Kaiser Health News Original Stories

1. A Racial Gap In Attitudes Toward Hospice Care

Hospice use has been growing fast in the United States as more people choose to avoid futile, often painful medical treatments in favor of palliative care and dying at home surrounded by loved ones. But some African-Americans have long resisted the concept, and their suspicions remain deep-seated. (Sarah Varney, 8/25)

3. Political Cartoon: 'Lost Cause?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Lost Cause?'" by Signe Wilkinson .

Here's today's health policy haiku:

MEDICARE ADVANTAGE AND THE MARKETPLACE

Does market merging
further hurt competition
in Advantage plans?

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Health Law Issues And Implementation

4. Late Tax Filers Risk Big Bills, Loss Of Obamacare Subsidies

The best way to avoid the loss is to file your 2014 taxes by August 31. Elsewhere, 26 percent of employers could be hit by the so-called "Cadillac" tax on high-benefit health plans -- which could also spell trouble for flexible spending accounts.

The Associated Press: Tardy Tax Filers Risk Loss Of Health Care Subsidies
Sign-up season for President Barack Obama's health care law doesn't start for another couple of months, but the next few days are crucial for hundreds of thousands of customers at risk of losing financial aid when they renew coverage for 2016. Call them tardy tax filers: an estimated 1.8 million households that got subsidies for their premiums last year but failed to file a 2014 tax return as required by the law, or left out key IRS paperwork. (8/24)

Forbes: Obamacare Cadillac Tax Worries For 26% Of Employers
The latest analysis of the so-called “Cadillac tax” on rich medical plans projects one in four employers offering health benefits “could be affected” by the regulation in 2018 if they don’t make changes to their benefit structures. The Cadillac tax was created as part of the Affordable Care Act largely as a way to help fund benefits to the uninsured under the law. Starting in 2018, employers pay a 40 percent tax on costs of health plans that are above $10,200 per individual and $27,500 for family coverage. (Japsen, 8/25)

CNBC: Obamacare Cadillac Tax's Secret Threat To FSAs
If you like your flexible spending account...you might not be able to keep your flexible spending account. Obamacare's looming "Cadillac tax" on high-cost health plans threatens to hit 1 in 4 U.S. employers when it takes effect in 2018—and will impact 42 percent of all employers by a decade later, according to a new analysis. (Mangan, 8/25)

5. Republican Candidates' Plans To Replace Obamacare Eclipsed By Other Campaign Issues

Politico reports that health law alternatives offered last week by Scott Walker and Marco Rubio have not helped the candidates gain any ground, while The Hill examines the difficulties presidential hopefuls face with voters who want to keep their new insurance or benefits.

Politico Pro: GOP Plans To Replace Obamacare Gain Little Traction On Campaign Trail
Has battling to kill Obamacare lost cachet for Republican presidential candidates? Two leading GOP contenders strode into their party’s most vexing policy fight last week, offering blueprints to replace the 5-year-old health law. The response? A collective yawn. A week later, Scott Walker and Marco Rubio’s Obamacare alternatives have all but disappeared from the campaign trail conversation, eclipsed by new twists in Trump’s GOP-leading candidacy and the fight he picked over birthright citizenship. (Cheney, 8/24)

The Hill: GOP Struggles To Replace ObamaCare Without Losing Voters
Just before Louisiana Gov. Bobby Jindal revealed his plan to replace ObamaCare last year, he sat down with 15 of Washington’s top conservative healthcare wonks to discuss it. They didn’t approve. “Near the end, they said, ‘You make a good point, but what you’ve put forward, we just don’t think it’s politically viable,’” Jindal’s long-time adviser Curt Anderson recalled in an interview this week. To his surprise, he said the group agreed the next GOP nominee couldn’t entirely roll back ObamaCare for fear of losing votes from millions already with coverage. In other words, even ObamaCare’s toughest critics say that parts of the law are here to stay. (Ferris, 8/24)

Capitol Hill Watch

6. Repeal Of Obamacare Taxes On House GOP Minds As Shutdown Looms

The caucus is also targeting full repeal of the health law as well as legislation on over-the-counter drugs and health savings accounts. Also, a standoff over Planned Parenthood funding is adding to concern over a government shutdown.

Natioinal Journal: House Republicans Really Think They Can Amend Obamacare This Fall
While congressional leaders continue to debate whether to pursue near-full repeal of the Affordable Care Act through budget reconciliation, and GOP presidential candidates lay out Obamacare-replacement proposals, House Republicans are looking at a smaller batch of changes to the health care law they think could make it to President Obama's desk. House Ways and Means Health Subcommittee Chairman Kevin Brady told National Journal that his panel could mark up health care tax legislation later this year. He floated bills related to over-the-counter drugs, health savings accounts, and—perhaps most ambitiously—a repeal of Obamacare's unpopular "Cadillac tax" on high-end insurance plans. The health care agenda will be determined in part by Capitol Hill's other business. (Scott, 8/24)

The Hill: House GOP Adds Healthcare Tax Bill To Fall Agenda
House GOP leaders are eyeing a package of healthcare bills this fall that will target some of the most despised taxes under the Affordable Care Act. Rep. Kevin Brady (R-Texas), chairman of the Ways and Means Committee's Health Subcommittee, said he expects a comprehensive bill repealing healthcare taxes to be ready sometime after lawmakers return from recess. (Ferris, 8/24)

