- KFF Health News Original Stories 3
- Even In High-Deductible Plans, Some Service May Be Covered Without Cost To You
- Texas' Changing Relationship To Obamacare
- Why Nearly Half Of The Obamacare Co-Ops Have Folded
- Political Cartoon: 'Party Hearty'
- Health Law 4
- With Premiums Up For Some, Obamacare Affordability Concerns Could Hurt Enrollment
- Officials Urge Consumers To Shop Around For Health Coverage
- Montana Wins Federal Approval Of Medicaid Expansion Plan
- As Arizona Co-Op Folds, 59,000 Must Search For Alternate 2016 Coverage
From KFF Health News - Latest Stories:
KFF Health News Original Stories
Even In High-Deductible Plans, Some Service May Be Covered Without Cost To You
KHN’s consumer columnist answers readers’ questions about high deductible plans, out of network benefits and increases in premium costs. (Michelle Andrews, 11/3)
Texas' Changing Relationship To Obamacare
For the moment, Texas Republicans still consider the Affordable Care Act to be political kryptonite, but the story on the local level is different: many moderates want the money that would come with expanding Medicaid, the state-federal health care program for the poor. (Carrie Feibel, Houston Public Media, 11/3)
Why Nearly Half Of The Obamacare Co-Ops Have Folded
As open enrollment begins for the health exchanges, one development that's turning into a concern is the collapse of a number of alternative insurance plans known as co-ops. KHN's Mary Agnes Carey joins PBS NewsHour's Judy Woodruff to answer real Americans’ questions about shopping for coverage. (11/2)
Political Cartoon: 'Party Hearty'
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Party Hearty'" by John Deering.
Here's today's health policy haiku:
FOR MEDICAID EXPANSION, ELECTION DAY STAKES ARE HIGH IN KY, VA.
State Medicaid plans
Hang in the balance as the
Voters go to polls.
- 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:
With Premiums Up For Some, Obamacare Affordability Concerns Could Hurt Enrollment
In related news, The Washington Post maps the state-by-state rate changes for health law plans. Elsewhere, The Fiscal Times offers a primer on how to sign up during open enrollment season and The Hill reports on the status of the Cadillac tax debate.
CBS News:
For Some, Obamacare Does Not Seem So Affordable
The third year of open enrollment for health insurance under the Affordable Care Act began this week. Premiums are up and some people have decided they are not so affordable. Lisa Patton turns 26 years old this month. That means, she will lose coverage under her parents health insurance. But she doesn't want to pay up to $250 a month for a plan under Obamacare. (Goldman, 11/2)
The Washington Post's The Fix:
The GOP’s Potent New Anti-Obamacare Argument, In 2 Maps
In 2013, then-Senate Majority Leader Harry Reid (Nev.) articulated what was a general belief among Democrats: the Affordable Care Act would help the party. Granted, the timeframe Reid predicted was that it would help last November. ... But the idea that being the party that helped Americans get access to affordable health care would be a boon was not unique to Reid. For a long time, Obamacare was viewed fairly negatively, according to regular polling from the Kaiser Family Foundation. In recent surveys, though, attitudes are about evenly split. So maybe the legislation is poised to be a boon for Democrats in 2016! Or, maybe not. (Bump, 11/2)
The Fiscal Times:
How To Apply For Obamacare In 2015
The latest open enrollment period to sign up for insurance from the Affordable Care Act (otherwise known as Obamacare) kicked off on Sunday, one that federal officials are anticipating to be their toughest season to date. (Dent, 11/2)
The Hill:
Battle Over 'Cadillac Tax' Heats Up
Longtime opponents of the ObamaCare “Cadillac tax” met with lawmakers this week with a new message: We’re willing to compromise. In a fly-in visit with key members and committee staff, employer benefits lobbyists went in seeking a more politically viable solution than full repeal. (Ferris, 11/2)
Officials Urge Consumers To Shop Around For Health Coverage
Health and Human Services Secretary Sylvia Burwell says Americans looking for health insurance should take the time to look for better deals. It's a sentiment shared among many health law advocates, including the interim head of Minnesota's health exchange.
