First Edition: August 1, 2014

Today's headlines include more questions about how healthcare.gov will function during the next open enrollment period.

Kaiser Health News: Florida's Largest Health Insurer Is Raising Exchange Rates An Average Of 17.6 Percent
Kaiser Health News staff writer Phil Galewitz reports: “Florida Blue, the state’s largest health insurer, is increasing premiums by an average of 17.6 percent for its Affordable Care Act exchange plans next year, company officials say. The nonprofit Blue Cross and Blue Shield affiliate blames higher health costs as a result of attracting older adults this year who previously lacked coverage and are using more services than expected” (Galewitz, 8/1). Read the story.

Kaiser Health News: Good News On California ACA Rates. But Why?
KQED’s Lisa Aliferis, working in partnership with Kaiser Health News and NPR, reports: “Covered California's executive director and other analysts pointed to specific factors for this moderate increase. For starters, enrollment was very strong in 2014, more than a million people. In addition, healthy people signed up, spreading the risk. But the state's insurance commissioner, Dave Jones, sees a different force in play. He believes that a statewide ballot measure, Proposition 45, has insurers scared” (Aliferis, 8/1). Read the story.

Kaiser Health News: Health On The Hill: House Panel Focuses 'Microscope' On Marketplace Open Enrollment
House members examined concerns raised in a GAO report about the healthcare.gov website during a subcommittee hearing Thursday. Kaiser Health News’ Mary Agnes Carey and CQ Roll Call's Melissa Attias discuss the action (7/31). Listen to the audio or read the transcript.

Kaiser Health News: A Reader Asks: With Job-Based Coverage, Can I Still Qualify For Cost-Sharing Subsidies
Kaiser Health News’ consumer columnist Michelle Andrews explains that if the insurance offered through an employer is considered affordable, you can’t qualify for the health law’s program to provide financial help to cover costs such as deductibles and co-payments (8/1). Read her response.

Kaiser Health News: Capsules: Unfavorable Views Of Health Law Spike In July: Poll; Covered California Rates Up Modest 4.2 Percent
Now on Kaiser Health News’ blog, Jordan Rau reports on new poll findings: “The health law’s unpopularity among the public rose sharply in July with a surge of disapproval from people who had been agnostic about it in recent months, a poll released Friday shows. The law is as unpopular as it has been since it was enacted four years ago” (Rau, 8/1). 

Also on the blog, Capital Public Radio’s Pauline Bartolone reports on Covered California’s rates: “Covered California says health care premiums will go up modestly for most people buying coverage on the state exchange next year by an average of 4.2 percent” (Bartolone, 8/1). Check out what else is on the blog.

The New York Times: Work To Bolster Health Website Is Raising Cost, Officials Say
Obama administration officials said Thursday that the cost of the federal health insurance exchange was growing because they were assigning new work to contractors in an effort to prevent a repetition of the problems that crippled HealthCare.gov last fall. Andrew M. Slavitt, the No. 2 official at the Centers for Medicare and Medicaid Services, told Congress that the agency was changing requirements for its contracts to expand the scope of work that must be done (Pear, 7/31). 

Politico: Questions Linger About Obamacare Website, Year 2
HealthCare.gov is expected to enroll millions of new people in Obamacare this fall and re-enroll millions more who signed up the first time around. It’s likely a more demanding task than the one that it buckled under last year. Will it be up to the task? (Norman and Haberkorn, 7/31). 

Los Angeles Times: Obamacare Premiums To Rise A Modest 4.2% In 2015
Defying an industry trend of double-digit rate hikes, California officials said the more than 1.2 million consumers in the state-run Obamacare insurance exchange can expect modest price increases of 4.2% on average next year. On Thursday, Covered California announced the results of its negotiations with Anthem Blue Cross, Kaiser Permanente and other major insurers, an important yardstick for President Obama's Affordable Care Act (Pfeifer, Terhune and Karlamangla, 7/31).

The Wall Street Journal: California Sees Health-Law Premiums Rising 4.2% In 2015
Premiums for health-law plans in California will go up 4.2% on average next year, an increase that the state's insurance marketplace said was limited partly due to the large and relatively healthy pool of enrollees it had attracted. Nationally, 2015 rate changes for plans sold through marketplaces created under the Affordable Care Act will vary widely, with a mix of increases and some declines. But California is seen as a bellwether. According to federal statistics released May 1, the state had about 1.4 million of the 8 million total people who selected a marketplace plan during the open-enrollment period for 2014 coverage (Wilde Mathews, 7/31).

Los Angeles Times: Lawyers Challenging Health Subsidies Seek Quick Supreme Court Ruling
Lawyers challenging President Obama's healthcare law filed a quick appeal with the Supreme Court on Thursday, urging justices to take up the issue this fall and throw out insurance subsidies for nearly 5 million Americans. "The monumental significance of this legal issue requires the court's immediate, urgent attention," they said in a filing. "The longer the lawless IRS rule is in effect, the greater the upheaval when it is ultimately vacated" (Savage, 7/31). 

