Kaiser Health News Original Stories

3. Research Gives Context To Addressing Nation's Drug Abuse Crisis, Review Finds

As presidential candidates, state officials and even President Barack Obama wrestle with how to handle drug addiction, scientists lay out some of the intersections between opioid prescriptions and heroin abuse in the New England Journal of Medicine, including findings that crackdowns on opioid prescriptions may not fuel increases in heroin use. (Shefali Luthra, 1/13)

4. Political Cartoon: 'Smile, You're On Camera'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Smile, You're On Camera'" by Chip Bok.

Here's today's health policy haiku:


Biden to pilot
New “moonshot” to cure cancer.
A mission of love.

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.

Health Law Issues And Implementation

5. Obama Hopes To Entice Reluctant GOP States With Extended Medicaid Funding

Full federal funding of the Medicaid expansion is scheduled to slowly phase down to 90 percent starting next year. Obama wants to allow any state that decides to expand Medicaid eligibility under the law to get three years of full federal funding, no matter when the expansion starts.

Kaiser Health News: Obama Seeks To Offer New Incentive For States To Expand Medicaid
With full federal funding for expanding Medicaid set to expire at the end this year, President Barack Obama is proposing to indefinitely extend the health law provision for any of the 19 states that have not yet adopted the enhanced eligibility. But Obama would need the Republican-controlled Congress to approve the offer. That appears unlikely considering Congress voted last week to repeal the Affordable Care Act, though the GOP critics did not muster enough support to override the president’s veto. Obama will seek congressional approval for extending the three years of full federal funding in his 2017 fiscal year budget proposal, which is scheduled to be released Feb. 9. (Galewitz, 1/14)

Reuters: Obama To Offer In Budget To Extend Deadline For Medicaid Expansion
President Barack Obama will offer a financial incentive in his fiscal 2017 budget proposal to 19 state governments that passed up an earlier offer to help pay to expand Medicaid coverage to more low-income residents, the White House said on Thursday. Obama's new proposal would give states more time to opt in, and would pay for the expansion for three years, the White House said in a release. (Rampton, 1/14)

USA Today: President To Propose Incentive To Lure More States To Expand Medicaid
President Obama plans to propose giving new states that expand Medicaid coverage to the poorest of the poor more time before they have to chip in to cover the new recipients, the White House said in a blog post early Thursday. Obama's fiscal 2017 federal budget will include a legislative proposal to provide any state that expands Medicaid with the same three years of full federal funding and same phase down as the states that expanded the program in 2014. (O'Donnell, 1/14)

The Wall Street Journal: Obama Seeks To Boost Financial Assistance For States’ Medicaid Expansion
White House officials said President Barack Obama will ask Congress to include three years of full federal funding of expansion for any state that extends eligibility for the program to most low-income residents. "This common-sense proposal makes the expansion as good a deal for states that expand now as it is for the states that have already done so," wrote Shaun Donovan, director of the White House Office of Management and Budget, and Cecilia Muñoz, assistant to the president and Director of the Domestic Policy Council. (Radnofsky, 1/14)

Los Angeles Times: Can Obama Persuade Reluctant States To Expand Medicaid? New Aid Plan Aims To Do So
Providing this additional assistance would probably be expensive. The White House did not provide a cost estimate. It also would require congressional approval, which is likely to be difficult, given persistent GOP antipathy to the health law. Congressional Republicans this month passed legislation, which Obama vetoed, that would have repealed large sections of the law, including the Medicaid expansion. (Levey, 1/13)

6. Health Law's Risk Strategies Could Be Creating Reverse Robin Hood Effect

The original purpose of the obscure insurance risk adjustment was to support plans with a lot of sick patients by giving them money from ones with healthier customers. In reality, critics say, it's not working that way. In other health law news, "concierge medicine" is no longer just for billionaires and more on what the Cadillac tax delay means.