The Charlotte Observer:
US Health Secretary Urges NC Residents To Shop Around For Health Insurance
As North Carolina is reeling from some of the highest health insurance rates in the nation under the Affordable Care Act, U.S. health secretary Sylvia Mathews Burwell on Monday advised residents to shop around for better deals. Burwell stressed a lesson repeated often by ACA advocates: Rates can appear excessively high for the same plan year-over-year, but customers are likely to find better deals if they explore other plans. (Murawski, 11/2)
Minnesota Public Radio:
Interim MNsure CEO Urges Minnesotans To Shop Around For Health Care
It's open enrollment season for individual health plans, and that's true whether you're looking to buy directly from an insurance company or through MNsure, Minnesota's health insurance exchange. (11/2)
In other health law marketplace news, a large insurer in Kansas leaves the federal exchange, and enrollment is examined in Oregon and Virginia --
The Kansas Health Institute News Service:
Marketplace Insurer's Departure Creates Enrollment Concerns
Groups working to boost health insurance enrollment in Kansas are concerned their efforts could be undermined by the last-minute departure of one of the state’s largest insurers. Coventry Health Care of Kansas Inc. and Coventry Health & Life Insurance Co. — both subsidiaries of Aetna — abruptly decided to stop offering policies to Kansas consumers in the federal marketplace. The decision, made two weeks before the start of the open enrollment period, surprised state insurance regulators. (McLean, 11/2)
The Oregonian:
Open Enrollment Begins For Oregonians Buying Their Own Health Coverage
The once-a-year open enrollment period has begun for the more than 240,000 Oregonians who buy their own health coverage and are not on Medicare. Officials and insurance agents encourage consumers to start shopping now for next year's policy, as enrollment ends Jan. 31 – earlier than last year. If you want to have your new policy in place for the new year, you'll need to enroll in December – or by December 15 if you use the federal health insurance exchange, HealthCare.gov. (Budnick, 11/2)
The Richmond Times-Dispatch:
Nearly 400,000 Virginians Sign Up For Affordable Care Act In 2015
Approximately 385,000 Virginians signed up for plans on the Affordable Care Act marketplace for 2015, but thousands more who are eligible for subsidies did not. (Smith, 11/2)
Montana Wins Federal Approval Of Medicaid Expansion Plan
The state's plan, which won approval in a Republican-controlled legislature after a bitter fight, needed waivers from the federal government because the state is requiring participants to pay a small premium and take part in a jobs-skill survey.
The Wall Street Journal:
Montana Is 30th State To Expand Medicaid Under Health Law
Montana became the 30th state to opt into the health law’s expansion of Medicaid on Monday, after federal officials said they’d signed off on a plan under which the state would increase the number of low-income residents it covers but impose certain eligibility conditions. The announcement brings the Obama administration to a critical milestone in its effort to persuade states to go along with a key tenet of the Affordable Care Act, after a 2012 Supreme Court decision that effectively gave the states a choice over the matter. (Radnofsky, 11/2)
The Hill:
Montana Is 30th State To Accept ObamaCare Medicaid Expansion
Montana officially became the 30th state to expand Medicaid under ObamaCare on Monday when the Obama administration approved its expansion plan. In April, Montana’s Republican legislature approved Medicaid expansion, but like other Republican-controlled states, it made some changes to put a conservative twist on the program. (Sullivan, 11/2)
MTPR:
Montana's Medicaid Expansion Plan Gets Green Light From Feds
