First Edition: December 1, 2014

Kaiser Health News: More Competition Helps Restrain Premiums In Federal Health Marketplace
A surge in health insurer competition appears to be helping restrain premium increases in hundreds of counties next year, with prices dropping in many places where newcomers are offering the least expensive plans, according to a Kaiser Health News analysis of federal premium records. KHN looked at premiums for the lowest-cost silver plan for a 40-year-old in 34 states where the federal government is running marketplaces for people who do not get coverage through their employers. Consumers have until Feb. 15 to enroll for coverage in 2015, the marketplace’s second year. (Rau and Appleby, 12/1)

Kaiser Health News: Medicare Tightens Non-Emergency Use Of Ambulances To Combat Fraud
Beginning Dec. 1, seniors living in three states will need prior approval from Medicare before they can get an ambulance to take them to cancer or dialysis treatments. The change is part of a three-year pilot to combat extraordinarily high rates of fraudulent billing by ambulance companies in Pennsylvania, New Jersey and South Carolina. (Gillespie, 12/1)

Kaiser Health News: School District Pays For Health Care But Can’t Get Itemized Bill
About a year ago at a Miami-Dade County school board meeting, superintendent Alberto Carvalho was happy to announce the district and the teacher’s union had just ratified a new contract. 'I believe that this contract honors and dignifies what you do every single day,' he told the school board members. It included bonuses for most teachers and it settled how to handle health care expenses after yet another year of rising costs. (Mack, 12/1)

The Washington Post: Healthcare.gov’s Insurance Marketplace For Small Businesses Gets Off To A Slow Start
A year after the Obama administration temporarily shelved an unfinished part of HealthCare.gov intended for small businesses, it has opened with reports of only modest technical flaws — but with doubts that it will soon benefit the millions of workers at little companies with inadequate health insurance or none at all. (Goldstein, 11/30)

NPR: For Some Uninsured, Simply Signing Up Is A Challenge
When the Affordable Care Act rolled out last year, Californians enrolled in both Covered California and expanded Medicaid in high numbers. But there are still millions in the state without health insurance. Undocumented people don't qualify for Obamacare benefits. And many others still find coverage too expensive — or face other obstacles in enrolling. One of those people is Leaburn Alexander. ... He says he makes just under $11 an hour, and after taxes, child support and other expenses, he brings home just enough to cover rent. ... There's no room in the budget for health insurance. (Morehouse, 11/30)

The Wall Street Journal: Health-Insurance Site Snags Immigrants
Legal immigrants are running into fresh problems signing up for insurance on HealthCare.gov, presenting a hurdle in the Obama administration’s efforts to cover more Hispanics. Immigrant groups say people born outside the U.S. who are entitled to private insurance under the Affordable Care Act are having trouble proving their identities to the federal insurance marketplace and uploading documents that demonstrate they are in the country legally. Some also are being routed first to Medicaid, the state-federal insurance for the poor, even though they don’t qualify. (Radnofsky, 11/27)

Los Angeles Times: Many Agents Still Waiting To Be Paid For Covered California Enrollments
California's health exchange is leaning on insurance agents to enroll thousands of people in Obamacare coverage. Trouble is, some agents haven't been paid for months. In some cases, agents are owed thousands of dollars in commissions for getting folks signed up earlier this year. And they said they still face long waits on the phone to get simple issues resolved for customers. Their experiences could sap much of the enthusiasm among Covered California's most effective sales force. (Terhune, 11/26)

Los Angeles Times: Unequal Treatment In Arizona, Swings In Medicaid Access Show Program's Impact
Bad timing turned Karen Slone's medical problem into a crisis. Slone, 53, a former administrative assistant with diabetes, followed doctors' advice for years, getting regular checkups. Then, last year, she lost her job and her insurance, and stopped going to the doctor. When she spotted a sore on her foot, a common complication of diabetes, Slone tried Neosporin and Band-Aids. By the time she went to an emergency room weeks later, she had a raging infection. Surgeons had to remove bones in two toes. (Levey, 11/30)

The New York Times: Wyoming Devises Plan To Expand Medicaid
With a plan released Wednesday by the administration of Gov. Matt Mead, a Republican, Wyoming has become the latest state seeking to expand Medicaid. The plan would provide Medicaid coverage to an additional 18,000 low-income people, according to the state’s health department. If it wins federal and state legislative approval, Wyoming will join 27 states that have expanded the program under the Affordable Care Act, including nine with Republican leadership. As several other Republican governors have done, Mr. Mead wants to require some people who receive coverage under the expansion to pay something toward the cost. (Goodnough, 11/27)

The Washington Post: Democrats Have A New Internal Battle: The Middle Class Vs. The Poor
While the law was touted as a way to keep health insurance costs down and limit the growth of the nation's debt, it taxes the rich in order to pay for health insurance for the poor. When all is said and done, the Congressional Budget Office says that 13 million Americans will gain coverage under the ACA's expansion of Medicaid — a program only available for the poor. And a substantial portion of the insurance subsidies offered under the ACA flow to those earning modest wages. (Goldfarb, 11/26)

