- KFF Health News Original Stories 5
- Red State Idaho Launches Its Own Obamacare Exchange
- Answers For Consumers As Obamacare Enrollment Reopens
- More States Expected To Expand Medicaid In 2015
- Network Blues: Big Bills Surprise Some E.R. Patients
- Medicare Proposes Coverage Of Low-Dose CT Scans To Detect Lung Cancer
- Political Cartoon: 'Reverting To Type?'
- Capitol Watch 4
- On The Cusp Of Its Second Enrollment Period, Health Law Still Faces Challenges
- States Race To Make Last-Minute Health Exchange Improvements
- Politics, Funding And Policy Issues Swirl Around State Medicaid Expansion Decisions
- Obamacare Architect Slammed For Voter 'Stupidity' Comments
From KFF Health News - Latest Stories:
KFF Health News Original Stories
Red State Idaho Launches Its Own Obamacare Exchange
Idaho will have the only new state marketplace this year, while Oregon and Nevada abandon failed state exchanges and go with healthcare.gov instead. (Phil Galewitz, 11/12)
Answers For Consumers As Obamacare Enrollment Reopens
KHN's Mary Agnes Carey and health policy analyst Susan Dentzer joined Judy Woodruff on PBS NewsHour Tuesday to answer questions from consumers about enrollment and the health care law. (11/12)
More States Expected To Expand Medicaid In 2015
Texas and Florida, with their large uninsured populations, are not expected to offer coverage to many low-income patients. (Mary Agnes Carey and Phil Galewitz, 11/12)
Network Blues: Big Bills Surprise Some E.R. Patients
Even when using hospitals in their insurance network, people often find that the doctors are not covered and they are responsible for those charges. (Carrie Feibel, Houston Public Media, 11/11)
Medicare Proposes Coverage Of Low-Dose CT Scans To Detect Lung Cancer
Beneficiaries who have a 30-year, pack-a-day smoking history would be eligible for this screening test. (Lisa Gillespie, 11/11)
Political Cartoon: 'Reverting To Type?'
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Reverting To Type?'" by Mike Luckovich, Atlanta Journal-Constitution.
Here's today's health policy haiku:
WHAT JONATHAN GRUBER SAID
He regrets comments
made about health law’s passage…
Still, news loves a gaffe.
- 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:
On The Cusp Of Its Second Enrollment Period, Health Law Still Faces Challenges
Those challenges are of both a political and legal nature, notes The New York Times. Other news outlets analyze premium costs: how they might change for 2015 coverage and fluctuate among states. Headlines also continue to parse the Obama administration's enrollment projections and examine why Latinos continue to be an important population to reach with the sign-up message.
NPR:
Affordable Care Act Has Many Political And Legal Challenges Ahead
The federal health exchange website is live this week for window shopping and people will begin to purchase new health insurance there on Saturday. But the Affordable Care Act still has many political and legal challenges ahead. (Liasson, 11/11)
CBS News:
Obamacare 2015: Higher Costs, Higher Penalties
With the Affordable Care Act to start enrollment for its second year on Nov. 15, some unpleasant surprises may be in store for some. That's because a number of low-priced Obamacare plans will raise their rates in 2015, making those options less affordable. On top of that, penalties for failing to secure a health-insurance plan will rise steeply next year, which could take a big bite out of some families' pocketbooks. (Picchi, 11/12)
U.S. News & World Report:
Health Insurance Premiums To Fluctuate Under Obamacare
Worried consumers have cited that they think their health care premium costs are on the rise, but recent analyses show the price of insurance is going to vary widely – primarily depending on where people live, but also depending on medical providers, the number of insurance companies and how many people ultimately choose to enroll. (Leonard, 11/11)
Marketplace:
Let's Do The Numbers Of Obamacare Enrollment
The Congressional Budget Office thinks a total of 13 million people will be insured through the heath care exchanges under the Affordable Care Act in 2015. The Department of Health and Human Services says, no, it’ll be in the 9 million range. One reason for the discrepancy: The CBO assumes lots of employers will shift more workers from company insurance plans, to the exchanges next year. But in reality, they may not be in any rush. (Marshall-Genzer, 11/11)
The Wall Street Journal:
Latinos Lag Under Health Law
One quarter of Hispanics in the U.S. lack health insurance, the highest rate for any racial or ethnic group, according to census data. Reducing that number will be one of the Obama administration’s biggest challenges when it reopens health-insurance exchanges for a second year on Saturday. During the first year’s sign-up period, just 2.6 million of an estimated 10.2 million uninsured Hispanics eligible for coverage enrolled in health plans, according to an October report by the Department of Health and Human Services. (Campo-Flores, 11/11)
States Race To Make Last-Minute Health Exchange Improvements
With the second lap of enrollment about to begin, a number of states are making sure their call centers are staffed up and other consumer-friendly changes are ready. In other news, Politico Pro reports that some states are finding it difficult to recoup the money spent on botched websites. News outlets also report on specific developments in Idaho, Minnesota, Arizona, Missouri and Nevada.
