When the Bush administration choked federal funding for research involving cells taken from human embryos, some states opted to start their own programs. (Guy Gugliotta, 11/6)
Despite strong enrollment in Kentucky's online health insurance marketplace, participation in its exchange for small employers also created by the Affordable Care Act has mostly been a dud. (Phil Galewitz, 11/5)
Two studies analyze the decline in PPO plans that provide some coverage when patients seek care from doctors, hospitals and other providers that are not on the plan’s network. (Michelle Andrews, 11/6)
Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Best Shot'" by Jerry King.
Here's today's health policy haiku:
DEBATE OVER MEDICARE, OTHER BENEFITS DIVIDES GOP
Over entitlement growth
But how to fix it?
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.
The process of buying a health plan can be complicated and several outlets provide tips for shoppers and advice about what to consider. At the same time, federal officials are heating up their enrollment campaigns, including an appearance by the HHS secretary in New Jersey.
The Fiscal TImes: Why You Might Be Choosing The Wrong Obamacare Plan
Shopping for health insurance can be a baffling maze of unfamiliar terms and puzzling acronyms — premiums, deductibles, PPOs, HMOs, POS. The Affordable Care Act, also known as Obamacare, added new elements that can heighten the confusion: Consumers have to navigate four different levels of plans, determine what subsidies they’re eligible for based on their income and calculate what plan would work best for them over the coming year. That’s why some Obamacare shoppers who signed up through healthcare.gov have chosen plans that cost too much. (Dent, 11/5)
The Oregonian: 5 Things You Need To Do When Buying Health Insurance
Steven Conner, a 56-year-old self-employed contractor in Gresham, learned recently his health plan premium will jump by $145 a month. Conner is not alone. In June the state approved significant hikes for the more than 240,000 Oregonians who buy their own policies and are not on Medicare. (Budnick, 11/5)
Marketplace: Insurers Offer Narrower Networks On Health Exchanges
When open enrollment began on the nation's healthcare exchanges on November 1, many people who bought insurance for 2015 found that the 2016 plans they had to choose from have narrower networks of hospitals. In addition, premiums might be significantly higher. Insurers have asked the federal government for permission to increase premiums by as much as 40 percent or more. (Safo, 11/5)
The Wall Street Journal: New Federal Initiative Aims To Enroll Northern New Jersey’s Uninsured
When Health and Human Services Secretary Sylvia Mathews Burwell hosts a round-table discussion Friday at a health clinic in Jersey City, N.J., she is expected to do the predictable: encourage people to enroll in health insurance offered through the Affordable Care Act. More surprising is a new federal enrollment effort targeted for northern New Jersey. The state typically fares better than many other states when percentages of the uninsured are compared. ... the northern part of the state has characteristics that make it ripe for an increase in health-insurance sign-ups, including a significant population of Hispanic residents, who are more likely to be uninsured than non-Hispanic whites. (Ramey, 11/5)
The Wall Street Journal: Number Of Uninsured In U.S. Declines In First Half Of Year
An estimated 9% of Americans were uninsured in the first half of 2015, a significantly lower rate than in years before the health law was in effect, according to new federal government figures published Thursday. (Radnofsky, 11/5)
National Journal: The Price Of Bucking Obamacare Is About To Increase—Will People Still Pay It?
