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KHN First Edition: November 2, 2015


First Edition

Monday, November 02, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Alaskans Face Tough Choices Because Of High Insurance Costs
Alaska Public Radio Network's Annie Feidt, working in partnership with Kaiser Health News and NPR, reports: "Customers can begin buying plans on starting on Nov. 1 and do so through Jan. 31, 2016. Rates for individual health plans went up an average of 7.5 percent nationally. Within that not-too-alarming average are outliers. Some states saw their average rate go down; others saw a big percentage leap from a reasonable starting price. For instance, Boise, Idaho, saw a 30 percent spike in premiums from about $210 to $273 a month. But Alaska is a special case. It has the highest premiums in the country, and it has seen some of the highest percentage increases over the past two years. That makes paying for insurance especially difficult for families like the Ebbessons." (Feidt, 10/30)

Kaiser Health News: A Med School Teaches Science And Data Mining
Kaiser Health News staff writer Julie Rovner reports: "Medicine, meet Big Data.For generations, physicians have been trained in basic science and human anatomy to diagnose and treat the individual patient. But now, massive stores of data about what works for which patients are literally changing the way medicine is practiced. 'That’s how we make decisions; we make them based on the truth and the evidence that are present in those data,' says Marc Triola, an associate dean at New York University School of Medicine. (Rovner, 10/30)

The New York Times: Many Need To Shop Around On As Prices Jump, U.S. Says
In Tennessee, the state insurance commissioner approved a 36 percent rate increase for the largest health insurer in the state’s individual marketplace. In Iowa, the commissioner approved rate increases averaging 29 percent for the state’s dominant insurer. Health insurance consumers logging into on Sunday for the first day of the Affordable Care Act’s third open enrollment season may be in for sticker shock, unless they are willing to shop around. Federal officials acknowledged on Friday that many people would need to pick new plans to avoid substantial increases in premiums. (Pear and Goodnough, 10/30)

The Wall Street Journal: Health Law’s Strains Show
The Affordable Care Act’s third open enrollment season got under way, with a new array of health plans that show how the law’s influence is starting to transform the insurance industry. Sunday’s kickoff appeared to go relatively smoothly, with little evidence of technical glitches at as consumers started to shop for coverage that will take effect in 2016. (Wilde Mathews, 11/1)

The Wall Street Journal: Next Enrollment Season for Affordable Care Act Kicks Off
The third open enrollment season under the Affordable Care Act kicked off with subdued consumer activity and scant signs of major technology problems that could tamp down sign ups. The Obama administration was expecting a slow sign-up pace Sunday because of the weekend timing but is gearing up for brisker enrollment in the weeks to come. Open enrollment for new and returning customers on the federal marketplace and most state-run exchanges runs through Jan. 31. (Armour, 11/1)

The Wall Street Journal: Businesses, Patients Feel Marketplaces’ Ripple Effect
As the Affordable Care Act moves toward its third year of full implementation, the ripple effects of change stemming from the law and its signature marketplaces are being felt in almost every corner of the health-care system. Consumers this week start signing up for new coverage on the marketplaces, one of the most high-profile changes the law has brought to the health-care industry. (Wilde Mathews, 11/1)

The Associated Press: Health Law's 3rd Sign-Up Season Faces Challenges From Prices
The government's insurance website is faster and easier to use, but as a third sign-up season gets underway, President Barack Obama's health care law is approaching limits. Enrollment on the federal and state exchanges began Sunday. While the law's expanded coverage has reduced the uninsured rate to a historic low of about 9 percent, the gains will be harder in 2016. (Johnson and Alonso-Zaldivar, 11/2)

The Washington Post: Third Year Of ACA Sign-Up Starts, On Time But With Muted Fanfare
The kickoff fair in the District was among many community events planned nationwide in coming days to draw attention to the three-month window to sign up for coverage under a law that remains politically divisive five years after its passage. Around the country, the first day was relatively quiet., the online enrollment system on which 38 states are relying this year, opened at about 7 a.m. Eastern time as scheduled. During its first six hours, about 40,000 applications were submitted through, according to federal officials. (Goldstein, 11/1)