Montana’s plan calls for some recipients to pay a token premium that still might pose a challenge for some living just above the poverty level. It also asks participants to take part in a job skills survey. Both of those features were the subject of intense negotiations between the state and federal governments. The state expects about 45,000 of the estimated 70,000 eligible low-income people to sign up. For many, it will just mean having access to check-ups and other wellness care, but for a few it could literally be a lifesaver. (Jess, 11/2)
The Associated Press:
Federal Health Officials Approve Montana Medicaid Waiver
The Democratic governor said gaining federal approval of the Montana plan was difficult after the nearly three-year fight to pass the compromise legislation. ... The state Legislature rejected a Medicaid expansion bill in 2013 and a proposed voter initiative failed to qualify for the 2014 election ballot. Bullock's plan was rejected again in this year's legislative session, but this time was replaced by a compromise bill sponsored by Sen. Ed Buttrey, R-Great Falls. Lawmakers passed that measure, but the state needed a waiver by the federal government because of the changes, such as charging premiums and outsourcing the program's administration to a third party. (Volz, 11/2)
In Texas, a state known for strong opposition to the federal health law, officials in at least one city are more open to Medicaid expansion arguments --
Kaiser Health News:
Texas’ Changing Relationship To Obamacare
The online federal insurance marketplace opened for business Sunday. It’s the third year of open enrollment for these subsidized plans, established by the Affordable Care Act. Many Texans still oppose the law, even though the state is home to the most uninsured people in the country. For the moment, Texas Republicans still consider the Affordable Care Act to be political kryptonite. ... But the story on the local level is different. Harris County is home to Houston, where Judge Ed Emmett, a moderate Republican who is chief executive for the county, has supported it for years. The CEO of the taxpayer-supported Harris Health System, George Masi, says he needs the revenue that Medicaid expansion would bring. He’s had to lay off more than 100 employees and cut back on charity care. (Feibel, 11/3)
As Arizona Co-Op Folds, 59,000 Must Search For Alternate 2016 Coverage
Meanwhile, reporters from KHN and PBS NewsHour discuss the factors that have contributed to the collapse of a growing number of nonprofit insurance co-operatives set up by the 2010 health law.
The Associated Press:
Health Insurance Co-Op Order Means 59,000 Must Find Coverage
About a third of the Arizonans who bought health insurance on the federal marketplace for 2015 will have to find a new provider following action by state insurance regulators to suspend the state's nonprofit insurance co-op's ability to sell new policies over concerns it could fail. The suspension of Meritus Health Partners means about 59,000 people will need new insurance unless the order is lifted. More than 50,000 of those people bought their plans through the marketplace. (Christie, 11/2)
Kaiser Health News:
Why Nearly Half Of The Obamacare Co-Ops Have Folded
As open enrollment begins for the health exchanges, one development that’s turning into a concern is the collapse of a number of alternative insurance plans known as co-ops. KHN’s Mary Agnes Carey joins PBS NewsHour’s Judy Woodruff to answer real Americans’ questions about shopping for coverage. Watch the video. (11/2)
Valeant Tells Doctors That Their Prescriptions Won't Be Disrupted
Valeant Pharmaceuticals sent a letter to doctors to try to reassure them after the company severed its controversial business ties with specialty pharmacy Philidor. In other marketplace news, Quest Diagnostics expands its data analytics business, AmSurg suspends acquisition talks with Team Health and Pamplona announced plans to buy MedAssets for $1.86 billion.
