First Edition: May 2, 2014

May 2 2014

Today's headlines include coverage of the latest round of health insurance enrollment data released by the Obama administration.  

Kaiser Health News: Telemedicine Policy Draws Opposition From Patient Advocates, Health Care Providers
Kaiser Health News staff writer Lisa Gillespie reports: "New guidelines issued by the Federation of State Medical Boards could have a chilling effect on the growth of telemedicine – especially in rural areas and among low-income patients, say some patient advocates, health care providers and health care companies. But the federation says the updated guidance will safeguard patients' privacy and ensure high-quality care in the current fast-changing health care delivery environment" (Gillespie, 5/2). Read the story.

Kaiser Health News: Capsules: Healthcare.gov Finished Strong Despite Rocky Start, Enrollment Data Show; Doctors Think Others Often Prescribe Unnecessary Care
Now on Kaiser Health News' blog, Phil Galewitz reports on new enrollment data: "Obama administration officials on Thursday predicted health insurance premiums would be stable next year despite concerns that not enough young and healthy people signed up through the online insurance exchanges" (Galewitz, 5/1). 

Also on the blog, Jordan Rau reports on physicians' thoughts about their colleagues and unnecessary care: "Three out of four physicians believe that fellow doctors prescribe an unnecessary test or procedure at least once a week, a survey released Thursday finds. The most frequent reasons that physicians order extraneous-;and costly-;medical care are fears of being sued, impulses to be extra careful and desires to reassure their own assessments of the patient, the survey said" (Rau, 5/1). Checkout what else is on the blog.

The New York Times: A Late Rush To Sign Up For Insurance
The number of people signing up for health insurance through the federal marketplace soared in March, exceeding the number who signed up in the previous five months, the Obama administration said Thursday in its final report on enrollment under the new health care law. The report, for the first time, provided information about the racial and ethnic backgrounds of those signing up. Of the 3.8 million people in the federal exchange who voluntarily disclosed such information, 63 percent were white, 17 percent were black, 11 percent were Hispanic and 8 percent were Asian, officials said (Pear, 5/1).

Los Angeles Times: State-By-State Differences In Obamacare Enrollment Could Affect Rates
Sign-ups for insurance through President Obama's health law varied widely across the country in the first year for the online marketplaces, according to a government report released Thursday that shows consumers flocked to coverage in some states but not in others. These differences could exacerbate regional variations in premiums next year, with potentially steep rate increases for people in states with low enrollment (Levey, 5/1).

NPR: Obamacare Sign-Ups Show Wide Variation By State, Ethnicity
The total number of people buying plans outside of government exchanges is estimated at somewhere between 5 million and 8 million people. Medicaid also saw a surge in enrollment during the last six months, as 27 states expanded the program (as the ACA encourages). About 4.8 million people signed up for benefits via Medicaid or the Children's Health Insurance Program. About 85 percent of all those who signed up via the exchanges received federal subsidies of their monthly premiums (Whitney, 5/1). 

The Wall Street Journal: Obama Administration Says 28% Of Health-Law Enrollees Are 18 To 34 Years Old
The data, released Thursday by the Obama administration, painted a more complete picture of enrollment in the plans. They show that about 28% of people picking plans on the state and federal insurance exchanges by April 19-;after most states' enrollment deadlines passed-;were 18 to 34 years old, a generally healthy group. The proportion is higher than previous counts. But it is significantly below the 40% level that some analysts consider important for holding down rates by balancing the greater medical spending generated by older enrollees (Radnofsky and Mathews, 5/1). 

The Washington Post: States That Didn't Set Up Marketplaces See Surge In Health Plan Enrollment, Figures Show
A last-minute deluge of health insurance sign-ups came from states where political leaders have opposed the Obama administration's health-care law, according to federal figures released Thursday. In March and April, the number of people enrolling in plans more than doubled in the 36 states that chose not to set up their own marketplaces, the figures show. Most of these states deferred to the federal marketplace, HealthCare.gov, in a show of resistance to the program (Somashekhar and Keating, 5/1). 