USA Today: Federal Health Site Premiums, Number Of Insurers Vary Widely By Area
Consumers shopping on the federal health exchange for 2016 plans will still be able to pick from about five insurance companies, but there will be fewer plans on average to choose from, federal health officials said Friday. About 90% of consumers who return to will have plans from three or more insurers to choose from for 2016 coverage, Department of Health and Human Services officials said. (O'Donnell, 10/30)

Real Clear Health: Burwell Kicks Off Marketplace Open Enrollment, Touting Improvements
Burwell spoke at an enrollment center in the lobby of the Martin Luther King library in downtown Washington. She quoted King in her speech as having said, "Of all the forms of inequality, injustice in health care is one of the most shocking and inhumane." HHS expects to have about 10 million individuals covered by a marketplace plan when open enrollment concludes at the end of January. That would be up from about 9.1 million Americans currently carrying marketplace coverage, but it would still leave nearly 10 million eligible Americans uninsured. Burwell promised that HHS would "work harder and work smarter" to sign up as many as possible. (Eisenhower, 11/2)

Los Angeles Times: Officials Launch Bus Tour To Promote California Health Insurance Exchange
The head of California’s health insurance exchange toured Los Angeles by bus Sunday, seeking to publicize the Affordable Care Act’s potential benefits among Southern Californians, many of them Latino, who officials say have failed to take advantage of the law. On the first day of this year’s open-enrollment period for federally subsidized health plans, the tour’s first stop — in East L.A. at the nonprofit care provider AltaMed Health Services — previewed what state officials say will be an overarching strategy as they seek to boost enrollment in the third year of the state-run marketplace, called Covered California. (Jamison, 11/1)

Los Angeles Times: Officials Push For More Californians To Sign Up For Health Insurance
Public officials have planned a promotional bus tour to get more Californians to enroll in the state's health insurance exchange, Covered California, with the first day of this year's open-enrollment period beginning Sunday. Residents will have three months during open enrollment to sign up for the exchange. Covered California has 1.3 million consumers, about 90% of whom receive subsidies to help cover their premiums. (Sewell, 11/31)

Politico: The Texas County Where Only 12 People Signed Up For Obamacare
In rural Borden County, 12 people signed up for Obamacare this year. Livid over the government telling them they must buy something and loath to take anything that looks like a “handout,” the uninsured here are likely to stay that way. As Obamacare’s third open enrollment season began Sunday, this rock-solid conservative community of about 650 people offers a window into the challenges health law advocates face to expand coverage around the country. (Pradhan, 11/2)

The Wall Street Journal: Medicare Cuts Back Work Of Auditors Probing Improper Payments To Hospitals
The federal Medicare agency is sharply cutting back the work of auditors that review hospital claims and seek to recoup improper payments for the government, according to a letter reviewed by The Wall Street Journal. Recovery audit contractors, as they are known, recouped $2.4 billion in improper payments in 2014, down from $3.7 billion in 2013 before the agency scaled back other audit activities and temporarily suspended the program for several months, according to a Medicare report. (Weaver, 10/30)

The New York Times: New Medicare Rule Authorizes ‘End-Of-Life’ Consultations
Six years after legislation to encourage end-of-life planning touched off a furor over “death panels,” the Obama administration issued a final rule on Friday that authorizes Medicare to pay doctors for consultations with patients on how they would like to be cared for as they are dying. The administration proposed the payments in July, touching off none of the rancor that first accompanied the idea during debate on the Affordable Care Act in 2009. (Pear, 10/30)

The Wall Street Journal: End-Of-Life Discussions Will Be Reimbursed By Medicare
The rule announced Friday by the Centers for Medicare and Medicaid Services will reimburse, starting Jan. 1, health-care providers if they choose to have conversations with Medicare patients about advance care planning—also known as end-of-life discussions. The decision affects about 50 million beneficiaries and could ripple through the health-care industry. Private insurers often follow payment practices adopted by Medicare, the national insurance program for seniors and the disabled. (Armour, 10/30)

