Kaiser Health News Original Stories

3. Political Cartoon: 'Two Of A Kind?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Two Of A Kind?'" by Chip Bok, Akron Beacon Journal.

Here's today's health policy haiku:

AS SEEN ON TV?

Telemedicine
I can stay in my snow globe
Like the Truman Show

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Health Law Issues And Implementation

4. Hospitals Could Face Financial Strain If The Supreme Court Upends Key Part Of Health Law

A decision by the justices to throw out subsidies in the three dozen states that chose to use healthcare.gov instead of establishing their own marketplace could shift more uncompensated care costs to hospitals. Meanwhile, news outlets also estimate how many people within certain states might lose their subsidies.

Bloomberg News: Hospital Chains Can't Move Home-State Republicans On Obamacare
Conventional wisdom says big corporations that employ lots of people in a state generally call the shots with local politicians, especially when those corporations are the source of major campaign contributions. But that's not the case in Tennessee. At least when it comes to Obamacare. Tennessee is looming as ground zero for the political fallout from the Supreme Court's decision, which could come as early as Thursday, on the insurance subsidies at the heart of President Barack Obama's health care law. Some of the nation's biggest hospital chains are based in the Volunteer State and stand to lose hundreds of millions of dollars if the justices invalidate the subsidies. Yet they haven't been able to make the state's Republicans budge off their stance against the health care law. (Tracer, 6/23)

Modern Healthcare: Hospital Cost Of Uninsured: $900 Per Patient, Per Year
New research suggests the financial strain on hospitals and households will be immediate and significant if a U.S. Supreme Court decision ends subsidies for health insurance in 36 states. As many as 6.4 million Americans who bought insurance may drop it and become a financial burden to providers. The study, published by the National Bureau of Economic Research, found a “minimum and unavoidable” demand for hospital care among the uninsured at an annual cost to hospitals of $900 a patient. (Evans, 6/23)

The Nashville Tennessean: ACA Uncertainty Sends Tennessee Official To DC To Testify
The future of health insurance premiums on the federally run marketplace is rife with uncertainty, and Tennessee's insurance commissioner is headed to Washington, D.C., to talk about it. Insurers are beginning to get a view into how people who buy insurance on the exchange use insurance, but a U.S. Supreme Court case set to be decided in the coming days could throw the nascent system into disarray. (Fletcher, 6/23)

The Associated Press: Groups Estimate 160,000 Hoosiers Could Lose Subsidies
About 160,000 low- and moderate-income Indiana residents could lose health insurance premium subsidies provided under the Affordable Care Act if the U.S. Supreme Court rules them illegal, two groups estimated Tuesday. The nonpartisan Kaiser Family Foundation and Families USA, an advocacy group for affordable health care, both based their estimates on data provided by the U.S. Department of Health and Human Services. (6/23)

New Hampshire Public Radio: SCOTUS Decision On Healthcare Subsidies Could Disrupt N.H. Insurance Market
The United States Supreme Court is expected to decide a case this month that could be do or die for President Obama’s signature healthcare law. At issue are the subsidies available to people who purchase insurance plans on Healthcare.gov, also called the healthcare exchange. New Hampshire is one of 37 states using this federally-operated insurance marketplace, and if the Supreme Court rules in favor of the plaintiff in the case, about 30,000 people in New Hampshire may see their subsidies disappear. (Biello, 6/23)

Even though California's subsidies aren't at risk, the exchange -- Covered California -- still will face challenges -

The San Jose Mercury News: Covered California Health Insurance Exchange At A Crossroads
Even if the court rules in favor of the plaintiffs trying to gut the law, imperiling the subsidies 6.3 million people are using to help pay their insurance bills, the decision should have no immediate effect on California and other states that have set up their own state-run exchanges. ... But that doesn't mean the Golden State's exchange, called Covered California, doesn't face other significant challenges, from trying to build up its enrollment numbers, to the end of federal revenue guarantees for health insurance companies that agree to participate in the exchange -- something observers say could cause premiums to spike. (Seipel, 6/23)

Meanwhile, Business Insider offers this possible clue regarding how a pivotal justice may vote on the case -

Business Insider: This Comment From Justice Kennedy Could Signal The Fate Of Obamacare
The Supreme Court will issue a decision on President Barack Obama's signature healthcare law any day now, and Justice Anthony Kennedy made a telling comment in March that could signal how he will vote. Kennedy, a key swing voter, said during oral arguments that he saw a "serious constitutional" question with the interpretation of the Affordable Care Act (ACA) set forth by the plaintiffs who are trying to strike it down. (Fuchs, 6/23)

5. Florida, Obama Administration Reach Agreement On Funding For Hospitals

The "agreement in principle" will give $1 billion in funding for Florida hospitals that provide care to large numbers of uninsured patients. The federal government has cut its contributions to the funding for hospitals prompting a lawsuit by Gov. Rick Scott and a divisive argument in the state legislature over expanding Medicaid.

