Kaiser Health News Original Stories

4. Political Cartoon: 'Best Shot'

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

Republican angst
Over entitlement growth
But how to fix it?

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Health Law Issues And Implementation

5. Consumers Urged To Shop Carefully For 2016 Marketplace Plan To Save Money, Get Best Care

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)

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 -

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)

6. Failure Of Health Law Co-Ops Draws Congressional Scrutiny, Shakes Up Some State Insurance Markets

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 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)

Marketplace

7. Administration Warns States Against Limiting Costly Hepatitis C Drugs In Medicaid Programs

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)