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From Kaiser Health News:

Kaiser Health News Original Stories

2. Officials Warn Some Older Marketplace Customers To Switch To Medicare

The government is sending emails and letters to some seniors to warn them that if they are eligible for Medicare and stay on the health law's exchange, they will have to repay any subsidies they receive and if they miss their Medicare enrollment opportunity, they will face a life-long penalty. (Susan Jaffe, 10/14)

4. Political Cartoon: 'A Real Bargain'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'A Real Bargain'" by Signe Wilkinson .

Here's today's health policy haiku:


If you lien on me
Better not be a felon,
Nor unapproved care.

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.

Summaries Of The News:

Health Law Issues And Implementation

5. Obama Administration Launches Full-On Courtship As Open Enrollment Nears

It will use social media, TV ads, email and direct mail to reach more uninsured Americans. But the media blitz will run up against Republicans' campaigns touting the opposite message. Meanwhile, a study projects that enrollment will either plateau or drop off this year.

The Associated Press: Mailings, Social Media Ads Woo Uninsured For Health Sign-Up
The Obama administration says it’ll send more than 10 million mailings to woo the uninsured for the final health care law sign-up season of President Barack Obama’s tenure. Add to that countless email messages to both prospective and returning customers — and ads on social media platforms such as Instagram and Facebook. (10/13)

The Wall Street Journal: Health-Care Law Ads Clash With GOP Message
The Obama administration is planning to use television ads and direct mail to boost participation in the Affordable Care Act’s exchanges in the coming open-enrollment period, but its timing will mean fighting for attention amid the noise of the election. The ads, which are partly focused on the affordability of coverage under the law, will run headlong into campaigns by opponents of the law who are using their own political ads to denounce it as a costly boondoggle. (Armour, 10/13)

The Hill: Administration Plans New ObamaCare Outreach Tactics
The Obama administration is touting new outreach tactics that it says will help bring more young people into ObamaCare as a new signup period nears. Officials say they have learned lessons from the first three years of signups in order to hone their messages. Bringing a higher percentage of young and healthy people, or increasing the overall enrollment number, would help ease insurer concerns about a smaller and sicker group of enrollees than expected. (Sullivan, 10/13)

The Hill: Study Projects Flattening ObamaCare Sign-Ups In 2017 
A new analysis projects that ObamaCare enrollment will be roughly flat or could even decline slightly next year. The analysis from Standard & Poor's projects that between 11.7 million and 13.3 million people will sign up for ObamaCare in the enrollment period that begins Nov. 1. That is compared to 12.7 million who signed up last year. That means that two years of growth in the marketplace will turn into a “significant slowdown” for 2017, the report says. (Sullivan, 10/13)

Bloomberg: Obamacare Enrollment To See ‘Significant Slowdown’ Next Year
Enrollment in the Obamacare insurance marketplace is likely to stall or even decline for 2017 as higher premiums drive away people who aren’t eligible for government subsidies, according to S&P Global Ratings forecasts. ... This November will be the fourth open enrollment period for individuals to choose insurance plans under the Affordable Care Act, President Barack Obama’s signature health-care law. The “significant slowdown” predicted by S&P would be another setback for ACA’s government-run insurance markets, after big insurers pulled out of many states because of mounting losses. (Doherty, 10/13)

6. Those Who Benefit Most From Health Law Also Highlight Cracks In Its Foundations

One of the fundamental challenges of the health law is that those who needed coverage the most are getting it. But their care is expensive and younger, healthier people aren't joining to offset the cost. Meanwhile, more than 1 million customers will need to find new plans as insurers pull out of the marketplace.

The New York Times: Health Care Law’s Beneficiaries Reflect Its Strengths, And Its Faults
Cara Suzannah Latil is living proof that the Affordable Care Act works — but also of why a central piece of the law is in turmoil. Ms. Latil, 49, who works at a homeless shelter in Santa Fe, N.M., is one of millions of Americans who once found it difficult or impossible to get health insurance because they already had serious illnesses. Hepatitis C was ravaging her liver when she learned in 2014 that she also had breast cancer. Through the health care law, she was able to buy subsidized insurance that paid for all but $800 of her cancer surgery and radiation, she said, as well as tens of thousands of dollars’ worth of medications that cured her hepatitis. (Goodnough and Abelson, 10/14)

