First Edition: May 8, 2014

Today's headlines include reports from a Capitol Hill hearing featuring health insurers' testimony about their experiences with new enrollment under the health law.  

Kaiser Health News: California's Small Business Health Insurance Exchange Off To Slow Start
Kaiser Health News staff writer Anna Gorman, working in collaboration with the Voice of San Diego, reports: "California's insurance marketplace for small businesses has attracted just a fraction of eligible companies, with most being deterred by technology glitches, paperwork delays and customer service problems" (Gorman, 5/8). Read the story.

Kaiser Health News: Hospitals Boost Patient Safety, But More Work Is Needed
Kaiser Health News staff writer Jordan Rau reports: "Two major safety shortcomings in America's hospitals-;the frequency with which patients get hurt during their stays and the large number who are readmitted-;have decreased as government penalties and other programs targeting them kick in" (Rau, 5/7). Read the story.

Kaiser Health News: Capsules: PhRMA: High Cost-Sharing Could Harm Patient Drug Access; Report: Federal Exchange A Comparative Bargain; Arizona Offers 'Sneak Peak' At Costs Of Shifting Kids Off CHIP
Now on Kaiser Health News' blog, Mary Agnes Carey writes about the drug industry's concerns about the health law's cost-sharing requirements: "Enrollees in soe of the health law's most popular plans will face high cost-sharing requirements that the pharmaceutical industry says could keep patients from getting the drugs they need" (Carey, 5/7). 

Julie Rovner writes about a new report on the federal exchange: "As rocky as its rollout was, it cost the federal exchange, healthcare.gov, an average of $647 of federal tax dollars to sign up each enrollee, according to a new report. It cost an average of $1,503 – well over twice as much – to sign up each person in the 15 exchanges run by individual states and Washington, D.C. The report, released Wednesday, was compiled using data from federal enrollment figures and federal exchange funding for both the federal and state exchanges" (Rovner, 5/8).

Also on the blog, Phil Galewitz takes a look at CHIP and Arizona: "Families of Arizona children who were forced to switch from the Children's Health Insurance Program (CHIP) to private plans sold in the federal marketplace are likely paying more and getting fewer benefits, according to a study by Georgetown University researchers released Thursday. Millions of families who are ineligible for Medicaid could soon face the same choice if Congress chooses not to extend funding for the state-federal CHIP program when it expires in October 2015. Arizona was the first and only state to end its children's insurance program -; because its state legislature acted before the 2010 Affordable Care Act banned states from reducing children's health coverage" (Galewitz, 5/7). Check out what else is on the blog.

The New York Times: Called by Republicans, Health Insurers Deliver Unexpected Testimony
House Republicans summoned a half-dozen health insurance executives to a hearing Wednesday envisioned as another forum for criticism of the Affordable Care Act. But insurers refused to go along with the plan, and surprised Republican critics of the law by undercutting some of their arguments against it. Insurers, appearing before a panel of the Energy and Commerce Committee, testified that the law had not led to a government takeover of their industry, as some Republicans had predicted. Indeed, several insurers said their stock prices had increased in the last few years (Pear, 5/7).

The Associated Press: Health Insurers: Payment Rates Above 80 Percent
Aetna reported payment rates in "the low- to mid-80 percent range;" Wellpoint said the rate was as high as 90 percent for those whose premium had come due; the Blue Cross and Blue Shield Association said 80 to 85 percent; and the Health Care Service Corporation, which sells Blue Cross Blue Shield plans in five states, pegged the rate at 83 percent or above. The figures were in line with what individual insurers have said on earnings calls with analysts and elsewhere in recent weeks. Democrats seized on the figures disclosed at a House hearing as the latest sign that the health care law has defied its critics and is working (5/7).

The Wall Street Journal: Insurers: High Proportion Of Health Plan Enrollees Paid Premiums
Insurance company executives on Wednesday told Congress that high proportions of people signing up for coverage under the Affordable Care Act paid their first month's premium, fueling the partisan fight over the impact of the health law. Officials from Aetna Inc., WellPoint Inc. and Health Care Service Corp. said that in March and April they had seen around 80% to 90% of enrollees who faced payment deadlines respond to invoices by the insurers' deadlines. They expect more people who had signed up for coverage toward the end of the enrollment period to pay in the coming weeks (Radnofsky, 5/7).

USA Today: Insurers: Most New Enrollees Have Paid Health Premiums
Insurers also have duplicate enrollments caused by the disastrous launch of the federal HealthCare.gov exchange website. Many people were advised to start from scratch, but their original applications were still in the system, Pratt said. The insurers said back-end payment issues are still causing problems (Kennedy, 5/7).

The Associated Press: Obama HHS Nominee Gets First Turn Before Senators
Sylvia Mathews Burwell was to testify Thursday before the Senate Health, Education, Labor and Pensions Committee, the first of two Senate committees that will hold hearings on her nomination. Burwell is Obama's choice to replace Health and Human Services Secretary Kathleen Sebelius, who resigned last month after presiding over the passage of the health law and the disastrous rollout of the federal enrollment website. Sebelius left just as the law had begun to recover with stronger-than-expected sign-up numbers (5/8).