The New York Times:
States Race To Improve Health Insurance Exchanges
Massachusetts and Minnesota have sharply increased the number of call center workers who will help people enroll in health plans through the states’ insurance exchanges. Colorado has created an online avatar named Kyla to guide consumers through the sign-up process. And Maryland has replaced its exchange, which floundered last year, with Connecticut’s successful model. (Goodnough, 11/11)
Politico Pro:
States Slow To Recoup Money For Botched Obamacare Sites
Some of the states that built Obamacare exchanges wasted tens of millions of dollars paying contractors to build websites that ultimately didn’t work. Some are still trying to get the money back but not very aggressively. And like most issues that concern the health law, state efforts to recover money from the botched exchanges are clouded by political accusations. (Pittman, 11/11)
The New York Times' The Upshot:
Affordable Care Act Enrollment FAQs
Common questions about open enrollment and the Affordable Care Act. (Margot Sanger-Katz, 11/11)
Politico Pro:
Idaho Bucks The Trend On Obamacare Exchanges
Idaho is about to become the only state to break up with HealthCare.gov to enroll people in Obamacare. The evolution in Idaho — which will run its own website for 2015 sign-ups — is a sharp contrast to some of its neighbors’ experiences during the health care law’s first year. The exchanges in Nevada and Oregon suffered from such dysfunctional technology that both states are moving to the federal exchange for at least the upcoming enrollment season. (Pradhan, 11/11)
Kaiser Health News:
Red State Idaho Launches Its Own Obamacare Exchange
Idaho on Saturday becomes the latest state to launch its own health insurance exchange under the federal health law, with marketplace officials promising an easier shopping experience for consumers and greater responsiveness to insurance agents. But the exchange, yourhealthidaho.org, will be challenged to do as well as the federal insurance exchange during the first open enrollment period that ended last March. About 76,000 Idahoans signed up for private coverage at healthcare.gov, one of the most successful enrollments in any state. (Galewitz, 11/12)
Minnesota Public Radio:
As Much As They Dislike MNsure, Republicans May Only Tinker With It
As much as members of the GOP frequently criticize MNsure — and promise much more scrutiny of the exchange during the session that begins in January — with a Democratic governor and Senate still in place, big changes in MNsure remain unlikely. (Pugmire, 11/11)
The Yuma Sun:
Local Agencies Brace For ACA Open Enrollment
The second annual open enrollment period for health insurance under the federal Affordable Care Act begins Saturday, Nov. 15, and a coalition of local health care agencies will mark the launch with educational fairs and events as part of the “Cover Yuma County” campaign. Last year consumers nationwide struggled to sign up via the broken Healthcare.gov website, and locals had the added glitch of two out of the six insurers they were given to choose from not actually contracting with any Yuma County providers. The available plans for 2015 were posted on Healthcare.gov Monday, and Justin Farren, business development director for Yuma Regional Medical Center, said history is repeating itself in at least one respect. (Herzog, 11/11)
The St. Louis Post-Dispatch:
Missouri Consumers To Pay More For Health Coverage Next Year
Missouri health insurance consumers can get a first look at rates for 2015 coverage on HealthCare.gov, but they may be in for a bit of sticker shock.
