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KHN First Edition: June 22, 2015


First Edition

Monday, June 22, 2015
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: Getting A Medi-Cal Card Doesn’t Always Guarantee Health Care
Kaiser Health News staff writer Anna Gorman reports: "In an effort to control costs in its rapidly expanding Medi-Cal program, California has relied heavily on managed care insurance companies to treat patients like Anderson. The state pays insurers a fixed amount per enrollee and expects the companies to provide access to doctors and comprehensive care. But a scathing state audit released last Tuesday shows that California is failing to make sure those plans deliver. Like Anderson, many enrollees have insurance cards but often have trouble getting in to see doctors." (Gorman, 6/22)

Kaiser Health News: Looming Decision Could Cripple Part Of N.C. Health Insurance Market
WFAE's Michael Tomsic, working in partnership with Kaiser Health News, and NPR, reports: "Roughly half a million North Carolinians could soon lose money they depend on for health insurance. The U.S. Supreme Court will rule soon on a key part of the Affordable Care Act. It governs federal subsidies for insurance in states like North Carolina that did not set up their own exchange or marketplace. The result could be disastrous for many low-income Americans and for insurance markets in about three dozen states." (Tomsic, 6/22)

The Wall Street Journal: Insurers, Hospitals Brace For Affordable Care Act Ruling
Hospitals, doctors and consumers are preparing for the fallout if the Supreme Court strikes down subsidies that help about 6.4 million Americans buy health insurance under the Affordable Care Act. Some people are making medical appointments now, in anticipation of being unable to afford their insurance. Hospitals are exploring ways to increase charity care or planning their lobbying strategies should subsidies on the federal insurance exchange be found illegal. And doctors worry about what they would tell their patients. (Armour, 6/21)

The New York Times: Health Insurers Brace For Supreme Court Ruling
Their industry already upended with the passage of the federal health care law, insurance companies are facing another upheaval if the Supreme Court rules that millions of Americans are not eligible for subsidies to help defray the cost of their coverage. The court is expected to decide by the end of June or in early July whether it agrees with the plaintiffs in King v. Burwell that the language in the Affordable Care Act allows the government to offer subsidies only in those states that have established their own insurance marketplaces. (Abelson, 6/21)

The New York Times: States Take Few Steps To Fill Gap If Supreme Court Blocks Health Subsidies
As the Supreme Court prepares to rule on whether to block health insurance subsidies in 34 states that use the federal insurance exchange, Pennsylvania and Delaware are the best prepared. They have submitted detailed plans for creating their own exchanges by next year, a move intended to keep subsidies flowing to their residents, though possibly with an interruption. (Goodnough, 6/21)

The Wall Street Journal: State GOP Leaders Press Congress To Revamp Health Care Law
State Republican leaders are ratcheting up the pressure on Congress to overhaul the Affordable Care Act if the Supreme Court this month rules that subsidies on the federal exchange are invalid. Republicans from 33 states have written to Congress as part of a coordinated message urging federal legislators to develop a plan that would free states from the pressure of setting up their own exchanges to salvage subsidies, according to the Foundation for Government Accountability, a conservative think tank. (Armour, 6/19)

The Wall Street Journal: MIT Economist Jonathan Gruber Had Bigger Role In Health Law, Emails Show
Jonathan Gruber, the Massachusetts Institute of Technology economist whose comments about the health-care law touched off a political furor, worked more closely than previously known with the White House and top federal officials to shape the law, previously unreleased emails show. The emails, provided by the House Oversight Committee to The Wall Street Journal, cover messages Mr. Gruber sent from January 2009 through March 2010. Committee staffers said they worked with MIT to obtain the 20,000 pages of emails. (Armour, 6/21)

