Kaiser Health News Original Stories

2. Political Cartoon: 'When Least Expected?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'When Least Expected?'" by Lee Judge, Kansas City Star.

Here's today's health policy haiku:

MISSING MEDICAID SERVICES

Low-income patient
In need of a breast exam.
Doctor turns away.

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Health Law Issues And Implementation

3. Insurers Seek Big Rate Increases, Citing Sicker Obamacare Customers

The increases are in the 20 percent to 40 percent range and federal officials say they are determined to scale them back. But Oregon's insurance regulator OK'd some big rate increases in that state.

The New York Times: Health Insurance Companies Seek Big Rate Increases For 2016
Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more, saying their new customers under the Affordable Care Act turned out to be sicker than expected. Federal officials say they are determined to see that the requests are scaled back. Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives. (Pear, 7/3)

The Wall Street Journal: Oregon Backs Hefty Rise In Health-Insurance Premiums
Oregon’s insurance regulator has approved big premium increases sought by health plans for 2016 under the health law, and in some cases ordered higher raises than insurers requested, signaling that the cost of insurance for people who buy it on their own could jump after two years of relatively modest growth. Around the U.S., the biggest insurers have proposed hefty premium increases for the year ahead, based on what they say they now know about the costs of covering people newly enrolled under the Affordable Care Act. Supporters of the health law have been counting on state regulators to rein in hefty premium increases for the law’s third year in full effect. (Radnofsky, 7/3)

4. Clinton Warns That GOP President Would Repeal Health Law

In Fourth of July weekend campaigning, Democratic presidential candidate Hillary Clinton used the health law to rally supporters in New Hampshire. Elsewhere, Republican candidate Chris Christie says people he would appoint to the Supreme Court would not have upheld a key part of the health law and also doubles down on his pledge to revamp Medicare and Social Security.

The Washington Post: Clinton Warns That A Republican President Would Repeal Obamacare
Hillary Rodham Clinton sharpened her partisan rhetoric to appeal to Democratic primary voters [in New Hampshire] Friday by issuing a dire warning: President Obama's health care law would disappear if a Republican wins the White House in 2016. ... "If the country elects a Republican president, they will repeal the Affordable Care Act. That is as certain as I can say it," she continued, noting the unlikelihood that Democrats take over the Senate and House next year. (Rucker, 7/3)

The New York Times: Hillary Clinton Warns That A Republican President Would Repeal The Health Law
Mrs. Clinton’s speech demonstrated the challenge she faces: She must keep a wary eye on Mr. Sanders without attacking him, but she must also seem engaged and rouse her supporters, so attacks on the Republican field on issues like the Affordable Care Act have been her approach. She kept to that script here on Friday, warning that a Republican president would repeal the health care law, and she denounced the administration of George W. Bush for “poor management” of the economy that led to the recession. (Haberman, 7/3)

Reuters: U.S. Republican Christie Criticizes High Court's Gay Marriage Ruling
U.S. Republican presidential candidate Chris Christie said on Sunday Supreme Court justices of his liking would not have legalized same-sex marriage and would have struck down a key provision of a national health care law. ... "If the Christie-type justices had been on that court in the majority, we would have won those cases in the Supreme Court rather than lost them," he told "Fox News Sunday" in an interview. (Lange, 7/5)

The Fiscal Times: Christie Doubles Down On Vow To Overhaul Medicare And Social Security
It t has never been a way to win friends and influence voters, but New Jersey Gov. Chris Christie isn’t shying away from reform of two “do-not-touch” entitlements—Medicare and Social Security. His goal is to cut the long-term debt since formally announcing his improbable campaign for the GOP presidential nomination last week. ... During an interview today on “Fox News Sunday,” Christie doubled-down on his pledge to pursue major entitlement reform if he somehow overcomes other huge political liabilities to win the primary and general elections next year. “I put that plan forward and I’m going to keep talking about it,” Christie said. They say don’t touch it. I’m going to hug it.” (Pianin, 7/5)

Bergen County Record: Analysis: Christie Campaign Strategy Taking Shape
In diners and in pubs, at house parties and during town-hall-style events, Governor Christie spent his first week on the campaign trail as a declared presidential candidate trying to sell his policies to New Hampshire voters. Christie has delivered four policy speeches so far, giving specific proposals on how to overhaul Social Security and Medicare, on national defense, on the economy and on education. Christie this month said he will deliver two more, one on reforming the country’s criminal justice system and another on immigration. (Hayes, 7/4)

5. Health Law Spurs For-Profit Diet Clinics

The New York Times reports on how a provision in the law that requires insurers to pay for nutrition and obesity screening has been a boon for some of these clinics. Also in the news about the health law's implementation are reports about how hospitals are changing how they care for chronically ill patients, a deeper look at Chief Justice John Roberts' opinion to uphold the law's subsidies and other GOP efforts to chip away at the law.