The Washington Post: Critics Say ACA ‘Risk’ Strategies Are Having Reverse Robin Hood Effect
The administration defends its approach, but critics say the “risk adjustment” program is having a reverse Robin Hood effect — taking money from some plans that are small, innovative or fast-growing, while handing windfalls to some of the industry’s most entrenched players. The goal of the practice is to help keep insurance markets stable by sharing the “risk” of sicker people and removing any incentive for plans to avoid individuals who need more medical care. Such stability is likely to encourage competition and keep overall prices lower for consumers, while its absence can undermine both and limit coverage choices — the basic principles of the law. (Goldstein, 1/13)

Kaiser Health News: Fueled By Health Law, ‘Concierge Medicine’ Reaches New Markets
A growing number of primary care doctors, spurred by the federal health law and frustrations with insurance requirements, are bringing a service that generally has been considered “health care for billionaires” to middle-income, Medicaid and Medicare populations. It’s called direct primary care, modeled after “concierge” practices that have gained prominence in the past two decades. (Luthra, 1/14)

California Healthline: 'Cadillac' Tax Delay: A Chance To Refine or First Step To Kill It Altogether?
Opponents of the Affordable Care Act's so-called "Cadillac" tax won a major victory last month when President Obama delayed its implementation for two years via a spending package. Under the Cadillac tax, companies pay a 40% levy on the value of generous employee health plans above a certain limit. The first year of the tax calls for a $10,200 annual cap for an individual plan and a $27,500 cap family coverage. (Ackerman, 1/14)

Meanwhile, states prepare for the end of open enrollment —

The Sacramento Bee: No Health Insurance? Californians Face Tax Bite Of Up To $10,000 Per Family
Sign up for health care coverage of pay the price. That's the message from Covered California officials, who urged consumers Wednesday to sign up for Obamacare coverage by the Jan. 31 deadline or face stiff tax penalties. This year, the penalties are hitting harder, ranging from a minimum of $700 for an individual to as much as $10,000 for a family of four, depending on income. The average penalty in 2016 will be $969. That’s a 47 percent increase from last year, according to a recent analysis by the nonprofit Kaiser Family Foundation. (Buck, 1/13)

The Associated Press: MNsure Vows To Up Staffing To End Long Call-Wait Times
Officials at MNsure vowed Wednesday to beef up call center staff for the final weeks of open enrollment, hoping to reverse lengthy call delays late last month that hark back to the exchange's disastrous first year rollout. Just past a key deadline for consumers to buy insurance effective for the new year, MNsure said it is on track to meet projections for signups for the private plans that fund its budget. Open enrollment ends Jan. 31. But after focusing last year on improving its call center to soothe frustrated customers, some people still spent more than an hour waiting for help in the final week of December. (Potter, 1/13)

WBTV (Charlotte, N.C.): Woman Spends More Than 7 Hours On Hold With Blue Cross Blue Shield
There's a new song on repeat inside Stephanie Nelson's home, but it's not one you would expect. "That ping ping, just makes me want to punch somebody in the face," Nelson said. Nelson is talking about the hold music that plays over and over as she waits for a representative from Blue Cross Blue Shield North Carolina to answer. ... When WBTV visited Nelson Tuesday afternoon, she had been on hold for hours – nearly five to be exact – trying to work out her BCBS insurance policy that's somehow disappeared. (Morgan, 1/14)

7. Kentucky Governor's Move To Disband Health Marketplace Raises Concerns

The insurance exchange had been among the country's most successful, but the Republican governor had vowed to get rid of it during the campaign.

The New York Times: With Health Care Switch, Kentucky Ventures Into The Unknown
There is no longer any question that Gov. Matt Bevin of Kentucky plans to shut down the health insurance exchange his state built to enroll residents for coverage under the Affordable Care Act. Now that he has notified the Obama administration of his intention to do so, the question is, will it change the law’s substantial impact there? It is hard to predict, partly because what Mr. Bevin is doing is without precedent. While a few states have been forced to largely rely on the federally run exchange after their own versions failed, Kentucky will be the first to abandon a homegrown exchange that functions well. (Goodnough, 1/13)

CQ Healthbeat: Kentucky Advocates Defend Health Insurance Exchange
Kentucky Gov. Matt Bevin’s plan to eliminate the state’s health insurance exchange will diminish the level of enrollment support for low-income residents, who used it to sign up by the thousands for coverage under the 2010 federal health care law, according to the system’s advocates. Bevin told federal officials in a Dec. 30 letter that the state intends to drop its exchange, Kynect, and have its residents use Healthcare.gov, the federal health exchange, to sign up for insurance. Bevin’s office provided no details about the timing of the transition, but said there will be no impact on Kentuckians’ ability to obtain or continue health care coverage for the 2016 plan year. (Evans, 1/14)

8. Va. Gov

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