The Wall Street Journal: N.Y. Is Poised To Let Pregnant Women Sign Up For Obamacare Coverage
New York is poised to become the first state to allow women who become pregnant to sign up for health insurance under the Affordable Care Act – even after the open-enrollment period has passed. Legislation establishing a pregnancy as a so-called qualifying event that enables women to enroll in ACA health coverage at any time passed the New York legislature on Wednesday, and was sent to Gov. Andrew Cuomo for his signature. (Armour, 6/19)

Politico: Price Tag Of Obamacare Repeal: $353 Billion
The Congressional Budget Office’s conclusion today that sacking Obamacare would swell the budget deficit by as much as $353 billion wasn’t at all what Republicans were expecting. Using so-called dynamic scoring, which attempts to account for the economic effects of policy changes, a repeal would still hit the deficit, although by less — about $137 billion, CBO said. ... Republican reaction focused on the positive economic impact and played down the deficit implications. (Faler, 6/19)

The Washington POst: Obamacare Repeal Could Add $353 Billion To The Deficit
Repealing President Obama’s signature health care law would add significantly to the deficit, even under a new accounting method advocated by congressional Republicans who want to get rid of the Affordable Care Act. The Congressional Budget Office on Friday projected that scrapping the law would cost $353 billion over the next decade using its traditional scoring method and $137 billion under the model favored by Republicans, which takes into account the economic impact of tax and spending policies. (Snell, 6/19)

The Associated Press: Study Says Repealing ‘Obamacare’ Would Add To Budget Deficit
The report from the Congressional Budget Office comes ahead of a highly anticipated Supreme Court ruling that could have a major impact on the Affordable Care Act, nullifying health insurance subsidies for some 6 million people in more than 30 states. The budget analysts said that would add a host of new uncertainties to their estimates. Republicans now in control of both chambers of Congress say they are not backing away from their promise to repeal “Obamacare.” (Taylor and Alonso-Zaldivar, 6/20)

The New York Times: Mixed Effects Are Seen On An Affordable Care Act Repeal
The nonpartisan Congressional Budget Office said Friday that repealing the Affordable Care Act would significantly increase federal budget deficits and the number of people who are uninsured. But, it said, repealing the law would also raise economic output because it would create incentives for some people to work more. The estimates came in the first major study issued by the new director of the budget office, Keith Hall. It was also the first report to use new methods of fiscal analysis, according to instructions from the Republican majority in both houses of Congress. (Pear, 6/19)

The Wall Street Journal: Health Law Repeal Would Raise Federal Deficits By $137 Billion In 10 Years, CBO Says
Repealing the Affordable Care Act would cost the U.S. government $137 billion over the next decade and more than that in the following 10 years, the Congressional Budget Office said Friday. The report—the first federal assessment since the main provisions of the ACA took effect in 2014—found that repealing the law would increase deficits by $353 billion over 10 years. But after taking into account economic factors, including the slightly larger workforce participation that would result from repeal, that amount would fall to $137 billion. (Timiraos and Radnofsky, 6/19)

The Associated Press: Study Says Repealing 'Obamacare' Would Add To Budget Deficit
A nonpartisan government study says repealing President Barack Obama's signature health care law would modestly increase the budget deficit and the number of uninsured Americans would rise by more than 20 million. The report from the Congressional Budget Office comes ahead of a highly anticipated Supreme Court ruling that could have a major impact on the Affordable Care Act, nullifying health insurance subsidies for some 6 million people in more than 30 states. The budget analysts said that would add a host of new uncertainties to their estimates. (Taylor and Alonso-Zaldivar, 6/20)

The Wall Street Journal: Health Mergers Could Cut Consumer Options
The nation’s biggest health insurers, which are pursuing a series of potential megamergers, have market overlaps that could damp competition in sectors such as private Medicare plans, an analysis of state and federal data by The Wall Street Journal has found. The board of Cigna Corp. on Sunday rejected a $47.5 billion bid from Anthem Inc. that was disclosed on Saturday. Aetna Inc. has made an offer for Humana Inc. in recent days. Those deals, if completed, would shrink the current top five insurers to a powerful big three, each with revenue on paper of more than $100 billion. Meantime, the largest player by revenue, UnitedHealth Group Inc., has recently made a takeover approach to Aetna. (Wilde Mathews and Weaver, 6/21)