The Associated Press: Health Law: 8 Million Chose New Plan Under Law
Still, strong state-by-state performance indicates that the health care law is making inroads around the country, even as Republicans insist repealing "Obamacare" will be a winning issue in the fall congressional elections. An Associated Press analysis of the government numbers found that 31 states met or exceeded enrollment targets set by the administration before the insurance exchanges opened. Twenty of those are led by Republican governors, many of whom were hostile to the program (5/1). 

Politico: Report: Obamacare Sign-Ups Cross 8 Million
About 13 million people got coverage under Obamacare during the first open enrollment season of the Affordable Care Act, enough for administration officials to be confident that every state's insurance market will be stable going into 2015. … The report said 8 million had signed up in the state and federal exchanges, and that Medicaid and Children's Health Insurance Program enrollment had grown by at least 4.8 million since October. Many were newly insured (Cheney and Haberkorn, 5/2). 

USA Today: Silver Plans By Far The Most Popular Insurance Option
The type of plans selected by those choosing private insurance, as well as the new customers' demographics, were key parts of the latest HHS report, which covers the entire open-enrollment period for the law. Silver plans cover 70% of health costs, leaving the consumer responsible for the rest. Consumers could choose from bronze, silver, gold or platinum plans, with platinum plans having the highest premium and the lowest out-of-pocket costs for the consumer. About 20% chose bronze, 9% chose gold, 5% chose platinum. Two percent a bare-bones catastrophic care plan. All plans include no out-of-pocket costs for preventive exams, such as yearly physicals or women's annual cancer screenings (Kennedy, 5/1). 

The Washington Post's Wonkblog: Obamacare's Hispanic Enrollment Is Low, New HHS Report Shows
Hispanics, a key demographic for the Affordable Care Act, did not appear to sign up for health insurance through the law's marketplaces at the rate the Obama administration had hoped, according to new government data. The enrollment report from the Department of Health and Human Services, the first national data on the ethnicity of Obamacare enrollees, and sheds new light on the health-care law's efforts to reduce uninsured rates among minority populations who disproportionately lack health coverage (Millman and Somashekhar, 5/1). 

The Associated Press: Maryland Falls Short Of Insurance Enrollment Goal
Newly released figures show that Maryland fell far short of projections enrolling residents for private insurance through its troubled health exchange, even as national enrollment figures exceed expectations. Numbers released Thursday by the U.S. Department of Health & Human Services show that, through April 19, 67,757 Marylanders have signed up for private insurance under the Affordable Care Act. Last year, federal officials had projected that 150,000 Marylanders would enroll (5/1).

The Associated Press: About 216K In Va. Sign Up Under Health Overhaul
The federal data shows that many Virginia residents who have obtained coverage are older, though about 39 percent are under age 35. More than half are women, and 82 percent are getting financial help to pay their monthly premiums (5/1).

The Associated Press: Data Show Most In NY Health Exchange Get Subsidies
A federal report shows nearly three-fourths of those insured through New York's new health exchange are getting financial assistance. Applicants with incomes up to 400 percent of the federal poverty line are eligible for tax credits to help offset premium payments (5/1). 

Los Angeles Times: Medi-Cal Backlog Hits 900,000 As computer Problems Persist
Around 900,000 Medi-Cal applicants statewide -- 300,000 of them in Los Angeles County -- are still awaiting final processing of their applications, state and local officials said Wednesday. The state backlog grew by 100,000 during the month of April, as new applications for the state's healthcare program for the poor continued pouring in and stubborn problems with computer systems persisted (Brown, 5/1). 

The Washington Post: McAuliffe Explores Whether He Can Expand Medicaid Coverage Without Legislature's Okay
Virginia Gov. Terry McAuliffe is considering expanding health coverage for the poor without the approval of the state legislature, a move that would muscle his top priority past Republican opponents but also throw his young administration into a partisan firestorm and uncertain legal territory (Vozzella, 5/1). 

