- KFF Health News Original Stories 5
- Insurance Marketplaces Offer Options For Consumers Without Job-Based Coverage
- L.A. County Health Department Allegedly Falsified Nursing Home Probe Records
- In Surprise Move, Supreme Court Will Examine Key Part Of Health Law
- Consumer Guide To The Supreme Court’s Action On ACA Subsidy Issue
- Missouri Primary Care Doctors Face Substantial Medicaid Cut
- Political Cartoon: 'Tusk, Tusk?'
- Health Law 4
- Consumers Can 'Window Shop' On Healthcare.gov Before Sign-Up Period Begins
- Md. Officials Cross Fingers That New Website Is Ready For Enrollment Challenge
- High Court To Hear Another Health Law Challenge - This One Focuses On Tax Subsidies
- Latinos Likely To Steer Clear Of Insurance Even Though Many Qualify For Subsidies
From KFF Health News - Latest Stories:
KFF Health News Original Stories
Insurance Marketplaces Offer Options For Consumers Without Job-Based Coverage
But those who fail to enroll in insurance can face penalties and the loss of subsidies to help pay premiums. (Mary Agnes Carey and Julie Appleby, )
L.A. County Health Department Allegedly Falsified Nursing Home Probe Records
Two staffers accuse the county of altering the dates when complaints were received amid rising concern over the pace of investigations. (Anna Gorman, )
In Surprise Move, Supreme Court Will Examine Key Part Of Health Law
Once again, the Supreme Court will decide whether the Affordable Care Act lives or dies. (Julie Rovner, )
Consumer Guide To The Supreme Court’s Action On ACA Subsidy Issue
At issue is whether the federal government can pay subsidies to people living in states that use healthcare.gov, the federal exchange. (Mary Agnes Carey, )
Missouri Primary Care Doctors Face Substantial Medicaid Cut
The health care law boosted payments for two years to primary care doctors who treat Medicaid patients. But that boost is set to expire, leaving some providers and their patients in a tough spot. (Jordan Shapiro, The St. Louis Post-Dispatch, )
Political Cartoon: 'Tusk, Tusk?'
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Tusk, Tusk?'" by Steve Sack, Minneapolis Star Tribune.
Here's today's health policy haiku:
YOU BETTER SHOP AROUND...
Just window shopping?
New healthcare.gov website
open for business
- Anonymous
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to an original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of KFF Health News or KFF.
Summaries Of The News:
Consumers Can 'Window Shop' On Healthcare.gov Before Sign-Up Period Begins
HHS officials hope this function will help reduce strain on the federal website, which will launch Nov. 15 for the health law's second open season.
The New York Times:
New Healthcare.gov Opens Early To Allow For Review Of Plans
The Obama administration said Sunday that consumers could shop for health insurance and compare their options on HealthCare.gov starting Monday, even before the open enrollment period formally begins five days later. (Pear, 11/9)
The Washington Post:
Consumers Now Able To Window-Shop For Insurance On HealthCare.gov
The window-shopping period is beginning several days before the Nov. 15 official start of the sign-up period for people in the three dozen states that rely on the federal exchange to renew their coverage or buy insurance for the first time. (Goldstein, 11/9)
USA Today:
Healthcare.gov Opens For Insurance Plan Shoppers
The Department of Health and Human Services is trying to prevent a repeat of last year's disastrous rollout of HealthCare.gov, an experience that many newly insured consumers may want to avoid going through again. HHS principal deputy administrator Andy Slavitt said the window shopping "functionality has been ready for a while ... (but) obviously we've been continuing to test it." (O'Donnell, 11/9)
The Wall Street Journal:
Upgraded Health Site Faces Test This Week
An updated version of HealthCare.gov now includes a window-shopping tool that could help the website withstand new pressures, including millions of people returning in coming months for insurance, federal officials said Sunday. ... Supporters of the 2010 health law, bruised by the site’s poor performance early on, have sought assurances that it will perform better this time around. Critics, including Republicans set to take control of the Senate in January, are likely to point to any flaws as proof of bigger problems with the law. (Radnofsky, 11/9)
Reuters:
U.S. Officials Hope New Healthcare.gov Avoids Last Year's Problems
U.S. officials planned to unveil an improved healthcare insurance website on Sunday they hope will allow the second enrollment period under President Barack Obama's health reform plan to avoid the technical meltdown that plagued its launch last year. The reconfigured HealthCare.gov insurance marketplace will go live Sunday night before a three-month open enrollment period that begins Nov. 15, during which existing policyholders can change their coverage. (Schneider, 11/9)
Still, officials are concerned that some issues from the last time around could again pose problems and The Washington Post offers a closer look at how they are working to avoid that -
The Washington Post:
Obama Officials Work On Health Site Contingency Plans As Enrollment Nears
With the next time to buy health plans under the Affordable Care Act starting in less than a week, the Obama administration is expressing confidence that HealthCare.gov is no longer the rickety online insurance marketplace that exasperated consumers a year ago. Behind the scenes, however, federal health officials and government contractors are scrambling, according to confidential documents and federal and outside experts familiar with this work. (Goldstein, 11/9)
Politico:
Last Fall’s Healthcare.gov Ghosts Could Haunt 2015 Sign-Up
The second year of Obamacare’s open enrollment begins Saturday, and unresolved problems from the first season are complicating the already daunting task of enrolling millions of uninsured and re-enrolling millions more. (Mershon, Haberkorn and Norman, 11/10).
And here are some points consumers need to know about -
Kaiser Health News:
Insurance Marketplaces Offer Options For Consumers Without Job-Based Coverage
But those who fail to enroll in insurance can face penalties and the loss of subsidies to help pay premiums. Kaiser Health News’ Mary Agnes Carey and Julie Appleby discuss what you need to know before open enrollment in the health law’s marketplaces begins again on Nov. 15, including details on the health law’s online marketplaces, or exchanges. (Carey and Appleby, 11/10)
Md. Officials Cross Fingers That New Website Is Ready For Enrollment Challenge
Meanwhile, tabulating the total cost so far to operate Maryland's online insurance marketplace is proving difficult. Also in the news, reports on enrollment and outreach efforts from Connecticut, Michigan and Washington state.
