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KHN First Edition: October 2, 2015


First Edition

Friday, October 02, 2015
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: Newly Insured Treasure Medicaid, But Growing Pains Felt
Kaiser Health News staff writer Sarah Varney reports: "The Affordable Care Act unleashed a building boom of community health centers across the country. At a cost of $11 billion, more than 950 health centers have opened and thousands have expanded or modernized. In San Diego, new clinics have popped up on school campuses and busy street corners. Cramped storefront clinics have been replaced with gleaming, three-story medical centers with family medicine, radiology and physical therapy on site. They are outfitted to care for new immigrants in dozens of languages from Spanish to Somali." (Varney, 10/2)

Kaiser Health News: Insurers Find Out-of-Network Bills As Much As 1,400 Percent Higher
Kaiser Health News staff writer Anna Gorman reports: "It’s common knowledge that consumers have to pay more money if they choose doctors or hospitals outside of their insurance plan’s network. But a new analysis prepared by the insurance industry seeks to show just how much more in each of the 50 states. Out-of-network providers charged patients on average 300 percent more than the Medicare rate for certain treatments or procedures, according to the analysis of 2013 and 2014 claims data released Thursday by the America’s Health Insurance Plans." (Gorman, 10/1)

Kaiser Health News: Adults With Insurance Often Still Have Unmet Dental Needs, Survey Finds
Kaiser Health News consumer columnist Michelle Andrews writes: "Dental care ranked number one among health care services that people with insurance say they’re skimping on because of cost, a new survey found. One in five adults reported that they had unmet dental care needs because they couldn’t afford necessary care, according to the brief by researchers at the Urban Institute’s Health Policy Center. People said they were more likely to go without dental care than prescription drugs, medical care, doctor or specialist care, and medical tests." (Andrews, 10/2)

The Wall Street Journal: Health Law’s Program To Ease Insurers’ Risks Has Shortfall
An Affordable Care Act program meant to ease risks for health insurers in the law’s new marketplaces will initially pay many companies less than they expected, likely putting financial strain on some. Federal authorities said that insurers will at first receive only about 12.6% of the money that they requested from the program, known as risk corridors, for 2014, its first year of operation. Insurers have requested approximately $2.87 billion in payments from the program based on their 2014 results. But the pool available to make those payments is just $362 million, which came from collections from other insurers that did relatively well on their marketplace business. (Wilde Mathews and Armour, 10/1)

The Washington Post: Health Insurers To Receive A Fraction Of What They’re Owed Under ACA Program
Health insurers in the marketplaces created by the Affordable Care Act will be reimbursed this year only 13 percent of the money they are owed under a program designed to help cushion the burden of covering large numbers of people who need expensive medical treatment. ... A senior official with the Centers for Medicare and Medicaid Services said the agency would attempt to pay more of what it owes next year and, if necessary, the year after. But the official, briefing reporters on the condition of anonymity, acknowledged that the ability to fully pay hinges on Congress’s willingness to provide additional money. (Goldstein, 10/1)

The Associated Press: Insurers Face Health Overhaul Losses For 2014
The Department of Health and Human Services released updated numbers for a program that helps stabilize premiums in the health care law's insurance markets, which offer taxpayer-subsidized private plans. Under that program, insurers whose medical claims costs were lower than expected pay in money to help insurers whose costs were higher. (10/1)

The New York Times: Health Law Revision Is Approved
The Senate passed legislation on Thursday intended to protect small and midsize businesses from increases in health insurance premiums, clearing the bill for President Obama’s expected signature. The action by Congress was a rare example of bipartisan agreement on how to revise the Affordable Care Act. (Pear, 10/1)

The Associated Press: Congress Passes Bill Easing Small Business Health Law Rules
Congress approved bipartisan legislation Thursday aimed at preventing premium increases that some smaller businesses were expecting next year under President Barack Obama's health care law. The measure, which Obama is expected to sign, represents an uncommon instance in which both parties have rallied behind an effort to revamp part of Obama's signature health care overhaul. Most congressional efforts to retool the statute have been Republican drives to repeal it or scale it back that Democrats have blocked. (10/1)

The Wall Street Journal: Treasury’s Lew Says Congress Must Raise Debt Limit By Nov. 5
Rep. Mick Mulvaney (R., S.C.) said he had “encouraging conversations” with GOP colleagues over the past month on demanding changes to entitlement programs as part of any debt-ceiling package. “Spending for the sake of spending is going to be a real difficult vote,” he said. Still, it isn’t clear what such a package would look like, and several Senate Republicans who face close elections next year have resisted proposals for big changes to popular programs like Social Security and Medicare. (Timiraos and son, 10/1)

USA Today/Detroit Free Press: ACLU Sues Catholic Hospital System Over Abortion Policy
A federal lawsuit accuses a Catholic health system with 86 hospitals nationwide of “denying appropriate emergency care to women suffering pregnancy complications.” The American Civil Liberties Union and the American Civil Liberties Union of Michigan filed an amended complaint Friday against Trinity Health, headquartered in Livonia, in U.S. District Court in Detroit. (Anderson, 10/1)