Politico: House GOP Leaders Desperate To Avoid Shutdown
An explosive confrontation brewing between the House Republican leadership and conservatives over Planned Parenthood is threatening to shut down the government for the second time in three years. And House GOP leaders have yet to settle on a strategy to avert it. Desperate to avoid another closure, Speaker John Boehner (R-Ohio) and his team would prefer to build bipartisan opposition to funding the group through a series of high-profile Congressional investigations. But, at this point, that seems unlikely to cut it with a bloc of House conservatives who have said they simply won’t vote for a large-scale spending plan that funds Planned Parenthood. (Sherman and Palmer, 8/25)

7. Menendez Case Continues To Take Shape

Sen. Robert Menendez, D-N.J., was indicted in April for allegedly accepting hundreds of thousands of dollars in improper gifts and campaign contributions as bribes in exchange for using his office to aid Dr. Salomon Melgen.

Politico: DOJ: Robert Menendez Response To Bribery Charges 'Naked Rhetoric'
Menendez, who was first elected to Congress in 1992 and became a senator in 2006, was indicted in April for allegedly accepting hundreds of thousands of dollars in improper gifts and campaign contributions as bribes in exchange for using his office to aid Melgen. Both men have sought to have the charges against them dropped. According to the indictment, Menendez received nearly $1 million worth of gifts and campaign contributions from Melgen in exchange for using his Senate office to aid Melgen in a multimillion-dollar billing dispute with the Centers for Medicare & Medicaid Services; to attempt to enforce a $500 million port security contract Melgen had with the Dominican Republic; and to obtain visa applications for several of Melgen’s girlfriends. Melgen would reportedly send his private jet to pick up Menendez and a guest in New Jersey for flights to Florida or Melgen’s resort home in the Dominican Republic, all at no cost. Menendez subsequently was compelled to repay tens of thousands of dollars for unreported flights. (Bresnahan, 8/24)

The Washington Post: Prosecutors Claim ‘Unmistakable’ Evidence Of Menendez Wrongdoing
The investigators found “repeated and substantial use of defendant Menendez’s power and influence to further the personal whims and financial interests of defendant Melgen,” the filing says. “No ordinary constituent from New Jersey received the same treatment, and the quid pro quo outlined in the indictment is clear and unmistakable.” ... The 14-count indictment accused Menendez of using the influence of his office to advance Melgen’s financial interests in exchange for luxury gifts, lavish vacations and more than $750,000 in campaign donations. Prosecutors charged that Menendez, a former chairman of the Senate Foreign Relations Committee, twice intervened on the doctor’s behalf — first with federal regulators investigating Melgen’s Medicare billings and then when Melgen sought to secure a ­port-security contract in the Dominican Republic, according to the indictment. (Leonnig, 8/24)

The New York Times: Prosecutors Rebuke Menendez Over Request To Dismiss His Corruption Case
Justice Department prosecutors scolded Senator Robert Menendez and his lawyers on Monday, rebuking the indicted lawmaker for what they described as a disingenuous attempt to have corruption charges against him thrown out in federal court. In a series of filings answering Mr. Menendez’s request that his case be dismissed, Justice Department lawyers defended their handling of a lengthy investigation into the senator, which resulted in a 14-count indictment in April. (Burns, 8/24)

Marketplace

8. Report Finds Lack Of Competition Among Medicare Advantage Plans

The study by the Commonwealth Fund finds that in 97 percent of markets a small number of insurers dominate, which could raise concerns about some high-level insurance company mergers. Also in industry news, health analytics company Inovalon is acquiring the consulting firm Avalere Health and two large kidney-care providers plan consolidations.

The New York Times: With Mergers, Concerns Grow About Private Medicare
As some of the nation’s largest health insurers plan to merge, a new report raises fresh concern over the lack of competition in the private Medicare market. The analysis, released on Tuesday, concludes “there is little competition anywhere in the nation.” The report from the Commonwealth Fund, a research group, looked at the market share of insurance companies offering private Medicare Advantage plans in 2012. The authors found that 97 percent of markets in United States counties were “highly concentrated,” in which a small number of insurers dominated. The lack of competition was worse in rural markets. (Abelson, 8/25)

Modern Healthcare: Robust Medicare Advantage Competition Almost Nonexistent
Competition among Medicare Advantage plans more closely resembles local oligopolies instead of a buzzing market overflowing with options for seniors, a new study from the Commonwealth Fund shows. The lack of competition is especially relevant as the U.S. health insurance market teeters on the precipice of further consolidation. Aetna and Anthem are undergoing federal scrutiny over their deals that would drastically enlarge their Medicare Advantage memberships. (Herman, 8/25)

The Wall Street Journal: Gauge Shows Trader Unease On Merger Outcomes
The gap between the price offered and the trading price of a number of companies that are subject to pending takeover bids widened dramatically last week, a sign of investor nervousness about deals whose outcome could help determine whether the merger boom continues. ... For patient, steel-nerved investors, though, there could still be big profits to be made. A wager placed Friday that Aetna Inc. will complete its $34 billion takeover of rival health insurer Humana Inc., for example, is set to return some 22% should the deal close on schedule in late 2016. The spread, which largely reflects nervousness that regulators will reject the deal and possibly an accompanying tie-up between Anthem Inc. and Cigna Corp., rose from 21.2% a week earlier. That is a relatively modest move showing that not all spreads widened dramatically last week. (Raice and Hoffman, 8/24)