Politico: Questions Sylvia Mathews Burwell Will Face On Obamacare
The White House's new pick to run Obamacare will kick off her confirmation battle Thursday with the first of two grillings from Senate Republicans. Sylvia Mathews Burwell has a very strong chance of getting confirmed with strong support of Senate Democrats and even some Republicans who have indicated that they could vote for her, barring a significant gaffe or a skeleton discovered in her close (Haberkorn, 5/7).

The Associated Press: Gov't Report: Hospitals Improving Patient Safety
The government says hospitals are becoming safer for patients due to a quality improvement partnership between industry and federal agencies. A report out Wednesday from Health and Human Services finds that adverse events such as medication mistakes, falls and infections went down by 9 percent from 2010 to 2012, the latest year that such statistics were available (5/7).

The Washington Post's Wonkblog: Hospitals Are Cutting Down Their Deadly Mistakes, HHS Says
People are human, hospitals are staffed by humans, so it's no surprise that mistakes happen in hospitals. But it looks like hospitals are getting better at cutting down on their own errors. The rate of hospital-acquired conditions -; complications that develop during a patient's stay -; dropped nine percent between 2010 and 2012, according to new data from the Department of Health and Human Services. That translates to 15,000 fewer deaths in hospitals, a $4.1 billion savings in avoidable costs and a total of 560,000 "patient harms" avoided in 2011 and 2012, HHS says. For reference, a Journal of Patient Safety study last year estimated anywhere between 210,000 and 400,000 hospital deaths tied to preventable harm each year (Millman, 5/7).

The New York Times: American Legion, Citing Problems, Calls For Veterans Secretary To Resign
Mr. Dellinger's alarm grew when reports soon emerged that the department's medical center in Phoenix, and possibly other veterans hospitals, was using off-the-books lists to conceal long appointment waiting times. Finally, when the department's under secretary for health insisted in recent congressional testimony that nothing had been found wrong in Phoenix, Mr. Dellinger had had enough. This week the Legion, one of the nation's oldest and most influential veterans organizations, called for Mr. Shinseki and two other senior department officials to resign, the first time the group has sought to oust a public official since 1978 (Oppel Jr., 5/7).

The Washington Post: 'Face Of The Campaign' Mired In Health Law Snags
Celeste Castillo, a Guatemalan immigrant, was invited to a news conference with Illinois Gov. Pat Quinn and Health and Human Services Secretary Kathleen Sebelius early last year to help promote enrollment in the country's new health insurance marketplaces (5/7).

Los Angeles Times: Thom Tillis' North Carolina Win Is A Victory For A Redefined GOP
Tillis, though, is hardly a bipartisan pragmatist in the old-school GOP style. He is a conservative leader who, according to his campaign, wants to "shrink" government, believes "the traditional family is the bedrock of America's culture" and calls Obamacare a "cancer" that needs to be repealed. Under his watch, the North Carolina statehouse has enacted strict voting laws and refused to expand Medicaid under Obama's Affordable Care Act, partly giving rise to the "Moral Mondays" protest movement by the NAACP that has spread across the South (Mascaro, 5/7).

The Washington Post's Wonkblog: Obama's Former Medicare Chief On Why He Wants To Bring Single-Payer To Massachusetts 
Don Berwick – who, as administrator of the Centers for Medicare and Medicaid Services, oversaw large chunks of the early implementation of the Affordable Care Act – is trying to shake up the health policy world again. He ran CMS from July 2010 to December 2011, and left because Senate Republicans blocked his confirmation to lead the agency permanently. Now, more than two years later, he is a long-shot Democratic candidate for governor of Massachusetts and the heart of his platform is a single-payer health plan (Millman, 5/7).

The Wall Street Journal: Humana Earnings Shrink On Higher Costs
Humana Inc. said first-quarter profit shrank 22%, after a legal settlement helped boost year-earlier results. Still, revenue and earnings came in above analysts' forecasts, as Humana reported growing membership in Medicare Advantage plans, which are the private industry's version of the federal program for the elderly and disabled (Mathews and Rubin, 5/7).

NPR: Drug Industry Moves To Cut Costs, Banks On Future Big Sellers
Bayer has announced it is buying Merck's consumer drugs business, and Pfizer is trying to take over AstraZeneca. Why is this reorganization happening now, and what does it mean for drug development? (Hensley, 5/8).

Los Angeles Times: Medications May Reduce Violent Crime Risk In Those With Mental Illness
For people with severe psychiatric illness, taking an antipsychotic medication appears to drive down the risk of engaging in criminal violence, a large study has found. And for patients diagnosed with bipolar disorder, a mood-stabilizing medication has the same effect (Healy, 5/7).

NPR: Telepsychiatry Brings Emergency Mental Health Care To Rural Areas
North Carolina is facing a very big mental health care challenge -; 28 counties across the state do not have a single psychiatrist. That's despite the fact that in recent years, emergency rooms in the state have seen more patients with mental health, developmental disability or substance abuse problems. So the state is trying telepsychiatry. When a patient comes into an emergency room, they can be connected via a two-way video connection with a psychiatrist. A recent study by the nonpartisan North Carolina Center for Public Policy Research found that the method is having some success in providing more timely treatment (5/7).