Kaiser Health News Original Stories

1. Farm Contractors Balk At Obamacare Requirements

The federal health law is putting farmers in a tough spot. Many contractors supplying workers have to offer health coverage. Insurance is costly, and contractors worry about immigration fallout. (April Dembosky, KQED, 2/11)

2. Political Cartoon: 'One And The Same'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'One And The Same'" by Dan Piraro.

Here's today's health policy haiku:

ANOTHER FIGHT IN THE BATTLE AGAINST ZIKA

A mosquito’s bite
Could add fuel to battle
Over abortion.

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

3. New Ky. Governor's Efforts On Health Care Galvanizing ACA Supporters And Opponents

Gov. Matt Bevin has become a hero to conservative Republicans opposed to the federal health law, while Obamacare supporters are concerned that his actions could hurt the 2 million people who have gained coverage in the state. In other news, a look at how the health law is affecting farm contractors, and Maryland reports its enrollment numbers.

The Fiscal Times: New Governor Moves Quickly To Dismantle Obamacare In Kentucky
Tea party Republican Matt Bevin had to tone down his anti-Obamacare rhetoric in order to win election as governor of Kentucky last November. Since then, there has been intense speculation over what Bevin would do to make good on his campaign promise to phase out Kynect, Kentucky’s state-run health insurance exchange .... Bevin is a hero among conservative Republicans who have been trying for years in Washington to either dismantle or seriously weaken the ACA, the signature health care initiative of President Obama. However, critics and healthcare advocates warn that Bevin’s move will create chaos and confusion for more than two million Kentuckians who currently are enrolled in private health insurance policies or Medicaid through Kynect. (Pianin, 2/10)

Kaiser Health News: Farm Contractors Balk At Obamacare Requirements
Obamacare is putting the agricultural industry in a tizzy. Many contractors who provide farm labor and must now offer workers health insurance are complaining loudly about the cost in their already low-margin business. Some are also concerned that the forms they must file with the federal government under the Affordable Care Act will bring immigration problems to the fore. About half of the farm labor workforce in the U.S. is undocumented. (Dembosky, 2/11)

The Baltimore Sun: State Health Insurance Enrollment Exceeds Goal
More than 162,000 Marylanders signed up for insurance under the Affordable Care Act, a 33 percent jump from last year that surpassed a state goal of 150,000 new people on the health insurance rolls. Officials with the Maryland Health Benefit Exchange, which oversees the state's enrollment efforts, released Tuesday the final numbers for this year's three-month enrollment period, which ended Feb. 5. Consumers had an extra five days to get insurance this year because of the January snowstorm that crippled the region. (McDaniels, 2/10)

4. Kansas House Rejects Debate On Medicaid Expansion

In a procedural move, the Kansas House denied efforts by expansion supporters to add the program during a debate on the budget. News outlets also report on Medicaid expansion debates in New Hampshire and Nebraska.

Topeka (Kan.) Capital-Journal: House Blocks Debate On Medicaid Expansion On Procedural Grounds
The House rejected an attempt Wednesday to force a debate over Medicaid expansion amid work on the state budget. Representatives voted 85-37 to block a Medicaid expansion package on procedural grounds. ... Last year, the House Vision 2020 Committee put forward a Medicaid expansion package, though it wasn’t debated on the House floor. It isn’t entirely clear House leadership would have enough votes to stop expansion from passing the chamber if it was brought up for a vote. Before the 2016 session, House Speaker Ray Merrick, R-Stilwell, also took three Republicans off the House Health and Human Services Committee. All three of the lawmakers are supporters of expansion. (Shorman, 2/10)

KCUR (Kansas City Public Radio): Medicaid Expansion Votes Denied In Both Kansas Chambers
House members were denied a vote on Medicaid expansion on procedural grounds in a floor debate Wednesday that mirrored one the Senate had a day earlier. Rep. Jim Ward, a Democrat from Wichita, tried to attach the amendment to enact expansion during the beginning of an hours-long debate on the state budget. ... He was stymied by a House rule that requires offsetting spending cuts for any amendments that add costs to the budget. Ward disagreed strongly when the rule was invoked. Under the ACA, Medicaid expansion is fully federally funded this year, but the states must kick in 5 percent next year. (Marso, 2/10)

The Associated Press: Republicans Block Kansas House Debate On Medicaid Expansion
The vote Wednesday in the GOP-dominated chamber was 85-37 against debating a proposal from Democratic Rep. Jim Ward of Wichita to expand for three years the health program for the poor, a move encouraged by President Barack Obama's health care law. The Kansas Medicaid program provides coverage for 362,000 poor and disabled Kansans, and Ward's proposal would have provided coverage for another 160,000 people. ... The Kansas Hospital Association and many advocates for the poor and disabled are pushing for an expansion of the Medicaid program. The 2010 federal health care law encouraged states to expand their Medicaid programs by promising that the federal government would pick up almost all of the costs. ... Republican Gov. Sam Brownback and GOP legislative leaders have argued that the federal government can't be trusted to keep its funding promises because of its own budget problems. Opponents also believe expanding Medicaid would be far more expensive for Kansas than supporters of the idea say. (2/10)

