Kaiser Health News Original Stories

1. A Looming Tax On High-End Health Plans Draws Fire From Many Sides

A plan to tax high-value health insurance plans is meeting stiff resistance from both sides of the aisle in Congress despite calls to make employers more demanding health coverage shoppers – and the $87 billion in revenue the tax could generate over the next decade. (Mark Zdechlik, Minnesota Public Radio, 10/15)

3. Political Cartoon: 'Asleep At The Switch'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Asleep At The Switch'" by Rex May.

Here's today's health policy haiku:


Not a hot topic
for Dems, but Jeb’s 10-page plan
outlines replacement.

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.


4. Millions On Medicare Face Unprecedented Premium Increases

Congress has so far failed to find a way to stave off 2016 Part B premium hikes that could reach 52 percent for more than 30 percent of Medicare recipients.

The Wall Street Journal: Medicare Rates Set to Soar
That is creating uncertainty for many seniors on Medicare Part B, which covers outpatient care such as doctor’s visits. About 30% of the roughly 52 million people enrolled in Part B could see a 52% rise in those premiums if Congress and the Obama administration don’t find a way to freeze or reduce the increase. Open enrollment for Medicare for 2016 starts Thursday, though Congress could subsequently act to prevent the rise. (Armour and Tergesen, 10/14)

The Wall Street Journal: Few Options For Seniors Facing A Jump In Medicare Premiums
Unless Congress or the Obama administration intervenes, nearly one-third of Medicare beneficiaries may see a 52% increase in 2016 premiums for Part B, which covers doctor visits and other types of outpatient care. There are steps some affected individuals may be able to take to sidestep the increase, but there can be significant trade-offs. (Tergesen, 10/14)

USA Today: Medicare Part B Premiums To Rise 52% For 7 Million Enrollees
But 2016 might not be anything like 2015 for some 30% of Medicare beneficiaries — roughly 7 million or so Americans. That’s because premiums for individuals could increase a jaw-dropping 52% to $159.30 per month ($318.60 for married couples). And for individuals whose incomes exceed certain thresholds, premiums could rise to anywhere from $223.00 per month up to $509.80 (or $446 to $1,019.60 for married couples), depending on their incomes. (Powell, 10/14)

With open enrollment beginning Oct. 15, experts advise all Medicare recipients to evaluate plan options, including prescription drug coverage -

The New York Times: Check Your Medicare Prescription Drug Plan, Then Check It Again
Thursday is the start of the annual open enrollment period for Medicare, the federal health plan for people over age 65. If you have traditional fee-for-service Medicare and you are satisfied with your coverage, you don’t need to change anything. But if you also buy a stand-alone prescription drug plan, or if you are enrolled in a private Medicare managed-care plan — known as a Medicare Advantage plan — health experts say you should review your policy and compare options, even if you are happy with your current coverage. (Carrns, 10/14)

Kaiser Health News: Don’t Just Renew Your Medicare Plan. Shopping Around Can Save Money.
Ten years after a prescription drug benefit was added to Medicare, 39 million older or disabled Americans have coverage to help pay for their medicine, including most of the 17 million with private insurance policies known as Medicare Advantage, an alternative to traditional Medicare. The annual enrollment period for these private drug and Advantage plans for 2016 starts Thursday and runs through Dec. 7. (Jaffe, 10/15)

Pittsburgh Post-Gazette: Medicare Enrollment Begins Thursday
In seven years as coordinator of the Allegheny County Apprise program that offers counseling on different Medicare plan options, “I have never seen this volume of calls” from seniors worried about what to do, Bill McKendree said Wednesday. ... Much of the anxiety, Mr. McKendree said, has to do with the ongoing battle between Pittsburgh health giants Highmark and UPMC following the expiration of their contract, with the latest dispute concerning whether UPMC must include insurer Highmark’s Medicare Advantage members in its network next year under consent decrees both parties signed last year. A final ruling on that is now in the hands of the state Supreme Court and may not be announced before the open enrollment period ends. (Twetd, 10/15)

In other Medicare news -

CQ Healthbeat: Medicare Cuts Would Reduce Access To Colonoscopy, Doctors Say
Proposed cuts in Medicare payments could cause many doctors to reduce the number of colonoscopies they perform for the elderly and disabled or drop this patient population entirely, reducing access to a widely used form of screening for the nation’s second-most deadly cancer, physicians’ organizations argue. The Centers for Medicare and Medicaid Services is expected to release the final version of the payment rule later this month. In it, the agency will set the rates for different forms of colonoscopy procedures and likely will explain its response to arguments raised by doctors. (Young, 10/14)

The Associated Press: St. Tammany Parish Leads State In Medicare Spending
Five Louisiana parishes, led by St. Tammany, are among the 20 counties with the highest Medicare per capita spending in the country. That's according to a report from the Kaiser Family Foundation. St. Tammany ranked No. 10 at $11,146 in 2013, the latest data available. The figures were adjusted to account for differences in Medicare prices and beneficiaries' health risk. (10/14)

Campaign 2016

5. While In Las Vegas For Debate, Democratic Presidential Hopefuls Woo Nevada's Culinary Union

High on the 55,000-member union's wish list is a repeal of the health law's "Cadillac" tax. Meanwhile, news outlets continue to examine aspects of Tuesday night's debate, including health care for people who are in the U.S. illegally. Largely absent from the discussion, however, was mention of Planned Parenthood. And the minimal focus given to drug pricing issues made biotech stocks rebound on Wednesday.

