In This Edition:
From Kaiser Health News:
Many aging gays and lesbians who have lived openly for decades are finding that the world of assisted living and nursing homes can be decidedly less accommodating. (Anna Gorman, 10/17)
Other insurers complain that Blue Cross Blue Shield plans have bloated overhead costs and reap too much from the Obamacare risk-adjustment fund, paid for by insurers. The companies deny it. (Chad Terhune, 10/18)
The plans sought to discourage costly HIV patients by not including their drug needs in formularies or requiring high cost sharing, a Harvard Law School group says in a complaint filed with HHS. (Michelle Andrews, 10/18)
Research released by the American College of Emergency Physicians highlights how gaps in mental health care play out in the emergency room with longer stays and difficulties in securing follow-up care. (Shefali Luthra, 10/17)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Into The Light'" by John Deering from "Strange Brew".
Here's today's health policy haiku:
KRATOM’S RECLASSIFICATION STALLED BY ACTIVISTS’ OPPOSITION
The DEA saw
It as a schedule I drug.
Then came the phone calls.
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:
Officials say the new option will simplify shopping under the Affordable Care Act by reducing variation among plans. Meanwhile, UnitedHealth adjusts its forecast following its decision to drop out of the marketplaces, and the Koch brothers launch a million dollar ad campaign using Obamacare to target competitive Senate seats.
The New York Times: HealthCare.Gov Will Add ‘Simple Choice’ Plans In Effort To Improve Value
When the Affordable Care Act’s health insurance marketplace opens in two weeks, many consumers will have a new option for the law’s fourth open-enrollment period: standardized health plans that cover basic services without a deductible. With many health plans on the marketplace coming with deductibles in the thousands of dollars, consumers have complained that they were getting little benefit beyond coverage for catastrophic problems. The new standardized options are meant to address that concern — to ensure that “enrollees receive some upfront value for their premium dollars,” as the Obama administration said. (Pear, 10/17)
Bloomberg: UnitedHealth Boosts Forecast As It Puts Obamacare Woes In Past
UnitedHealth Group Inc. boosted its full-year profit forecast, as its health insurance and consulting businesses both recorded strong results following the company’s retreat from Obamacare, announced earlier this year. Earnings for 2016, excluding some items, will be about $8 a share, up from a previous forecast of $7.80 to $7.95. Third-quarter adjusted earnings were $2.17 a share, UnitedHealth said Tuesday in a statement, beating the $2.08 average of analysts’ estimates compiled by Bloomberg. (Tracer, 10/18)
Morning Consult: Obamacare Ads Ding Democratic Senate Hopefuls
As Democratic challengers to Republican senators try to harness momentum from Donald Trump’s many controversies, a conservative group said it will spend big to hit them over President Obama’s own polarizing signature achievement: the Affordable Care Act. Americans for Prosperity, a group funded by the billionaire Koch brothers, launched a million dollar ad campaign on Tuesday pointed at voters in eight states with competitive Senate contests, from states where the Republican is way ahead, such as Ohio, to the tightening contests in Missouri and Indiana. (Yokley, 10/17)
Morning Consult: AHIP Head Thinks ACA Risk Programs Will Need Changes
Marilyn Tavenner, the face of private insurers, does not think Affordable Care Act exchanges are about to implode. But she does think Congress will have to make some tough decisions relatively soon about how much to buffer insurers from risk. “I do not think the exchanges are in a death spiral. I do think they’re unstable, and we have a responsibility to stabilize them,” said Tavenner, president and CEO of America’s Health Insurance Plans, in an interview with Morning Consult. “That’s on all of us.” (Owens, 10/17)
Media outlets also offer developments on the health law out of the states —
Dallas Morning News: Latest Blow For Obamacare: Health Insurance Brokers Add Fees
Health insurance brokers are one of many industries that help both individuals and small businesses navigate the complex health insurance maze. Their services have been highlighted as key to helping uninsured Americans get enrolled following the Affordable Care Act rollout. The number of people employed to help insurance shoppers to shop has been steadily increasing, with just over one million agents, brokers and related service employees logged in 2014, according to The Statistics Portal. Nearly 260,000 worked in Texas. Brokers typically get paid by commission from health insurers when they enroll someone into a plan. However, they say it’s been harder to do business, and not just because of the delay in getting access to plan information. (Rice, 10/17)
Detroit Free Press: Obamacare Rates To Jump 16.7% In Michigan Despite State Scrutiny
The sticker price for individual health plans sold on Michigan's Affordable Care Act exchange will jump 16.7% next year under new rates announced Monday by state officials. The rates will be in effect Nov. 1, when open enrollment starts again on Healthcare.gov. The double-digit increases will mean a financial hit for taxpayers in general, as well as some of the 393,322 Michiganders who currently buy individual health insurance on or off the government-run exchange. (Reindl, 10/17)
The Philadelphia Inquirer/Philly.com: Phila. Area Faces Hefty Increases In Affordable Care Act Rates
Because of market turmoil and decisions by United Healthcare and Aetna to withdraw from Affordable Care Act exchanges in Pennsylvania for 2017, the remaining insurer in the Philadelphia area, Independence Blue Cross, has been granted a bigger rate increase -- 28 percent -- than it requested in the spring, the state Insurance Department said Monday. Insurance Commissioner Teresa Miller said additional companies beyond United and Aetna were considering ending their ACA individual-exchange businesses in Pennsylvania. If that happened, some counties might have been left without any offerings on the exchange, which is where individuals have to buy plans to qualify for federal subsidies. (Brubaker, 10/17)
California Healthline: Are Blues’ Plans Benefitting Unfairly From Program To Offset Cost Of Sicker Patients?
