KHN's Morning Briefing will not be published on Thanksgiving or on Friday. Look for it again in your inbox on Monday, Nov. 30.
A KHN analysis finds a sharp difference in premium prices between plans that offer out-of-network care and those that do not. (Julie Appleby and Jordan Rau, 11/25)
Federal policy requires that California broaden taxes on insurers to fund Medicaid, but state insurers and many Republican legislators are opposed. (Barbara Feder Ostrov, 11/25)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: Permission To Pig Out" by Steve Kelley and Jeff Parker, from 'Dustin'.
Here's today's health policy haiku:
TURKEY, STUFFING AND GRAVY
Thanksgiving is here.
Enjoy food and family.
We’ll be back Monday.
If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.
Some of the co-op failures and the threat from UnitedHealthcare about a possible pull-out in 2017 are prompted by low levels of federal payments to help shield insurers from losses in the exchanges. Rubio helped lead an effort to stop those payments. Meanwhile, HHS Secretary Sylvia Burwell says she is trying to get more information about costs to consumers.
The Hill: Rubio Budget Win Is Dealing Heavy Blow To ObamaCare
Sen. Marco Rubio may have dealt the biggest blow in the GOP’s five-year war against ObamaCare. A 2014 budget measure inspired by the Florida senator and presidential hopeful is pushing some insurers to drop out of the ObamaCare exchanges, experts say. ... This fall, more than a dozen health insurers representing 800,000 people have dropped out of the ObamaCare exchanges, many out of fear that the administration no longer has the cash to cushion their losses in the costly early years of the marketplace. ... The angst in the industry centers on an obscure program in the healthcare law known as “risk corridors” that was designed to shield insurers against losses. Rubio in 2013 went on the warpath against the program, decrying it as a “taxpayer bailout.” (Ferris, 11/24)
Bloomberg: Top Obamacare Official Makes Tweaks As Insurer Complaints Grow
To reduce turbulence in Obamacare’s fledgling insurance markets, the Obama administration’s top health official is pushing to get more information to consumers about what they’ll actually pay for health care, which can include out-of-pocket costs as well as premiums. The changes are meant to help people choose coverage that fits their needs when up-front premiums and out-of-pocket costs are added together, Health and Human Services Secretary Sylvia Mathews Burwell said during an interview at Bloomberg News’s Washington bureau. Cases of patients signing up, paying for a time, and then dropping out of Obamacare have plagued insurers like UnitedHealth Group Inc., which is debating whether to exit the government-run market to avoid more financial losses. (Tracer and Winkler, 11/24)
Kaiser Health News: As HMOs Dominate, Alternatives Become More Expensive
Consumers seeking health policies with the most freedom in choosing doctors and hospitals are finding far fewer of those plans offered on the insurance marketplaces next year. And the premiums are rising faster than for other types of coverage. The plans, usually known as preferred provider organizations or PPOs, pay for a portion of the costs of out-of-network hospitals and physicians. They are the most common type offered by employers, and some consumers in the individual marketplaces find them more appealing than health maintenance organizations and other policies that pay only for medical facilities and doctors with whom they have contracts. (Appleby and Jordan, 11/25)
News outlets also report on state developments -
The Associated Press: Health Co-Op Failure In NY Leaves Doctors Owed Millions
The sudden collapse of the largest nonprofit insurance cooperative created by President Barack Obama's health care law is causing headaches in New York, especially for medical providers owed millions of dollars for treating the failed plan's patients. More than 200,000 people insured through Health Republic Insurance of New York have until Monday to sign up with another company if they want to maintain coverage in December. State regulators ordered the insurer to shut down at the end of the month because of severe financial problems. They are also investigating what they say were inaccurate financial filings by the company. (Caruso, 11/24)
The Associated Press: Arizona Health Insurance Co-Op To Close Shop Dec. 31
Executives with Arizona's nonprofit health insurance co-op said Tuesday that they have failed to come up with additional financial backing and the insurer plans to shut down all operations Dec. 31. The announcement by Meritus Health Partners means 59,000 Arizonans it now covers need to find a new insurer by Dec. 15 if they want coverage on Jan. 1. The decision comes nearly a month after the state Department of Insurance suspended its right to sell new policies or renew current ones and placed it under formal supervision. Federal officials also pulled its policies from the health insurance marketplace website late last month. (Christie, 11/24)
The Associated Press: MNsure Says More Qualifying For Subsidies This Year
More Minnesota residents are qualifying for financial help this year to buy coverage on the state's health insurance exchange. MNsure announced Monday that more than 70 percent of the customers buying private insurance so far this month have received federal subsidies. That's up from roughly 50 percent last year. (11/23)
The Tampa Bay Times: Tampa Again Opening Recreation Centers To Obamacare Navigators
For a third straight year, Tampa is opening its recreation centers to health care navigators so residents can get advice about signing up for coverage under the Affordable Care Act. This year, Tampa is competing with 20 other cities in a White House-sponsored Healthy Communities Challenge competition to see which can sign up the highest percentage of people who lack coverage. The winning community will get a visit from President Barack Obama to highlight its success. (Danielson, 11/24)
The Oregonian: Oracle Wins Key Federal Ruling In Cover Oregon Website Case
Oregon's court battle with Oracle America is not going to get cheaper anytime soon. In August 2014, the state and the California software giant each filed lawsuits blaming the other for the $300-million collapse of the much-touted Cover Oregon health insurance website project. (Budnick, 11/24)
Researchers find a substantial increase in the number of women under the age of 26 who get a diagnosis of early-stage cervical cancer since the implementation of the health law, which allowed young adults to stay on their parents' plans until that age.