The Associated Press: Medicare To Begin Paying For End-Of-Life Counseling
Medicare said Friday it will pay doctors to help patients plan what kind of care they want at the end of life, an idea more broadly accepted than six years ago, when it touched off a political uproar about “death panels.” Numerous physician and health groups urged the policy change. Some doctors provide this “advance-care planning” to their patients without getting paid for the counseling time, and some private insurers already reimburse for it. (Neergaard, 10/30)

The Washington Post: Watchdog: Cash Benefit Program Overpaid Disabled Workers By $11 Billion Over Nine Years
One of the largest federal programs that provides cash benefits to disabled workers overpaid $11 billion during the past nine years to people who returned to work and made too much money, a new study says. The Social Security Administration, which runs the Disability Insurance program, gave up on recovering $1.4 billion of the excess payments because they were found to be the agency’s fault, not the workers’, the Government Accountability Office found. (Rein, 11/2)

The Associated Press: US Reaches Settlement With 457 Hospitals Over Cardiac Device
Justice Department said Friday that it had reached settlements totaling more than $250 million with hundreds of hospitals where doctors implanted cardiac devices in violation of Medicare coverage requirements. The settlements encompass nearly 500 hospitals in 43 states where cardioverter defibrillators were implanted in Medicare patients too soon after they suffered a heart attack, had heart bypass surgery or angioplasty. (Biesecker, 11/1)

USA Today: How To Navigate Medicare Open Enrollment Season
April might be the cruelest month, but Oct. 15 through Dec. 7 have to be the cruelest days of the year. That’s when Uncle Sam asks millions of Medicare beneficiaries to review and change, if need be, their Medicare health plans and prescription drug coverage for the following year. Here’s what you need to know to survive this year’s season. (Powell, 10/30)

The Wall Street Journal: Where Paul Ryan Stands On The Issues
As chairman of the House Ways and Means Committee, and the Budget panel before that, Rep. Paul Ryan (R., Wis.) has dealt with some of the most contentious issues not only in the House, but also within the Republican Party, where spending and the reach of government are often flash points. Here’s where he stands on some key issues. ... Voted to repeal the Affordable Care Act and says Republicans should replace it with a plan that has fewer coverage mandates, allows insurance sales across state lines and provides tax credits to help people purchase insurance. ... Mr. Ryan’s most contentious proposal called for overhauling Medicare to allow Americans who turn 65 in the future to choose between private insurance plans with government support for premiums or staying in traditional Medicare, though their costs could rise. (11/1)

The Washington Post's Fact Checker: Hillary Clinton’s Misleading Claim That ‘numerous Surveys’ Show Veterans Are Satisfied With VA Medical Care
Several readers asked us to fact-check this claim, which drew sharp backlash from veterans groups and both Republican and Democratic lawmakers. Clinton is referring to the VA scandal that unfolded in 2014 after whistleblowers alleged that dozens of veterans died at the Phoenix VA while waiting for medical care. The VA Office of Inspector General later acknowledged that wait lists may have contributed to the veterans’ deaths. Patient and appointment record falsification and manipulations were then found to be a systemic, years-long problem. (Lee, 11/2)

The Washington Post: Trump Announces Plan To Improve Veterans’ Health Care
Billed as “the Trump Plan” in keeping with the billionaire developer’s habit of naming things after himself, the initiative would allow veterans to get medical care from any doctors or medical facilities that accept Medicare. It also would give veterans education benefits, business loans, job training and placement services to ease their transition from battlefield to civilian life. The plan was cheered by veterans in the crowd, which the campaign estimated at more than 5,000. (Vozzella, 10/31)