St. Louis-area customers will have almost twice as many options to consider once open enrollment begins Saturday. Four insurers are selling a total of 42 different plans, a substantial increase from last year when only two carriers combined to sell 25 plans. ... But the increased competition isn’t necessarily driving down costs. (Shapiro, 11/10)
The Wall Street Journal:
New Nevada Health-Exchange Chief Faces Technology Shift
Nevada’s health exchange will look different this time around. After a bumpy first year, the exchange has uncoupled from its technology provider, Xerox Corp. , and connected instead to HealthCare.gov, the federal-government site. It also has a new leader, and new challenges. (Radnofsky, 11/11)
Politics, Funding And Policy Issues Swirl Around State Medicaid Expansion Decisions
News outlets report on various expansion issues, including the latest developments from Texas, Utah, Pennsylvania and Missouri.
The Texas Tribune:
Feds Have New Leverage In Medicaid Showdown
If Texas wants to keep receiving billions of federal dollars to help hospitals care for uninsured patients, state lawmakers may have to look again at expanding Medicaid coverage for impoverished adults, some political observers say. That's because in 2016, Texas will have to ask the federal Centers for Medicare and Medicaid Services to renew a five-year waiver to pump $29 billion into state health care coffers. Since landing its first such waiver in 2011, Texas leaders have defiantly refused to expand Medicaid as envisioned under the Affordable Care Act, leaving more than 1 million impoverished Texans with no health insurance. (Walters, 11/11)
Deseret News:
Florida Group Targets 'Healthy Utah' Medicaid Expansion Alternative
A Florida-based group is trying to stop Gov. Gary Herbert's Healthy Utah alternative to Medicaid expansion with a new website urging Utahns to sign a petition against the plan. The petition on UnhealthyUtah.com asks Herbert not to bring "D.C. values" to the state with his plan for spending the $258 million available to Utah for Medicaid expansion under the Affordable Care Act, also known as Obamacare. ... Jonathan Ingram, director of research for the Foundation for Government Accountability, incorporated in 2011 in Naples, Florida, said Utahns need to hear their case against Healthy Utah. (Roche, 11/11)
The Philadelphia Inquirer:
Corbett, Wolf Could Be On Medicaid Collision Course
Gov. Corbett this summer achieved what few thought was possible: Overcoming unlikely odds, the Republican won Obama administration approval for Pennsylvania to run its own version of Medicaid expansion. With that the program to bring insurance coverage to about 600,000 people gained support from disparate interests - insurance companies, health-care providers, and advocates for the uninsured. Corbett's reelection loss last week all but doomed his signature program, "HealthyPA," just as it was about to begin. And now confusion may loom for as many as 1.4 million people - those currently enrolled in Medicaid and those uninsured but newly eligible. (Worden, 11/11)
The Wall Street Journal:
Hospital CEO Contends With Medicaid Conundrum
The future of Truman Medical Centers, a two-hospital safety-net system [in Kansas City, Mo.], depends on the state legislature—and no one understands that better than its new chief executive, Charlie Shields. Mr. Shields, a genial 55-year-old, spent 20 years as a Republican lawmaker, ending up as the leader of the Missouri Senate before term limits forced him to step down. In 2010, he became chief operating officer of one of Truman’s hospitals, and in July he succeeded longtime Truman CEO John W. Bluford III. (Wilde Mathews, 11/11)
Kaiser Health News:
More States Expected To Expand Medicaid In 2015
Texas and Florida, with their large uninsured populations, are not expected to offer coverage to many low-income patients. Kaiser Health News staff writers Phil Galewitz and Mary Agnes Carey discuss what you need to know before open enrollment in the health law’s marketplaces begins again on November 15th. (Carey and Galewitz, 11/12)
Meanwhile, Pennsylvania officials are planning changes to the state's Medicaid program that is not linked to expansion issues.
The Associated Press:
Corbett Admin Says Medicaid Overhaul Will Simplify, Save Money
[Pennsylvania] Gov. Tom Corbett's administration is telling hundreds of thousands of adult Medicaid enrollees that their benefits will change as part of an overhaul of the medical coverage plans beginning Jan. 1. Notices were mailed last week, and adult enrollees will be sorted into one of two plans that best fit their needs, according to a spokeswoman for the Department of Public Welfare. ... The overhaul in medical plans under the traditional Medicaid program — which already insures many nursing home residents, childless adults with no income and some low-income parents — is separate from the vast, federally funded expansion of Medicaid eligibility set to take effect in Pennsylvania on Jan. 1. (Levy, 11/11)
Obamacare Architect Slammed For Voter 'Stupidity' Comments
A year-old video showing MIT economist Jonathan Gruber saying that "lack of transparency" made the passage of the health law possible has hit a political nerve.