The New York Times: Rise In Early Cervical Cancer Detection Is Linked To Affordable Care Act
Cancer researchers say there has been a substantial increase in women under the age of 26 who have received a diagnosis of early-stage cervical cancer, a pattern that they say is most likely an effect of the Affordable Care Act. Starting in 2010, a provision of the health law allowed dependents to stay on their parents’ health insurance until age 26. The number of uninsured young adults fell substantially in the years that followed. The share of 19- to 25-year-olds without health insurance declined to 21 percent in the first quarter of 2014 from 34 percent in 2010 — a decrease of about four million people, federal data show. (Tavernise, 11/24)
USA Today: Early Detection Of Cervical Cancer Increased After ACA Expanded Coverage
The Affordable Care Act may have helped more women get early treatment for cervical cancer, according to a preliminary new study. The fraction of young women whose cervical cancers were found and treated early -- when women have a better chance of survival -- increased after 2010, when the ACA expanded insurance coverage to young people by allowing them to remain on their parents' health plans. (Szabo, 11/24)
Meanwhile, in Alabama, a recent state task force recommendation gives the idea of Medicaid expansion additional momentum.
The Fiscal Times: How States Are Using Medicaid Funds To Help The Homeless
One of the most important developments in Medicaid’s 50-year history has been the Obamacare provision that allows states, if they choose, to greatly expand their health insurance coverage to virtually all low-income families and individuals below retirement age. (Pianin, 11/24)
AL.com: Obamacare Medicaid Expansion Could Cover 290,000 In Alabama
John Dunnam of Warrior works 12 to 20 hours a week as a janitor. He collects a small salary that barely covers rent, food and other bills. It certainly wouldn't cover the monthly cost of health insurance on the federal exchange. ... Dunnam falls into the Medicaid gap, a group of patients who were supposed to be covered by an expansion of Medicaid – the health care program for low-income adults under Obamacare. ... On Wednesday, the Health Care Improvement Task Force unanimously recommended that the governor and legislature reverse their earlier decision and close the coverage gap for nearly 300,000 patients like Dunnam. (Yurkanin, 11/24)
The Associated Press examines the tactics and issues that will be involved in the Republican push to overturn the 2010 health law and federal funding of Planned Parenthood. Also, Politico Pro looks at competing congressional strategies on mental health overhauls.
The Associated Press: GOP Sets Senate Push Against Health Law, Planned Parenthood
Congressional Republicans hope a post-Thanksgiving drive to obliterate President Barack Obama's health care law and block Planned Parenthood's federal funds will spotlight their fierce support for top-tier conservative causes. The certain veto waiting at the White House will only help them sharpen their stance for voters, they say. Yet even as GOP leaders express optimism that they'll push the bill through the Senate, the run-up to the debate reveals the tightrope they face to win the needed votes. (Fram, 11/24)
Politico Pro: Mental Health Bill Collides With Guns — Again
The spate of mass killings over the past year reignited mental health reform efforts in both chambers of Congress. A bipartisan bill is gaining momentum in the Senate, with the HELP committee likely to take it up early next year. The House Energy and Commerce health subcommittee recently approved a similar bill and Speaker Paul Ryan this month said on “60 Minutes” that he wants Congress to move ahead on mental health. But the Senate’s No. 2 Republican, John Cornyn of Texas, has been working behind the scenes to drum up support for his own mental health legislation, which includes language endorsed by the National Rifle Association. Cornyn says his bill would boost the federal background check system to prevent guns from getting into the hands of those with serious mental illness. His critics say the legislation actually loosens restrictions on gun purchases, under the umbrella of mental health reform. (Ehley, 11/24)
Before entering GOP politics, Dr. Ben Carson tried to develop a nonprofit that would provide financial assistance to patients without insurance, but it didn't work. In other campaign news, Democratic presidential contender Martin O'Malley offers his plan for health care, and Republican Sen. Marco Rubio refines his comments about abortion.