Los Angeles Times: Democratic Candidates Court Culinary Union, The Kingmaker Of Nevada
The quest for union support already appears to have had an impact on the candidates’ positions on at least one issue. Clinton, Sanders and O’Malley have all called for repeal of the “Cadillac tax” in the Affordable Care Act, a 40% levy on certain generous employer-sponsored health coverage plans, which is set to take effect in 2018. Getting rid of that tax is a prime issue for the Culinary Union and other labor organizations that have negotiated substantial benefit plans for their members. (Lee, 10/15)

Los Angeles Times: Hillary Clinton Just Backed Healthcare For Immigrants In The U.S. Illegally
Over the last year, California politicians have been blazing a trail many doubted the rest of the country would follow: offering free healthcare to hundreds of thousands of people in the country illegally. But on Tuesday, presidential front-runner Hillary Rodham Clinton took a stance on the contentious issue during a televised Democratic debate, boosting it onto a prominent national stage. (Karlamangla, 10/14)

The Wall Street Journal's Washington Wire: Democratic Debate Spotlights Health Care For Illegal Immigrants
The Democratic debate made clear that the two leading candidates for the party’s presidential nomination both would allow illegal immigrants to buy coverage on government websites, but not much more. That’s about the same as the status quo. The 2010 health-care overhaul — supported by all the candidates on the stage Tuesday night — requires people to prove legal residency to shop for coverage on HealthCare.gov or obtain tax credits to help pay premiums. They also can’t enroll in Medicaid, the state-federal program for the poor that also locks out many legal immigrants. The Obama administration extended those rules to children granted immigration enforcement reprieves under a 2012 executive action, and has said it would do the same for adults. (Radnofsky, 10/14)

The Washington Post's The Fix: Abortion And Planned Parenthood Were Absent From Tuesday’s Debate. Paid Leave Was Not.
Let's acknowledge this off the top. A certain set of videos, congressional hearings, efforts to defund a large organization and a big announcement from that same agency that it would change the terms of its fetal tissue program have occupied a lot of time and attention over the last few months. But Tuesday night, it seemed as if the words "abortion" and "Planned Parenthood" almost went missing from the first Democratic debate. (Ross, 10/14)

The Wall Street Journal's MoneyBeat: Biotechs Bounce After Receiving Little Focus In The Democratic Debate
No news is good news for biotechs. The Nasdaq Biotechnology Index is getting reprieve Wednesday, up 1.9% midday versus the S&P 500’s 0.1% decline, after the recently contentious topic of drug pricing received little attention in Tuesday night’s Democratic presidential candidate debate. ... Despite Mrs. Clinton being vocal about her disdain for drug costs lately, the topic only briefly came up during Tuesday’s debate when candidates were asked which enemy they are most proud of. Mrs. Clinton named drug companies in a list that also included health insurance companies, Iranians, Republicans and the National Rifle Association. (Scholer, 10/14)

CNN: Sanders Stretched Truth On VA Record During Debate, Some Vets Say
Sen. Bernie Sanders touted his record on veterans' issues during Tuesday's debate, citing his position as the former chairman of the Senate Committee on Veterans Affairs when Congress provided billions of extra dollars to boost healthcare for veterans last year. ... Yet some veterans groups and others criticize Sanders for what they call a lack of oversight of the VA, and for at times coming to its defense in the midst of the scandal that rocked the agency in 2014. (Griffin and Devine, 10/14)

Capitol Hill Watch

6. Capitol Hill Focus To Return To Budget Issues And Raising Debt Limit

Meanwhile, Republicans' efforts to recruit Rep. Paul Ryan, R-Wis., to run for speaker of the House continues to draw headlines, speculation and analysis. And the Planned Parenthood controversy continues.

Politico: CBO: Debt Limit Must Be Raised In Next 30 Days
Lawmakers must raise the debt limit in the next 30 days, the Congressional Budget Office warned Wednesday. The nonpartisan agency said the Treasury Department will run out of the accounting maneuvers as well as the cash reserve it's used to stave off default "sometime during the first half of November." (Faler, 10/14)