The Washington Post:
Who Is Jonathan Gruber?
The MIT economics professor, best known until now for his key role advising the Obama administration on the Affordable Care Act, has come under attack after a year-old video of a University of Pennsylvania panel surfaced that featured him referring to the "stupidity of the American voter" and a “lack of transparency” as crucial to the passage of the 2010 health reform law. Those comments have struck a nerve on the right, with some of the law’s critics pointing to Gruber’s comments as evidence that the administration intentionally deceived the American public on the costs of the program. (DelReal, 11/11)
Fox News:
Obamacare Architect: Voter ‘Stupidity’ Prompted Cost Concealing
Just a few days before Americans get the pleasure of wading through the upgraded though still not completely debugged Healthcare.gov Website, another bombshell that paints a picture of public deception in pushing through the president’s unpopular health law has been dropped by Obamacare’s chief architect. (11/11)
House GOP Eyes Budget For Health Law Repeal, Medicare And Medicaid Transformations
Additionally, Rep. Paul Ryan, R-Wis., and Sen. Marco Rubio, R-Fla., are teaming up to develop a proposal to replace Obamacare. Former White House adviser David Axelrod recommends compromise, but Sen. Ted Cruz, R-Texas, is holding firm in his commitment to undo the Obama administration's landmark legislative achievement.
The New York Times:
In Control, Republicans See Budget As Way To Push Agenda
Next year, House Republicans will try again to transform Medicare and Medicaid, repeal the Affordable Care Act, shrink domestic spending and substantially cut taxes for high earners through the budget process. Then they will leave it to the new Senate Republican majority to decide how far to press the party’s small-government vision, senior House aides said this week. (Weisman, 11/12)
CNN:
Rubio, Ryan Crafting Obamacare Alternative
Two potential 2016 Republican presidential candidates -- Wisconsin Rep. Paul Ryan and Florida Sen. Marco Rubio -- are teaming up on a proposal to replace President Barack Obama's signature health care law. Their plan could be voted on in the new Congress next year, when the GOP will control both the House and Senate. (Walsh, 11/11)
The Chicago Sun Times:
Axelrod Says Obama Should Compromise On Obamacare Work Week
Obamacare has been under a consistent attack from Republicans since its creation, and while President Barack Obama said he's open to making "responsible changes to the Affordable Care Act to make it work better," former White House senior adviser David Axelrod said compromise is key. And while on MSNBC's "Morning Joe," Axelrod pointed directly at the definition of full-time workers under the law. "I think the key is to say, 'Are there areas in which they can work?'" Axelrod said. "Is it, you know, the number of hours from 30 to 40 in terms of how people are categorized for the program and what businesses have to do, whether a 30-hour week is enough to qualify for the program or whether you need more hours, those are things they ought to be able to compromise on." (Merda, 11/11)
Politico:
Ted Cruz Out On A Limb On Obamacare Repeal
Ted Cruz is still ready to use any means necessary to repeal Obamacare. But even his fellow conservatives aren’t all jumping on board – a sign that the Republican repeal or bust movement is struggling while Obamacare continues to enroll millions of people with health insurance. (Nather, 11/11)
The Washington Post's Fact Checker:
Repeat After Me: It’s About Obamacare And Workers, Not Jobs
Thom Tillis is a newly-minted senator from North Carolina, having narrowly defeated the incumbent, Sen. Kay Hagan (D). But in one of his first interviews since the campaign ended, he hauled out a stale talking point that has long been debunked. What’s dismaying about this is that The Fact Checker called out Tillis on this issue back in February, when his campaign first aired an ad making this claim. Time for a refresher course! (Kessler, 11/12)
Also in the news, women's health issues continue to draw voter attention -
Politico Pro:
Poll Finds Women’s Health Still A Winning Issue With Voters
Two abortion-rights groups released a four-state poll Tuesday that they say shows the Democrats’ focus on women’s health issues wasn’t the reason for their midterm election losses. (Villacorta, 11/11)
Meanwhile, on the legislative front -
CQ Healthbeat:
Bill Would Encourage VA To Accept Help From Volunteer Doctors
The House's chief appropriator on veterans' issues is making the case that it has been too difficult for doctors who want to volunteer their time at short-staffed Department of Veterans Affairs facilities and has readied legislation to address the issue in the upcoming lame duck session. Texas Republican John Culberson, who chairs the House Military Construction-Veterans Affairs Appropriations Subcommittee, said in an interview that the process of volunteering time at the VA is a "bureaucratic morass" and argued the department was turning away free help. (O'Brien, 11/10)
Investors Plow $7.5M Into Health Insurance Comparison Tool
The owners of Priceline.com and Kaha are building a website that they say will enable consumers to compare 75,000 state and federal exchange plans, as well as off-exchange plans. Other stories look at health savings accounts and whether life insurance companies should have access to your genetic test results.
