrease their dependence on hospital emergency rooms by providing them access to more appropriate, lower-cost primary care. But a study published in the journal Science on Thursday finds that's not the case. When you give people Medicaid, it seems they use both more primary care and more emergency room services (Rovner, 1/2). 

Los Angeles Times: Expanding Medicaid Increases ER Visits In Oregon Study
An Oregon Medicaid expansion program found that low-income adults who were covered by government health insurance had visited  hospital emergency rooms 40% more often than other adults. The study, published online Thursday in the journal Science, comes at a time when many states are expanding Medicaid as part of the Affordable Care Act, or Obamacare. While federal and state policymakers have argued that expanding Medicaid would reduce costly and inefficient use of hospital emergency rooms by increasing access to primary healthcare, the Science study suggests this is not the case (Morin, 1/2).

The New York Times: Emergency Visits Seen Increasing With Health Law
Supporters of President Obama's health care law had predicted that expanding insurance coverage for the poor would reduce costly emergency room visits because people would go to primary care doctors instead. But a rigorous new experiment in Oregon has raised questions about that assumption, finding that newly insured people actually went to the emergency room a good deal more often (Tavernise, 1/2).

The Washington Post's Wonkblog: Study: Expanding Medicaid Doesn't Reduce ER Trips. It Increases Them. 
As the health-care law expands Medicaid to cover millions more Americans, a new Harvard University study finds that enrollment in public program significantly increases enrollees' use of emergency departments. The research, published Thursday in the journal Science, showed a 40 percent increase in emergency department visits among those low-income adults in Oregon who gained Medicaid coverage in 2008 through a state lottery. This runs counter to some health-care law supporters' hope that Medicaid coverage would decrease this type of costly medical care, by making it easier for low income adults to see primary care providers (Kliff, 1/2). 

The Wall Street Journal: Putting The Uninsured On Medicaid Doesn't Cut ER Visits
Some supporters of President Barack Obama's health-care overhaul say that putting uninsured Americans on Medicaid will reduce costly emergency-room visits by giving them more access to care in other settings. But a new study found the reverse: A group of 10,000 low-income Oregon residents who recently obtained Medicaid coverage visited ERs 40% more often than those without insurance (Beck, 1/2).

Los Angeles Times: Compromise Remains Elusive On Health Law's Contraceptive Coverage
The intensifying Supreme Court clash over whether birth control should be required under President Obama's signature healthcare law has revealed just how deep divisions remain between administration officials and Catholic leaders over where to draw the line between religious freedom and women's reproductive rights (Savage and Levey, 1/2). 

The Washington Post: D.C. Program Reflects National Trend Toward Moving Older Americans Out Of Nursing Homes
For 60 years, Bobbie Jones, 88, had lived in the same Petworth rowhouse where she raised four children -; including one born in an upstairs bedroom -; and became a grandmother to 10 and a great-grandmother to nine. But last year, a stroke and a fall landed her in the hospital and then in a nursing home. In the past, a nursing home might have wound up being where she lived out the rest of her days. But through a new program that helps District residents receive care in their homes and communities, Jones was able to go home. She is among 58 people who have been relocated since the D.C. Office on Aging launched its Nursing Home Transition Program in April (Bahrampour, 1/2).