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Kaiser Health News Original Stories

3. Political Cartoon: 'Over-Caffeinated'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Over-Caffeinated'" by Hilary Price.

Here's today's health policy haiku:


Reference pricing …
It's kinda controversial?
Just ask Medicare.

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Summaries Of The News:

Health Law Issues And Implementation

4. Insurers Seeking Rate Hikes Of 20 Percent Or More For 2017

The proposed increases are an indicator of how the big health plans are adapting to the Affordable Care Act's transformation of the way health coverage is priced and sold in the U.S.

The Wall Street Journal: Insurers Seek Big Premium Boosts
Big health plans stung by losses in the first few years of the U.S. health law’s implementation are seeking hefty premium increases for individual plans sold through insurance exchanges in more than a dozen states. The insurers’ proposed rates for individual coverage in states that have made their 2017 requests public largely bear out health plans’ grim predictions about their challenges under the health-care overhaul. According to the insurers’ filings with regulators, large plans in states including New York, Pennsylvania and Georgia are seeking to raise rates by 20% or more. (Radnofsky, 5/25)

Bloomberg: Avalere: 2017 ACA Premium Requests Up 16 Percent In 9 States
Average premium requests for 2017 for the most popular type of ACA marketplace plans are 16 percent higher in the first nine states to make them public, according to an Avalere Health analysis released May 24. The 16 percent average increase is for all silver-tier plans, which cover an average of about 70 percent of medical claims. (Hansard, 5/24)

The Philadelphia Inquirer: Pa. Health Insurance Firms File Rate Increase Requests
The Pennsylvania Insurance Department on Wednesday released preliminary rate requests for 20 small-group health plans and 18 individual plans that will be offered under the Affordable Care Act for next year. The requests for increases now under review by the insurance department averaged 7.9 percent for small group plans and 23.6 percent for individual plans, but the final rates that will be posted in October could be lower. (Brukbaker, 5/25)

The Des Moines Register: Coventry Wants To Raise Health Insurance Rates 18%
Iowans buying Obamacare-subsidized health insurance could be in for a big price increase next year. The main insurance carrier selling such plans to Iowans wants to raise rates to most of its customers by at least 18 percent. Coventry Health Care has notified the Iowa Insurance Division of its proposed 2016 rate increases, which would affect about 47,000 Iowans. (Leys, 5/26)

Miami Herald: New Insurer To Offer Obamacare Coverage In South Florida For 2017
Harken Health Insurance Company, an independent subsidiary of UnitedHealth Group, the nation’s largest health insurer, said it will sell coverage for 2017 on the ACA exchange in Miami-Dade and Broward counties using a managed care model that includes a network of primary care clinics and personal counselors to guide members through the healthcare experience. (Chang, 5/25)

5. IRS Officials Reportedly Raised Questions About Health Law Payments At Center Of Court Battle

The cost-sharing subsidies for low-income people buying coverage on the online insurance marketplaces are at the heart of a lawsuit filed by Republican members of the House, who say they were never approved by Congress. Also in the news, House Republicans find fault in how Oregon set up its enrollment website.

The Hill: IRS Doubted Legality Of ObamaCare Payments, Former Official Says
The IRS raised concerns in early 2014 about the legality of certain ObamaCare payments that Republicans are now challenging in a lawsuit, according to a deposition from a former agency official. David Fisher, who was the IRS’s chief risk officer, told the House Ways and Means Committee that agency officials questioned whether the Affordable Care Act provided the authority to make certain payments to insurers without an appropriation from Congress. (Sullivan, 5/25)

The Wall Street Journal: D.C. Appeals Court Set To Determine Fate Of Several Obama Initiatives
The Supreme Court may be keeping a lower profile while it is short-handed, but high-stakes cases remain in Washington—at a powerful appeals court that could determine the fate of several important Obama administration initiatives. The U.S. Court of Appeals for the District of Columbia Circuit is preparing for cases examining signature Obama administration climate change regulations on power plants, as well as economic-crisis era rules for the nation’s largest financial firms. The court also soon could be reviewing a challenge to the implementation of President Barack Obama’s signature health-care law, a showdown between the administration and House Republicans. (Kendall, 5/25)

The Associated Press: Congressional Panel Releases Critical Cover Oregon Report
A Republican-led U.S. House committee has found former Gov. John Kitzhaber and a federal agency mishandled the creation of Oregon's health insurance enrollment website, with the Democratic governor's political advisers making decisions based on his re-election campaign. In a staff report released Wednesday, the Republicans on the committee said they are asking the Justice Department and state attorney general to conduct criminal investigations into the actions involving Cover Oregon. (5/25)

Fox News: House Panel Calls For Criminal Probe Into Failed Oregon Health Care Exchange
Ex-Oregon Gov. John Kitzhaber and his staff mismanaged the creation of the state’s doomed health insurance website, including by making decisions based on his re-election campaign, according to a congressional report released Wednesday which seeks a criminal probe. ... Democrats on the committee released their own report, which laid the blame at the feet of Oracle Corporation, the state’s contractor, saying it misled officials and failed to deliver a functioning website. (5/25)

6. W. Va. Medicaid Expansion Advocates Worry About Future Costs

Under the federal health law, West Virginia and the other states that expanded their Medicaid programs will begin to pick up some of the costs next year, adding to already burdened state budgets.

West Virginia Public Broadcasting: Is Medicaid Expansion Contributing To WV Budget Crisis?
[N]ext year, the Medicaid expansion agreement between states and the federal government will begin to change. “Starting in January of 2017, West Virginia will have to pay a 5 percent match for Medicaid Expansion. In the governor’s budget that’s 14 million extra dollars for next year,” said Renate Pore, director of health policy for West Virginians for Affordable Healthcare. In 2018, the state will have to match 6 percent, then 7 the following year, until by 2020 the match will cap at 10 percent and approximately 50 million additional dollars out of the state budget to pay for Medicaid. ... advocates like Pore they are worried about how the state will continue funding Medicaid. (Lofton, 5/23)

North Carolina Health News: Medicaid Expansion Remains A Hot Issue At General Assembly
With officials from the state Department of Health and Human Services wrapping up work on an overhaul of the state’s Medicaid program this week, lawmakers, physicians and patient advocates gathered at the General Assembly Wednesday to push for Medicaid expansion to be included in the state’s reform plan. Dozens gathered for a press conference in the state legislative building that featured patients who could qualify for the state’s Medicaid program but don’t. (Nigam, 5/26)


7. Missouri Is First State To Rebuke Proposed Aetna-Humana Merger Over Antitrust Concerns

The insurers have 30 days to “submit a plan to remedy the anti-competitive impact of the acquisition,” according to the Missouri Department of Insurance's preliminary order, or stop selling certain plans in the state.

Reuters: Aetna-Humana Tie-Up Is Anti-Competitive In Missouri: State Regulator
A tie-up of Aetna Inc and Humana Inc would be anti-competitive in Missouri for several types of insurance, including individual Medicare Advantage plans where the combined company would have more than a 50 percent market share, the Missouri Department of Insurance said. The department said in an order, dated May 24 and posted on its website, that if the proposed acquisition of Humana by Aetna were to go forward, the companies would need to stop selling individual insurance, small group and certain Medicare Advantage plans in its state. (Humer, 5/25)