Kaiser Health News Original Stories

5. Political Cartoon: 'Flipping The Station'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Flipping The Station'" by Bob Englehart, Hartford Courant.

Here's today's health policy haiku:


Death to Cadillac
Tax, bipartisan snafu,
Hillary et tu?

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Capitol Hill Watch

6. Congress OKs Health Law Tweak To Ease Insurance Rules For Mid-Size Businesses

The White House has signaled that President Barack Obama will sign the measure.

The Wall Street Journal: Bill Waiving Insurance Rules For Midsize Businesses Clears Senate
A bill waiving the federal health law’s insurance rules for tens of thousands of midsize businesses cleared the Senate Thursday in a rare example of congressional agreement to undo part of the 2010 Affordable Care Act. The legislation had already passed the House, and the White House appears open to signing it. ... The Senate used a fast-track process that avoided an up-or-down vote on the measure, which would free companies with 51 to 100 workers from requirements on coverage standards and pricing. ... The issue is separate from another provision in the Affordable Care Act that requires businesses with 50 or more full-time workers to offer them coverage or pay a penalty. (Radnofsky, 10/1)

The New York Times: Health Law Revision Is Approved
At issue is a provision of the health care law that expands the definition of a “small employer” to include companies with 51 to 100 employees, subjecting them to stringent insurance regulation starting Jan. 1. States have historically defined small employers as those with 50 or fewer employees. ... The bill, approved this week in the House and the Senate by voice vote, eliminates a provision of the law that would have imposed tough, potentially costly new requirements on businesses with 51 to 100 employees. (Pear, 10/1)

Also on Capitol Hill, interest in rolling back the health law's "Cadillac tax" is gaining momentum -

The Columbus Dispatch: Portman, Democrats Agree On Killing Obamacare ‘Cadillac Tax’
Sen. Rob Portman welcomed calls from Sen. Sherrod Brown and other Democrats to kill a tax that helps finance the 2010 health law that has extended health coverage to more than 14 million Americans. In a conference call with Ohio reporters on Thursday, Portman, R-Ohio, said that while he always has opposed the law signed by President Barack Obama, he hopes “we can make a bipartisan effort to kill the tax.” (Baedorf, 10/2)

Meanwhile, another congressional budget deadline looms -

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)

Health Law Issues And Implementation

7. Program To Help Health Insurers Deal With Risk Comes Up Short On Cash

Administration officials announce that a health law program designed to reimburse insurers who underestimated the cost of covering new patients coming into the marketplace has not collected as much money as insurers requested.

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 insurance industry was disappointed at what its officials called a significant shortfall. "Stable, affordable coverage" depends on adequate funding of the program, said a statement from Marilyn Tavenner, CEO of America's Health Insurance Plans, the industry lobby. "It's essential that Congress and (the administration) act to ensure the program works as designed and consumers are protected." ... Despite the concerns of insurers, the Republican-led Congress is unlikely to allocate any additional money for the program, a temporary stabilization fund that lasts three years. (Alonso-Zaldivar, 10/1)

In other health insurance news -

Kaiser Health News: Insurers Find Out-of-Network Bills As Much As 1,400 Percent Higher
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)

8. Under Alaska's Medicaid Expansion, 2,000 New Enrollees See Chance For Fresh Start

In other Medicaid expansion news, California's enrollment efforts have been very successful. But the state's health insurance program for low-income people now faces some growing pains in dealing with the health care needs of this ballooning population.

Alaska Public Radio: With Medicaid Expansion, The Chance For A Fresh Start
Alaskans have been able to sign up for Medicaid expansion for one month. Nearly 2,000 people have enrolled during that time. Kenneth Taylor signed up the first week and is anxiously waiting for his enrollment card. Taylor has two types of cancer, in his kidney and his prostate. He’s also trying to manage several chronic conditions, including high blood pressure, diabetes, sleep apnea and asthma. (Feidt, 10/1)

Kaiser Health News: Newly Insured Treasure Medicaid, But Growing Pains Felt
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

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