Some health insurers say they’re paying too much to rival Blue Cross Blue Shield plans under a key pillar of the federal health law designed to compensate insurers that take on sicker and more expensive patients. The critics’ chief complaint is that the Affordable Care Act’s risk-adjustment program unfairly rewards health plans — including Blue Shield of California — that have excess administrative costs and higher premiums. That comes at the expense of more efficient, lower-priced plans in the individual market, they say. (Terhune, 10/18)
The vice president detailed improvements that have come from the cancer moonshot initiative so far and laid out ambitious projects for the upcoming years.
Stat: 3 Big Projects The White House Cancer Moonshot Is Pursuing
Liquid biopsies. A “groundbreaking” Defense Department study. Partnerships with Lyft and Uber for patient transportation. The White House’s cancer moonshot, the future of which Vice President Joe Biden outlined in a new report on Monday, has a lot of moving parts. The report details nearly 20 projects that are already underway or soon will be in the moonshot’s first year and another two dozen planned for its second year and beyond. Major themes include harnessing big data, sharing research among scientists, and expanding preventive measures like the HPV vaccine and colorectal cancer screening. (Scott, 10/17)
Modern Healthcare: In Final Cancer Moonshot Report, Biden Lays Out Progress And Obstacles
Vice President Joe Biden delivered his final report Monday on the “Cancer Moonshoot,” reiterating how the U.S. is at an “inflection point” in the fight against cancer. He cited reasons to be hopeful, even as he acknowledged challenges ahead in the drive to achieve a decade of progress on fighting cancer in five years. President Barack Obama launched the Cancer Moonshot in January and tasked Biden with overseeing the initiative to double the pace of cancer research. Monday's report laid out a strategy to do so, organized into five strategic goals: catalyzing scientific breakthroughs, maximizing the power of data, bringing new therapies to patients more rapidly, improving prevention and diagnosis, and enhancing access and care for patients. (Whitman, 10/17)
The Hill: Biden: 'Trust Me' On Congress Funding Cancer Research
Vice President Biden on Monday hinted that GOP leaders in Congress have already agreed to “significant increases” in cancer research funding later this year.“ Congress is stepping up. Trust me,” Biden told some of the nation’s leading cancer researchers at an event at the White House. Biden, who lost his oldest son to brain cancer last year, has led the Obama administration’s initiative known as the “cancer moonshot” since January. (Ferris, 10/17)
Morning Consult: Biden Highlights Path Forward For Cancer Moonshot
The report highlights more than a dozen ongoing and future initiatives that have been launched as part of the effort, which was first announced by President Obama during his January State of the Union address. Biden has said he hopes to make a decade’s worth of progress on cancer research in half that time. “Funding and resource limitations are an ongoing challenge,” the report says. “Nonetheless, the vision is to improve existing programs so that they work optimally, efficiently, and with a broader perspective on their opportunities to improve health care quality and the health of people with and at risk of cancer.” (McIntire, 10/17)
Roll Call: Biden Presents 'Moonshot' Task Force Report
Vice President Joseph R. Biden Jr. released on Monday a federal report on the cancer moonshot initiative that highlights goals to accelerate the development of cures, including more widespread sharing of data and faster research and approval timelines for new treatments. ... The program has yet to receive any federally appropriated money. Neither of the pertinent spending bills for next year that the Senate and House Appropriations committees approved included funding directly for the moonshot initiative. Both, however, did increase funds for the National Cancer Institute and the NIH more broadly. (Williams, 10/17)
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