In This Edition:
From Kaiser Health News:
States that expanded eligibility for Medicaid have failed to enroll large numbers of a significant group that stood to benefit: ex-inmates. (Jay Hancock, Kaiser Health News, and Beth Schwartzapfel, The Marshall Project, 12/6)
Many consumers find that doctors listed in their plan’s directories aren’t accepting new patients, charge large concierge fees or may not even be in the network. Regulators don’t check. (Jay Hancock, 12/5)
As patients’ share of medical bills has grown with the rise in deductibles, copays and coinsurance, providers have become laser focused on getting payments up front. (Michelle Andrews, 12/6)
Marijuana use is increasingly popular among older Americans, a new study shows. (Carmen Heredia Rodriguez, 12/6)
States can set their own rules about these benefits for Medicaid enrollees and a study shows wide disparities. But researchers say a repeal of the health law’s expansion could derail progress. (Carmen Heredia Rodriguez, 12/6)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Repeal And Wait?'" by Jeff Danziger.
Here's today's health policy haiku:
A MARKET TREND: DOCS’ WANT UP-FRONT PAYMENT FOR CARE
Paying cash? Credit?
Those are questions patients face
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:
The Freedom Caucus, which boasts about 40 members, says it is unacceptable to wait three years to replace the health law. Meanwhile, a court has decided to press pause on a court case involving payments to insurers under the Affordable Care Act, House Speaker Paul Ryan promises no one will be worse off with Republicans' plans for health care coverage and more from Capitol Hill.
Politico: Freedom Caucus Opposes GOP's Obamacare Replacement Plan
The Republican congressman who made his name as the instigator of John Boehner’s ouster last year was set to take the reins of the House Freedom Caucus on Monday night. And first up on Rep. Mark Meadows’ to-do list: Torpedoing GOP leadership’s tentative plans to take as long as three years to replace Obamacare. (Bade, 12/5)
The Hill: Court Delays GOP's ObamaCare Suit Until Trump Is In Office
A federal judge on Monday agreed to hit pause until the start of the Trump administration on the House GOP’s long-standing legal challenge of ObamaCare payments. The U.S. Court of Appeals ruled in favor of Republican leaders, who had requested their case be considered after President-elect Donald Trump takes office. Any actions on the case, known as House v. Burwell, are now postponed until Feb. 21. (Ferris, 12/5)
The Associated Press: Appeals Court Agrees To Delay GOP Lawsuit Over Health Law
A federal appeals court has agreed to delay consideration of a lawsuit from Republican lawmakers over the Obama health care law. President-elect Donald Trump and Republicans in Congress plan to repeal and replace the law. The three-judge panel in Washington on Monday gave both sides in the case until Feb. 21 to clarify their positions. House Republicans say a change in policy under the new administration could render the case moot. (12/5)
Morning Consult: Court Agrees To Temporary Delay Of GOP Obamacare Lawsuit
A federal appeals judge said House Republicans’ lawsuit challenging Affordable Care Act subsidies would be placed on hold until Feb. 21, 2017, a move that will give the Trump administration time to decide its next steps. (McIntire, 12/5)
Milwaukee Journal Sentinel: Ryan: Obamacare Phaseout Will Leave 'No One Worse Off'
House Speaker Paul Ryan said Monday he envisions an extended transition from Obamacare that ensures “no one is worse off” after Congress votes to repeal the program. The Speaker declined to say how long it would take Republicans to design a replacement so that the millions of people now covered by the Affordable Care Act can be transitioned off it. (Gilbert, 12/5)
The Hill: Ryan Aide: No Shift In Stance On Healthcare Assistance
Speaker Paul Ryan (R-Wis.) is not shifting his position on how the financial assistance in an ObamaCare replacement would be structured, according to a spokeswoman, after questions were raised by his comments in a “60 Minutes” interview. Ryan told the CBS News program that low-income people should receive more financial assistance to help them afford health insurance than higher-income people. (Sullivan, 12/5)
Morning Consult: McCarthy Says No Date For Obamacare Repeal, But Coming ‘Soon’
