Kaiser Health News Original Stories

2. Political Cartoon: 'Deadly Drug'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Deadly Drug'" by Randy Bish, Pittsburgh Tribune-Review.

Here's today's health policy haiku:

YOU GOT THE BLUES...

ICD-10 Blues?
Unfortunately, there is
No code for that one.

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Health Law Issues And Implementation

3. Ky.'s Health Insurance Co-Op Set To Close, While Others Face Stiff Fiscal Challenges

The programs, set up by the health law in 23 states with initial federal backing, attracted large customer support in a number of areas but have suffered from financing problems. Five have either closed or plan to close at the end of the year.

The Washington Post: Financial Health Shaky At Many Obamacare Insurance Co-Ops
A new breed of health insurers created under the Affordable Care Act — representing one of the government’s most innovative attempts in decades to foster better coverage — is on shaky financial ground in many of the 23 states where the plans began. ... But in recent months, nearly half of the unorthodox start-ups have been told by federal regulators that their finances, enrollment or business model need to shape up. The Centers for Medicare and Medicaid Services (CMS), which oversees the health-care law, recently sent warning letters to 11 of the “co-ops,” as they’re known. The agency placed them on “enhanced oversight” or required them to produce a plan of “corrective action,” or both, according to federal figures not previously made public. Several have been notified in the past two weeks. (Goldstein, 10/10)

Lexington Herald-Leader: Kentucky Health Cooperative Going Out Of Business; 51,000 Insurance Customers Affected
The largest private provider of health insurance policies on Kynect, Kentucky's health insurance exchange, is going out of business. The Louisville-based Kentucky Health Cooperative Inc. announced Friday that it will end current memberships on Dec. 31 and will not add new members because of financial problems. It will not offer health insurance plans on Kynect when open enrollment for 2016 coverage starts on Nov. 1. The cooperative has about 51,000 members in all 120 Kentucky counties. (Brammer, 10/9)

The Louisville Courier-Journal: Health Coop Closes, 51,000 Need New Insurance
The Kentucky Health Cooperative, a nonprofit, government-subsidized insurance group aimed at offering consumers more choices in health coverage under the Affordable Care Act, will stop offering health plans at the end of this year. ... The state Cabinet for Health and Family Services said the state Department of Insurance will be working with customers to ensure coverage continues through this year when most of the cooperative policies expire. (Yetter, 10/9)

The Hill: Kentucky Nonprofit Health Insurer To Shut Down
The Department of Health and Human Services says that it recognizes that the low payments to insurers could have raised financial concerns for some insurers, and that as start-ups, not all co-ops would succeed. The Obama administration said when making the risk corridor announcement earlier this month that the low payments could cause “isolated solvency and liquidity challenges” for a small number of insurers. The Kentucky co-op is the fifth to close, following New York’s co-op last month. (Sullivan, 10/9)

4. Affordability Key Factor For Newly Insured Who Drop Their Health Law Coverage

Confusion about the health exchanges and insurance plans may also play a contributing role for those who decide to drop out, experts say. In related news, CBS News looks at the early impact of Obamacare on employers.

The New York Times: Insurance Dropouts Present A Challenge For Health Law
On Nov. 1, a new sign-up period for health insurance under the Affordable Care Act will begin .... But even as those efforts begin, the public insurance exchanges, also known as marketplaces, created by the law are facing another challenge: keeping the customers they already have. About 9.9 million people were enrolled in the federal and state marketplaces at the end of June, a drop of about 15 percent from the 11.7 million who the Obama administration said selected plans during the open enrollment period that ended in February. ... enrollment counselors, health care providers and consumers say cost is a factor. ... Experts also point to another factor behind dropping or losing coverage: confusion. Some who signed up for coverage this year lost it within months because they did not understand what information they had to supply or even that they were required to make monthly payments, according to counselors. (Goodnough, 10/11)

CBS News: Obamacare's Impact On Employment: An Early Look
Before the Affordable Care Act went into effect last year, critics claimed it would lead to job losses and cuts in employee hours. But how is it really playing out? The dire predictions have so far proved to be unfounded, according to a new research paper from Federal Reserve Bank of New York economist Maxim Pinkovskiy. (Picchi, 10/12)