Reuters:
Valeant Sends Letter To Doctors, Seeks To Reassure Over Pharmacy Ties
Valeant Pharmaceuticals International Inc sought to reassure doctors on Monday that the company's decision to cut ties to a controversial specialty pharmacy would not disrupt doctors' ability to prescribe the company's drugs to patients. In a letter to healthcare professionals seen by Reuters, Chief Executive Officer Michael Pearson said that Valeant would pay for the cost of its products through Nov. 8 and make sure patients could fill their prescriptions with no out-of-pocket expenses, wherever possible. Patients on government-run health plans such as Medicare are not eligible. (O'Donnell and Humer, 11/2)
The Wall Street Journal's CIO Report:
Quest Diagnostics CIO Leads Move Beyond Lab Tests Into Data Analytics
Quest Diagnostics Inc., facing revenue pressure as health insurers contain costs, is trying to move beyond lab tests. CIO Lidia Fonseca is leading efforts to capitalize off of Quest’s enormous stockpiles of data, which include 20 billion test results, and offering new data services to hospitals and health insurance companies. “The analytics for us are really a new source of revenue,” said Ms. Fonseca. “We’re not just a lab anymore, we’re a lab plus an insights company,” she said. (King, 11/2)
The Wall Street Journal:
AmSurg Withdraws Bid For Team Health
AmSurg Corp. on Monday withdrew its offer to buy Team Health Holdings Inc. after the fellow provider of outsourced physician services rejected AmSurg’s revised offer. AmSurg had said it would withdraw its offer if Team Health hadn’t engaged in talks by 4 p.m. EST Tuesday. A representative for Team Health had declined to comment on the ultimatum. (Minaya, 11/3)
The Wall Street Journal:
Pamplona To Acquire MedAssets In $1.86 Billion Deal
MedAssets Inc. agreed to be acquired by Pamplona Capital Management LLP in a deal valued at roughly $1.86 billion. MedAssets’ shares rose 29% to $30.5 in recent premarket trading to reflect the offer of $31.35 a share, a 32% premium to Friday’s close. ... Pamplona plans to combine the health-care technology and services company’s revenue-cycle-management segment with Pamplona-owned health-information-management firm Precyse, which currently is a strategic partner of the MedAssets revenue cycle unit. (Stynes, 11/2)
Report: Death Rates Tick Up For Middle-Aged Whites
The report, published in the Proceedings of the National Academy of Sciences, suggests that mental health issues and addiction play a role in reversing decades of advances in longevity.
The Wall Street Journal:
The Death Rate Is Rising For Middle-Aged Whites
White, middle-aged Americans are dying at a rising rate, a new study shows, a startling reversal that suggests addiction and mental-health issues are setting back decades of gains in longevity. Suicide, alcohol abuse, drug overdoses and chronic liver diseases largely drove the rise, which occurred between 1999 and 2013, according to the report published Monday in the Proceedings of the National Academy of Sciences. (McKay, 11/2)
The Washington Post:
A Group Of Middle-Aged Whites In The U.S. Is Dying At A Startling Rate
An increase in the mortality rate for any large demographic group in an advanced nation has been virtually unheard of in recent decades, with the exception of Russian men after the collapse of the Soviet Union. The rising death rate was accompanied by an increase in the rate of illness, the authors wrote in the Proceedings of the National Academy of Sciences. (Bernstein and Achenbach, 11/2)
The Associated Press:
Study: Death Rates Rising In Middle-Aged Whites
The U.S. death rate has been falling for decades, but researchers have detected one group in which the rates have been steadily ticking up — middle-aged white people. Suicides and deaths from drug overdose and alcohol abuse are being blamed. Deaths rates for other races have continued to fall, as they have for whites 65 and older. But death rates for whites 35 to 44 have been level recently, they're beginning to turn up for whites 55 to 64, and — most strikingly — death rates for whites ages 45 to 54 have risen by half a percent per year since 1998, said the authors, Anne Case and Angus Deaton of Princeton University. (Stobbe, 11/2)
Election Results Likely To Impact Medicaid Expansion Debate
Kentucky's expansion of the health insurance program for low income people has been a hot topic in the state's governor's race. Similarly, in Virginia, the possibility of Medicaid expansion is tied to who wins control of the state Senate. News outlets also report on state ballot initiatives in California and New York.
