Note To Readers

KHN's Morning Briefing will not be published Sept. 4. Look for it again in your inbox Sept. 5.

In This Edition:

From Kaiser Health News:

Kaiser Health News Original Stories

3. Podcast: ‘What The Health?’ Hurricane Harvey And Health Costs

In this episode of “What the Health?” Julie Rovner of Kaiser Health News, Joanne Kenen of Politico and Margot Sanger-Katz of The New York Times discuss the potential health impact of Hurricane Harvey on the Texas Gulf Coast, and what impact the relief effort in Washington could have on an already jampacked September agenda. Also this week: an interview with Elisabeth Rosenthal about why medical care costs so much. (8/31)

5. Why One California County Went Surgery Shopping

Fed up with high hospital costs and limited competition, Santa Barbara County sends willing employees out of town for better bargains. Local governments are slowly joining private employers in aggressively seeking out the best care for the lowest price.  (Chad Terhune, 9/1)

Summaries Of The News:

Health Law

8. Administration Guts Health Law Ad Budget While Critics Call Sabotage

On top of the 90 percent cut to the advertising budget for the open enrollment period, grants to navigators who help people sign up for coverage were nearly halved.

The New York Times: Trump Administration Sharply Cuts Spending On Health Law Enrollment
The Trump administration is slashing spending on advertising and promotion for enrollment under the Affordable Care Act, a move some critics charged was a blatant attempt to sabotage the law. Officials with the Department of Health and Human Services, who insisted on not being identified during a conference call with reporters, said on Thursday that the advertising budget for the open enrollment period that starts in November would be cut to $10 million, compared with $100 million spent by the Obama administration last year, a drop of 90 percent. Additionally, grants to about 100 nonprofit groups, known as navigators, that help people enroll in health plans offered by the insurance marketplaces will be cut to a total of $36 million, from about $63 million. (Goodnough and Pear, 8/31)

The Washington Post: Trump Officials Slash Advertising, Grants To Help Americans Get Affordable Care Act Insurance
The announcement late Thursday afternoon, just nine weeks before the start of the fifth annual enrollment season, is the first indication of how an administration determined to overturn the health-care law will oversee the window for new and returning consumers buying coverage for 2018. In a conference call with reporters, three federal health officials extended the White House’s pattern of denigrating the ACA and its effectiveness. They also reversed a promise that Health and Human Services staff had made two months ago to nearly 100 organizations receiving “navigator” grants that their funding would be renewed. (Goldstein, 8/31)

The Wall Street Journal: Administration Cutting Ads And Grants Aimed At Boosting Affordable Care Act Sign-Ups
The administration is also cutting grants to organizations that help consumers understand their coverage and financial-aid options under the law. HHS will give $36.8 million in grants in 2017 to such groups, known as “navigators,” a drop of about 40% from the $62.5 million awarded in the previous enrollment period. Agency officials said they are basing that funding on the navigators’ ability to reach their enrollment goals. An organization that met 30% of its sign-up goal, for example, would get 30% of the grant it had previously received. (Armour and Wilde Mathews, 8/31)

The Hill: Trump To Slash ObamaCare Outreach Funding
“A health-care system that has caused premiums to double and left nearly half of our counties with only one coverage option is not working," said HHS spokeswoman Caitlin Oakley. "The Trump administration is determined to serve the American people instead of trying to sell them a bad deal.” (Sullivan, 8/31)

Bloomberg: Trump Guts Budget For Obamacare Ads 
Experts who have studied the law or helped run it say otherwise, and that such drastic reductions look more like efforts to let the program wither, as Trump has threatened, two months before sign-ups open. Follow the Trump Administration’s Every Move Follow the Trump Administration’s Every Move “It seems perfectly appropriate to review outreach efforts and see if they can be done more efficiently, but these cuts are quite large,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation, a health research group. “There’s no doubt that cuts to outreach and advertising will result in more people uninsured.” (Tracer and Edney, 8/31)

Modern Healthcare: CMS Slashes ACA Marketplace Education And Outreach Funds
Margaret Murray, CEO of the Association for Community Affiliated Plans, said the decision to cut advertising is disappointing and will make it harder to attract younger consumers who don't prioritize health insurance. "We're concerned this will depress enrollment particularly among younger, healthier people," Murray said. "Our plans are committed to getting people in, but you need the force of the federal government." (Livingston, 8/31)

Politico: Trump Administration Slashes Obamacare Outreach
Scaling back advertising and outreach is likely to depress enrollment in the marketplaces, particularly among healthier customers who, compared to sicker patients, are less likely to seek out insurance. Healthier customers are vital to balancing out the costs of sicker customers in the insurance marketplaces. “The Trump administration is deliberately attempting to sabotage our health care system," Senate Minority Leader Chuck Schumer said in a statement. "When the number of people with health insurance declines and costs skyrocket, the American people will know who's to blame.” (Pradhan, 8/31)

The Hill: Dems Blast Trump For Trying To 'Sabotage' ObamaCare
Top Democrats blasted the Trump administration on Thursday for moving to slash funding for ObamaCare advertising and enrollment outreach. "The Trump administration is deliberately attempting to sabotage our health care system. When the number of people with health insurance declines and costs skyrocket, the American people will know who's to blame," Senate Minority Leader Charles Schumer (D-N.Y.) said in a statement. (Delk, 8/31)

9. Hickenlooper, Kasich Unveil Bipartisan Health Plan Aimed At Shoring Up Marketplaces

Six other governors are backing the plan that Govs. John Hickenlooper (D-Colo.) and John Kasich (R-Ohio) have worked on for months.

The Associated Press: Governors Urge Keeping US Health Law's Individual Mandate
A bipartisan governor duo is urging Congress to retain the federal health care law's unpopular individual mandate while seeking to stabilize individual insurance markets as lawmakers work on a long-term replacement. The recommendation is part of a compromise plan that's designed to be palatable to both parties. It was endorsed by six other governors. (Smyth and Anderson, 8/31)

The Washington Post: Bipartisan Group Of Governors Calls On Congress To Shore Up Elements Of Affordable Care Act
In a blueprint issued Thursday, the eight governors ask House and Senate leaders of both parties to take several steps to reverse the rising rates and dwindling choices facing many of the 10 million Americans who buy health plans on their own through ACA marketplaces. Specifically, the state leaders say Congress should devote money for at least two years toward “cost-sharing subsidies” that the 2010 health-care law promises to pay ACA insurers to offset deductibles and other out-of-pocket expenses for lower-income customers. The House sued the Obama administration over the subsidies’ legality, and President Trump has repeatedly suggested that he might halt the payments — sending tremors through insurance companies in the marketplaces. (Goldstein, 8/31)