The Obama administration has announced a change in how the out-of-pocket health spending limits will be calculated for families, but employers object that it will leave them holding the bill. (Michelle Andrews, 8/14)
A study done in Massachusetts highlights the difficulties consumers face in trying to find out how much health care services cost. (Martha Bebinger, WBUR, 8/14)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Soup To Nuts?'" by Mike s.
Here's today's health policy haiku:
MEDICARE POLICY BRINGS CHALLENGE
Advocates urge change
on observation care -- three
midnights rule not cool.
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About 950,000 people enrolled in health law insurance coverage beyond the official enrollment period -- between Feb. 23 and June 30 -- because they experienced life changes such as losing their job-based insurance or having a baby that made them newly eligible.
The Wall Street Journal: HealthCare.gov Saw Almost 950,000 Sign Up After Open Enrollment
Almost 950,000 new customers selected health coverage on HealthCare.gov outside of the open-enrollment period after they became eligible due to changes such as losing their employer-provided insurance or having a baby, according to a government report on the federal health insurance exchange. With the new consumers who enrolled during the year due to changes in their circumstances, the Obama administration remains on track to meet its goal of 9.1 million to 9.9 million people who have paid for coverage through the insurance exchanges by the end of 2015. (Armour, 8/13)
The Associated Press: Health Law Sign-ups Keep Growing, Uninsured Rate Declines
Nearly a million people signed up for health insurance under the Affordable Care Act even after the official enrollment season ended, helping push the share of uninsured Americans below 10 percent and underscoring how hard it could be for Republicans to dismantle the program. The Health and Human Services Department said Thursday that 943,934 new customers had signed up since open enrollment ended on Feb. 22, benefiting from “special enrollment periods” keyed to life changes and other circumstances. (Alonso-Zaldivar, 8/13)
Politico Pro: Nearly 1 Million Sign Up For Obamacare Through Special Enrollment
Nearly 1 million people signed up for health insurance on the Obamacare exchanges this spring, outside of the scheduled enrollment season, because of special circumstances, the Obama administration said Thursday. About 944,000 people chose health care plans on HealthCare.gov between Feb. 23 — shortly after the last enrollment season ended — and June 30. During that time, people were eligible to sign up if they had a qualifying life event, such as aging off a parent’s health plan. HHS also opened up a short window to enroll during tax season. (Haberkorn, 8/13)
And on the topic of health exchanges -
Minnesota Public Radio: MNsure Website Getting A Facelift From D.C. Non-Profit
MNsure has hired the non-profit company Consumers' Checkbook to help improve the shopping experience on its website. The Washington D.C.-based company has a lot of experience providing price and service comparison tools, and has worked on other state health insurance exchanges. (8/13)
Wis. Gov. Scott Walker used this issue to draw a clear line to separate himself from Ohio Gov. John Kasich and N.J. Gov. Chris Christie. Other talk among the GOP presidential hopefuls has to do with childhood vaccinations, fetal tissue research ethics, and Planned Parenthood and race.
WMUR: Walker Says Unlike Kasich, Christie, He Rejected Medicaid Expansion
Scott Walker said Thursday he knows and likes John Kasich and Chris Christie, but the Wisconsin governor said that unlike the chief executives of Ohio and New Jersey, he didn’t accept Affordable Care Act Medicaid expansion dollars. ... Walker said Kasich is “a good guy” and has “a solid record in Ohio.” “There’s a couple of differences between me and any of the other governors on the (debate) stage the other night, meaning Gov. Christie and Gov. Kasich,” he said. “I didn’t take the Medicaid expansion under Obamacare,” as Kasich and Christie did. “I think that’s important to a lot of Republicans -- that I didn’t further Obamacare." (DiStaso, 8/13)
The New York Times: John Kasich’s Appeal To Moderates Gains Traction In New Hampshire
But what [Ohio Gov. John Kasich] is not saying is just as revealing. During the event, at a country club in a Democratic-leaning part of the state, he dispatched a question about whether he would support legalized abortion in cases of rape, incest and when the life of the woman is in jeopardy with a single word — “Yes” — cutting off discussion of an issue that has addled some of his opponents. ... Mr. Kasich says he is most animated by what he calls “people in the shadows,” those with mental illness, developmental disabilities and in at-risk minority communities. (Martin, 8/13)
The Washington Post: Carly Fiorina: Parents Should Not Be Forced To Vaccinate Their Children
GOP presidential hopeful Carly Fiorina said Thursday that parents should not be forced to vaccinate their children against diseases like measles and mumps, although she added that public school systems can forbid unvaccinated children from attending. "When in doubt, it is always the parent's choice," Fiorina said during a town hall in an agricultural building in rural Iowa on Thursday evening. "When in doubt, it must always be the parent's choice." (Johnson, 8/13)
The Hill: Carson: Planned Parenthood Targets Black Neighborhoods To 'Control' Population
