First Edition: May 6, 2014

May 6 2014

Today's headlines include news from Massachusetts that the state is scrapping efforts to fix its troubled health exchange and will start over -- from scratch.  

Kaiser Health News: Insuring Your Health: Health Law Requires Medicare To Cover Dementia Evaluation
Kaiser Health News consumer columnist Michelle Andrews writes: "For the millions of seniors who worry that losing their keys may mean they're losing their minds, the health law now requires Medicare to cover a screening for cognitive impairment during an annual wellness visit. But in a recent review of the scientific research, an influential group said there wasn't enough evidence to recommend dementia screening for asymptomatic people over age 65. What's a worried senior to think?" (Andrews, 5/6). Read the column.

Kaiser Health News: Capsules: More Insurance Equals Fewer Deaths In Massachusetts; Colorado Redraws Map To Cut Sky-High Ski Town Rates; Hospitals' Purchase Of Doctors Leads To Higher Prices, Spending, Study Finds; Study: Illegal Immigration Doesn't Cause Overuse Of Health Care
Now on Kaiser Health News' blog, WBUR's Martha Bebinger reports on how coverage rates have impacted Massachusetts' death rate: "Fewer people died in Massachusetts after the state required people to have health insurance, according to researchers from the Harvard School of Public Health. In each of the first four years of the state law, 320 fewer Massachusetts men and women died than would have been expected. That's one life extended for every 830 newly insured residents" (Bebinger, 5/6). 

In addition, Eric Whitney reports on Colorado's attempt to redraw the insurance rate map: "Relief is in sight – and it won't involve a lawsuit – for the four counties in Colorado that have the highest Obamacare health insurance premiums in the country. Local officials in the ski resort region in the mountains west of Denver had threatened to sue over the high rates. But on Friday Colorado Insurance Commissioner Marguerite Salazar said she wants to redraw those boundaries, making the resort counties part of a much larger 22-county pool" (Whitney, 5/5). 

Phil Galewitz writes about a new study showing that hospitals purchase of doctors' practices leads to higher prices: "The study, published Monday in the journal Health Affairs, was based on an analysis of 2.1 million hospital claims from workers of self-insured employers between 2001 and 2007. The analysis by Stanford University researchers found prices were most likely to increase when hospitals bought physician practices, as opposed to hospitals forming looser contractual relationships with physicians" (Galewitz, 5/5). 

Also on Capsules, Marissa Evans reports on the relationship between illegal immigration and the overuse of care: "Even before the Affordable Care Act was close to passing, it was clear that immigrants illegally living in the country would not be part of many of the law's benefits. They are not allowed to buy health insurance from the online marketplaces, at least in part because opponents argued that these immigrants overburden emergency rooms and hospitals. But a study released Monday finds that they're less likely to use health services than U.S. citizens and other immigrants here legally" (Evans, 5/5). Check out what else is on the blog.

The Washington Post's Wonkblog: Health Care's $85 Billion Challenge – Uncompensated Care In The Obamacare Age
A Monday morning survey showed a steady decrease in the uninsured rate since Obamacare's insurance marketplaces opened, but tens of millions will remain uninsured. And a separate study Monday showed just how much it could cost to care for them. Health-care providers faced $74.9 billion to $84.9 billion in care costs for the uninsured and people who struggled to pay their medical bills, according to new estimates published in the journal Health Affairs. Using the lower of the two estimates, Urban Institute researchers calculated that hospitals provided $44.6 billion of the uncompensated care, publicly supported community providers delivered $19.8 billion, and office-based physicians provided about $10.8 billion (Millman, 5/5).

The New York Times: Massachusetts Starts Over On Health Website After Troubles
Massachusetts will stop trying to fix its deeply flawed health insurance website and instead buy new software to help its residents enroll in coverage, officials there said Monday. But the state will also prepare to join the federal insurance marketplace by the next enrollment period, which starts in November, in case the new system is not working in time (Goodnough, 5/5).

The Wall Street Journal: Massachusetts Scraps Its Health Insurance Exchange
Massachusetts health officials said Monday they are scrapping the state's problem-plagued insurance exchange in favor of a private company's version used in other states, while considering connecting to the federal site as a backup. Massachusetts already has comprehensive health coverage, thanks to a 2006 state law. But overhauling the state's online exchange to comply with different rules under the federal health law, passed a few years later, has raised technical challenges (Kamp, 5/5).

Politico: Massachusetts Ditches RomneyCare Health Exchange
RomneyCare's pioneering health insurance exchange is headed for the scrap heap. Bay State officials are taking steps this week to junk central parts of their dysfunctional health insurance exchange -; the model for President Barack Obama's health care law -; and merge with the federal enrollment site HealthCare.gov (Cheney, 5/6).

The Wall Street Journal's Washington Wire: Poll Shows Portion Of Uninsured Drops To 13.4% In April
The percentage of American adults without health insurance dropped to 13.4% in April, polling organization Gallup reported Monday, signaling that the federal health law improved coverage rates during the initial enrollment period. Gallup said 15% of Americans were uninsured in March, and attributed the decline to "the surge in late health insurance sign-ups to meet the official March 31 deadline" (Radnofsky, 5/5).

The Washington Post's Wonkblog: The Uninsured Rate Keeps Falling And Falling, Survey Says
The nation's uninsured rate after Obamacare's first enrollment has dropped to the lowest point in at least six years, according to a new Gallup poll. The 13.4 percent uninsured rate among adults – the lowest since Gallup starting tracking the number in January 2008 – is down from 17.1 percent near the end of 2013 and 15.6 percent at the end of this year's first quarter. The uninsured rate fell 2.2 percent between April and the first quarter of 2014, suggesting that Obamacare's late enrollment surge was driven by people who previously lacked coverage (Millman, 5/5).