Los Angeles Times: Health Insurer Cigna Rejects Anthem's $54-Billion Takeover Bid
In a fiery response, Cigna Corp. rejected a $54-billion takeover bid from Anthem Inc. and unleashed several criticisms of the health insurance giant. Cigna said Sunday that the $184-a-share offer was inadequate and not in the best interests of its shareholders. The nation's fifth-largest health insurer expressed frustration with Anthem taking its private negotiations public a day earlier and for failing to address key issues such as the fallout from a massive data breach at Anthem this year. (Terhune, 6/21)

The Wall Street Journal: Anthem Raises Offer For Cigna; Aetna Bids For Humana
Intensifying a five-way merger frenzy, Anthem Inc. went public Saturday with a sweetened $47.5 billion takeover offer for Cigna Corp. and Aetna Inc. in recent days made a takeover proposal for Humana Inc. Anthem in a statement said it has offered $184 a share for Cigna. That equates to about $47.5 billion for all the company’s stock that was recently outstanding. Anthem is making the cash-and-stock offer public in an effort to put pressure on Cigna through its shareholders, according to a person familiar with the matter. (Rockoff, Cimilluca, Mattioli and Hoffman, 6/21)

The New York Times: Cigna Rejects An Overture From Anthem
The world of American health insurance may soon become even smaller, with the biggest companies seeking to become even bigger. A scramble has broken out within the industry as various providers jockey for position and make overtures to rivals. Anthem made the first public move, unveiling a $47 billion takeover bid for Cigna on Saturday after months of negotiations had stalled. On Sunday, Cigna fired back, rejecting the bid as “inadequate and not in the best interest of Cigna’s shareholders.” (de la Merced and Abelson, 6/21)

The Associated Press: Health Insurer Cigna Rejects Anthem Takeover Bid
Health insurer Cigna Corp. has rejected a $47 billion offer to be acquired by its larger rival, Anthem Inc., saying the terms of the bid are inadequate and “woefully skewed in favor of Anthem shareholders.” Cigna’s sharply worded rejection came just one day after Anthem went public with its cash-and-stock offer, which amounts to about $184 for each Cigna share or about an 18 percent premium on Cigna’s closing stock price on Friday. (Baily, 6/21)

Los Angeles Times: Anthem Reveals $54-Billion Bid For Cigna After Merger Talks Break Down
Healthcare giant Anthem Inc. stepped up its pursuit of rival Cigna Corp. with a $54-billion takeover bid amid an industrywide merger frenzy that could dramatically reshape the insurance market. Anthem, the nation's second-largest health insurer, said Saturday it had offered $184 a share for Cigna in cash and stock, or $54 billion, including debt. But Anthem expressed frustration that talks had broken down in recent days over the future role of Cigna’s chief executive. (Terhune, 6/20)

The New York Times: Anthem Makes $47 Billion Offer For Rival Cigna
The move is the latest step toward an expected consolidation among health insurance companies. Last month, Humana, another competitor, was said to be exploring a sale of itself. Driving the push to get bigger has been the Obama administration’s health care overhaul, which has bolstered revenues. Yet, at the same time, profit margins have come under pressure in the face of greater pricing transparency and less generous funding of government plans. (Cane and Abelson, 6/20)

The Wall Street Journal: Aetna Makes Takeover Proposal To Humana
Aetna Inc. has made a takeover proposal to Humana Inc., one of a number of recent moves by big health insurers to find merger partners. Aetna in the last few days made the proposal, according to people familiar with the matter. It isn’t clear how much Aetna indicated it would pay. Humana has a market value of $30 billion. The company hired Goldman Sachs Group Inc. to help it field takeover interest, people familiar with the matter have said. (Mattioli and Hoffman, 6/20)