The Baltimore Sun:
Md. Exchange Attempts 'Do-Over' With New Website
Lost applications, frozen computer screens and hours spent waiting on hold for help — those consumer problems made up last year's narrative about Maryland's health insurance exchange, the online marketplace launched under the federal Affordable Care Act. Now, as state officials prepare to unveil a revamped exchange Sunday, they face a new set of challenges: They must eliminate technological problems that led the website to crash on its launch last year, restore consumer confidence in the system and — with Republicans poised to control Congress and the Maryland governor's seat — confront more questions about the future of Obamacare. (Cohn, 11/8)
The Baltimore Sun:
Maryland Health Exchange Final Tab Still Unclear
The Maryland health exchange debuts its new online marketplace this weekend, and officials say they expect it to run more smoothly this time. The revamped website comes at a cost, but tabulating the price tag to build and run both the old and new website isn't so easy. (Cohn, 11/8)
The Seattle Times:
Healthplanfinder Q&A: How To Find Help With 2015 Health Plans
Q:What is happening this week with the Affordable Care Act? A: The online insurance exchanges created by the ACA are opening up Saturday for consumers seeking individual insurance plans for 2015. The open-enrollment runs through Feb. 15. (Stiffler and Marshall, 11/8)
Connecticut Mirror:
Obamacare: Who’s Still Uninsured In CT, And Why?
Connecticut had one of the lowest uninsured rates in the country before Obamacare, and has been heralded as one of the most successful states in rolling out the health law. But even here, on the eve of the second sign-up period for private insurance under the health law, it’s not hard to find people without health insurance. (Levin Becker, 11/10)
The Detroit Free Press:
More Plans, Insurers In Michigan
Open enrollment of federal health reform's centerpiece — health plans for the uninsured and the underinsured on state marketplaces — opens Saturday with more companies and more than twice as many plans in Michigan. In many cases, premium costs have fallen, on the Michigan Health Insurance Marketplace, or state exchange, driven down by a crowded marketplace, according to agents, consumer advocates and insurers. (Erb, 11/9)
The Detroit Free Press:
Detroit Medical Center Beefs Up Efforts To Reach Uninsured
When it comes to health coverage, sometimes the message just can't be conveyed in radio spots or on billboards. Rather, it has to be from a trusted neighbor or loved one, said Conrad Mallett, chief administrative officer at Detroit Medical Center, which last year launched www.pathtohealth.com. Working with churches, shelters and community groups, DMC's Path to Health campaign was one of the largest efforts to help enroll metro Detroit's uninsured in health coverage. For thousands, that's Healthy Michigan, the state's new Medicaid plan made possible under federal health reform and opened April 1. (Erb, 11/9)
On the Medicaid expansion front -
Caspar Star-Tribune:
Wyoming Health Advocates Optimistic Following Medicaid Announcement
Wyoming health advocates remain optimistic as they await the release of a new Medicaid expansion plan from the state Health Department. Gov. Matt Mead announced Thursday the imminent release of a report detailing the Wyoming Department of Health’s discussions with the Centers for Medicare and Medicaid services. Mead said federal health officials have eased their stance on elements of Wyoming’s plan, including cost-sharing and workplace training programs. (Graff, 11/8)
Meanwhile, here's the latest on SHOP exchanges -
The St. Louis Post-Dispatch:
Multistate Small Businesses Face Challenge With New Insurance Marketplace
Businesses with employees in multiple states could face additional hurdles when looking to offer health insurance coverage through the online marketplace.
The online access to the Small Business Health Options Program, or SHOP, is scheduled to go live Nov. 15. Firms with fewer than 50 full-time workers will then be able to sign up for SHOP plans through HealthCare.gov. But like the marketplace for individual customers, SHOP plans will be organized by state — posing an additional challenge to small employers with workers who live or work in different states. (Shapiro, 11/9)
High Court To Hear Another Health Law Challenge - This One Focuses On Tax Subsidies
The high court's announcement Friday that it would hear the case came as a surprise and puts at risk the overhaul's central aim of extending health coverage to lower-income Americans who don't qualify for Medicaid or have access to employer-sponsored coverage.
