A federal institute created by the health law is seeding research projects around the U.S. that connect medical professionals with patients to find better treatments. (Guy Gugliotta, 11/4)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Fast Track'" by Ron Morgan.
Here's today's health policy haiku:
NEW GOP TARGET: INSURANCE CO-OPS
They're dropping like flies...
Failing co-ops give ammo
to foes of health law.
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.
Michigan's was the most recent to announce its departure. Meanwhile, the financial disintegration of these nonprofit insurers has given GOP health law opponents new ammunition and was the topic of a Tuesday House Ways and Means Committee hearing.
The New York Times: Failed Co-Ops Add Ammunition To G.O.P. War On Health Law
The financial failure of more than half the nonprofit health insurance companies created under the Affordable Care Act has handed Republicans a new weapon in their campaign against the health law, thrown the Obama administration on the defensive once again and left more than a half-million consumers in the cold. “Any start-up faces the inherent risks of building a business from the ground up,” Dr. Mandy Cohen, the chief operating officer at the Centers for Medicare and Medicaid Services, told Congress on Tuesday at a contentious hearing of the House Ways and Means Subcommittee on Health. “As with any new set of business ventures, some co-ops have succeeded while others have encountered more challenges.” (Pear, 11/3)
The Associated Press: More Than Half Of Health Law's Insurance Co-Ops Are Closing
Republicans and Democrats on the House Ways and Means Committee traded blame for the mess, which is forcing several hundred thousand people to find new coverage for 2016. Republicans said the taxpayer-financed program exemplifies the problems of "crony capitalism" in which the government backs certain businesses for political purposes. Democrats countered that deep funding cuts forced by the GOP worsened the problems and contributed to the financial instability of many co-ops. (11/3)
The Washington Post: More Than Half Of ACA Co-Ops Now Out Of Insurance Marketplaces
More than half of the nonprofit health insurance co-ops formed through the Affordable Care Act are now off the market for the coming year, with the last-minute departure of a plan in Michigan. On Tuesday, two days after the start of the new enrollment season in insurance exchanges created under the health-care law, the Web site of Michigan’s Consumers Mutual Insurance posted notice that it will not sell coverage for 2016. ... The latest gyrations are occurring as the co-ops become new fodder for the partisan acrimony that has surrounded the 2010 law since its beginnings. At a hearing Tuesday afternoon of a House Ways and Means subcommittee, Republicans accused the Obama administration of wasting taxpayers’ money on an aspect of the law that they say is failing. Democrats countered that a series of GOP-forced budget cuts crippled many co-ops’ chances to thrive. (Goldstein, 11/3)
Fiscal Times: Obama Administration Cuts Its Losses With Crumbling Health Care Co-Ops
The Obama administration signaled Tuesday that it had nothing up its sleeve to salvage a crumbling network of non-profit insurance coops created under the Affordable Care Act, also known as Obamacare, to give more choice and less costly policies to consumers. The administration is hoping to keep the remaining dozen out of 23 operational for at least another year. During a House Ways and Means subcommittee hearing that was one part status report and one part post-mortem, Mandy Cohen, the chief operating officer of the Centers for Medicare and Medicaid Services, which operates Obamacare, said the administration was essentially cutting its losses while keeping close watch on the surviving health insurance co-ops. (Pianin, 11/4)
The fines against Blue Shield of California and Anthem Blue Cross result from consumer complaints in 2014 that the insurers' doctor directories were inaccurate. Also, newspapers in Milwaukee, Wis., and Tampa Bay, Fla., look at current enrollment issues, especially cost.
Los Angeles Times: California Fines Top Health Insurers For Overstating Obamacare Networks
California regulators fined two insurance giants for overstating their Obamacare doctor networks and said the companies will pay millions of dollars in refunds to patients who paid too much for care. The state’s Department of Managed Health Care levied fines of $350,000 against Blue Shield of California and $250,000 for Anthem Blue Cross. (Terhune, 11/3)
The Sacramento Bee: Anthem, Blue Shield Fined $650,000 For Faulty Doctor Directories
As part of the bumpy rollout of Obamacare in California, two major insurers – Anthem and Blue Shield – were issued $650,000 in fines Tuesday because they provided inaccurate doctor directories that resulted in costly overcharges for some patients. The fines are based on statewide surveys in June 2014 that found more than 25 percent of Anthem Blue Cross and Blue Shield of California’s online doctor listings were faulty, either because the physicians weren’t in the location listed or weren’t offering plans as cited. (Buck, 11/3)
The Milwaukee Journal Sentinel: Market Continues To Evolve For ACA Insurance Plans
As the third enrollment period gets underway, the market for health plans sold on the exchanges set up through the Affordable Care Act remains in flux — and it is likely to stay that way for several more years. Some insurers are increasing premiums sharply. Others are lowering premiums. One insurer is pulling out of the Milwaukee market. Another is entering the market. And one is dropping one of its health plans. (Boulton, 11/3)
Tampa Bay Times: Obamacare Open Enrollment Gets Off To Smooth Start, But Navigators Still Face Challenges
It took Doug Calwhite about 30 minutes Monday to enroll in a new health insurance plan on the Obamacare marketplace. The 62-year-old retired maintenance mechanic stopped into the University of South Florida's Marshall Student Center for in-person assistance from enrollment experts known as navigators. One quickly helped him trade his midrange silver plan for a more economical bronze plan. (McGrory, 11/3)
The Associated Press reports that hot-button issues such as Planned Parenthood funding fights will be hurdles to avoiding a December government shutdown.