House Majority Leader Kevin McCarthy said the process for repealing Obamacare will likely start as the next Congress gets going. “I don’t want to set a date, but I would tell you very soon in the new Congress,” McCarthy told reporters Monday. His comments come as some Republicans are coalescing around a plan to repeal the law without a replacement drafted, with a transition period to allow current consumers to maintain coverage as the GOP works to implement a new system. But other Republicans are expressing apprehension with that plan. Sen. Susan Collins may not vote to repeal the Affordable Care Act without a detailed replacement, the Maine Republican told the Portland Free Press on Friday. (McIntire, 12/ 5)
Portland (Maine) Press Herald: Sen. Collins Has ‘Reservations’ About Privatizing Medicare, Repealing Health Care Law Without Replacement
Sen. Susan Collins of Maine said Friday that she’s unlikely to support efforts to privatize Medicare and might not vote to repeal the Affordable Care Act, positions that would put her at odds with Republican party leaders. Though Collins opposed the Affordable Care Act and says it needs many fixes, she might not support repealing the law if a suitable, detailed replacement is not identified. However, Collins stressed in a brief interview Friday that she’s not sure how she would vote on the issue. (Lawlor, 12/3)
And in other news —
Modern Healthcare: What Will It Take To Keep Insurers From Fleeing After The ACA'S Repeal?
Health insurers and regulators are extremely nervous about congressional Republican leaders' announced plans to repeal most of the Affordable Care Act soon after Donald Trump takes over the presidency next month and wait several years to establish a new system. But some insiders say they are encouraged that GOP leaders are slowly recognizing they need to take steps to shore up the fragile individual insurance market that covers nearly 20 million Americans and avoid measures that drive health plans out of the market in 2018. Meanwhile, some state insurance officials are examining what tools they have to keep the insurance market functioning in the event of an ACA repeal early next year. (Meyer, 12/5)
Modern Healthcare: The State Of The ACA's Risk Corridors
The Obama administration is now on the hook for more than $8 billion in payments to cover insurer losses on the health insurance exchanges, but industry experts are growing doubtful the full tab will ever be paid. At the same time, while Republican lawmakers are committed to sewing up the federal wallet to keep the current administration from paying insurers what they call a “bailout,” they don't want to see the insurance markets collapse under their watch. Any replacement plan for the Affordable Care Act—which President-elect Donald Trump and Republicans in Congress have vowed to repeal and replace—would require private insurers to jump on board. And alienating them by refusing to pay promised funds would be bad for business, experts say. (Livingston, 12/5)
The New York Times offers a look at those who don't qualify for Medicaid but don't make enough to get help with coverage through federal subsidies.
The New York Times: Life In Obamacare’s Dead Zone
“I tried to get Obamacare,” [Janet] Foy recalls. “I called the number, and when the woman told me what it would cost me, I just about dropped the phone. She told me I’d needed to make at least $12,000 a year for there to be any help to make it something I might be able to afford. Which still doesn’t make a lot of sense to me, even now, that having no money meant I got no help when I really needed it.” She also learned that she could not expect any help from Medicaid, which in her home state remained available only if you fit the criteria sometimes known by the shorthand “poor and” — poor and pregnant, poor and disabled. As a single childless woman, she could forget about it. (Verzemnieks, 12/6)
In other news —
Kaiser Health News: Insurers’ Flawed Directories Leave Patients Scrambling For In-Network Doctors
As consumers review their coverage and shop for 2017 insurance through the federal health law’s online marketplaces during the annual open enrollment period, many of the directories they are using are outdated and inaccurate. Some doctors in the directories are not accepting new patients and some are not participating in the network, say experts, brokers and consumers. Still other physicians in the directories, who are listed as “in-plan,” charge patients thousands of dollars extra per year in “concierge fees” to join their practices. (Hancock, 12/5)