Los Angeles Times:
In Surprise Move, Supreme Court To Hear Healthcare Law Challenge
The Supreme Court put President Obama's healthcare law back into legal peril, announcing it would consider a conservative group's claim that the law does not allow the government to subsidize health insurance for low and middle-income Americans in two-thirds of the states. The announcement surprised legal observers who had expected the justices to wait on the issue, at least until a court of appeals [in Washington, D.C.] had finished considering it. Friday's decision to quickly move ahead provided a strong indication that at least four justices remain determined to undo central elements of the law. (Savage, 11/7)
The Wall Street Journal:
Supreme Court To Hear Case On Health-Care Law Subsidies
The case granted Friday marks the law’s third trip to the high court and sets the stage for another major health-care ruling next summer. The appeal threatens a principal aim of President Barack Obama ’s signature law—extending private health insurance to lower-income Americans who don’t receive coverage from their employers or qualify for Medicaid—and could cripple the law if the challengers prevail. (Bravin and Radnofsky, 11/7)
The New York Times:
Justices To Hear New Challenge To Health Law
The Supreme Court on Friday agreed to hear a new challenge to the Affordable Care Act, potentially imperiling President Obama’s signature legislative achievement two years after it survived a different Supreme Court challenge by a single vote. The case concerns tax subsidies that currently help millions of people afford health insurance under the law. According to the challengers, those subsidies are being provided unlawfully in three dozen states that have decided not to run the marketplaces, known as exchanges, for insurance coverage. (Liptak, 11/7)
The Washington Post:
Supreme Court Will Hear Newest Challenge To Affordable Care Act
The Supreme Court announced Friday that it will hear the most serious challenge to the Affordable Care Act since the justices found it constitutional more than two years ago: a lawsuit targeting the federal subsidies that help millions of Americans buy health insurance. More than 4 million people receive the subsidies, which the Obama administration contends are essential to the act by making insurance more affordable for low- and middle-income families. (Barnes, 11/7)
Politico:
Supreme Court Move Comes At Challenging Time For Obamacare
The Supreme Court’s decision Friday to take up a challenge to Obamacare subsidies couldn’t come at a worse time: Republicans fresh off big election wins are vowing to dismantle the law while the White House is readying a second enrollment season that it needs to get off to a better start than last year’s disaster. The case taken by the court, King v. Burwell, puts at risk the health law’s low- and middle-income subsidies for millions of Americans who live in states that did not set up their own health insurance exchanges. (Haberkorn, 11/10)
Kaiser Health News:
In Surprise Move, Supreme Court Will Examine Key Part Of Health Law
Kaiser Health News staff writer Julie Rovner reports: "Once again, the Supreme Court will decide whether the Affordable Care Act lives or dies. Defying expectations, the court announced Friday it has agreed to hear – during this term – a case that challenges the heart of the law: subsidies to help people pay their insurance premiums. In about three dozen states, the federal government runs the online marketplaces where individuals can find health plans." (Rovner, 11/7)
NPR:
Supreme Court Agrees To Hear New Health Law Challenge
In a rare and unexpected move, the U.S. Supreme Court has agreed to hear a new challenge to the Obama health care overhaul, dealing the White House yet another blow this week. Health care experts say an adverse ruling would be catastrophic for the health insurance program that the president has fought to enact and preserve. (Totenberg, 11/7)
McClatchy:
Supreme Court To Hear New Obamacare Challenge
Writing another prescription for showdown, the Supreme Court on Friday said it would consider a new challenge to the Patient Protection and Affordable Care Act. In a highly anticipated decision, issued without written explanation, the court announced it would set arguments for the King v. Burwell case that will shape the future of the health exchanges set up under the law. (Doyle, 11/7)
ABC News:
How The Supreme Court Could ‘Blow A Big Hole’ In Obama’s Legacy (Or Not)
“The highest court in the land has now spoken,” an elated and relieved President Obama said after the Supreme Court upheld a key provision of the Affordable Care Act in 2012. Not so fast. Now the law -- a centerpiece of Obama’s presidency -- is before the Court again after the justices announced last Friday that they would hear a fresh challenge to an important part of Obamacare. (De Vogue, 11/10)
The Fiscal Times:
The Biggest Threat to Obamacare Is Not a GOP Congress
Republicans have promised to revive their war on Obamacare when they take control of the Senate in January, but lurking in the distance is an even greater threat to the president’s health care law—one that could have devastating implications for millions of people who have obtained health insurance through federal exchanges. (Ehley, 11/7)
News outlets also examine how this case could affect consumers, hospitals and insurers. States also have a stake -
Kaiser Health News:
Consumer Guide To The Supreme Court’s Action On ACA Subsidy Issue
The Supreme Court on Friday agreed to hear a case on a subject that’s important to millions of people who receive subsidies to help purchase coverage under the health-care law. Friday’s decision follows earlier action in July when two U.S. appeals courts issued conflicting rulings on the issue. Kaiser Health News' Mary Agnes Carey answers some frequently asked questions about those court decisions and how they impact consumers. (Carey, 11/7)
Modern Healthcare:
This Again? Supreme Court Takes Up Obamacare Future
The court's decision to take the case is likely to create uncertainty in the healthcare industry and could shake consumers' confidence just before open enrollment for 2015 coverage begins Nov. 15. “What it means is the rest of us have to work doubly hard to make sure people understand there are still subsidies available,” said Kathleen Oestreich, CEO of Meritus, a not-for-profit insurer in Arizona. ... Following news of the court's decision to take the case, major health insurers and hospital operators saw share prices tumble. (Schencker, Evans and Demko, 11/8)
The Wall Street Journal:
States Urge Upholding Of Health Law’s Tax Credit
Eleven states that could be affected if the Supreme Court upholds the latest challenge to the Affordable Care Act told a court earlier this week they had assumed residents could still receive the law’s tax credits even if they didn’t build their own exchanges. ... In the brief the states said they assumed there wouldn’t be a problem with the tax credits when they opted not to run their own exchanges, saying they “elected to forgo establishing their own exchange under the ACA with the understanding that relying on a federally facilitated exchange would not harm state citizens or interfere with state insurance market.” (Radnofsky, 11/8)
Bloomberg:
Hospitals Fall After Top Court Clouds Future Of ObamaCare
U.S. hospital owners including Community Health Systems Inc. (CYH) may suffer a significant blow if the Supreme Court takes away subsidies that some Americans get to buy health insurance under the Affordable Care Act. The court said yesterday that it would rule on whether people in at least 34 states will be allowed to receive subsidies to buy insurance under the law, which has helped cut the number of uninsured showing up at hospitals. (Gilblom, 11/8)
Georgia Health News:
Latest ACA Court Case Reverberates In Georgia
The U.S. Supreme Court’s decision Friday to take up a case challenging the subsidies in the Affordable Care Act’s exchanges could wind up having a huge impact in Georgia. The federal subsidies help millions of Americans afford health insurance offered in the exchanges, which were created as part of the health reform law. (Miller, 11/7)
Latinos Likely To Steer Clear Of Insurance Even Though Many Qualify For Subsidies
The Los Angeles Times reports that health officials in California are meeting immigration concerns head on with a new ad campaign. Meanwhile, the Detroit Free Press notes that the health law's fines for businesses begin in 2015.