The Wall Street Journal: Investors Debate The End Of The Health-Care Stock Surge
The thriving health-care sector is starting to look too rich for some investors’ taste. Health-care companies in the S&P 500, ranging from health insurers to medical-device makers to biotechnology firms, have risen 26% in the past year. That is the largest increase among S&P 500 sectors and more than three times the 7.7% gain in the S&P 500 in the same period. (Vaishampayan, 6/21)

The Washington Post: 2016 GOP Contenders Face Major Political Dilemma In Obamacare Ruling
The pressing problem for the 2016 Republican field falls into the “dog catches car” category: It’s one thing to call for the Affordable Care Act to be repealed or to promise an Oval Office signing ceremony for its repeal. It’s another to endorse pulling insurance subsidies used by more than 6 million people in 34 states, including at least 1.3 million Florida residents. A ruling that subsidies provided to consumers to help them purchase health insurance are not legal could spark chaos in the insurance marketplace and help shape the electoral landscape in several key swing states. Beyond those voters directly affected, many more could see their premiums increase if the law unravels, driving up the number of uninsured. (Zezima and Sun, 6/20)

Politico: Obamacare Looms Over Kasich's Presidential Bid
The Republicans running for president have practically made careers out of skewering Obamacare — so when Ohio Gov. John Kasich makes his expected entry into the race, he’s likely to have a giant Obamacare target on his back. Kasich says he is no fan of the president’s health care law. But he fought his own party to implement one of its core components and is now gearing up to face GOP primary voters who want to rip the health law to shreds. His decision two years ago to embrace Obamacare’s expansion of Medicaid to provide health coverage to low-income adults — a move that offered bipartisan cover to the White House during a tumultuous period — is likely to dog him in Iowa and New Hampshire. (Pradhan and Cheney, 6/20)

The New York Times: Wait Lists Grow As Many More Veterans Seek Care And Funding Falls Far Short
One year after outrage about long waiting lists for health care shook the Department of Veterans Affairs, the agency is facing a new crisis: The number of veterans on waiting lists of one month or more is now 50 percent higher than it was during the height of last year’s problems, department officials say. The department is also facing a nearly $3 billion budget shortfall, which could affect care for many veterans. (Oppel, 6/20)

The Associated Press: Report: Wait Lists For Vets Even Longer Today Than Last Year
The number of veterans seeking health care but ending up on waiting lists of one month or more is 50 percent higher now than it was a year ago when a scandal over false records and long wait times wracked the Department of Veterans Affairs, The New York Times reported. The VA also faces a budget shortfall of nearly $3 billion, the Times reported in a story posted online ahead of its Sunday editions. The agency is considering furloughs, hiring freezes and other significant moves to reduce the gap, the newspaper reported. (6/20)

The Associated Press: Planned Parenthood: No New Texas Abortion Clinics In Works
Planned Parenthood President Cecile Richards said Saturday that her organization has no immediate plans to build more abortion clinics in Texas, where only eight facilities are likely to remain if another round of strict regulations takes effect July 1. Only the U.S. Supreme Court can now stop Texas from forcing abortion facilities to be constructed like surgical centers, and prevent a second major wave of clinic closures statewide in as many years. Texas had 41 abortion clinics in 2012. (Weber, 6/20)

The Washington Post: Another Locality Is Poised To Require Paid Sick Leave, Just As Obama Asked
The Montgomery County Council is poised to pass legislation next week requiring employers to provide workers at least seven days a year of paid sick leave, joining other state and local governments — including the District’s — in approving a benefit that has stalled at the federal level. Nearly 40 percent of the nation’s private-sector employees, many in lower-paid service industries, have no paid sick leave, according to the Bureau of Labor Statistics. Advocates say that means workers risk losing pay to stay home when they are ill or need to care for a sick child or relative. (Turque, 6/19)

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