Morning Briefing
Summaries of health policy coverage from major news organizations
First Edition: December 12, 2014
The Wall Street Journal: Health Insurers Brace For Last-Minute Rush
With only days to go before the deadline for consumers to choose next year’s health-law insurance plans, insurers and the federal government are bracing for what could be a crush of last-minute enrollment decisions. Of the approximately five million people who enrolled in 2014 health plans through the federal marketplace, only 720,000 had returned to the HealthCare.gov website to select a plan for 2015, according to the latest government tally through Dec. 5. Some 664,000 more people bought plans on the site for the first time. That leaves millions of enrollees who have yet to make a decision for next year. (Mathews, Radnofsky and McCabe, 12/11)
The New York Times: Many Choose Not To Save In The Health Marketplace
Across the nation, millions of people who bought insurance through the exchange in this inaugural year of coverage under the health care law must decide by Monday whether to switch plans for 2015 if they want a new plan starting Jan. 1. If they do nothing, most of the 6.7 million people who remained enrolled as of last month will automatically be re-enrolled in their current plans or similar ones. More often than not, the premiums for those in the most popular plans will increase, according to a New York Times analysis of data from the McKinsey Center for U.S. Health System Reform. (Goodnough, 12/11)
The Washington Post: HHS Uses 7-Eleven Receipts To Remind People To Sign Up For Healthcare.gov
The Department of Health and Human Services will promote HealthCare.gov at the bottom of some 7-Eleven receipts in an effort to reach demographics that could be uninsured, the department announced Thursday. The department is partnering with PayNearMe, an electronic payment processing system that lets businesses process large cash payments. (Ravindranath, 12/11)
The Washington Post: House Passes $1.1 Trillion Spending Bill
Congress managed to narrowly avoid another government shutdown crisis Thursday night when the House approved a $1.1 trillion spending package to keep most government agencies operating through next summer. The 219-to-206 vote came with less than three hours to go until government funding expired. (O'Keefe, 12/11)
The Wall Street Journal's Washington Wire: How ‘Cromnibus’ Helps Blue Cross And Blue Shield
Tucked away near the end of the 1,600-page spending bill is a long-awaited technical fix to the health overhaul law — one that benefits Blue Cross and Blue Shield insurers and has been in the works since the bill was passed in 2010. The backstory: Many of the nonprofit ‘Blue’ health plans receive tax breaks on their expenses and reserves as part of a 1980s arrangement in which they lost their broader tax-exempt status. Under the 2010 health law, Blue plans had to spend at least 85% of their revenue from insurance premiums on medical claims to continue to qualify for the breaks. The provision in the “cromnibus” bill ... would let the Blue plans count spending on improving health-care quality toward the 85% threshold. (Radnofsky, 12/11)
The Associated Press: Nearly 9 In 10 Doubt Obama, GOP Can Break Gridlock
Americans may not agree on much lately, but one opinion is nearly universal: There’s almost no chance that President Barack Obama, a Democrat, and the Republican Congress can work together to solve the country’s problems. What does the public think they’ll be able to do? A majority say Obama is likely to prevent Congress from repealing the health care law passed in 2010, while nearly half say the GOP is likely to block Obama’s executive order on immigration. (12/11)
The Wall Street Journal: Medicare Overbilling Probes Run Into Political Pressure
When investigators suspected that Houston’s Riverside General Hospital had filed Medicare claims for patients who weren’t treated, they moved to block all payments to the facility. Then politics intervened. Rep. Sheila Jackson Lee, a Texas Democrat, contacted the federal official who oversees Medicare, Marilyn Tavenner, asking her to back down, according to documents reviewed by The Wall Street Journal. In a June 2012 letter to Ms. Tavenner, Rep. Jackson Lee said blocking payments had put the hospital at financial risk and “jeopardized” patients needing Medicare. (Stewart and Weaver, 12/11)
Los Angeles Times: Philadelphia Transit System Sues Gilead Sciences Over $1,000-A-Pill Drug
Philadelphia’s transit system is taking on Gilead Sciences Inc. over its sky-high pricing of the breakthrough hepatitis C drug Sovaldi. The Southeastern Pennsylvania Transportation Authority alleged in a lawsuit filed Tuesday in federal court in Philadelphia that Gilead is engaging in “price gouging” by charging $1,000 a pill, or $84,000 for a standard 12-week treatment. (Pfeifer, 12/11)
The Washington Post's Wonkblog: A New Lawsuit Claims $84,000 Is Way Too Much For This Lifesaving Drug
The federal lawsuit from Philadelphia's public transit agency appears to be the first directly challenging the price of Sovaldi, which costs $84,000 overall during a normal 12-week course of treatment in the United States. Since Gilead Sciences launched Sovaldi last year, the drug has shattered sales records and set off a contentious debate about how to make treatments affordable and accessible while also encouraging drugmakers to invest in new drug development. (Millman, 12/11)
The Wall Street Journal: Jury Trial Fails To Resolve Questions Over Access To Generic Drugs
A closely watched trial that many hoped would help clarify a contentious battle over access to generic drugs instead ended in disappointment last week. In fact, the outcome only seems to have underscored the difficulty in sorting out so-called pay-to-delay deals, a topic that has embroiled the pharmaceutical industry, regulators and the courts for years. (Silverman, 12/11)
The Associated Press: NY Tells Insurers To Cover Transgender Treatment
New York's financial regulators advised health insurers statewide on Thursday to cover transgender treatment deemed to be medically necessary. The Department of Financial Services said commercial insurers may not deny needed treatment for gender dysphoria — when someone's gender at birth is contrary to his or her identity. The guidance sends the message that discrimination against transgender people won't be tolerated, department Superintendent Ben Lawsky said. (Virtanen, 12/11)
The Washington Post: Two Area Hospitals Treating Patients At Risk For Ebola
Two Washington-area hospitals said on Thursday that they are treating patients at risk for Ebola. The National Institutes of Health said Thursday it had admitted an American nurse who was exposed to the Ebola virus while volunteering in Sierra Leone. Washington Hospital Center also said that it admitted a patient who showed symptoms of the disease. (Zauzmer and Hedgpeth, 12/11)
The Associated Press: In Newtown, Mental Health Needs Persist 2 Years After School Shooting
Anxiety, depression, guilt, sleeplessness, marital strife, drug and alcohol abuse — two years after the massacre at Sandy Hook Elementary School, the scope of the psychological damage to children, parents and others is becoming clear, and the need for treatment is likely to persist. "Here it is two years later, and it's still hard to deal with. But God, you didn't want to know me two years ago," said Beth Hegarty, a Sandy Hook mother who happened to be inside the school that day with her three daughters, all of whom survived. (12/11)