The Miami Herald:
Healthcare.com Attracts $7.5M In Funding For Comparison Website
HealthCare.com likes to describe itself as the "Kayak of healthcare." On Tuesday, the Miami-based private online marketplace for insurance announced it closed a Series A funding round of $7.5 million from the owners of Priceline.com and Kayak, among other brands including most recently, OpenTable. The funding announcement comes as the U.S. government’s Healthcare.gov begins its second year of enrolling patients under Obamacare. Vargas said HealthCare.com’s healthcare insurance comparison tool, released this fall, allows people to compare 75,000 state and federal exchange plans as well as off-exchange plans (but it will not include subsidies available through Healthcare.gov). “Going forward, we are going to be adding other comparison features into other products such as Medicare and dental insurance,” Vargas said in an interview with the Miami Herald Tuesday morning. (Dahlberg, 11/11)
The Washington Post:
The Small Change That Can Save You Thousands Of Dollars A Year In Health Costs
Welcome to open enrollment season. That time of year when you get e-mail after e-mail from your employer reminding you of all the changes you need to make to your benefits. Of all the decisions that need to be made around now, one that often gets looked over is the chance to open a health savings account. (Marte, 11/11)
Los Angeles Times:
Should Life Insurance Firms Have Access To Your Genetic Test Results?
So, you're thinking you might like to check out one of those inexpensive new tests that would give you some insight into, say, the health implications of your ethnic heritage. It may, incidentally, turn up findings you may or may not want -- say, on your Alzheimer's disease risk, or your risk of developing lung, breast or skin cancer. ... Although the Genetic Information Nondiscrimination Act of 2008 bars the use of genetic information for health insurance coverage decisions, it does not do so when it comes to life insurance, disability insurance or long-term care insurance. (Healy, 11/11)
Kaiser Health News:
Network Blues: Big Bills Surprise Some E.R. Patients
In-network” and “out-of-network” – for people with health insurance, those words mean one thing: money. If you don’t want to get charged extra, you get your treatment done in-network. It sounds straightforward, but sometimes it doesn’t work out that way, even when patients think they’re playing by the rules. Jeffrey Craig Hopper, a probate attorney in Austin, Texas, knows all about following the rules. Still, accidents happen. Last June he was coaching a Little League practice session when an errant baseball smashed into his face. (Feibel, 11/11)
HHS Official: Providers Warn Patients Away From Dual-Eligible Pilots
Melanie Bella, who oversees programs for Americans covered by both Medicare and Medicaid, complains that providers are warning patients they will lose benefits if they participate in a managed-care initiative designed to test ways to reduce costs and improve quality. Meanwhile, a Center for Public Integrity probe finds that nursing home patients may not be receiving the advertised level of care.
Modern Healthcare:
CMS Official Says Some Providers Obstructing Dual-Eligible Demo
The CMS official in charge of coordinating care for Americans covered by both Medicare and Medicaid says some healthcare providers are illegitimately trying to dissuade dual-eligible beneficiaries from participating in a managed-care initiative designed to test ways to reduce costs and improve quality. She said her agency has increased its surveillance of these providers, though she did not identify any by name. “We are unfortunately seeing lots of bad behavior in most of the states,” said Melanie Bella, director of the Medicare-Medicaid Coordination Office at the CMS, during the National Association of Medicaid Directors (NAMD) on November 4. (Dickson, 11/11)
NBC News:
Nursing Home Care Levels May Be Much Lower Than Families Think
Many U.S. nursing home patients may not be receiving the level of care their loved ones believe they're getting, a Center for Public Integrity probe has found. Staffing levels reported by thousands of nursing homes on a widely-used government website were higher than the staff levels calculated by the Center for Public Integrity through an analysis of annual financial reports submitted by the homes, suggesting that consumers in those facilities may not be getting as many hours of skilled care as they expect. Experts have shown that the amount of care provided by nursing homes is linked to the quality of care. (Lowenstein, 11/12)
Modern Healthcare:
Kidney Groups Disappointed By CMS' Five-Star Rating System
Kidney care providers in the United States say they are disappointed and seriously concerned about the CMS' decision to move forward with its five-star rating program for dialysis facilities. The federal agency announced late Friday that it would go ahead in January with the rollout of the rating system, using methodology that has drawn harsh criticism from kidney-care groups since they first viewed it this summer. Kidney Care Partners said Monday that it is deeply troubling that the CMS would “summarily dismiss” recommendations provided by dialysis providers during a review period. (Rice, 11/11)
A selection of health policy stories from Kansas, Virginia, Hawaii, Massachusetts, Arizona, California, Texas and Maryland.