Meanwhile, stronger privacy protections will be added to healthcare.gov -

The Associated Press: US Boosts Privacy Protection On Health Insurance Website
Responding to criticism from civil liberties advocates, the Obama administration said Friday it has strengthened consumer privacy protections on the government's health insurance website as a new sign-up season nears. HealthCare.gov CEO Kevin Counihan said in a blog post that the web page will have a new 'privacy manager' that lets consumers opt out of embedded connections to third-party advertising, analytics and social media sites. (Alonso-Zaldivar, 10/9)

The Hill: ObamaCare Website Will Honor Do Not Track Requests
HealthCare.gov is going to honor Do Not Track requests this enrollment season. The Center for Medicare and Medicaid Services, which runs the ObamaCare website, said that it would not track users who toggle a setting in their browser that sends the requests to the website. Websites are not currently required to honor Do Not Track requests, although every major browser gives users the option of turning on the setting. (McCabe, 10/9)

And in more news on the cost of health care in the U.S. -

The Fiscal Times: U.S. Still Behind Other Countries In Effective Health Spending
For years America’s gold-plated healthcare system has provided little bang for the buck. In 2013, the U.S. outspent 13 other high-income countries on medical care – including Australia, Canada, Germany and Great Britain. Yet the U.S. had comparatively poor health outcomes, including a shorter life expectancy and greater prevalence of chronic conditions, according to a new study by the Commonwealth Fund. (Pianin, 10/11)

5. New Numbers Indicate Enrollment Dip In Ark. Expanded Medicaid Program

Meanwhile, news outlets in Ohio and Alaska report on the impact of expansion efforts.

Arkansas Online: Medicaid's Enrollment Takes A Dip
The number of people approved for coverage under Arkansas' expanded Medicaid program rose to 263,387 in July before falling by almost 29,219 by the end of September, according to numbers released Friday by the state Department of Human Services. Meanwhile, the cost per person of the so-called private option, which covers most of the newly eligible adults, has increased from June to September by $6.89, from $484.94 to $491.83. The federal waiver authorizing the program sets a monthly cost target of $500.08 per enrollee for 2015. (Davis, 10/10)

KTOO: What Medicaid Expansion Means For This Juneau Family
Medicaid expansion has been available to Alaskans for over a month, and 93 people in the capital city have enrolled. 263 in all of Southeast. It’s providing coverage for the uninsured. But it’s also offering increased care for those who qualify with Indian Health Service. For one Juneau man, that means having options to treat alcohol addiction. (Jenkins, 10/11)

6. Audit Finds Md. Exchange Failed To Protect Customers' Personal Information

The state audit also criticized other aspects of the exchange, including how contracts were awarded and a wide range of fiscal issues.

The Baltimore Sun: State Audit Criticizes Health Exchange Procurement Practices
A state legislative audit sharply criticized Maryland health exchange officials for a wide range of fiscal failures, including how it awarded contracts to companies building the state's initially troubled online insurance marketplace. The rollout of the Maryland Health Connection in 2013 was one of the worst under President Barack Obama's landmark health care reform initiative. The state ended up cutting ties with the initial contractor and replacing the technology behind the exchange. (McDaniels and Cox, 10/9)

Capitol Hill Watch

7. Republicans Continue To Lobby For A 'Speaker Ryan'

House members praised Paul Ryan during the Sunday political talk shows, saying he has the support of both the establishment and hard-line factions of party. But so far the Wisconsin lawmaker has resisted the calls to run for the top post.

The Wall Street Journal: Paul Ryan Seen As Able To Bridge The GOP Gap
Still, several influential conservatives say Mr. Ryan, with admirers among both establishment types and hard-liners in the caucus, is the closest thing to a consensus candidate and would draw more GOP votes in the conference than anyone, including Mr. McCarthy. Mr. Ryan, 45 years old, first came to prominence in the years following the 2006 elections that drove Republicans out of power in the House. Dismayed by the party leadership’s cautious approach to changes in fiscal policy, Mr. Ryan began circulating a set of far-reaching ideas for an overhaul of federal budget, tax and entitlement programs. These proposals made him a favorite target of liberal Democrats, particularly his calls to revamp Medicare, which they argue would slash benefits. (McKinnon, 10/11)

Politico: What It Would Take For Ryan To Run
Paul Ryan has made it abundantly clear he does not want to be speaker of the House. He enjoys the wonkery that comes with being Ways and Means chairman and believes he'd lose that as ringleader of the unwieldy Republican Conference. But there’s one remote scenario, people close to him say, in which Ryan would consider abandoning his long-laid career plans and go for the speakership: if he was the true consensus choice of the party. That means no opposition, no sniping, no acceding to demands in exchange for support. (Sherman, 10/12)