The Wall Street Journal's Washington Wire: Gruber Episode: A Moment For Obama To Reassess Pledge Of Transparency
As candidate Barack Obama described it, the health-care overhaul was supposed to be a model of participatory democracy. C-SPAN would bring its cameras right into the room when elected officials, drug industry lobbyists and insurers hashed out an agreement that would transform the nation’s health-care system. If anyone sought to cut a deal that subverted the public interest, you’d know. It never happened. The bill passed in predictable Washington fashion. As ever, the cameras weren’t there to record the backroom deal-making. (NIcholas, 12/1)

The New York Times: Suit On Health Law Puts Focus On Funding Powers
In mounting the latest court challenge to the Affordable Care Act, House Republicans are focusing on a little-noticed provision of the law that offers financial assistance to low- and moderate-income people. Under this part of the law, insurance companies must reduce co-payments, deductibles and other out-of-pocket costs for some people in health plans purchased through the new public insurance exchanges. The federal government reimburses insurers for the “cost-sharing reductions.” In their lawsuit, House Republicans say the Obama administration needed, but never received, an appropriation to make these payments to insurance companies. (Pear, 10/29)

Los Angeles Times: With Executive Action, Obama Risks Losing Chief Justice John Roberts
Two years ago, the chief justice surprised many by joining liberals on the court to uphold the constitutionality of Obama's Affordable Care Act. And he probably holds the deciding vote in a second legal challenge to the healthcare law — one that seeks to eliminate government insurance subsidies to low- and middle-income enrollees in two-thirds of the nation.But Roberts, an appointee of President George W. Bush, has shown an increasing skepticism toward what conservatives call Obama's tendency to overreach. (Memoli, 12/1)

The New York Times: Case Seeking Job Protections For Pregnant Women Heads To Supreme Court
She sued under the federal Pregnancy Discrimination Act, and the Supreme Court will hear her case on Wednesday. Women’s rights groups hope that Ms. Young’s case will snap their recent losing streak at the court, which has included decisions on equal pay, medical leave, abortion and contraception. (Liptak, 11/30)

The Washington Post: Former UPS Driver At Center Of Pregnancy Discrimination Case Before Supreme Court
A private woman, Peggy Young didn’t want all the world to know her most intimate business, including her two failed attempts at conceiving a child with her former husband before her pregancy in 2006 cost her her job delivering letters at United Parcel Service in Landover, Md. All Peggy Young wanted, she says, was to drive. But when her bosses at UPS told her to take unpaid leave until she was no longer pregnant, Young sued, saying the company violated the federal Pregnancy Discrimination Act of 1978 and failed to treat a pregnant Young the way it treated other employees. She lost twice in courts in Maryland, which agreed with UPS that Young did not prove the company discriminated against her because of her pregnancy. On Wednesday, the Supreme Court will hear oral arguments in her appeal of the closely watched case. (Schulte, 11/30)

USA Today: Pregnant Worker's Case To Test Justices' 'Blind Spot'
Several cases involving gender discrimination and reproductive rights have hit a 5-4 roadblock at the conservative-leaning court under Chief Justice John Roberts. Now groups representing women, workers, employers and others are watching to see how the justices handle the company's refusal to reassign Young to light duty during her pregnancy. After last June's ruling that Hobby Lobby and other employers with religious objections could deny their employees health insurance coverage for contraceptives, Justice Ruth Bader Ginsburg went so far as to suggest her male colleagues had a "blind spot" on the issue. (Wolf, 11/30)

The Associated Press: New Approach With Elderly Addicts At Nursing Home
A surge in baby boomers has driven up the number of elderly people abusing drugs or alcohol, bringing more attention to the sometimes-delicate problems involved in treating addiction in the aging. Last summer, the Jewish Home Lifecare nursing home in the Bronx set out to address those issues. Patients 60 and older who come in for rehab after a hospital stay are also screened for addiction and offered a chance at recovery. (11/30)

The Washington Post: U.S. Hospitals Wary Of Caring For Ebola Patients Because Of Cost And Stigma
U.S. officials trying to set up a network of hospitals in this country to care for Ebola patients are running into reluctance from facilities worried about steep costs, unwanted attention and the possibility of scaring away other patients. “They’re saying, ‘Look, we might be willing to do this, but we don’t want to be called an Ebola hospital. We don’t want people to be cancelling appointments left and right,’ ” said Michael Bell, director of laboratory safety at the Centers for Disease Control and Prevention. (Sun and Dennis, 11/28)

Los Angeles Times: Kaiser Criticized Over Mental Health Care Staffing
Health care giant Kaiser Permanente is facing mounting criticism about the care it provides mental health patients in California. A union is accusing the company of understaffing its mental health unit, causing patients to face excessive delays before treatment. Last year, state officials fined the Oakland company $4 million for numerous violations related to patient access to mental health services. (Pfeifer, 11/27)