Tallahassee Democrat: Feds Say Hospital Funding Deal Reached ‘In Principle’
After months of wrangling about the issue, a top federal official Tuesday outlined a deal to continue Florida’s Low Income Pool health-funding program for two years. Federal official Vikki Wachino sent a letter to state Medicaid Director Justin Senior that said an agreement “in principle” has been reached about the size of the program and how money will be divvied up among hospitals and other health providers. ... Part of the debate in recent months stemmed from uncertainty about how much money would be available to help hospitals cover the costs of caring for uninsured patients. But the issue became tangled in a fierce political battle about a state Senate plan to use federal Medicaid money to offer health coverage to hundreds of thousands of uninsured Floridians — a plan that House Republican leaders opposed and, ultimately, killed. (Saunders, 6/23)

Tampa Bay Times/Miami Herald: Fight Over Hospital Funding For Poor In Florida Ends Quietly
The tumultuous debate over the future of health care funding for the poor came to a quiet end Tuesday as the governor signed into law a budget that includes $1 billion to pay for charity care and raise Medicaid rates at Florida hospitals. In a letter to state officials, the federal Centers for Medicare and Medicaid Services (CMS) said they have "agreed in principle" to a Florida plan for distribution of the Low Income Pool (LIP) funds that pay for hospital care for Medicaid beneficiaries and the low-income uninsured. The plan also calls for paying higher Medicaid rates to hospitals, particularly those that care for large numbers of uninsured patients. State lawmakers had to redesign the LIP program and raise Medicaid reimbursement rates because the federal government reduced LIP money for Florida by $1.2 billion for the coming year, which led to a budget impasse between the House and Senate this spring and then to a special session on the budget that ended last week. (Klas and Chang, 6/23)

The Associated Press: Florida, Feds Agree To Extend Hospital Low-income Pool Funds
The Obama administration and the state have reached an agreement in principle to continue funding Florida's hospital low-income pool for two more years but at a much lower cost, officials said Tuesday. Florida will receive $1 billion this year — about half of what the state has been receiving — and $600 million for 2016-2017. The federal government must still wait until the end of a public review to issue its final ruling. The fight over the funds tore apart Florida's regular legislative session in late April and prompted Gov. Rick Scott to sue the federal government. (6/23)

And on the Medicaid expansion front -

Maine Public Broadcasting: Maine House Endorses Medicaid Expansion But Passage Unlikely
After more than an hour of debate, the House voted to expand Medicaid coverage in Maine to an estimated 70,000 poor residents and generate millions in federal funds for health care providers. ... Opponents argued the expansion is not a good long-term investment and the bill's future is uncertain. The Senate has yet to consider the measure and Gov. Paul LePage has said he would veto any bill lawmakers passed that would expand Medicaid. (Leary, 6/23)

6. First Full Year Of Health Law Brought Sharpest Drop In Uninsured Rate

The uninsured rate among adults under 65 dropped from 20.4 percent in 2013 to 16.3 percent in 2014 -- the biggest drop recorded in the CDC's annual National Health Interview Survey since it began publishing the report in 1997. The survey reported that Texas remains the state with the highest rate of uninsured adults -- with a decline of 2.7 percentage points to 25.7 percent in 2014.

Fortune: How Obamacare Has Impacted The Uninsured Rate
An annual survey by the Centers for Disease Control and Prevention (CDC) recorded the sharpest drop in uninsured adults in 2014 since the survey began in 1997. The uninsured rate among adults under 65 dropped from 20.4 percent in 2013 to 16.3 percent in 2014. The uninsured rate among adults 19-25, especially, saw progress from 31.3 percent uninsured to 26.9 percent in 2014. The growing prevalence of insurance reflects the start of Obamacare’s expanded coverage in January 2014. In states that accepted Medicaid expansion with Obamacare, the percentage of insured adults dropped from 18.4 to 13.3 percent — 2 percentage points more than the drop in states that refused the expansion. (Groden, 6/23)

Business Insider: The Uninsured Rate Just Experienced Its Sharpest Drop Ever Under Obamacare
The uninsured rate in the US declined by nearly one-fifth with the Affordable Care Act implemented for a full year, according to data released Tuesday by the Centers for Disease Control and Prevention. The CDC's National Health Interview Survey, considered the most reliable government estimate of the country's uninsured population, found the uninsured rate for adults under the age of 65 dipped from 20.4% in 2013 to 16.3% in 2014. Americans could start buying insurance through marketplaces set up by the Affordable Care Act beginning in October 2013. (Logiurato, 6/23)

The Statesman: Texas Lags Behind The National Average In Rate Of Uninsured Adults
The number of people lacking health insurance in Texas remains stubbornly high more than a year after the Affordable Care Act took effect and Texas continues to lead the nation in the rate of uninsured residents, according to a federal study released Tuesday. The National Health Interview Survey by the Centers for Disease Control and Prevention found the rate of uninsured Texans ages 18 to 64 fell 2.7 percentage points to 25.7 percent between 2013 and 2014. Nationally, the percentage of uninsured Americans dropped 4.1 percentage points to 16.3 percent over the same period. (Eaton, 6/23)

Meanwhile, in the news from the insurance industry -

The Wall Street Journal: UnitedHealth Group Exits Health Insurers’ Largest Trade Group
UnitedHealth Group Inc. is leaving the health insurance industry’s largest trade group this month, saying the company’s interests were no longer being best represented. UnitedHealth, the largest U.S. health insurer, will sever its relationship with America’s Health Insurance Plans, a national association with almost 1,300 member companies, according to a statement from the company. (Amour, 6/23)

Capitol Hill Watch