The Associated Press:
Kentucky Governor's Race Hinges On Health Insurance
The campaign for Kentucky's next governor ends Tuesday as voters elect someone to replace a popular two-term Democratic governor in a race that has turned on health insurance for 500,000 people and public preschool options. Republican Matt Bevin, Democrat Jack Conway and independent Drew Curtis have contrasted sharply in a race watched closely for its proximity to the 2016 presidential election and for its competitiveness in one of the nation's last two-party states. (Beam, 11/3)
Politico:
GOP Mounts Late Offensive In Key Kentucky Race
Bevin, for instance, once voiced skepticism of early-childhood education. But he later backtracked and said suggestions that he didn’t support early-childhood education were “absolute bunk.” Bevin opened his campaign by pledging to reverse Medicaid expansion in the state, a stance from which he has since repeatedly tried to step away. (Robillard, 11/2)
Fox News:
Kentucky's Governor Race Tops Tuesday's Ticket, Could Be 'Test' For Outsider Candidates
The race has also turned into a referendum on ObamaCare, and the results could affect the health insurance of more than half a million people. Democratic Gov. Steve Beshear, also retiring because of term limits, used an executive order to expand the state's Medicaid program to cover an additional 400,000 Kentucky residents and create a health exchange. And more than 100,000 residents have purchased discounted health plans with the help of federal subsidies. (Weber, 11/2)
The Richmond Times-Dispatch:
Voters To Settle Control Of Virginia Senate
Republicans now hold a 21-19 edge in the state Senate. Gov. Terry McAuliffe, a Democrat heading into the last two years of his administration, hopes to take over the chamber in order to balance the big GOP majority in the House of Delegates. The outcome of today’s contest for control of the state Senate could determine the fate of McAuliffe’s key initiatives, from the two-year budget he will propose next month, to Medicaid expansion under the Affordable Care Act. (Cain, 11/2)
The Washington Post:
Va. Elections For Legislature, County Boards And Mayor Drive Voters To Polls
In a district covering Prince William and Manassas, Democrat Jeremy McPike and Republican Hal Parrish are vying for the seat held by Sen. Charles J. Colgan (D-Prince William), who is retiring after 40 years. Parrish, the Manassas mayor, opposes Medicaid expansion, has an A-minus rating from the National Rifle Association and cast the tiebreaking vote allowing hospital-style restrictions on Manassas abortion clinics. McPike, who works for the city of Alexandria, favors Medicaid expansion, gun control and abortion rights.
The San Jose Mercury News:
Measure Slashing Drug Prices May Go To California Voters Next Fall
The skyrocketing cost of prescription drugs -- already a hot issue on the U.S. presidential campaign trail -- may be headed to California's statewide ballot next fall. Advocates of a proposed measure that would require state programs to pay no more for prescription drugs than prices negotiated by the U.S. Department of Veterans Affairs said they had turned in 542,879 signatures by Monday's 5 p.m. deadline, well beyond the 365,880 required by the state. (Seipel, 11/2)
The Associated Press:
Highlights From California Marijuana Legalization Measure
A ballot initiative spearheaded by tech billionaire Sean Parker that seeks to legalize recreational marijuana use in California was submitted to state officials on Monday. Although the Adult Use of Marijuana Act is one of at least a dozen marijuana legalization measures vying for a place on the November 2016 ballot, it has received support from key interest and advocacy groups and stands poised to secure significant financial backing. (11/2)
The Associated Press:
Seneca Nation To Explore Medical Marijuana In Referendum
The Seneca Indian Nation is weighing whether to get into the medical marijuana business. Members of the western New York tribe are set to vote Tuesday on a referendum that would allow the tribal council to draft laws and regulations surrounding the manufacture, use and distribution of medical marijuana. (11/3)
Iowa Lawmakers Launch Oversight Effort Regarding State's Medicaid Privatization Plan
News outlets also report on Medicaid news in California and Ohio.
The Des Moines Register:
Will Medicaid 'Oversight' Ignore Past Issues?
