Kaiser Health News Original Stories

3. Hospital Deductibles Are For Admitted Patients Only

KHN consumer columnist Michelle Andrews also answers reader questions about how insurance-provider networks function and parents’ responsibility to provide coverage for children who are not yet 26. (Michelle Andrews, 8/4)

5. Political Cartoon: 'Happy Belated?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Happy Belated?'" by Clay Bennett.

Here's today's health policy haiku:


If patients come back
Too often, hospitals get
Fined by Medicare.

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Health Law Issues And Implementation

6. Health Law Reduces Out-Of-Pocket Expenses, But Medical Costs Can Still Be Overwhelming

One of the key aims of the health law was to protect consumers from ruinous medical debt, but some people still find it difficult to pay their health bills. Also, another health law provision created an organization to figure out which medical treatments work best to help consumers and the government save money on care.

The Center for Public Integrity: Obamacare Research Institute Plans To Spend $3.5 Billion, But Critics Question Its Worth
Business has been brisk at the Patient-Centered Outcomes Research Institute or, PCORI, as it is known. The institute was created by Congress under the Affordable Care Act to figure out what medical treatments work best — measures largely AWOL from the nation’s health care delivery system. Since 2012, PCORI has committed just over $1 billion to 591 “comparative effectiveness” contracts to find some answers, with much more spending to come. Money has thus far gone to researchers and medical schools, advocacy groups and even the insurance industry’s lobbying group, which snagged $500,000. (Schulte, 8/4)

7. Obama Administration Calls On States To Push Back On Big Insurance Rate Increases

The move could set up a clash with insurers that say they lost money on policies sold on the health law's marketplaces. Some are seeking premium hikes of 10 to 40 percent or more. Meanwhile, Politico reports that states with thorough rate review processes are likely to see smaller rate increases.

The New York Times: Obama Administration Urges States To Cut Health Insurers’ Requests For Big Rate Increases
Hoping to avoid another political uproar over the Affordable Care Act, the Obama administration is trying to persuade states to cut back big rate increases requested by many health insurance companies for 2016. In calling for aggressive regulation of rates, federal officials are setting up a potential clash with insurers. Some carriers said they paid out more in claims than they collected in premiums last year, so they lost money on policies sold in the new public marketplaces. After finding that new customers were sicker than expected, some health plans have sought increases of 10 percent to 40 percent or more. (Pear, 8/3)

The New Jersey Record: Affordable Care Costs May Rise In N.J.
Three insurers that sold health coverage this year to about 135,000 New Jersey residents through the federal Affordable Care Act are asking the state to approve double-digit price hikes for 2016. Price boosts also could be in the offing for the two other companies that participated in the HealthCare.gov marketplace set up by Obamacare, but there is no way to know because requests for increases under 10 percent don’t have to be disclosed in New Jersey until November. (Washburn, 8/3)

A quirk in the law may force thousands of federal retirees to pay higher Medicare premiums in 2016 than other beneficiaries -

The Washington Post: Some Federal Retirees Could Face Extra-Large Jump In Medicare Premiums
Hundreds of thousands of federal retirees could pay higher Medicare premiums in 2016 than most other enrollees will pay due to a combination of low inflation and a quirk in the law. Most of those retired under the Civil Service Retirement System are excluded from a “hold harmless” provision that keeps an individual’s Medicare Part B premium steady if his or her Social Security benefit does not rise enough to cover the increase in those premiums. (Yoder, 8/4)

Capitol Hill Watch

8. Senate Push To Cut Off Planned Parenthood's Federal Funds Blocked

Democrats are able to stall a bill that would halt funding for the women's health-care organization. Republicans pledge to continue the fight, which could extend into the budget debate this fall.

The Washington Post: Republican Effort To Strip Planned Parenthood Funding Stalls In Senate
The 53-46 procedural vote fell short of the 60 ayes needed to proceed with a bill that would immediately stop funding for the beleaguered women’s health-care provider. But the willingness of GOP leaders to bring the measure to a vote showed the new political importance of a social issue that had been sidelined just a month ago and heralded higher-stakes showdowns to come. (DeBonis, 8/3)

Politico: GOP: Planned Parenthood Fight To Go On
Republicans are divided over whether they should use this fall’s government funding bill to attack Planned Parenthood — and risk a high-stakes shutdown fight — after Senate Democrats blocked a standalone bill to defund the organization on Monday evening. (Everett and Bresnahan, 8/3)

The Associated Press: More Fights Ahead On Planned Parenthood After Senate Vote
In the aftermath of the Senate's derailing of Republican legislation halting federal dollars for Planned Parenthood, one thing seems clear: Many on both sides think they can ring up gains from the battle. Within minutes of Monday's Senate vote, abortion-rights groups were releasing TV ads attacking GOP supporters of the measure for stomping on women's health care needs. Conservatives were accusing Democrats of voting to protect taxpayer funds for an organization whose campaign contributions tilt lopsidedly to Democratic candidates. (Fram, 8/3)

Reuters: U.S. Senate Blocks Planned Parenthood Defunding Measure
Republican legislation to cut off federal funding for Planned Parenthood failed to gather enough support in the U.S. Senate on Monday, halting at least for now moves to punish the women's health group for its role in gathering fetal tissue from abortions for medical research. Senate Democrats succeeded in stopping the bill on a procedural vote. Sixty votes were needed to advance it in the 100-person chamber. It received 53 votes, with 46 senators opposing it. (Cornwell and Wilts, 8/3)

Fox News: Senate Fails To Advance Planned Parenthood Defund Effort
The Senate failed Monday to advance a Republican-led measure to halt federal aid to Planned Parenthood, but leaders of the GOP-controlled chamber appear ready to continue the fight, galvanized by a series of unsettling videos about the group. The vote to bring debate on the bill was 53 against to 46 in favor. (8/3)

CNN: Senate Vote To Defund Planned Parenthood Fails
The fight over funding for Planned Parenthood shifts to a must-pass government funding measure this fall after a procedural vote in the Senate on legislation that would have barred all federal funds for the group failed on Monday. (Walsh, 8/4)