Kansas Health Institute News Service:
Lawmaker Says Adjustment Needed In Law Mandating Autism Coverage
The Kansas House member who last session championed a bill that expanded insurance coverage for autism treatment said it may be adjusted in the upcoming legislative session. Rep. John Rubin, a Shawnee Republican who was re-elected last week, said he will propose changes to House Bill 2744, which was a compromise struck between insurance companies and autism treatment advocates. The bill passed last session was expected to extend coverage to about 750 Kansas children from birth to age 5, which is about 20 percent of those estimated to need such treatment in the state. The new mandate requires insurance companies to cover up to 25 hours per week of a therapy known as applied behavior analysis treatment. Rubin said when the legislative session begins in January, he will push to loosen licensure requirements established in HB 2744 that restrict who can provide the treatment. (Marso, 11/11)
The Associated Press:
Lawmakers Approve Health Care Law Change
Virginia lawmakers approved emergency legislation Monday allowing health insurance companies to renew plans that do not meet the standards of the Affordable Care Act. (11/10)
The Associated Press:
Maui Hospitals Expect Massive Cash Flow Deficit
Maui County hospitals in Hawaii's state-subsidized public hospital network will have a cash-flow deficit of more than $46 million in two years if the status quo continues, administrators said. Decreased state funding, a decline in federal Medicare reimbursements and increased infrastructure and labor costs are pushing the hospitals into the red, The Maui News reported Tuesday. The Maui region of Hawaii Health Systems Corp. includes Maui Memorial Medical Center, Kula Hospital and Lanai Community Hospital. The deficit may force the hospitals to drastically cut services and jobs. They say families may have to fly to Oahu to receive care, administrators said in a statement. (11/11)
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. Called One Care, the initiative was designed to better coordinate health care services for about 95,000 disabled and low-income adults under age 65 when it launched last October. But the state’s latest count shows fewer than 18,000 enrolled, and officials have repeatedly declined to release detailed information about the program’s finances or the quality of patient care because they say they want to be able to analyze a year’s worth of data first. (Lazar, 11/10)
The Wall Street Journal:
Arizona Ballot Measure That Pushes Back Against Federal Actions Passes
The measure garnered strong support from conservative groups, and reflects growing angst in conservative-leaning states about federal laws, including the health-care mandates. (Carlton, 11/11)
Richmond Times-Dispatch:
Divided JLARC Panel Delays Decision On Medicaid Study
The Joint Legislative Audit and Review Commission, generally known for staying above the General Assembly’s partisan and ideological fights, was headed for a sharply divided vote on a two-year study of Medicaid that would rely on outside consultants at an unspecified cost. The commission decided to defer acting on the study resolution until next month, after advocates of the study agreed to give members more time to determine the potential costs and scope of the review. Later on Monday, the General Assembly agreed on legislation to allow health insurers to offer customers the option of keeping health policies that don’t comply with the Affordable Care Act through Sept. 30, 2017. (Martz, 11/10)
The Associated Press:
California: Nurses Go On Strike