Legislators will meet Tuesday to launch a watchdog effort behind Iowa’s plan to privatize Medicaid, but it is uncertain whether some of the biggest controversies that have surrounded the effort will be the subject of the group’s review. The reason: The group was set up to focus on the plan’s possible Jan. 1 launch and ongoing operations. A separate legislative committee might take up the past problems at a meeting on Nov. 18. (Clayworth, 11/2)
The Des Moines Register:
Medicaid Communications Frequent During 'Blackout' Time
A far more extensive network of communications between former lawmakers, sitting legislators, the governor’s staff and companies vying for lucrative contracts to manage Iowa’s $4.2 billion Medicaid program was further revealed Friday in a case that threatens to derail the largest government privatization effort in state history. Many of the revelations emerged during the final day of a court hearing in which emails showed former House Speaker Christopher Rants was engaged in communications with a key member of Gov. Terry Branstad’s staff during a so-called blackout period meant to restrict contact with decision makers during the competitive bidding process. (Clayworth, 11/2)
California Healthline:
$6 Billion Waiver Gets Federal Approval
CMS officials on Saturday agreed in principle to a five-year, $6.2 billion waiver for California's Medicaid program. That was good news for California health officials, who plan to use the money mainly for Medi-Cal delivery system and payment reforms -- the next big steps in implementing the Affordable Care Act. The state also will get money for its whole-person pilot project and a revamp of its Medi-Cal dental system. (Gorn, 11/2)
The Columbus Dispatch:
Proposed Medicaid Cuts Worry Ohio Families In Need
An injury at age 5 cost Jadon Wade his ability to talk or move his arms and legs, but not his infectious laugh. Jadon delights in “knock-knock” jokes. Now 12, he’s happiest swinging in a hammock alongside his grandmother and legal guardian, Nancy Richardson, at their Delaware home. But if the Ohio Department of Medicaid follows through with its plan to stop funding 68 hours of nursing care for Jadon each week at home, Richardson fears that her grandson might have to move to an institution. (Sutherly, 11/2)
News outlets report on health issues in California, Illinois, Ohio, Missouri, Washington state, Oregon, Florida, Colorado and North Carolina.
Los Angeles Times:
After Missing Target, County Seeks To Ease Immigrants' Healthcare Enrollment
After months of debate last year, Los Angeles County officials agreed to pay for 146,000 people in the country illegally to receive medical care through the public health system. More than a year later, however, officials have fallen about 11,000 short of that target, and left more than $20 million of their budget unspent. (Karlamangla, 11/3)
Reuters:
Dismissal Of Chicago Retiree Healthcare Lawsuit In Hands Of Judge
An Illinois judge said on Monday he will rule no later than Dec. 11 on motions by Chicago and its four pension funds to dismiss a lawsuit that could greatly increase the cash-strapped city's retiree healthcare costs. Cook County Circuit Court Judge Neil Cohen heard nearly three hours or arguments by Clint Krislov, a lawyer representing Chicago retirees, who claimed his clients are entitled to lifetime healthcare coverage, and Richard Prendergast, the city's attorney, who contended the lawsuit should be tossed because it is based on faulty facts. (11/2)
The Associated Press:
Political Fight Hits Hard In Illinois’ Poorest Corner
The only public health clinic in Illinois’ poorest county is in a former synagogue off a largely abandoned main street, a bright spot with multicolored windows where seniors can get flu shots and moms get help feeding their kids. But today the lights are off and the doors locked. A sign on the door apologizes for the inconvenience: Because of the impasse over the state budget, we are only open on Wednesdays. (Burnett, 11/2)
The Columbus Post-Dispatch:
Independent Physician Group In Ohio Still Growing
Independent doctors across Ohio are quickly banding together to preserve and improve how they practice medicine — and to strengthen their collective voice in their dealings with insurance companies, suppliers and lawmakers. (Sutherly, 11/3)
Los Angeles Times:
How Much Does Severe Obesity Cost California? About $9.1 Billion
We know obesity increases your risk of having high blood pressure, getting diabetes and being diagnosed with certain cancers. Now it turns out it can also increase costs for your state government. A study published Monday in the journal Health Affairs found that medical care associated with severe obesity cost state-run health programs $8 billion in 2013. California's program for the poor, known as Medi-Cal, took the biggest hit, spending $1.3 billion that year on severe obesity-related care. (Karlamangla, 11/2)
The St. Louis Post Dispatch:
BJC HealthCare Cracks Down On Out-Of-Network Patients