Los Angeles Times:
Many Latinos Shun Obamacare For Fear Of Getting Relatives Deported
Lilian Saldana turned down Obamacare coverage once, and she might do it again. With sign-ups set to resume Saturday, the 23-year-old Covina resident and her younger sister are hesitant to enroll because their parents are immigrants who are not citizens and therefore ineligible for benefits under the Affordable Care Act. (Karlamangla and Terhune, 11/9)
The Detroit Free Press:
ACA Fines For Businesses Start In 2015
For businesses across Michigan and the country, the Obama administration's one-year reprieve from financial penalties under the national health care law is nearing an end, forcing some employers to chose between buying coverage for employees or paying fines. At the same time, some small businesses that already offer health insurance are facing big price hikes next year as Blue Cross Blue Shield of Michigan — the largest carrier in the state — has stopped allowing businesses to renew policies that aren't compliant with the Affordable Care Act. In their place it is offering more comprehensive, but pricier, insurance policies. (Reindl, 11/9)
Meanwhile, here's more on skinny plans --
The Oregonian:
As Health Insurance Networks Get Skinnier, Consumers Must Get Savvier
Insurers are increasingly using narrow or "skinny" networks to keep costs down, allowing them to offer lower premiums in the new, highly competitive world of the individual and business markets. That means consumers need to pay more attention than ever, as networks and plans change from year to year. They should start by checking insurer websites to see if their provider is part of a network — and then they should check with their provider as well. (Budnick, 11/7)
GOP Debates Strategy On Health Law
With its newfound control of Congress, Republicans debate whether to push for a full repeal of the health care law, as conservatives demand, or take aim at particular provisions, which some party leaders endorse. Meanwhile, the tea party worries what a rising GOP foretells for its fortunes.
The Hill:
McConnell Pressed To Repeal Obamacare With Budget Move
Conservatives in Washington are adamant that Senate Republicans should pass a full repeal of the healthcare law next year, even it if means a certain veto from President Obama. With Senate Democrats likely to filibuster any stand-alone repeal bill, conservatives say incoming Senate majority leader Mitch McConnell (R-Ky.) should use a procedural maneuver known as reconciliation to muscle through a bill with 51 votes. (Shabad, 11/10)
NBC News:
Here To Stay: Why The New Republican Congress Can't Gut Obamacare
Republicans may have promised to repeal or at least do a big makeover of Obamacare now that they control both the House and the Senate, but most experts believe it’s lip service only. (Fox, 11/8)
Bloomberg:
Republicans To Chip At Obamacare By Refining Work Hours
Newly empowered Republicans say they can’t repeal Obamacare and plan to chip away at the law piece by piece, starting with redefining full-time work in a way that could affect health coverage for 1 million people. House Speaker John Boehner and Senate Republican Leader Mitch McConnell yesterday said they want to rewrite the Affordable Care Act so employers could avoid providing health coverage to workers who put in less than 40 hours a week -- up from the law’s current 30-hour threshold. (Dorning and Woellert, 11/7)
The Washington Post:
How Killing The Medical Device Tax Became One Of Washington’s Top Priorities
Within days of the Republican Party regaining control of the Senate, a host of policy issues has quickly risen to the top of Washington's priorities list: trade, corporate tax reform, the Keystone pipeline. And then there's the medical device tax. The tax, passed as part of the Affordable Care Act, plays a marginal role in the health-care overhaul, but the push to repeal it has attracted millions of dollars of lobbying, as well as high-profile supporters on the Hill, from Sen. Elizabeth Warren (D-Mass.) to Sen. Orrin Hatch (R-Utah). (Millman, 11/7)
The Hill:
Right Debates How To Govern
With Republicans set to assume control of Congress for the first time in eight years, GOP leaders must decide which policies to push forward, and whether some bigger goals should be pushed to the side. Those taking the “don’t govern” approach argue measures to give Obama “fast-track” trade authority, tackle patent “trolls” or to repeal the healthcare law’s tax on certain medical devices are small-bore goals that should be swept aside in favor of more sweeping measures, such as repealing the individual mandate in ObamaCare. “Passing all of the Washington lobbyists’ wish-list items is not going to get Republicans through 2016,” said Matt Kibbe, president of the Tea-Party group FreedomWorks, which has frequently criticized GOP leaders.
Kibbe urged leaders to tackle the individual mandate and reign in so-called “risk corridors” in the healthcare law that conservatives deride as bailouts for insurance companies. He also wants to see Congress vote on an alternative to the healthcare law, something Republicans failed to do this past election cycle. (Wong, 11/9)
The New York Times:
With Fear of Being Sidelined, Tea Party Sees The Republican Rise As New Threat
As most Republicans were taking a victory lap the morning after the elections, a group of conservatives huddled anxiously in a conference room not far from Capitol Hill and agreed that now is the time for confrontation, not compromise and conciliation. Despite Republicans’ ascension to Senate control and an expanded House majority, many conservatives from the party’s activist wing fear that congressional leaders are already being too timid with President Obama. They do not want to hear that government shutdowns are off the table or that repealing the Affordable Care Act is impossible — two things Republican leaders have said in recent days. (Peters, 11/8)
Digital Records Pose Time, Security Challenges
A survey of more than 400 internists confirms what physicians have been saying for years: entering data into electronic records eats up a lot of time, reports NPR. In addition, the digitization poses security risks that the health industry is just starting to prioritize, says The Wall Street Journal.