Los Angeles Times: Massachusetts Study Suggests Health Insurance Saves Lives
Giving more people health insurance could save tens of thousands of lives nationwide, according to a new analysis of data from Massachusetts, whose reforms became the model for President Obama's health law (Levey, 5/5).

The New York Times: Mortality Drop Seen To Follow '06 Health Law
The study tallied deaths in Massachusetts from 2001 to 2010 and found that the mortality rate -; the number of deaths per 100,000 people -; fell by about 3 percent in the four years after the law went into effect. The decline was steepest in counties with the highest proportions of poor and previously uninsured people. In contrast, the mortality rate in a control group of counties similar to Massachusetts in other states was largely unchanged (Tavernise, 5/5).

The Wall Street Journal: WellCare Earnings Surge On Revenue, Membership Growth
WellCare Health Plans Inc. said first-quarter profit more than doubled as the health insurer posted stronger revenue and increased membership rolls. The company raised its adjusted earnings forecast for the year, now expecting $4.40 to $4.75 a share, from its prior view of $3.75 to $4.05 a share. The increased guidance came mainly from factoring in the company's better-than-expected first quarter results, as well as an improved outlook for the Medicaid Health Plans segment (Rubin, 5/6).

The Wall Street Journal: Tenet Healthcare Loss Narrows, Buoyed By Admissions Trend
Tenet Healthcare Corp. said its first-quarter loss narrowed on stronger revenue that was boosted by its Vanguard Health Systems acquisition. "Aided by our extensive preparations to serve the newly insured patient populations under the Affordable Care Act, we achieved a broadly-based improvement in our admissions trend in the first quarter," said Trevor Fetter, president and chief executive officer. "The strengthening volume trend was particularly pronounced in the states that expanded their Medicaid programs" (Stynes, 5/5).

The New York Times: Profits Off, Pfizer Again Aims To Lure AstraZeneca
As the drug maker Pfizer announced a 15 percent drop in first-quarter earnings on Monday, its chief executive renewed his call for its British rival AstraZeneca to accept Pfizer's offer to buy it. Pfizer has aggressively pursued AstraZeneca since January -; raising its offer to more than $106 billion as recently as Friday -; but so far AstraZeneca has rejected its advances, saying the bids are too low. On Monday during a conference call with analysts, Ian Read, Pfizer's chief executive, described Pfizer as in a "position of strength" (Thomas, 5/5).

USA Today: Germany's Bayer AG To Buy Merck's Consumer Biz For $14.2 Billion
In the latest deal in the pharmaceutical space, Germany-based Bayer AG is acquiring Merck's consumer care business, which includes well-known brands like Claritin, Afrin and Coppertone, for $14.2 billion. The deal means Bayer will get a list of well-known U.S. brands that sell at pharmacies with the hope of expanding their sales to a broader global clientele (Shell, 5/6).

Los Angeles Times: It's Tea Party Vs. GOP Establishment In North Carolina Primary
Hagan's camp took the unusual step of recently running a radio ad apparently intended to help Brannon, whom experts say would be easier for her to beat in the general election. The ad tears into Tillis' support for certain aspects of Obamacare, portraying him as soft on a signature GOP issue. Hagan, who supported Obamacare, defended the ad, accusing Tillis of waffling on the healthcare law. Tillis has promised to repeal Obamacare (Mascaro, 5/5).

The Washington Post: Vulnerable Democratic Sen. Hagan Runs Anti-Obamacare Attack Ads Against GOP Contender
The fliers landed in the mailboxes of Republican voters here last week with a warning likely to unnerve many conservatives. Thom Tillis, the Republican front-runner for a U.S. Senate seat, once called President Obama's health-care law "a great idea," the mailer said. The assertion echoed recent radio ads that also seem to question Tillis's adherence to the orthodoxy of a party that has made its opposition to the Affordable Care Act a centerpiece of its midterm-election strategy. But the warnings didn't come from any of the seven opponents Tillis will face in Tuesday's GOP primary, where he has been regularly attacked as not conservative enough. Instead, they were paid for by Sen. Kay Hagan, a Democrat who will face the eventual GOP nominee in November (Helderman, 5/5).

The Washington Post's Post Politics: GOP Senate Hopeful Ernst Fires Gun In Ad Vowing To 'Unload' On Obamacare
Republican U.S. Senate candidate Joni Ernst of Iowa has released a new TV ad vowing to "unload" on Obamacare, in which she takes target practice at a shooting range with a handgun. The narrator of the ad says Ernst, a state senator and lieutenant colonel in the Iowa Army National Guard, "carries more than just lipstick in her purse." The commercial portrays her riding a motorcycle to a shooting range where she takes target practice (Sullivan, 5/5).

The Associated Press: Health Care Law-Holocaust Comparison Criticized
A state Senator's blog post likening the insurance requirement under President Barack Obama's health care law to the forced deportation of Jews during the Holocaust drew swift condemnation Monday from leaders of both parties in Tennessee. Republican Sen. Stacey Campfield of Knoxville wrote the comment in a post titled "Thought of the Day" (5/5).

The Associated Press: Pharmacy Owner Serves Jail Time For Medicaid Fraud
A pharmacy owner has been sentenced for his part in a scheme that drained $16 million from the state Medicaid program. Attorney General Eric Schneiderman said Monday that 41-year-old Raheel Pervez of Dix Hills will serve one to three years for his part in a scheme that billed Medicaid for unfilled prescriptions (5/6).