BJC HealthCare has a message for patients who are out-of-network: We don’t want your business. With many consumers currently selecting insurance plans, the area’s biggest hospital system wants them to think twice before picking a plan that doesn’t include BJC as an in-network provider. A BJC representative announced its plans in a room full of insurance brokers at an industry meeting at the end of September, according to brokers who attended the event held in the Sheraton Clayton Plaza Hotel in Clayton. (Liss, 11/2)
The Associated Press:
E. Coli In Northwest Marks Chipotle’s 3rd Outbreak This Year
Chipotle closed 43 of its Pacific Northwest locations after the chain’s third foodborne illness this year sickened about two dozen people — prompting renewed scrutiny of a company that touts its use of fresh ingredients and farm-sourced fare. (Blankinship, 11/3)
The Miami Herald:
Miami Lawmaker Pushes Bill To Ban Unexpected Medical Charges For Emergency Services
Like most patients, Robert Delfino did what his doctor told him: Go to the hospital for an outpatient cardiac procedure to determine the cause of his heart condition. Delfino, 54, was following the advice of his cardiologist, listed in his insurance company’s provider network catalog. Fortunately for Delfino, of Delray Beach, his coronary blockage was not serious enough to require a stent. The real problem came two months later, when Delfino received a bill for $15,000 from the hospital, which was not an in-network provider. (Chang, 11/2)
The Tampa Bay Times:
Death On The Wards: 14 People Who Didn't Have To Die In Florida's Mental Hospitals
When Florida cut $100 million from mental hospitals and fired a third of their workers, patients paid the price — sometimes with their lives. Since 2009, injuries and violent incidents have increased across the state. In some cases, patients died after overworked hospital employees made mistakes or delayed calling 911 for hours. Here are the stories of how 13 patients and a baby wound up dead in the state’s care. (Cormier, Braga and Anton, 11/2)
The Denver Post:
Confusion About Free-Standing ER Brings Colorado Mom $5,000 Bill
Carol Marshall's twin teenage daughters rarely needed a childhood doctor. But this spring, during their senior year of high school, each came down with something that wouldn't go away. Their mother took them on separate trips to what she thought was an urgent-care clinic in an Aurora shopping mall. She said a doctor spent a couple of hours with Alyssa, who had developed pneumonia and needed an antibiotic, and about 20 minutes with Courtney, who was fighting a chest cold or flu. (Olinger, 11/2)
The Denver Post:
HIV/AIDs Patients Find Needed Dental Help At Howard Dental
Five years after being diagnosed with HIV, Matthew Bratrsovsky knows what it is like to be stigmatized by those who fear, or look down on, people who have the virus that causes AIDS. Bratrsovsky is thankful he can let his guard down at Howard Dental Center, a nonprofit that offers dental services to HIV-positive and AIDS patients.Drugs used to treat the infection can cause dry mouth, a condition that leads to gum problems and cavities. Jayson Richardson, 36, who lost 14 teeth to gum disease, came to Howard to be fitted for partial dentures. (McGhee, 11/1)
The Charlotte Observer:
Rotech Cites Lower Medicare Reimbursements, Lays Off 61 In Charlotte
Rotech Healthcare is laying off 61 workers in its Charlotte office, citing lower Medicare reimbursements that will take effect in January. The company said affected employees handle customer service and medical supply sales at its call center at 207 Regency Executive Park Drive, Suite 200. The job cuts represent 56 percent of Rotech’s local workforce. Medicare will cut reimbursements by 40 percent to 50 percent for several products that Rotech provides, including physician-prescribed oxygen, oxygen equipment, positive airway pressure devices and other durable medical equipment and services, Rotech said in a statement. (Peralta, 11/2)
The Denver Post:
What's Next For Cannabis Industry? Diverse, Portable Business Models
Justin Henderson was a little gun-shy at first. But it was 2008, and the Great Recession had stalled the real estate industry, leaving the Denver-based developer sitting on properties that weren t cash-flowing. When a couple of friends and colleagues started leasing their warehouses to pot growers, Henderson weighed his own options. It s a tricky thing to tell everybody in your conservative financial life that you re part of the marijuana industry, he said. Henderson now heads a company he believes is poised to become a mover in the cannabis industry beyond Colorado s borders. To do so, Henderson's Peak Marijuana Dispensary, 260 Broadway in Denver, is diversifying — developing a line of marijuana products, acquiring hemp grows, keeping an eye on the implications of health care research — and exploring how to use intellectual property and licensing agreements to expand to other states. (Wallace, 11/2)
Viewpoints: The Cost Of Co-Ops Failures; GOP's Plans For Medicare
A selection of opinions on health care from around the country.