Concord (N.H) Monitor: House Gets Closer To Reauthorizing Medicaid Expansion
The Republican-controlled House gave initial approval to a bill that reauthorizes the state’s Medicaid expansion program for two more years. “This is the right thing to do for New Hampshire,” said the bill’s sponsor, Rep. Joe Lachance, a Manchester Republican. “The program is good for our residents, it’s good for our business, why wouldn’t we support this?” The House voted 207-136 in favor of the bill. The 400-member chamber has long been viewed the biggest obstacle for Medicaid expansion, and its initial endorsement Wednesday signals that the proposal may face smooth sailing ahead. (Morris, 2/10)

New Hampshire Union Leader: House Preliminarily Approves Two-Year Extension For Medicaid Expansion
The House made some significant changes to a bill that would extend Medicaid expansion for two more years. The House voted 207-136 to preliminarily approve House Bill 1696, which will have to return to the House for a final vote after the Finance Committee reviews the bill. The House voted down several amendments aimed at scuttling the bill before approving changes to require a person on the program be a state resident and participants would not open a person to a federal background check. (Rayno, 2/10)

The Associated Press: New Nebraska Medicaid Bill Reopens Old Divide In Hearing
The newest attempt to expand health care coverage with Medicaid dollars reopened an old divide Wednesday before a Nebraska legislative committee. A coalition of doctors, hospitals, local governments and uninsured residents urged lawmakers to advance the bill. Conservative groups and members of Gov. Pete Ricketts' administration argued before the Health and Human Services Committee that the proposal is unsustainable. (Schulte, 2/11)

Marketplace

5. Insurers, Hit Hard By ACA Loses, Eye 2016 Profits As Pivotal To Staying In The Exchanges

Humana is the latest to say it has experienced loses from plans under the health law. “If 2016 is like 2015, we’ll have a real problem, because carriers could just start pulling out,” said one analyst.

The Wall Street Journal: Insurers Under Pressure To Improve Margins On Health Plans
After most health insurers racked up financial losses on Affordable Care Act plans in 2014, many companies’ results for last year worsened, creating heavy pressure to improve performance this year. An analysis of filings by not-for-profit Blue Cross and Blue Shield insurers ... shows the challenge facing the industry .... They paid out more for health care in the first three quarters of 2015 than they took in from premiums on their individual plans. On Wednesday, Humana Inc. became the latest of the big publicly traded companies to flag problems, saying its losses on individual plans deepened last year. (Wilde Mathews, 2/10)

The Wall Street Journal: Humana Profit Falls, But Guidance Comes In Above Views
Humana Inc., which in July agreed to be acquired by rival Aetna Inc., said profit fell 30% in the fourth quarter as it set aside a reserve to account for losses expected on its 2016 Affordable Care Act business, but the firm gave guidance for the year sharply above Wall Street expectations. “Humana faced challenges across a number of fronts in 2015,” said Chief Financial Officer Brian Kane. But he said strength in its clinical model and administrative cost discipline, along with targeted pricing, helped position the company for “meaningful margin improvement” in its core individual Medicare Advantage business for the year. (Steele, 2/10)

6. Unexpected Health Costs Add To Challenge Of Recovering From Medical Care

The Associated Press reports that nearly a third of insured Americans who have financial problems tied to medical bills faced charges that their insurance would not cover. In other news, The Wall Street Journal reports on a counter-intuitive finding that, in retirement, the healthier a person is, they more they will spend on health care.

The Associated Press: Surprise Insurance Fees Often Follow Medical Emergencies
Recovering from a medical procedure is always a challenge, but getting hit with unexpected insurance fees can add financial hardship to the process. As health insurance plans become increasingly complicated, more patients are facing unexpected fees when they step outside their plan's coverage network. In many cases, patients don't realize they've received out-of-network care until they're slapped with a bill for hundreds or thousands of dollars. (2/10)

The Wall Street Journal: Healthy? You’ll Spend More On Health Care In Retirement
The healthier you are, the more money you need to save for health care in retirement. That’s the counterintuitive finding of new research by the Empower Institute, which is sponsored by Empower Retirement, a division of Great-West Financial that administers $440 billion in retirement plans. “Excellent health, ironically, can actually raise an individual’s lifetime health spending” simply because healthier people can generally expect to live longer, says the report, released Wednesday. (Tergesen, 2/10)

Pharmaceuticals

7. Burwell Says Administration Is Pursuing 'Every Option' To Address High Prescription Drug Costs

In other news, drug maker Mylan reaches $7.2 billion deal to buy the Swedish company, Meda, which has a portfolio of specialty generic and over-the-counter products. With the purchase, Mylan will gain access to new markets.

Modern Healthcare: Burwell Says Administration Is Doubling Down On Drug Price, Opioid Battles
HHS Secretary Silvia Mathews Burwell told lawmakers Wednesday the administration is "pursuing every administrative option" for addressing high prescription drug prices, starting with a few provisions in President Barack Obama's fiscal 2017 budget. Sen. Jim McDermott (D-Wash.) said he supports the budget's call for allowing the HHS secretary to negotiate with pharmaceutical companies on prices for biologics and particularly expensive drugs. (Muchmore, 2/10)