Kaiser Health News Original Stories

5. Political Cartoon: 'Hang Out Your Shingle'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Hang Out Your Shingle'" by Marty Bucella.

Here's today's health policy haiku:

IT ALL COMES DOWN TO THE DATA

Tech will see you now,
and the doctor, if needed.
Just bring your data.

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Health Law Issues And Implementation

6. For Obamacare, Upcoming Enrollment Season Will Be Toughest Yet, Burwell Says

HHS Secretary Sylvia Burwell says the administration estimates that nearly 18 million people have gained insurance so far as a result of the health law, but officials will now be setting their sights on the less eager consumers.

The Wall Street Journal: HHS Secretary Says Coming Sign-Up Season Will Be Toughest Yet Under Health Law
Top Obama administration officials said Tuesday they were anticipating their toughest sign-up season yet for insurance coverage under the health law. Officials aim to make a dent in the number Americans still uninsured in the law’s third enrollment period. They are eyeing about 10.5 million people who could buy coverage through HealthCare.gov or state sites, often with federal subsidies to offset premiums, but who have resisted signing up as the law rolled out. (Radnofsky, 9/22)

The Associated Press: Uninsured Are Getting Harder To Sign Up
Health and Human Services Secretary Sylvia Burwell on Tuesday gave three reasons why the 2016 sign-up season will be a bigger challenge: The most eager customers have already signed up; many of the remaining uninsured are young adults who may not see the value of coverage and those who remain are juggling tight household budgets. (9/22)

USA Today: Feds Say Nearly 18 Million Now Insured Through Obamacare
Citing just-released federal data, Burwell said the 17.6 million people who gained coverage included children up to age 26 who were able to stay on their parents plans, the expansion of Medicaid and the availability of the state and federal insurance exchanges. Speaking at Howard University in Washington — one of the historically black colleges and universities — Burwell also noted that the uninsured rate dropped 10.3% among African-Americans as 2.6 million gained coverage. Four million Latino adults also became insured, representing an 11.5% decline in the rate of uninsured Hispanics. (O'Donnell, 9/22)

Kaiser Health News: HHS Vows Push To Enroll More Uninsured In Obamacare This Fall
Affordability continues to be a challenge, she said. Even with the law’s financial help to pay for premiums and out-of-pocket costs, some uninsured may simply not have the money to pay for coverage. Almost 40 percent of the uninsured who qualify for marketplace coverage earn between 139 and 250 percent of the poverty level, about $30,000 to $60,000 a year for a family of four, Burwell said. Nearly 60 percent of the uninsured are either confused about how the tax credits work or don’t know that they are available, and about half of the uninsured have less than $100 in savings, Burwell said. (Carey, 9/22)

7. State Officials Find Deficiencies In N.Y. Health Marketplace Controls

Controls that New York used to screen insurance applicants for coverage and subsidies were deficient, a state audit found. Also in the news are developments in Vermont and Washington state.

The Wall Street Journal: Audit Finds Deficiencies In New York State’s Health-Insurance Exchange
Some controls New York state relied on to make sure people were eligible for health-insurance coverage and subsidies on the state-run exchange were deficient, potentially letting some consumers get benefits they weren’t entitled to, an audit found. The inspector general for the Department of Health and Human Services reviewed a sample of 45 randomly selected applicants and analyzed their supporting documentation to see if the New York exchange followed federal regulations in determining eligibility for coverage and subsidies. (Armour, 9/23)

The Associated Press: Officials Hopeful Health Insurance Exchange Makes Deadline
Vermont officials said Tuesday they're cautiously optimistic the state's health insurance exchange will meet next week's deadline for smooth operations. State officials had promised in the spring that Vermont Health Connect would meet key benchmarks by Oct. 1, ahead of the Nov. 1 start to an open-enrollment period when new customers can sign up for health coverage through the exchange. (Gram, 9/22)

The Seattle Times: Big Switch: Health Exchange Customers To Pay Insurers Now
There have been weeks, even months, of warnings and notices, but starting Thursday, the 155,000 people enrolled in the Washington Health Benefit Exchange (WHBE) must pay their insurance companies directly instead of sending premiums to the state-run program. “After Wednesday at 5 p.m., we’ll no longer be aggregating premiums or accepting payments,” said Michael Marchand, spokesman for WHBE, which operates the state’s health insurance marketplace under the Affordable Care Act (ACA). WHBE officials voted last December to stop managing customer invoices and payments, partly to simplify the process — eliminating a middleman — and partly to halt glitches that left hundreds of enrollees with missed payments, lapsed insurance and incorrect bills. (Aleccia, 9/22)

8. Ky. Governor Defends State's Medicaid Expansion Against Republican Candidate's Complaints

Gov. Steve Beshear, who is not a candidate in the coming election, said the expansion has helped thousands of state residents and was designed to work effectively. Also, officials in Vermont are nervous about growing Medicaid costs, and in New Hampshire there are concerns about how a change to the Medicaid program would affect drug abuse programs.

Louisville Courier-Journal: Beshear Slaps Bevin, Defends Medicaid Expansion
Gov. Steve Beshear, in a statement Tuesday Morning, ripped Republican gubernatorial nominee Matt Bevin for suggesting that he would save money by seeking a waiver from the federal government to revamp Kentucky's Medicaid expansion. Bevin has wavered on how he would attack the the expansion while continually saying that Kentucky can't afford it. On some days, he says he would do away with the expansion, on others he has called for seeking a federal waiver to redesign the system and on one occasion, he said he would "tweak" it. But in a statement released by the Kentucky Democratic Party, Beshear said that the system his administration has designed is the most cost effective and helps more people in Kentucky, one of the sickest state's in the country. (Gerth, 9/22)

Vermont Public Radio: As Spiking Medicaid Costs Strain State Budget, Officials Look To Pinpoint Cause
Vermont is tied with Massachusetts for having the lowest rate of uninsured residents in the country. But that success might be coming at a high price. An unexpected spike in Medicaid costs has put the program and its thousands of new enrollees under heightened scrutiny. It's been less than three months since the start of the state fiscal year, but analysts say it already looks like Medicaid costs could come in as much as $60 million over budget in the 2016. (Hirshfeld, 9/23)

The Associated Press: Substance Abuse Crisis Could Shape Medicaid Expansion Debate
As [New Hampshire] lawmakers prepare for next year's political battle over Medicaid expansion, supporters said the state's ability to tackle a growing drug abuse problem will be dramatically reduced if the program comes to an end. "Medicaid expansion kind of allowed substance misuse providers to go from 0 to 60 from a service standpoint," said Abby Shockley, executive director of the New Hampshire Alcohol and Other Drug Service Providers Association. (Ronayne, 9/22)

Capitol Hill Watch

9. Senate Is Focal Point Of Plans To Avert Looming Government Shutdown

With just days remaining before the Oct. 1 budget deadline, Senate Majority Leader Mitch McConnell, R-Ky., is setting up votes to mollify the conservative wing of his party to clear a pathway to pass a temporary spending bill that would keep the feder
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