The Wall Street Journal: Health-Law Opponents Seek Supreme Court Review
Opponents of health-insurance subsidies tied to the Affordable Care Act moved quickly Thursday to get an appeal in front of the Supreme Court. The challengers, Virginia residents who objected to the subsidies, filed a petition with the high court just nine days after the Fourth U.S. Circuit Court of Appeals in Richmond, Va., upheld an Obama administration regulation that said subsidized insurance was available to qualifying consumers nationwide. That appeals court decision was one of two issued on the same day in mid-July that reached conflicting conclusions on the legality of the administration's approach. A federal appeals court in Washington ruled against the government, siding with a different group of challengers who argued language in the 2010 health-care law prohibited subsidies for those who buy insurance on a federal exchange, instead of one run by a state (Kendall, 7/31). 

Politico: Supreme Court Asked To Hear Obamacare Subsidies Case
The four Virginians whose challenge to Obamacare subsidies suffered a defeat last week are now asking the Supreme Court to hear the case. Their lawsuit was dismissed by the U.S. Court of Appeals for the 4th Circuit, which ruled that the Obama administration can legally award the subsidies through federally run insurance exchanges — not just those run by the states themselves. The individuals behind King v. Burwell say the subsidies are being improperly awarded through Virginia’s federally run exchange (Winfield Cunningham, 7/31). 

The Wall Street Journal’s Law Blog: A Primer On Boehner V. Obama
The House of Representatives on Wednesday voted 225-201 to authorize Republican Speaker John Boehner to bring a lawsuit against the Obama administration accusing the president of overstepping his legal authority. Here are answers to some frequently asked questions about the unprecedented constitutional battle unfolding in Washington (Gershman, 7/31). 

The Washington Post’s Wonkblog: Suddenly, Obamacare Is More Unpopular Than Ever
Even after survey after survey has recently shown a major drop in the nation's uninsured rate, Obamacare just had its worst month in a key health-care poll. Kaiser Family Foundation, which has done arguably the best and most consistent polling on the health-care law in the past four-plus years, found that public opinion on the law sank to a record low in July. More people than ever (53 percent) last month said they viewed the law unfavorably, an increase of 8 percentage points since June — one of the biggest opinion swings ever (Millman, 8/1). 

NPR: Congress Approves $16.3 Billion VA Health Care Bill
With a 91-3 vote in the Senate Thursday, Congress has passed a massive $16.3 billion bill to address problems with health care for veterans and other problems with the Department of Veterans Affairs. The bill now moves forward to the White House for President Obama's signature. The House voted overwhelmingly to approve the bill on Wednesday (Mullins, 7/31). 

The Associated Press: Congress Sends VA Overhaul to White House
The legislation is a response to reports of veterans dying while awaiting appointments to see VA doctors and cover-ups of the delays at several of the VA’s 1,000 hospitals and outpatient clinics. The bill devotes $10 billion in emergency spending over three years to pay private doctors and other health professionals to care for qualifying veterans who can’t get timely appointments at VA hospitals or clinics or who live more than 40 miles from one of them. It includes $5 billion for hiring more VA doctors, nurses and other medical staff and $1.3 billion to open 27 new VA clinics across the country (7/31). 

The Wall Street Journal: Senate Passes $17 Billion Bill To Help Pay For VA Overhauls
The Senate passed an approximately $17 billion compromise bill Thursday evening that would help pay for overhauls to the Department of Veterans Affairs, sending the measure to the White House for President Obama to sign. The measure, passing 91-3, cleared the last legislative hurdle following nearly two weeks of debate and parliamentary jujitsu. No date has been set for when the bill will be sent to the White House. Mr. Obama is expected to sign the measure (Kesling, 7/31). 

The Washington Post: Senate Sends VA, Transportation Bills To Obama On Eve Of Summer Recess
On veterans affairs, senators voted 91 to 3 to approve legislation injecting more than $16 billion into VA to help deal with extensive treatment delays and a recent record-keeping scandal. Republican Sens. Bob Corker (Tenn.), Tom Coburn (Okla.) and Jeff Sessions (Ala.) voted no because the legislation lacked spending cuts to match the new funding (Hicks and Halsey, 7/31). 

Politico: Senate Sends VA Reform Bill To Obama
The legislation was approved as Robert McDonald prepares to take control of the VA. There has been an acting head in charge of the agency since Eric Shinseki resigned as secretary in May (French, 7/31). 

The Wall Street Journal: Q&A: How Can Lenders Navigate Health Care Bankruptcies?
When a health-care company, particularly a hospital, files for Chapter 11 protection, it’s not your typical bankruptcy case. And that can be especially hard on lenders, according to a new report (Palank, 7/31).

The New York Times: F.D.A. Acts On Lab Tests Developed In-House
The Food and Drug Administration announced on Thursday that it would start regulating medical laboratory testing, saying that tests used to make important treatment decisions must be vetted and validated before they go into use (Pollack, 7/31). 

The New York Times: Wisconsin Justices Uphold Union Limits, A Victory For The Governor
Some labor leaders said that Mr. Walker’s measure all but eviscerated many public sector unions, leaving members wondering exactly what bargaining ability they were getting for their dues, which under the law can no longer be automatically withdrawn from their paychecks. Act 10 limited bargaining rights to pay raises within the rate of inflation. And with higher contributions from workers for their health care and pensions under the law, some union members said they could no longer afford dues. One Wisconsin union said it had lost as much as 60 percent of its membership (Davey, 7/31). 

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