Bloomberg: More Than 1 Million In Obamacare To Lose Plans As Insurers Quit
A growing number of people in Obamacare are finding out their health insurance plans will disappear from the program next year, forcing them to find new coverage even as options shrink and prices rise. At least 1.4 million people in 32 states will lose the Obamacare plan they have now, according to state officials contacted by Bloomberg. That’s largely caused by Aetna Inc., UnitedHealth Group Inc. and some state or regional insurers quitting the law’s markets for individual coverage. (Tracer, Darie and Doherty, 10/14)

In other health law news —

The Hill: Insurers Not Interested In Selling ObamaCare Across State Lines 
Donald Trump had one response when asked about how he would replace ObamaCare at this week’s presidential debate: He’ll allow companies to sell insurance across state lines. The GOP’s decade-old talking point has gained momentum since the healthcare law passed six years ago. But Republicans rarely — if ever — acknowledge that the crux of what they want is already allowed under ObamaCare. For the last 10 months, states have been legally allowed to let insurers sell plans outside their borders. (Ferris, 10/13)

Kaiser Health News: How Narrow Is It? Gov’t Begins Test Of Comparison Tool For Health Plan Networks
The incredible shrinking provider network is nothing new in marketplace plans. One way insurers have kept premiums in check on the individual market is by reducing the number of providers available in a plan’s network. Earlier this year, the federal government said that it would introduce a tool this fall to help consumers who are shopping on gauge how narrow a plan’s provider network is compared with others in the area. But most consumers who want that information will have to wait at least another year. (Andrews, 10/14)

7. Survey: Medicaid Spending Growth Tapering Off

Now, part of the cost burden of Medicaid coverage will start shifting toward the states because of the requirement they pick up 5 percent of expansion costs starting in 2017. Meanwhile, Virginia's governor will try again to persuade the state to pursue expansion.

Politico Pro: Medicaid Spending Growth Slows In 2016 
Spending growth under the Medicaid program tapered nationally in fiscal year 2016 as the initial effects of the Affordable Care Act’s coverage expansion began to wear off, according to a Kaiser Family Foundation survey released Thursday. Total Medicaid spending by the federal and state governments grew at a rate of 10.5 percent in fiscal year 2015 as Obamacare led to a surge in enrollment. In fiscal year 2016, spending growth declined to just under 6 percent. Officials project that fiscal year 2017 spending will grow even more slowly, at a rate of 4.5 percent. (Pradhan, 10/13)

Miami Herald: Medicaid Enrollment And Spending Stabilize, New Kaiser Survey Finds 
While national spending and enrollment for Medicaid continues to grow, it has slowed considerably following the 2014 implementation of the Medicaid expansion under the Affordable Care Act. That’s the finding of a new 50-state survey by the Kaiser Family Foundation. Medicaid, the state/national health program for low-income and disabled Americans, now covers nearly 73 million Americans and accounts for one in six dollars spent in the health care system after undergoing rapid growth when states expanded income eligibility for the program through the ACA. (Pugh, 10/13)

The Washington Post: McAuliffe Calls For Pay Cuts, Job Freeze And Reconsideration Of Medicaid Expansion
Virginia Gov. Terry McAuliffe, in an attempt to balance the state’s $1.5 billion budget shortfall, plans to eliminate planned pay raises for state employees and teachers and will ask the General Assembly to dip into the rainy-day fund to keep funding intact for education, public safety and Medicaid. “There will be no program cuts to public education, Medicaid for our families most in need, nor our core public safety services,” McAuliffe (D) said in a statement Thursday. (Sullivan, 10/13)

In other Medicaid news —

Kansas Health Institute: Need Disability Help In Kansas? Thousands Wait An Average Of Seven Years
In 2013 Republican Gov. Sam Brownback put Medicaid under the management of three private insurance companies, promising managed care would improve services, cut waste and save enough money to end the lists for the kind of services Nick Fugate needs. But families of Kansans with developmental disability didn’t trust the companies to provide the complicated help their loved ones needed. They managed to get the federal government to delay the switchover, but in February 2014 federal officials gave their approval and the KanCare experiment began for them. More than two years later, many families say they’ve seen few signs of improvement, particularly in the waiting list. Not only is there still a waiting list, it has grown by a few hundred to about 3,500 people. Except in emergency situations, the average wait is seven years. (Smith, 10/13)


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