NPR:
Electronic Medical Records, Built For Efficiency, Often Backfire
Electronic medical records were supposed to usher in the future of medicine. Prescriptions would be beamed to the pharmacy. A doctor could call up patients' medical histories anywhere, anytime. Nurses and doctors could easily find patients' old lab results or last X-rays to see what how they're doing. The computer system could warn doctors about dangerous drug combinations before it was too late. Many of those things are an everyday reality in doctors' offices and hospitals across the country. But a survey of more than 400 internists with experience using electronic medical records, or EMRs, documents what doctors have complained about for years: computerized records chew up a lot of time. (Hensley, 11/7)
The Wall Street Journal:
Health Care Industry Starts To Pay Attention To Cyber Risks
The health-care industry is grappling with how to protect personal health information from increasing cyber threats. In addition to meeting security and privacy regulations, companies can do more to prevent breaches by assessing and prioritizing cybersecurity risks, said Jim Routh, chief information security officer at health insurer Aetna Inc. The message has already caught on at some health-care companies, who are starting to look for technology executives with risk experience. (King, 11/7)
KCUR:
HHS Official: Let's Use Technology To Change The Way We Talk About Health
Many health experts say that, to save money and improve care, the United States needs to get past paper records and frequent visits to the doctor. And to encourage the switch to standardized electronic records, the federal government has begun offering incentives to providers. But the push to innovate has been met with some resistance. Dr. Jacob Reider is deputy national coordinator of health information technology for the U.S. Department of Health and Human Services. At this week’s annual Cerner conference, he told Heartland Health Monitor’s Alex Smith that his work is about more than swapping the manila envelope for cloud storage. (Smith, 11/7)
Facing Shortage, Officials Turn To Selling Docs On Working For The VA
And VA Secretary Robert McDonald says up to 1,000 workers face disciplinary action over veterans' long waits for care.
The New York Times:
Needing To Hire, Chief Of V.A. Tries To Sell Doctors On Change
Robert A. McDonald, formerly chief executive of Procter & Gamble, runs the government’s second-largest agency, the Department of Veterans Affairs. And he has been crisscrossing the nation looking for doctors-in-training to fill staffing shortfalls that over time could jeopardize care for millions of veterans. ... Mr. McDonald says he was shocked by a paucity of physicians, nurses and other clinicians in some veterans’ hospitals — a shortage that the department says contributed to delays in care that led to manipulated waiting lists for appointments. ... Mr. McDonald says the only way to address that shortage may involve not just increasing the number of students at existing medical schools but also building new schools. (Oppell, 11/8)
The Associated Press:
VA Chief Says 1,000 Workers Face Disciplinary Action
The Veterans Affairs Department is considering disciplinary action against more than 1,000 employees as it struggles to correct systemic problems that led to long wait times for veterans seeking health care and falsification of records to cover up delays, said VA Secretary Robert McDonald. In an interview with the CBS News program "60 Minutes," McDonald said the VA is taking "aggressive, expeditious disciplinary action, consistent with the law" against more than 1,000 of its 315,000 employees. (11/8)
Quarantine Policies Make Health Workers Reassess Overseas Work
News outlets also report on the decision by Kaci Hickox, the Maine nurse who refused to self-quarantine, to move out of the state; and the latest from Dallas, where the last of 177 people being monitored for Ebola have been cleared by officials.
The Associated Press:
Ebola Volunteers Wrestle With Quarantine Mandates
As Ebola-related quarantine policies have arisen around the United States, some health workers are reassessing whether, or how long, they can be among the hundreds that officials say are needed to fight the outbreak. Potential volunteers are anxious about what they might come back to, especially after seeing new rules arise so rapidly that nurse Kaci Hickox was sequestered in a medical tent for days because New Jersey announced new regulations the day she flew back from Sierra Leone. Others are facing family qualms. And as the year winds down, some aid workers wonder whether they'll be able to go home for the holidays. (Peltz, 11/8)
NPR:
Maine Nurse To Move Out Of State Following Ebola Quarantine Row
The boyfriend of Kaci Hickox, the nurse who defiantly refused to self-quarantine after she returned from West Africa, says the couple will move out of Maine this week after a state court order restricting their movement expires. Ted Wilbur withdrew from a nursing program at the University of Maine at Fort Kent, where the couple lives, and said Friday that he and Hickox were "going to try to get our lives back on track" by leaving the state. (Neuman, 11/9)
The Associated Press:
Dallas Reaches End Of Ebola Monitoring Period
Dallas calmly marked the end of its Ebola crisis on Friday when the last of the 177 people who were being monitored for symptoms of the deadly virus were to be cleared at midnight. Thirty-eight days after Thomas Eric Duncan was diagnosed with Ebola in a local hospital, officials expressed relief and resolve that they were prepared if anything similar — with its resulting panic, fear and constant media attention — ever happened again. (Merchant, 11/7)
The New York Times:
Dallas Closes The Door On Its Ebola Scare
Dallas ... has moved on. The city, the first to grapple with the virus in the United States and the near panic and quarantines that it set off, reached the end of its Ebola ordeal Friday, as the last person being monitored was cleared by officials. (Fernandez, 11/7)
Cigna Cuts HIV Drug Costs To Settle Discrimination Case
The health insurer agreed to restructure HIV prescription drug benefits, making them less costly to patients in Florida.
The Wall Street Journal:
Cigna Agrees To Restructure HIV Drug Benefits
Facing allegations of discriminating against people with HIV and AIDS, Cigna Corp. agreed to restructure the HIV prescription drug benefits in its 2015 plans in Florida, making them less costly and burdensome for such patients. The AIDS Institute and the National Health Law Program filed a complaint in May with the federal government, charging that Cigna and three other insurers unlawfully discriminated against people with HIV and AIDS in their Florida health plans by placing all HIV medications, including generics, on specialty drug tiers, where patients are required to pay 40% to 50% of the cost. (Beck, 11/7)
The New York Times:
Cigna Agrees To Reduce H.I.V. Drug Costs For Some Florida Patients
The health insurer Cigna has agreed to reduce the out-of-pocket costs that patients in Florida must pay for H.I.V. drugs, settling a complaint filed by advocacy groups, who said the drug pricing system in the state’s health care plans was discriminatory. The groups indicated Florida could serve as a test case for what they contend is discriminatory pricing by other insurers around the country. Under the settlement with Florida’s Office of Insurance Regulation, Cigna will place a $200 a month limit on the amount that patients have to pay for some commonly prescribed drugs like Atripla, and make other changes to make the drugs less costly and easier to get. The changes apply only to people who enroll in the company’s plans through the new health insurance exchanges, and will take effect for 2015 plans. (Thomas, 11/7)
State Highlights: Ohio Medicaid Costs Lower Than Expected; Fla. Gets $1.2M For Mental Health
A selection of health policy stories from Ohio, Florida, New York, California, Wisconsin, Massachusetts and Hawaii.