The Associated Press: Trump Releases Plan Aimed At Improving Veterans' Care
Republican presidential candidate Donald Trump released a plan on Saturday aimed at overhauling the Department of Veterans Affairs and improving veterans' health care and employment services. Under Trump's plan, eligible veterans would be able to bring their veterans' identification cards to any private doctor or facility that accepts Medicare and be able to receive immediate treatment. The change, he said, would help improve wait times and services by adding competition. (Colvin, 11/1)

The Wall Street Journal: Drug Makers Buy Pricey Vouchers To Speed Products To Market
There is a new price surge in the pharmaceutical industry—not for medications, instead for a limited number of government-issued vouchers that drug makers, including AbbVie Inc. and Sanofi SA, are buying to speed products to market. Legal provisions enacted in 2007 and 2012 require the U.S. Food and Drug Administration to issue “priority review vouchers” as rewards to developers of drugs for rare pediatric conditions or tropical diseases, such as malaria. Congress intended the vouchers to encourage more research into underfunded diseases. Companies receive them when the FDA approves their drug for sale and can redeem them to speed FDA consideration of a subsequent drug for any disease. (Loftus, 11/1)

The New York Times: G.O.P. Eyes Kentucky Governorship, But Candidate Is Making The Party Sweat
Yet if the go-it-alone style of Mr. Bevin, 48, is rattling Republicans, Mr. Conway, 46, is not exactly exciting Democrats. Party leaders praise him as smart and steady, but his shy nature makes voters think he is aloof; friends say he is happier talking policy than politicking. His big challenge is to distance himself from President Obama, whose health care law and efforts to regulate the coal industry make him hugely unpopular here. (Stolberg, 10/30)

The Wall Street Journal: Kentucky Gubernatorial Race May Give GOP An Opening
Though Kentucky has become reliably Republican in federal elections, Democrats have won every governor’s race except one since the 1970s, aligning themselves with an electorate that generally is centrist on economic issues and conservative on social ones. The state’s creation of a health-insurance exchange under the Affordable Care Act has been popular, while polls show a majority of Kentucky voters remain opposed to gay marriage. Registered Democrats outnumber Republicans in the state, 1.7 million to 1.3 million, but the GOP has made gains. (Campo-Flores, 10/30)

The Associated Press: Kentucky Governor's Race Headlines Off-Year State Elections
Kentucky has drawn interest not only for having an open gubernatorial seat but for being one of only a few states in the country where political power is divided. Democrats control statewide offices and the state House, while Republicans dominate the state Senate and the congressional delegation. The governor's race has turned into a referendum on President Barack Obama's signature health care law, and the results could affect the health insurance of more than half a million people. Beshear used an executive order to expand the state's Medicaid program to cover an additional 400,000 Kentucky residents and create a health exchange, where more than 100,000 people have purchased discounted health plans with the help of federal subsidies. (11/1)

The Associated Press: Police Adopt Drug Addict Program Pioneered In Massachusetts
A police program in northern Massachusetts that helps fast-track heroin addicts into treatment is catching on in other states and showing signs of reducing crimes associated with addiction. Gloucester police say dozens of departments in nine states have taken a page from their ANGEL program, which gives addicts a chance to make treatment rather than arrest the first response they get from police. (Marcelo, 11/1)

The New York Times: In Fight To Save Young People, Brooklyn Doctor Treats Violence As A Public Health Issue
Dr. Robert Gore was stirred awake one morning in July by an urgent phone call from work. That was not unusual, given his job in the emergency department at Kings County Hospital Center in Brooklyn, a level-one trauma center that provides the highest level of care. Still, his years of skillful, coolheaded practice, of stopping bleeding and saving lives, had not prepared him for what he heard. (Gonzalez, 11/1)

The New York Times: On Ballot, Ohio Grapples With Specter of Marijuana Monopoly
As a member of the International Cannabinoid Research Society, a collector of antique marijuana apothecary jars, the founder of an industrial hemp business and “a pot smoker consistently for 47 years,” Don Wirtshafter, an Ohio lawyer, has fought for decades to make marijuana l

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