Viewpoints: Many beneficiaries of health law don't vote; reboot for healthcare.gov

Sep 19 2014

The New Republic: The Strategy That Might Have Beaten Mitch McConnell
For starters, my strong hunch from my own reporting in the region over the past couple years-;including several trips to Kentucky for a new book on McConnell-;is that the Democrats' biggest problem in Appalachia and the Upland South is not that the people who are benefitting from Obamacare or would stand to benefit from it if their states fully implemented the law are voting against their own interests, for Republicans. It is that many of those people are not voting at all. Remember, the vast majority of Obamacare's beneficiaries in states like Kentucky that expanded Medicaid are poor, with incomes below 138 percent of the poverty level, the threshold up to which Medicaid coverage is to be expanded under the law. And poor people famously vote at far lower rates than everyone else (Alec MacGillis, 9/17).

The Wall Street Journal: Why A GOP Senate Majority Is Still In Doubt
There is also evidence there are limits to the efficacy of the Democrats' "war on women" narrative. Recent American Crossroads focus groups among swing women voters found they resent being treated as single-issue abortion voters, considering it condescending. They want candidates from both parties to talk about broader concerns like jobs, the economy, health care, energy, government spending and national security, and they are more than open to the GOP message. However, women do view attacks on Republicans over social issues as a way to determine whether a candidate is outside the mainstream. If GOP candidates address these concerns in a reasonable fashion, they undermine the Democrats' anti-women meme and can pivot successfully to larger issues. That's why Planned Parenthood has reacted with such fury to Republican Senate candidates in Alaska, Colorado and North Carolina saying they support making contraceptives available over-the-counter (Karl Rove, 9/16). 

The New Republic: How To Reboot Healthcare.gov
This year, healthcare.gov and the state exchanges all need to raise their game. While 8 million people signed up for private health plans via Obamacare last year, an estimated 8 million people eligible for subsidized private plan coverage remain uninsured. This isn't a surprise. Experts, like those at the Congressional Budget Office, have always predicted it would take several years before the law reached all of the people it could. Even so, it's hard not to be disturbed by polls showing widespread ignorance of how the Affordable Care Act works and how to take advantage of it (Andrew Sprung, 9/17).

The New York Times' The Upshot: With New Health Law, Shopping Around Can Be Crucial
If you bought health insurance at an Affordable Care Act marketplace this year, it really pays to look around before renewing your coverage for next year. The system is set up to encourage people to renew the policies that they bought last year -; and there are clear advantages to doing so, such as being able to keep your current doctors. But an Upshot analysis of data from the McKinsey Center for U.S. Health System Reform shows that in many places premiums are going up by double-digit percentages within many of the most popular plans (Margot Sanger-Katz and Amanda Cox, 9/17).

The New York Times' The Upshot: San Francisco Official Says He Takes Truvada To Prevent H.I.V., And More Gay Men Should, Too
Scott Wiener, a member of the San Francisco Board of Supervisors, made an unusual public announcement on Wednesday: He takes Truvada, a daily antiviral pill, to greatly reduce his risk of contracting H.I.V. (Josh Barro, 9/17). 

The Wall Street Journal's The Experts: Hospitals Must Invest In Preventing Medical Errors
Investors seem reluctant to back manufacturers of products that protect patient safety, such as fabrics that resist bacterial infection, devices that prevent wrong intravenous (IV) dosing and furniture that hinders falls. This seems counterintuitive, since medical mistakes present an overripe market for such innovation (Leah Binder, 9/17). 

The Wall Street Journal: Calling In The Military To Fight Ebola
This week President Barack Obama announced that the U.S. military would dramatically scale up its engagement in the response to the Ebola outbreak in West Africa, the worst ever such outbreak to occur. ... It might strike some as odd that the military is being called on to address a disease outbreak that poses little direct threat to the U.S. But the Department of Defense actually has a long history of engagement in global health activities, ranging from developing drugs and vaccines for diseases (including Ebola) to helping countries build their surveillance and health-care systems, and bolstering their ability to handle dangerous pathogens (Drew Altman, 9/17).

The New York Times' The Upshot: How Insurers Are Finding Ways To Shift Costs To The Sick
Health insurance companies are no longer allowed to turn away patients because of their pre-existing conditions or charge them more because of those conditions. But some health policy experts say insurers may be doing so in a more subtle way: by forcing people with a variety of illnesses -; including Parkinson's disease, diabetes and epilepsy -; to pay more for their drugs (Charles Ornstein, 9/17). 

Los Angeles Times: Dave Jones For State Insurance Commissioner
The two candidates running for state insurance commissioner present a stark contrast. The incumbent, Democrat Dave Jones, has used his regulatory authority to push insurers to slow the growth of premiums for auto, home and other property and casualty insurance. His challenger, Republican state Sen. Ted Gaines of Roseville, isn't convinced that the insurance commissioner should have the power to pass judgment over premiums. Gaines is an insurance agent, and that job may give him valuable insights into the industry. But Jones is the only sensible choice to oversee it (9/17). 

Journal of the American Medical Assocation: The Pioneer Accountable Care Organization Model: Improving Quality And Lowering Costs 
The Pioneer accountable care organization (ACO) model was one of the earliest models sponsored by the Centers for Medicare & Medicaid Services (CMS) Innovation Center and has arrived at a critical juncture in its evolution. ... The Pioneer model continues to mature, fueled by rapid cycles of measurement, reporting, learning, and refinement made possible by the close collaboration CMS has formed with participating ACOs. ... CMS will evaluate whether these Pioneer ACO results warrant expansion nationally. Early success in the Pioneer model suggests that in the long term, accountable care will offer patients the improved outcomes they deserve and ACOs the sustainable business model they need to stay focused on delivering high-value care (Hoangmai H. Pham, Melissa Cohen and Patrick H. Conway, 9/17).