The Wall Street Journal's CIO Journal: Xerox CIO Fixing Nevada Health Exchange, As Tough Decisions Loom
Xerox Corp. CIO Stephen Little is working with the state of Nevada as it tries to fix its technically-troubled state health exchange. Xerox, which has a $75 million contract with the state to build Nevada Health Link, dispatched Mr. Little and 250 engineers to Nevada in February to address more than 1,500 site defects (Boulton, 5/1). 

The New York Times: Patients Fear Mt. Sinai Will Drop Low-Cost Insurance Plans
Beth and Mr. Shuster appear to be among a number of people whose low-cost insurance plans are being dropped by Mount Sinai doctors. Patients said the changes were especially upsetting because the open enrollment period for insurance has passed, and federal law does not allow them to switch plans as a way of keeping their doctors. It was not clear on Thursday whether the changes were limited to a few doctors or part of a movement by a major institution to squeeze out low-paying plans under the Affordable Care Act or force higher reimbursement rates (Hartocollis, 5/1). 

The Wall Street Journal: Cigna Profit Surges On Improved Group Disability, Life Operations
Cigna also pointed to "effective medical management" in its employer and Medicare Advantage businesses. The company said it was continuing to expand its efforts to work closely with medical providers in financial arrangements that aim to rein in expenses and improve care. The insurer also said it expected to have around 290,000 enrollees in individual insurance at the end of 2014, with approximately 69,600 of those coming through government marketplaces. Cigna said it was seeing signs of higher-than-expected medical costs in its individual business, including health law-compliant plans sold through government marketplaces and outside (Mathews and Calia, 5/1). 

The Wall Street Journal: AstraZeneca Rejects Pfizer Bid
AstraZeneca on Friday rejected an improved takeover offer from Pfizer Inc. worth more than $106 billion, saying the proposal substantially undervalued the company. The British company said the financial and other terms described in the U.S. group's latest proposal were inadequate and not a basis on which to engage in talks (Plumridge, Rockoff and Cimilluca, 5/2). 

USA Today: Astra Zeneca Rejects Pfizer's Sweetened $106B Bid
British drug maker AstraZeneca rejected a sweetened offer from New York-based rival Pfizer, the firm said Friday. The new offer, which came in the wake of an earlier bid rejection by Britain's second-largest pharmaceutical firm, valued AstraZeneca at 50 pounds a share ($84.47) or $106 billion (Hjelmgaard, 5/2). 

The Texas Tribune/New York Times: Faulted In Medicaid Fraud, Company Keeps Contract
For nearly five years, a state contractor allowed workers with limited expertise to approve dental claims for Texas' Medicaid program, the joint state-federal insurer. State spending on orthodontic services spiraled out of control; by 2012, federal and state auditors found that the contractor's actions had opened the door for a "massive Medicaid fraud scheme" that cost taxpayers hundreds of millions of dollars (Aaronson, 5/1). 

Los Angeles Times: Seattle Mayor Proposes $15 Minimum Wage
A day after Republicans in the U.S. Senate quashed an effort to raise the federal minimum wage to $10.10 an hour, Seattle Mayor Ed Murray announced a proposal Thursday for a $15 municipal minimum wage that he said would "improve the lives of workers who can barely afford to live" in this high-tech city on Puget Sound. Declaring it a "historic" day for progressives seeking to address the issue of income inequality, Murray laid out his complex and controversial proposal, which would be phased in over several years at different rates for large and small businesses. At least initially, income from tips and employer-provided health insurance would be taken into account (LaGanga, 5/1).

The Associated Press: Lawmaker: Debt May Sink Some Health Care Providers
A New York lawmaker says thousands of health care providers could be without jobs if the state Workers Compensation Board doesn't step in to help with problems stemming from a 2009 bankruptcy. Queens Sen. Tony Avella, chair of the social services committee, is asking the board on Thursday for a six-month extension for companies that employ the workers to come up with a way to pay $188 million in debt from the Health Care Providers Self Insurance Trust bankruptcy (5/1).