GOP presidential candidate Dr. Ben Carson on Wednesday accused Planned Parenthood of disproportionately opening clinics in black neighborhoods as a way to “control that population.” In an interview with Fox News late Wednesday, Carson claimed Planned Parenthood’s founder, Margaret Sanger, was a racist who intentionally opened abortion clinics in predominately black neighborhoods. (Ferris, 8/13)
CNN: Carson Defends His Research On Aborted Fetuses
Republican presidential candidate Ben Carson on Thursday defended his past use of tissue from aborted fetuses for medical research even as he continued to criticize Planned Parenthood. The retired neurosurgeon said his research, which took place in 1992, does not conflict with his call to defund Planned Parenthood after several undercover videos surfaced that purportedly show officials with the organization working with research companies using tissue from aborted fetuses. Jen Gunter, an obstetrician-gynecologist, wrote on her blog that Carson had co-authored an academic paper published in Hum Pathol, in which he described working with material "from two fetuses aborted in the ninth and 17th week of gestation." (Scott and Spodak, 8/13)
The Washington Post's The Fix: Ben Carson’s Tortured Defense Of His Fetal Tissue Research
Ben Carson doesn't deny using fetal tissue from aborted fetuses for medical research in the early 1990s. But the way in which the former Johns Hopkins neurosurgeon received and used the tissue is very different from how Planned Parenthood obtains and sells its fetal tissue, he claims. (Phillips, 8/13)
Meanwhile, on the Democratic side of the primary ballot -
NPR: At Clinton Event, An Emotional Conversation On Substance Use
New Hampshire is in the throes of a drug epidemic driven by prescription opiods and heroin. "The state of New Hampshire loses a citizen to an overdose death about every day," said Tym Rourke, chair of the New Hampshire Governor's Commission on Alcohol and Drug Abuse. In New Hampshire, a recent poll about the most important problems facing the state found drug abuse ranks second. That puts it ahead of education, taxes and the state budget. And now politicians visiting the first-in-the-nation primary state are paying attention — in part because so many voters are bringing it up. (Keith, 8/14)
ProPublica: Insurance Lobby That Fought Hillarycare And Obamacare Now Has Sturdy Bridges To Democrats
When the former head of the U.S. government’s health insurance programs was hired in July to run a lobby that had spent tens of millions of dollars trying to derail Obamacare, it was more than just another spin of Washington’s revolving door. Marilyn Tavenner, former administrator of the Centers for Medicare and Medicaid Services, became chief executive of America’s Health Insurance Plans, the industry’s main lobbying group, which is known as AHIP. As the latest of a half-dozen prominent architects and overseers of Obamacare to move into the health industry, her move signified growing ties between health insurers and Democrats despite battles over the Affordable Care Act. (MacGillis, 8/13)
Massachusetts' consumers say it isn't easy to find out what a procedure will cost ahead of time, even though the state has a law requiring that information be available. face challenges in determining medical services pricing, Kaiser Health News also reports on how some business leaders and lawmakers want to reexamine the out-of-pocket spending limits for families set by the health law.
Kaiser Health News: How Much Is That Eye Exam? Study Probes The Elusive Quest For Health Care Prices
Let’s say you’re having trouble reading this. The words are a little fuzzy. You might need glasses or a new prescription. So you call to make an appointment for an eye exam and ask how much the visit will cost. You’re going to pay for the appointment because your insurance plan has a deductible that you haven’t met. Seems like a simple question, but be prepared: There’s a good chance you won’t get a simple answer. (Bebinger, 8/14)
Kaiser Health News: Business Leaders, GOP Question HHS’ Change On Families’ Out-Of-Pocket Limits
One of the health law’s key protections was to cap how much consumers can be required to pay out of pocket for medical care each year. Now some employers say the administration is unfairly changing the rules that determine how those limits are applied, and they’re worried it will cost them more. (Andrews, 8/14)
Meanwhile, other news outlets look into in- and out-of-network billing transparency as well as the practice of "balance billing" -
NewsWorks: Surprise! When Your Hospital Is In-Network, But Your Doc Isn't
Patients who have insurance and go to in-network hospitals may still wind up with unexpected bills. It happens when doctors are out of network and don't take a patient's insurance. In those instances, patients may owe the balance between what the provider charges and what the insurance plan is willing to pay. It's often referred to as surprise billing, a form of balance billing, and it's a situation that Michael Trost of Dingmans Ferry, Pa. encountered this past spring. An unanticipated trip to an in-network hospital and the subsequent surgery from an out-of-network doctor resulted in a surprise bill of $32,325. (Gordon, 8/13)
California Healthline: Advocates, CMS Warn Providers About Continuing Medicare 'Balance Billing'
CMS recently issued a report on the practice of "balance billing" -- under which health care providers charge qualified Medicare beneficiaries (QMBs) a share of the cost of care, such as copayments. That practice is illegal, CMS officials said. Seniors and people with disabilities are considered QMBs if their incomes are less than federal poverty level and they have limited assets. States are required through Medicaid to cover some of the QMBs' Medicare Part B premiums and the per-service cost-sharing, such as copayments. (Gorn, 8/13)