Cleveland Plain Dealer:
Ohio's Medicaid Costs Expected To Be About $470M Lower Than Anticipated
The cost of Ohio's Medicaid program is expected to be about $470 million less than what was originally estimated in the current two-year budget, and the bulk of that savings goes directly to the state. The anticipated savings is a result of multiple factors, said Greg Moody, director of the governor's Office of Health Transformation. A big one is that fewer people than expected are signing up for traditional Medicaid coverage, which costs the state more than the expanded Medicaid coverage that began this year. (Higgs, 11/7)
The Associated Press:
Florida Gets $1.2M For Mental Health Services
Federal health officials are giving Florida more than $1 million to expand access to mental health and substance abuse services. This week federal health officials announced $1,249,850 in Affordable Care Act funding to help five health centers in Florida establish or expand behavioral health services for 18,854 Floridians. The Sunshine State has dozens of health centers. In 2013, those health centers saw over 71,456 behavioral health patients. (11/10)
The New York Times:
Montefiore’s New Bronx Medical Center Emphasizes Outpatient Care
The newest medical complex in the Bronx offers valet parking, views of Long Island Sound, and operating rooms equipped with overhead lamps that do not throw shadows and nonporous, plastic-lined walls to reduce the spread of infection. But there is one amenity it does not have: overnight beds. Though it has the resources of a hospital, the $152 million complex operated by Montefiore Medical Center will send patients home the same day as part of the hospital system’s shift toward outpatient operations. ... The complex, known as Montefiore’s Hutchinson campus, will serve one of the nation’s poorest urban communities at a time when many Bronx residents are struggling with obesity, diabetes, asthma and other chronic diseases. (Hu, 11/7)
Los Angeles Times:
California Businesses Benefit From Election Day Outcomes
Health insurers spent tens of millions of dollars to stave off an initiative, Proposition 45, that would have regulated their rates. And doctors and hospitals ponied up equally large sums to defeat Proposition 46, which would have raised medical malpractice award caps for non-economic "pain and suffering." (Lifsher, 11/9)
Kaiser Health News:
L.A. County Health Department Allegedly Falsified Nursing Home Probe Records
The Los Angeles County Public Health Department falsified the dates it received complaints about nursing homes as pressure rose to meet state deadlines for launching investigations, according to two employees. In a letter last month to county, state and federal officials, inspector Kimberly Nguyen cited 11 cases in which she said the dates typed into the computer system were later than the dates the complaints were actually received. The cases mentioned in the letter involve alleged abuse, falls and pressure sores, she said. (Gorman, 11/10)
Milwaukee Journal-Sentinel:
Health Costs Increase 8-10% For Milwaukee Area Employers
The cost of health benefits for employers in the Milwaukee area increased by an average of 8% to 10% this year, with the steepest increases for small employers, according to an annual survey done by HCTrends. The HCTrends survey included about 150 employers and the increases varied significantly by employer. Premiums for large employers, for instance, rose by 5% to 7% on average, and many of them saw increases of less than 5%. (Boulton, 11/7)
The Boston Globe:
Program For Needy Patients Struggles
An experiment to improve care for thousands of Massachusetts’ sickest residents is proving more complex and expensive than health insurers and regulators envisioned, forcing the state and federal governments to shoulder more costs for the first-in-the nation program. (Lazar, 11/10)
The New York Times:
A Veteran Actor’s Backstage Fight For Affordable Health Care
Richard E. Waits was lying in bed hours before his audition, envisioning his metamorphosis. He closed his eyes and imagined his easy stride transformed into a jaunty strut, his smooth baritone sinking into a gravely rasp. But his anxieties kept intruding on his meditations. In about seven weeks, the health fund for Actors’ Equity, the union that represents theater performers, will drop Mr. Waits and scores of other struggling actors from its health insurance plan. (Swarns, 11/9)
Health News Florida:
Virtual Kiosks Take Care Outside Clinics
There was a time when you got sick, you waited to see the family physician. But then came the "Doc In A Box" clinics, where you went without an appointment, at night and on weekends. And it only got easier when mini-clinics began popping up in neighborhood pharmacies. (Shedden, 11/7)
The Associated Press:
Veteran Wait Times For Health Care Drop In Pacific
Wait times for veterans in Hawaii and other parts of the Pacific trying to see a primary-care doctor for the first time have dropped to 35 days from 110 days in May. Wayne Pfeffer, the director of the Veterans Affairs Pacific Islands Health Care System, had said in June that he hoped to reduce the wait time for new patients to 30 days within three months. (11/7)
The surprise announcement by the court Friday elicits a number of opinions.