As many as 18,000 nurses went on strike Tuesday and picketed in front of Kaiser Permanente facilities in Northern California over concerns about patient-care standards and Ebola. The two-day strike by the nurses, who have been in contract talks since July, was expected to affect at least 21 Kaiser hospitals and 35 clinics and last until 7 a.m. Thursday. (11/11)
The Washington Post:
Ebola Victim Thomas Eric Duncan’s Family Has Settled With Dallas Hospital
Now, after alleging that Texas Presbyterian had not done right by Duncan, his family has reached what its attorneys called a “resolution” with the health-care facility. According to a statement issued by the law offices of Miller Weisbrod, Duncan’s family will hold a press conference on Wednesday morning “regarding a resolution they have reached on behalf of the children and parents of the deceased with Texas Health Resources and all related entities,” as WFAA 8 reported. (Moyer, 11/12)
Stateline:
With New Casinos, Some States Offer Help To Gambling Addicts
Michael Rosen, an admitted gambling addict, is well-acquainted with the danger of proximity to temptation. Twice during substantial periods of abstinence, he found himself – by chance, he insists – staying in hotels with casinos. And both times, he didn’t remain in his room. “I couldn’t resist,” he said. Now 71 and “sober” since 2008, Rosen is a coordinator with the Maryland Center of Excellence on Problem Gambling. His job is to help others with a gambling problem get the help they need to prevent gambling from wreaking havoc with their lives. For many, that help may be the resolve to stay away from one of the five casinos that have sprouted in Maryland since voters approved casinos in 2008. Of the 23 states that allow casino gambling, 18 have statutes that provide services for people with gambling problems, according to the National Conference of State Legislatures. All five of the states that authorized casino gambling since 2004 (Florida, Kansas, Maryland, Oklahoma and Pennsylvania) passed legislation creating problem gambling programs at the same time. Some of the other states that previously allowed casino gambling, such as Nevada, New Jersey and New York, have since initiated their own addiction programs. (Ollove,11/11)
A selection of opinions on health care from around the country.
The Washington Post:
It Was About Obamacare. Big Time.
A number of liberal pundits working off of White House talking points became heavily invested in the argument that the election was not about Obamacare. They seemed to believe if the election was about something else, Obamacare wouldn’t be repudiated or the GOP would lack a mandate to get rid of it. This was, to put it mildly, silly and desperate. (Jennifer Rubin, 11/11)
USA Today:
Sen. Orrin Hatch: We're Ready To Repeal, Replace
Voters last week flatly rejected the Obama administration's policies and created a new opportunity to improve American health care by electing a Republican Congress that is firmly committed to repealing and replacing Obamacare. With a flawed website launch, failed state exchanges, burdensome mandates, mass cancellations of coverage and countless other broken promises paid for by Medicare cuts and a trillion dollar tax hike, it's no wonder so few Democratic candidates campaigned on the merits of Obamacare. (Sen. Orrin Hatch, R-Utah, 11/11)
USA Today:
Obamacare In Peril 4 Years Later: Our View
Getting Obamacare up and running has been like trying to build a house while gangs were throwing rocks at the carpenters and inept plumbers were bungling the pipes. Between relentless attacks and self-inflicted mistakes, what would have been a tough job under good conditions has flirted with disaster. And yet, at least for now, the law survives. Millions more people have health coverage than a year ago, including many who previously couldn't afford it or qualify. (11/11)
Reuters:
Should Obamacare Be Derailed By A Single Sentence?