The Wall Street Journal's Washington Wire: Planned Parenthood Gets Lift From Prank Gifts
It’s the thought that counts. As the 2016 campaign has launched into high gear over the past few months, so has another season: that of prank giving. Planned Parenthood – which provides women’s health services, including abortions — has received over a thousand individual donations in the names of politicians who oppose abortion and have been calling for the defunding of the organization. Sen. Ted Cruz (R., Texas), former Hewlett Packard executive Carly Fiorina, former Florida Gov. Jeb Bush and former Arkansas Gov. Mike Huckabee are among some of the most popular honorees, according to Planned Parenthood. Mr. Cruz is far and away the most popular donor, at 442 donations to Ms. Fiorina’s 83, Mr. Huckabee’s 77 and Mr. Bush’s 70, the group says. (Court, 10/1)

The Associated Press: Here They Come Again: Broader Health Care Debate For 2016
After seven years of the political drama known as "Obamacare," you might think voters would be tired of big ideas for revamping health care. If so, the presidential candidates seem to have missed the memo. The 2016 hopefuls in both parties are offering a full spectrum of options, from a system wholly run by the federal government to dialing back Washington's lead role. Much is promised by the candidates, but each approach has pitfalls. (10/2)

The Washington Post: Bernie Sanders Tells Latino Lawmakers: Undocumented Immigrants Should Benefit From Obamacare
Democratic presidential candidate Bernie Sanders supports allowing some of the nation's undocumented immigrants to obtain health-care coverage under the Affordable Care Act, he told Democratic lawmakers on Thursday. The Vermont senator, who is running a competitive race against Democratic presidential front-runner Hillary Rodham Clinton, made the comments during a 45-minute meeting with members of the Congressional Hispanic Caucus, according to attendees. (O'Keefe and Wagner, 10/1)

Politico: Planned Parenthood Critics Have New Target — Universities
Officials of the nation’s leading universities have watched with dread as the fallout from the Planned Parenthood sting videos has threatened to engulf labs that depend on fetal tissue for research. Now the abortion wars are raging on their doorsteps as lawmakers in Wisconsin and Ohio try to ban such research and other states limit access to the tissue. More than three dozen of the universities, including Harvard, Yale and Johns Hopkins, have been drawn into the fight despite their traditional deep aversion to an issue that can divide faculties and donors and draw the ire of anti-abortion advocates nationwide. (Norman, 10/2)

The Washington Post's Fact Checker: The Repeated, Misleading Claim That Planned Parenthood ‘Provides’ Mammograms
Readers asked us to fact-check Planned Parenthood supporters’ claims that the organization “provides” mammograms. Maloney’s statement above appeared to contradict comments by Planned Parenthood President Cecile Richards’s repeated claim at a Sept. 29 congressional hearing that the organization does not, in fact, offer mammograms or have mammogram machines in its clinics. (Lee, 10/2)

The Washington Post: Congress To VA: $1.6 Billion Denver Hospital Will Be Funded … This Time
Despite a last minute fight over funding for the Department of Veterans Affairs vastly over budget hospital in Denver, Congress agreed to fund the rising sticker price of the $1.6 billion medical facility, thought to be one of the most expensive hospitals in the world. Throughout the week, tensions increased over whether Congress would fund the last $625 million needed to finish the complex, whose price tag has ballooned to nearly three times the $604 million the VA originally budgeted for. The project is widely known as “the biggest construction failure in VA history.” (Wax-Thibodeaux, 10/1)

Los Angeles Times: Why Your Doctor Might Start Asking A Lot More Questions
Many residents of Los Angeles County might soon find they are getting more attention and questions from their doctors. That's because L.A. Care Health Plan -- a public health plan in L.A. County with more than 1.8 million members -- received a $15.8-million federal grant this week to help change the way physicians interact with patients and deliver care. (10/1)

Los Angeles Times: As California Goes... But Will Nation Follow State's Lead On Healthcare For Immigrants?
Like many blue states, California enthusiastically embraced Obamacare, signing up millions for health insurance. Now, it's venturing into a potentially costly and controversial new frontier of health policy: offering medical coverage to hundreds of thousands people living in the country illegally. In a matter of months, the number of California counties committed to providing low-cost, government-run medical care to such residents jumped from 11 to 48. And in June, Gov. Jerry Brown signed a state budget that for the first time funds healthcare for such children. (Karlamangla, 10/2)

NPR: Many Former Foster Youths Don't Know They Have Health Care
Laticia Aossey was flat on her back in an Iowa hospital bed with a tube up her nose, a needle for a peripheral IV stuck in one arm and monitors pasted to her body. It was early June 2014, a week after her 18th birthday, when a friend brought Aossey's mail from home — including one ominous letter. Aossey's health insurance was about to be discontinued. (Glier, 10/1)

The Associated Press: Report: $11 Million In Questionable Medicaid Payments
A long-delayed pilot study of Delaware’s Medicaid program has identified more than $11 million in possible waste, fraud and abuse. Officials said in releasing the report Thursday that they are recovering clearly erroneous payments and collecting more information on claims needing further review. (Chase, 10/1)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.

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