The New York Times: In Health Law, A Boon For Diet Clinics
Dr. Michael Kaplan looked across his desk at a woman who had sought out his Long Island Weight Loss Institute .... By the end of the 50-minute session, the woman had chosen Dr. Kaplan’s most expensive weight-loss plan: $1,199 for six weeks’ worth of meal-replacement products, counseling and vitamin supplements. ... Then he delivered some good news: Her insurance would probably reimburse her for at least a small portion of the bill, thanks to a provision in the federal health care law that requires insurers to pay for nutrition and obesity screening. The news was pleasing to the patient. But it has also created a financial opportunity for a corner of the diet industry that has often operated on the fringe of the medical establishment: for-profit diet clinics overseen by doctors. (Abrams and Thomas, 7/4)

The Philadelphia Inquirer: How The ACA Is Changing Chronic Care At Hospitals
Healthcare professionals say the landmark health reform law, the Affordable Care Act, is accelerating changes in how hospitals treat patients with chronic conditions like diabetes, heart failure and obesity. Successfully treating those patients, who use many more healthcare services, have higher rates of hospitalization and more frequent emergency department visits, is challenging because many of their conditions are aggravated by unhealthy eating habits and inactivity. Chronic disease rates increase steadily as patients age, making this issue particularly key to the Medicare program. (Taylor, 7/5)

NPR: Liberal Minority Won Over Conservatives In Historic Supreme Court Term
The court's other major decision at the end of the term upheld nationwide subsidies in the Affordable Care Act. And as [Walter] Dellinger observes, Chief Justice John Roberts' opinion for a 6 to 3 majority was "surprisingly favorable" to the law. "The first five pages of the chief justice's opinion ... is the best articulation of the case for the Affordable Care Act anybody has written," Dellinger says. The decision did something else important. It sided with the liberal view that legislation should be interpreted in terms of its overall purpose and not by flyspecking a phrase here and there. (Totenberg, 7/6)

The Wall Street Journal: House GOP And White House Trade Shots Over Obamacare
The Supreme Court showdown over the Affordable Care Act may be over, but the legal offensive against the law isn’t. Lawyers representing the Republican-controlled House of Representatives and the Obama administration took their best shots at each other’s arguments this week in their battle over Obamacare. The case, filed in federal court in Washington, D.C. last year, is about whether the executive branch overstepped its bounds in how it’s paying for and enforcing parts of the health law. (Gershman, 7/2)

Fox News: Republicans Look To Deliver Blow Against ObamaCare Tax
Despite the recent Supreme Court ruling upholding ObamaCare subsidies, opponents of the law remain poised to strike a key blow against another component of the health care overhaul in a matter of months. Republicans, with help from Democrats, have gained momentum in their long-running effort to repeal the law's controversial 2.3 percent excise tax on medical devices. ( Beaucar Vlahos, 6/4)

6. Many Conservatives Watching Indiana's Medicaid Expansion As Possible Model For Other States

When Indiana opted to expand its Medicaid program, it instituted a requirement for enrollees to pay small premiums for their care. That idea is attractive to other Republican-led states, including Ohio. Also, the issue of expansion continues to roil North Carolina lawmakers, and women's groups in Illinois are seeking state help to get free coverage for breast feeding services that they say were guaranteed under the health law.

Los Angeles Times: Indiana's Medicaid Experiment Offers A Conservative Take On Health Reform
Indiana, which has a conservative Republican governor and Legislature, is pioneering an experiment that requires low-income patients to contribute monthly to a special health account. ... Charging poor people small premiums or fees for care — long favored by conservatives who contend that "skin in the game" engages patients in their health — has historically produced mixed results. But at a time when Obamacare remains deeply unpopular among Republicans, the idea is attracting new interest as GOP governors seek ways to put a conservative stamp on expanding coverage. Indiana's experiment may provide a glimpse at where the health law is headed in some parts of the country. (Levey, 7/4)

The Associated Press: Ohio Medicaid Plan Would Require Enrollees To Share In Cost
About 1 million low-income Ohio residents could be required to pay a new monthly cost for Medicaid health coverage or potentially lose it under a Republican provision in the state budget, officials estimate. The idea, which will require federal approval, was part of the $71.2 billion, two-year spending blueprint that Republican Gov. John Kasich signed Tuesday. (Sanner, 6/2)

The Associated Press: NC Legislators Want Medicaid Reform Before Expansion
Despite a key win in the Supreme Court and pressure from liberal activists, North Carolina's legislative leaders said this past week that they have no plans to expand the state's Medicaid rolls through President Barack Obama's 2010 health care law. Demonstrators who have routinely come to the Legislative Building to protest Republican policies arrived again this past week on the coattails of a Supreme Court decision to uphold subsidies for individuals who purchased insurance on federal exchanges. They demanded Republican Gov. Pat McCrory and General Assembly leaders either accept federal funding to expand Medicaid enrollment through the Affordable Care Act, or come up with their own plan to close the insurance gap. (Moritz, 7/4)

The Seattle Times: Obamacare In Washington State: Are The Goals Being Met?
It has been five years since the Affordable Care Act (ACA) became law, and new data and numerous real-life stories are beginning to reveal how close or how far the ACA has come toward meeting its objective in Washington state. One challenge has been expanding the reach of insurance to more people. Today, more than 91 percent of the state’s population has coverage — the highest rate in decades, according to state officials. But coverage alone isn’t a measure of success. Equally important is whether people can afford their insurance and medical bills and whether they can get access to care that makes them healthier. (Stiffler, 7/4)