In completing a book on the saga of Obamacare, due out in about seven weeks, I thought the argument in King v. Burwell by the Obamacare opponents was so absurd that I didn’t spend much time on it. But what I did find out is that no legislator or staff member on either side of the aisle that I spoke with ever thought that the subsidies would not go to the states using the federal exchange, and that the confusion and inconsistency in the wording was the result of some last-minute cutting and pasting of a phrase from a prior draft. Put simply, from what I can tell, the Obamacare opponents’ current argument that the sentence they have homed in on was put there to penalize states that did not set up their own exchanges is not something that was on the minds — or that emerged in the conversations, memos or drafts — of anyone involved in the negotiating, writing and passing of Obamacare. (Steven Brill, 11/11)
Bloomberg:
How States Can Save Obamacare
It's possible that the congressional Democrats who drafted Obamacare five years ago purposely sabotaged their signature accomplishment, failed to tell anyone and are now lying about it. More likely, they just made a mistake -- and the states can easily address it. ... Until last week, refusing to build a state exchange was an easy way for state Republicans to demonstrate opposition to Obamacare without actually incurring any cost to their constituents. That calculus has now changed. If the court rules that subsidies are illegal in states that use the federal exchange, insurance will become unaffordable for the almost 5 million people who now get those subsidies. (11/11)
The Chicago Sun Times:
Obamacare Needs Boost In Illinois
More than 168,000 people in Illinois get a federal subsidy on their health insurance through the Affordable Care Act, better known as Obamacare. Beginning Friday and continuing through Feb. 15, thousands more people are likely to sign up for Obamacare, also finding it affordable because of the subsidy. For the sake of all these financially strapped people, the Illinois General Assembly should move quickly to make sure those tax considerations continue even if the U.S. Supreme Court next year rules against Obamacare’s current system of subsidies. (11/10)
Bloomberg:
Obamacare May Die So Gay Marriage Survives
The U.S. Court of Appeals for the Sixth Circuit last week essentially forced the Supreme Court to decide whether there's a constitutional right to same-sex marriage, by refusing to recognize such a right itself. The next day, the court agreed to hear a potentially fatal legal challenge to the Affordable Care Act. Taken together, these two cases transform the current Supreme Court term into a blockbuster -- and the linkage relationship between them will be all-important. ... if the Roberts Court (without Roberts’s vote) announces a fundamental constitutional right to marry, its liberal legacy will be so prominent that [Chief Justice John] Roberts may have reason that he can kill Obamacare without tarnishing the court’s reputation too much. (Noah Feldman, 11/11)
The Washington Post's The Volokh Conspiracy:
Obamacare And Gay Marriage — The Missing Link
On Tuesday, Harvard law professor Noah Feldman speculated in a blog post about a possible “linkage” between the pending ACA case and a likely same-sex marriage case this Term. Not that he asserts any linkage in the facts, legal issues, or background principles, which would be a fascinating read. ... the conjecture in his BloombergView post is unpersuasive on its own terms and reflects a dismaying trend in constitutional-law writing: a hyper-legal-realism that is neither legal nor very real. (Dale Carpenter, 11/12)
Roanoke Times:
Why Do Some GOP Governors Like Medicaid?
If even a conservative Republican such as [Ohio Gov. John] Kasich (and [Kentucky Sen. Mitch] McConnell, for that matter) can see value in expanding Medicaid, why are the Republicans in the Virginia General Assembly so adamant against it? Have they simply backed themselves into an ideological corner they can’t get out of? Political analyst Mark Rozell at George Mason University says yeah, that’s pretty much it: “Kasich and some of the other GOP governors are pragmatists who happen to be conservatives. The legislators here who oppose taking the federal money are ideologues who happen to hold elective positions." ... Used to be, Republicans were considered the party of business. And you can’t get more businesslike than the Virginia Hospital and Healthcare Association (or the state Chamber of Commerce, for that matter). Both groups are pushing for Medicaid expansion, citing the kind of bottom-line figures that Republicans used to crave. GOP legislators appear unwilling even to listen to big voices in the business community. (11/9)
The Wall Street Journal's The Experts:
Here’s The Math For Calculating ACA Subsidies
One health insurance-related mistake that I’ve seen many people make this year is to fail to realize that they have some control over the size of Affordable Care Act subsidies that they can receive for purchasing health insurance on the new exchanges. Assuming you meet the other requirements for eligibility (e.g., not having “affordable” coverage through your employer), your “household income” is what determines the size of the subsidies that you can receive. (Piper, 11/12)
The Wall Street Journal:
Ebola And American Role Models
Now declared Ebola-free, Craig Spencer left New York City’s Bellevue Hospital on Tuesday. How will he be received by a wary public? After returning from treating Ebola patients in West Africa last month, Dr. Spencer traveled around town in an Uber cab, went bowling and rode the subway hours before being diagnosed with the virus. He thus earned widespread condemnation in the media, charged with “selfishness,” “solipsism” and worse. ... Maybe it’s time to reconsider. (David Feith, 11/11)
The Journal of the American Medical Association:
Now Is The Time For True Reform Of Mental Health Services
The most positive aspect of health care reform is the widespread recognition of the complexity of the primary care of patients with chronic multiple comorbid illnesses. This includes the way in which frontline clinicians prioritize care needs in the context of numerous competing risks and value judgments, as well as the management of complex care transitions and the coordination of teams deployed to reflect the integration of all necessary care components. Mental health services, in this case to address dementia and depression in old age, must become a much higher priority in the health care system of the future. (Dr. Constantine G. Lyketsos, 11/11)