The Wall Street Journal:
ObamaCare’s Cascading Co-Op Failures
When it passed Congress in 2010, the Affordable Care Act offered substantial financial support to create nonprofit health-insurance plans. Today 11 of the 23 such regional Consumer Operated and Oriented Plans have failed—seven since the beginning of October. They’ve collapsed despite federal startup loans totaling more than $1.1 billion. These loans will likely never be fully repaid, while insurers and consumers will be on the hook for any unpaid claims left behind by failed insurers. (Adrian Smith, 11/2)
The Denver Post:
'Free' Health Care Costs Too Much
Last month, Colorado HealthOP, the state's largest non-profit health insurer, was removed from Colorado's Obamacare exchange, Connect for Health Colorado, because massive ongoing losses have rendered it financially unstable. As of next year, the co-op's 83,000 members will have to find new health coverage, while taxpayers are on the hook for more than $70 million in startup loans. The Denver Post reported earlier this year that Colorado HealthOP, which captured roughly 40 percent of all health insurance enrollments though the state exchange and was its largest carrier, garnered market share with an "aggressive price cut ... but analysts warn the move carries financial risk." (Ross Kaminsky, 10/31)
Health Affairs:
Public Litigation Challenging ACA Persists, But Court Dismisses State Government Challenge
Although Affordable Care Act (ACA) litigation seems unending, virtually all of the ACA lawsuits brought by private individuals have now either come to an end or are in their death throes (an important exception being the contraceptive coverage cases, which may well end up before the Supreme Court this term). Several cases filed by public entities, however, still continue before the courts. The most important of these is undoubtedly House v. Burwell, the case brought by the House of Representatives challenging the legality of funding for the ACA’s cost-sharing reduction payments, which will be heard in federal district court this winter. (Timothy Jost, 11/2)
Real Clear Health:
Douglas Holtz-Eakin: 'We've Created A Competition In Entitlement Programs'
Douglas Holtz-Eakin is the president of the American Action Forum and a former director of the Congressional Budget Office. He also served on President George W. Bush's Council of Economic Advisers. With the Affordable Care Act's insurance marketplaces beginning their third open enrollment this week, RealClearHealth talked to Holtz-Eakin about what's working, what's not working, what can be done today to address problems with the law, and what should be on the agenda of a new administration in 2017. (11/3)
Modern Healthcare:
GOP Debate, Ryan's Election As House Speaker Tee Up Medicare As A Top Issue
It's now conventional wisdom in the Republican Party that Medicare should be converted into a defined-contribution program to prod seniors into private Medicare plans and cap spending. That makes it likely Republicans will push forward with that model—which they've been advocating in various forms for more than 20 years—if they win the White House and maintain control of Congress in next November's elections. The big question is how much they'll actually do about it—or talk about it—prior to the elections, given Medicare's broad popularity. (Harris Meyer, 11/2)
JAMA:
Getting Serious About Reducing Suicide
Between 2005 and 2012, age-adjusted mortality rates declined for all 10 leading causes of death in the United States—except for suicide. The rate of suicide increased from 10.9 per 100 000 in 2005 to 12.6 per 100 000 in 2012. Suicide accounted for 41 149 deaths in 2013, the latest year for which national data are available. ... What is different about suicide, and why has there been so little progress in preventing it? (Jeffrey W. Swanson, Richard J. Bonnie and Paul S. Appelbaum, 11/2)