Politico: Ryan Pitches Unified GOP Agenda To Senators
At the beginning of this year, House and Senate Republicans huddled together in Hershey, Pa., to plot strategy and temper expectations that the GOP could unilaterally move legislation over Democratic objections in the Senate. But hopes for a unified front faded during the year as the House and Senate GOP sparred over immigration policy, surveillance legislation and how to defund Planned Parenthood. Finally, House conservatives resorted to begging the Senate to change its arcane rules; senators are now studying whether such a proposal is feasible. ... Ryan is clearly seeking a do-over — Republican senators said that he emphasized to them that he would be a diligent communicator, pointing to his five Sunday show appearances this weekend as evidence he is serious about coordination. (Everett, 11/3)
The Washington Post: Being GOP’s Next Great Communicator Will Be Delicate Task For Paul Ryan
In his years as House Budget Committee chairman, Ryan laid out spending blueprints that embraced ideas such as privatizing portions of Social Security, cutting Medicaid and converting Medicare to a voucher-based program — all of which provided fodder for Democratic attacks. Addressing reporters on Tuesday at his first news conference as speaker, Ryan said he would not shy away from presenting controversial policy prescriptions in an election year. ... The tax plans put forth by the 2016 GOP presidential nominees hew by and large to the principles Ryan has embraced in the past — reducing the number of income tax brackets, lowering rates, and eliminating loopholes and deductions. But Ryan’s ideas on reforming entitlement programs could prove more divisive. National front-runner Donald Trump, for instance, has pushed back on suggestions of major changes to Social Security and Medicare. (DeBonis, 11/3)
The Associated Press: Policy Fights, Funding Battles Still Pose Shutdown Threat
Despite a broad budget deal, the White House and congressional Republicans must resolve dozens of policy issues and spending fights if they are to avoid a holiday season government shutdown. Hot-button battles over Planned Parenthood, the environment and money for agencies like the IRS could still derail a must-do spending bill to keep the government running. (Taylor, 11/4)
The measure, introduced by Rep. Tim Murphy, R-Pa., is slated for markup today. Meanwhile, Sen. Kelly Ayotte, R-N.H., will introduce a bill to improve substance abuse treatment programs for pregnant women.
The Hill: GOP Changes Mental Health Bill, Seeking Dem Support
Rep. Tim Murphy (R-Pa.) on Tuesday introduced an updated version of his sweeping mental health reform legislation that seeks to allay some of Democrats’ concerns. The move comes the day before the bill is marked up in the House Energy and Commerce health subcommittee. The measure, billed as the Republican response to the mass shooting in Newtown, Conn., when it was first introduced in 2013, has been controversial and delayed for years, but is now moving forward. (Sullivan, 11/3)
Modern Healthcare: Congress Wrestles With Court-Ordered Mental Health Treatment
One of the provisions that is keeping a House mental health reform bill from relatively easy passage involves assisted outpatient treatment. Some experts say it has been unfairly labeled as questionable since widespread evidence has shown success. A few organizations, however, and about 20 Democrats in the House Energy & Commerce Committee, say assisted outpatient treatment, or AOT, is not proven to be helpful and the law as currently written would punish the five states that don't have AOT laws on the books. (Muchmore, 11/3)
The Associated Press: Ayotte Proposes Bill To Improve Substance Abuse Treatment For Pregnant Women, Moms
U.S. Sen. Kelly Ayotte is introducing legislation to improve treatment programs for pregnant women and mothers who have a substance use disorder, including a pilot program that allows funds to help women in non-residential settings. Ayotte, a Republican, was introducing the Senate version of the Improving Treatment for Pregnant and Postpartum Women Act on Tuesday. A similar bill was recently introduced in the House by U.S. Rep. Ben Ray Lujan, a Democrat from New Mexico. (11/4)
As the pharmaceutical industry comes under increased scrutiny, PhRMA launches a counteroffensive, blaming insurers and federal regulators for the skyrocketing costs. Meanwhile, in other drug industry news, Glaxo is set to seek approval for 20 new medications. And Kiplinger's offers tips on saving money on Medicare prescriptions.