The New York Times:
Health Care Reform Imperiled
Will five Supreme Court justices eliminate essential health care subsidies for more than four million lower-income Americans, based on a contorted reading of four words? It sounds inconceivable, but that would be the effect of a ruling in favor of the latest legal challenge to the Affordable Care Act. On Friday, the justices announced that they would hear that case, King v. Burwell, a dispute over the meaning of a single phrase — “established by the State” — in the 900-page health-care reform law. (11/7)
Los Angeles Times:
The Supreme Court Gives Itself A Second Chance To Kill Obamacare
How many times can Obamacare cheat death at the Supreme Court? The justices announced Friday that they will take up the case of King v. Burwell, which challenges the Obama administration's decision to make insurance subsidies available to low- and moderate-income Americans in all 50 states. If the plaintiffs prevail, subsidies will be cut off for residents in the states that did not set up their own insurance-buying exchanges. Such a ruling could be catastrophic to the 2010 Patient Protection and Affordable Care Act. Not only would it render insurance unaffordable to millions of Americans in 34 states that didn't establish exchanges, it would exempt large employers in those states from the mandate to provide affordable coverage to their full-time workers. (Jon Healy, 11/7)
Los Angeles Times:
The Supreme Court Puts The Screws To 36 State Governments
No piker when it comes to cliffhanging drama, the Supreme Court late Friday placed the governors and legislatures of 36 states in a corner, by taking up a challenge to the Affordable Care Act that directly threatens their citizens. ... Most objective commentators say the critics' argument is nonsense. The language at issue is an artifact a drafting glitch; to take it literally would make a hash of the entire law. And since the basic principle of statutory analysis is that a law must be read in its entirety, precisely to keep a stray, easily correctable error from wrecking a legislative initiative, elevating these four words to the defining principle of the Affordable Care Act is absurd. (Michael Hiltzik, 11/7)
The Washington Post:
Without Obamacare, I Would Have Died. I’m Scared The Supreme Court Is Going To Gut The Part That Saved Me.
The Obamacare subsidies saved my life. Now, I’m scared the Supreme Court is going to gut them. In 2010, at 54, I was diagnosed with non-alcoholic cirrhosis (end-stage liver disease). It’s debilitating, and a transplant is the only cure. ... In October 2013, I got a letter from my insurance company telling me that my existing high-risk insurance would be ending effective Dec. 31, 2013. I was told that if I wanted continued medical insurance, I would have to find another provider. I was terrified. ... My old insurer suggested we sign up for the Affordable Care Act exchange. So I called. The process was messy and frustrating. The Web site crashed; it took days to sign up, and countless phone calls. But eventually, I managed to enroll. (David Tedrow, 11/8)
Bloomberg:
How Liberals Can Win Obamacare Challenge
Could there be a silver lining for liberals if the court decides against the government? I think so, but it's not pretty. First, let's dispense with the idea that such a ruling would end Obamacare. Sure, the outlook would be grim in states that rely on federally run exchanges, where enrollees would end up paying the full cost of their coverage. ... some governors and lawmakers would almost certainly change course, having decided that refusing to build an exchange was a good way to oppose Obamacare when it cost them nothing, but stupid when it costs their residents health insurance. (Christopher Flavelle, 11/7)
The New York Times:
Death By Typo
On examination, it was clear what had happened: Whoever wrote down the lot’s description had somehow skipped a clause. And of course the town clerk fixed the language. After all, it would have been ludicrous and cruel to take away most of my parents’ property on the basis of sloppy drafting, when the drafters’ intention was perfectly clear. But it now appears possible that the Supreme Court may be willing to deprive millions of Americans of health care on the basis of an equally obvious typo. (Paul Krugman, 11/9)
Bloomberg:
Obamacare Courts Death Yet Again
It is safe to say, however, that the government is going into this round with a significantly weaker hand than it had even a few months ago. The law remains unpopular, and no, I don’t want to hear your explanation about how actually it’s really popular if you look at the polls right. The past election created unified control of Congress, which means there’s a reasonable chance of repealing or fixing the law in the face of an adverse ruling -- though not easily, and only over the screaming protests of President Obama and the Democrats, who will be outraged at what Republicans will demand. (Megan McArdle, 11/7)
Viewpoints: GOP Win Bolsters Health Law Foes; Ill. Cuts Medicaid Costs; CDC's Ebola Blunders
A selection of opinions on health care from around the country.
The Washington Post:
Which Republican Party Won The Midterms?
[Senate Republican leader Mitch] McConnell and his fellow candidates talked after their victory about coming together to govern, but they’re also on record pushing to repeal Obamacare and roll back other core Obama policies. If anything, the breadth and depth of the Republican victory will convince the party base — and the conservative activists, talk-radio hosts and bloggers animating it — that the obstruction of the past several years worked beautifully, that they have the power and the mandate to push radical anti-government policies, and that any compromise would be abandonment and betrayal. ... There is a reason why Republicans have not come up with a clear alternative to Obamacare, why they discuss entitlement reform only in general terms .... It is just not easy to come up with concrete policies aimed at solving problems without creating schisms in the party’s ranks or an outcry from its base. (Thomas E. Mann and Norman J. Ornstein, 11/7)
The Wall Street Journal:
What To Expect From The Next Congress On The ACA
Republican control of the next Congress is likely to bring ACA challenges in two flavors. There will be early “statement legislation” to repeal the law and possibly to repeal the ACA’s individual mandate, a linchpin of the law that spreads risk and makes its insurance market changes work. ... Then there is likely to be a series of legislative efforts to chip away at the ACA. ... But none of these likely proposals strikes at the core of the ACA: its coverage expansions and insurance reforms. These would continue regardless of whether such changes were made or how fiercely the battle over them is waged. (Drew Altman, 11/7)
Los Angeles Times:
This Boehner/McConnell Obamacare 'Fix' Could Hurt Millions Of Americans
The GOP manifesto published obligingly by the Wall Street Journal on Wednesday over the names of Republican leaders John Boehner, R-Ohio, and Mitch McConnell, R-Ky., included a tweak to the Affordable Care Act they say would provide Americans with "more hours and better pay." Don't you believe it. Their proposed change would threaten the livelihoods of as many as 81 million workers. It would have precisely the opposite effect they claim. And their reasoning for it is specious, too. The bottom line is that it would be a handout to cheeseparing employers, not a gain for their workers. (Michael Hiltzik, 11/7)