The fee levied on those who go without insurance but who can afford it sharply increases in 2016, a result of a three-year phase-in of the penalty. The higher the fee, health experts say, the likelier it is that consumers will choose to get or stay covered. But there’s a big caveat: It all depends on whether or not uninsured Americans, or those thinking about leaving the exchanges, know about the individual mandate and its steep fee increase. ... The fee for not having health insurance next year won’t be felt until Americans file their federal taxes due April 2017. But it’s much more than in the past: $695 per adult and $347.50 per child, or 2.5 percent of a household’s income—whichever is higher. (Roubein, 11/5)
And in news about state health marketplaces -
Minnesota Public Radio: Assessing The Usefulness Of MNsure's New Shopping Tool
Open enrollment for individual health insurance plans got underway over the weekend and so far MNsure reports that its computer systems and call center are operating that way they are supposed to. (Wurzer and Zdechlik, 11/5)
The Washington Post: Maryland To Seek More Money From Health-Exchange Vendors
Maryland’s attorney general sent a letter to lawmakers last week complaining that an upcoming audit could undermine efforts to recover money spent on the state’s flawed health exchange by focusing on mistakes made by government officials rather than the vendors who built the portal. (Nirappil, 11/5)
Meanwhile, The Huffington Post examines what the Kentucky governor's election may mean for the health law -
The Huffington Post: GOP Win In Kentucky 'Heartbreaking' For Obamacare Advocates
Kentucky attracted the national spotlight over the past two years as the state slashed its uninsured rate and implemented Obamacare more smoothly than President Barack Obama himself. Progressive activists and health care advocates fear that's all in jeopardy after Tuesday's victory by conservative Republican Matt Bevin in the race to be the next governor. (Young and Cohn, 11/5)
The collapse of 12 out of 23 nonprofit health insurance co-ops provides critics a new chance to take aim at the health law.
The Wall Street Journal: Failure Of Half Of U.S. Health Insurance Co-Ops Sparks New GOP Criticism
Several Republicans Thursday heaped blame on the Obama administration for the failure of more than half of the cooperatives set up under the health law to infuse competition into the insurance market. The collapse of 12 out of 23 operating co-ops is providing a fresh opportunity for the GOP to criticize the Affordable Care Act and make the health law a talking point in the presidential election. The criticism was aired at a hearing by a House Energy and Commerce subcommittee to examine the failing startups, which received more than $1 billion in federal loans that may not be paid back. (Armour, 11/5)
McClatchy: Congress Continues Probe Into Failing Obamacare Co-Ops
The nonprofit, member-run health insurance plans created by the Affordable Care Act are in a world of trouble. Twelve of the nation’s 23 Consumer Operated and Oriented Plans, known as co-ops, won’t provide coverage in 2016 after collapsing under the weight of low enrollment, financial problems and a host of technical and operational issues. (Pugh, 11/5)
The Arizona Republic: Arizona's Health Insurance Co-Op Meritus Fights Closing
Executives with Arizona’s health insurance co-op are attempting to convince the Arizona Department of Insurance’s director to reverse an order that effectively put the non-profit out of business. (Alltucker, 11/5)
The Detroit Free Press: Michigan Insurer Consumers Mutual Exits Marketplace
After days of speculation, a Michigan insurer — a one-of-a-kind entity in Michigan created under federal health reform — is pulling its business from the state's online marketplace. East Lansing-based Consumers Mutual will "enter into a run-off of its business," according to a statement from the Michigan Department of Insurance and Financial Services. The co-op established under the 2010 Affordable Care Act is far from alone in its decision. About a dozen altogether have closed recently, according to national news reports. (Erb, 11/5)
Meanwhile, KHN offers this report on the SHOP program -
Kaiser Health News: Kentucky’s Exchange Success Doesn’t Translate To Small Business Participation
Kaiser Health News staff writer Phil Galewitz reports: "Kentucky has run one of the most successful Obamacare individual health insurance exchanges, attracting enough people into private health plans and Medicaid to cut the state’s uninsured rate by half in two years. But Kentucky’s online health insurance marketplace for small employers also created by the Affordable Care Act has mostly been a dud. Just 92 employers have signed up and a total of 901 people, both workers and their dependents, have received coverage through the specialized exchange." (Galewitz, 11/5)
The federal officials also sent letters to drug makers asking what efforts they have pursued to make the drugs more affordable. In other news, a look at how the powerful drug makers' lobby is responding to recent reports of price hikes, and Pfizer announces it is increasing its drug assistance program for patients.
The Wall Street Journal: Federal Officials Warn States On Hepatitis C Drug Restrictions
In a sign of growing government interest in rising prescription-drug costs, federal officials on Thursday said state Medicaid programs may be violating federal law by denying patients expensive hepatitis C medications. They also asked drug makers to provide information on their pricing arrangements with health insurers, which officials said could help ease the financial burden on state budgets. (Walker, 11/5)