The Wall Street Journal:
Reversing The Medicaid Tidal Wave In Illinois
Every state is struggling with the explosive growth and cost of its Medicaid program. Illinois, however, found a way to reduce Medicaid spending significantly, freeing up money for other important projects—or better yet, tax cuts. ... Rep. Patti Bellock garnered bipartisan support to pass legislation in 2012 that included several Medicaid reforms. One of the most important was a provision to establish the Illinois Medicaid Redetermination Program to “redetermine” if Medicaid enrollees were still eligible to participate. The federal government requires states to do an annual audit of the Medicaid rolls to ensure that participants are eligible, but in most states few people are removed. (Merrill Matthews, 11/7)
Billings (Mt.) Gazette:
Montana Should Invest In Federalism
Obamacare has created uncertainty among patients, providers, and insurers. This is a perfect time to rebuild Montana’s Medicaid program, with our own funds and innovative solutions, and close the coverage gaps for the neediest in our society, especially the disabled. Montana need only look to the innovative solutions from other states that improve quality and reduce costs, including: Broadening the licensure of health care professionals; identifying and focusing resources in those particular geographic areas where the gap is the widest; conducting semi-annual audits of patients and providers to ensure money is spent appropriately; beginning managed care for the disabled; enhancing the use of public clinics for primary care; and extending Medicaid eligibility for parents, veterans, and the disabled earning less than 100 percent of the federal poverty level. (State Senate Majority Leader Art Wittich, 11/10)
The New York Times' The Upshot:
Shortage Of Medicaid Doctors? Not If You Ask Patients
One longstanding concern about Medicaid is that too few doctors will accept it, because it tends to pay providers less generously than private plans do. This concern shows up in news articles about Medicaid, driven by evidence from doctors’ offices. But if you ask Medicaid enrollees directly, they reveal that access to primary care is comparable to that for private plans. (Austin Frakt, 11/10)
The Philadelphia Inquirer:
Don't Blame Obamacare For High Deductible Plans
If last week's election proved anything, it showed we're far from finished with the debate over 2010's massive - and massively misunderstood - health-care reform, a law that strangely seems to get blamed for stuff it didn't cause. Senate leader-apparent Mitch McConnell and House Speaker John Boehner are once again promising Obamacare's repeal, arguing that it's "hurting the job market along with Americans' health care" - an odd critique of a law that has insured nearly 10 million people while the nation's jobless rate continues to fall. (Jeff Gelles, 11/9)
The New York Times:
The Ethics Of Infection
“First, do no harm” is supposed to be the guiding principle of health care workers. And within civil societies, at least, not harming others is considered every person’s moral, ethical and even legal responsibility. The heated debate over whether it’s responsible for health care workers who treated Ebola patients to go grocery shopping or bowling or get on a cruise ship before the end of the disease’s 21-day incubation period raises a larger question: What is everyone’s duty to prevent transmission of infectious diseases? (Kate Murphy, 11/8)
The Washington Post:
The Ebola Fight Is Far From Over
The Ebola outbreak is moving into a new phase that, in many ways, requires even greater attention and action than it has to this point. In addition to fears about the reach of the unforgiving virus and the spread of unfounded global panic, another concern has been added to the list: declaring “mission accomplished” too soon. (UN General Secretary Ban Ki-moon, 11/7)
Los Angeles Times:
The CDC Can't Seem To Get Its Ebola Messages Straight
The government’s response to Ebola overseas has been praiseworthy; the mishandled part has been at home. Not because Americans have much, if anything at all, to worry about in terms of an outbreak of disease here, but because the repeated missteps and continual changes in direction and message by the U.S. Centers for Disease Control and Prevention have contributed to an outbreak of fear and mistrust in the United States. (Karen Klein, 11/7)
The Washington Post:
The World Can’t Hide From Pandemics
Epidemics and pandemics are like earthquakes. Tragic, inevitable and unpredictable. It starts as a random event. A virus jumps species from a bird, bat or other animal to “patient zero” — who passes it on to other human beings. More likely than not, over the course of this century we will face an influenza pandemic similar to the one in 1918 that killed an estimated 50 million people . (Lawrence Summers, 11/9)
The New York Times:
Pregnant, And No Civil Rights
With the success of Republicans in the midterm elections and the passage of Tennessee’s anti-abortion amendment, we can expect ongoing efforts to ban abortion and advance the “personhood” rights of fertilized eggs, embryos and fetuses. But it is not just those who support abortion rights who have reason to worry. Anti-abortion measures pose a risk to all pregnant women, including those who want to be pregnant. (Lynn M. Paltrow and Jeanne Flavin, 11/7)
The New York Times:
Medical Records: Top Secret
In a digital age when we can transfer money to purchase a house online or view a college transcript by logging on to a secure website, why is it so often difficult for patients to gain access to their medical data? And who controls our health information? ... But the reality is that many hospitals and doctors have created a series of hurdles that must be cleared before patients can get their information. And many of those hurdles, experts say, are based on the economics of medicine. (Elisabeth Rosenthal, 11/8)
The Washington Post:
How A National Food Policy Could Save Millions Of American Lives
How we produce and consume food has a bigger impact on Americans’ well-being than any other human activity. The food industry is the largest sector of our economy; food touches everything from our health to the environment, climate change, economic inequality and the federal budget. Yet we have no food policy — no plan or agreed-upon principles — for managing American agriculture or the food system as a whole. That must change. (Mark Bittman, Michael Pollan, Ricardo Salvador and Olivier De Schutter, 11/7)
The Baltimore Sun:
Don't Lose State's Momentum Treating Heroin
Once largely relegated to Baltimore City, heroin use and its related adverse consequences are spreading to every part of the state, and an increasing number of Maryland's citizens are dying of heroin overdoses. The response to this increase in overdose deaths must be multi-faceted and include local prevention messaging, physician training on proper prescribing of opioid medications, federal and state law enforcement to reduce large-scale heroin trafficking, and efforts to increase the availability of treatment for those in need. (Robert P. Schwartz, 11/10)