Kaiser Health News Original Stories

3. Political Cartoon: 'Cough It Up'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Cough It Up'" by Jimmy Margulies.

Here's today's health policy haiku:


Wanted to see a
dermatologist. Health plan
said no -- send photo.

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Health Law Issues And Implementation

4. Healthcare.gov Enrollments Up Over This Time Last Year; Two-Thirds Are Repeat Customers

Of the 543,000 people who submitted applications for health law exchange insurance and chose plans, 34 percent are first-time users, according to the Obama administration. Meanwhile in Congress, a move by some Republican senators to repeal Obamacare is snagged on complex Senate rules.

The Associated Press: More Than 540k Sign Up For Health Overhaul Plans
The Obama administration says more than 543,000 people signed up for coverage last week under the president's health care law, as the 2016 enrollment season got underway. Premiums are going up for many plans, and consumers are being urged to shop around. The health care law offers subsidized private insurance for those who don't have coverage through their jobs. The Department of Health and Human Services said Thursday that returning customers accounted for about two-thirds of those picking a plan for next year. (11/12)

USA Today: Feds Say Health Site's First Week Was A 'Solid Start'
More than a half million people selected health plans during the first week of open enrollment on the federal insurance site HealthCare.gov, the Centers for Medicare and Medicaid Services said Thursday. HealthCare.gov is used by consumers in 38 states that didn't establish their own insurance exchanges under the Affordable Care Act. (O'Donnell, 11/12)

The Washington Post: HealthCare.gov Sign-Ups Ahead Of Last Year — But With Fewer Newcomers
Compared with a year ago, more Americans signed up for health plans during the opening week of the enrollment season on the federal insurance exchange, although the number of first-time customers lagged. About 553,000 consumers chose insurance plans through HealthCare.gov between Nov. 1 and Nov. 7, according to federal figures. ... The smaller share of newcomers is consistent with recent predictions by federal health officials and outside health-policy experts that attracting additional uninsured Americans to HealthCare.gov would prove more difficult. (Goldstein, 11/12)

The New York Times: Senate Rules Entangle Bid To Repeal Health Care Law
Efforts to repeal the Affordable Care Act have become snarled in the complex rules of the Senate, raising questions about whether the Republican-controlled Congress can fulfill its pledge to send a repeal measure to President Obama. Repealing the law, passed five and a half years ago, is a goal cherished by Republican politicians, including those running for president, and by elements of the party’s base. Mr. Obama has repeatedly vowed to use his veto power if necessary to preserve the health care law, the biggest change in domestic social policy in a generation. (Pear, 11/12)

Elsewhere, media outlets report on insurance enrollment news from Ohio and Florida -

Cleveland Plain Dealer: Obamacare In Ohio: Racial Disparity Remains Despite Gains In Coverage, Study Says
Ohio's rate of uninsured residents has dropped significantly under the Affordable Care Act, but the law is still not reaching many people of color, according to a new study. The uninsured rate among blacks in Ohio is nearly 33 percent higher than it is for whites; it is nearly 57 percent higher for Hispanics than for whites, according to a study by WalletHub, a consumer information company. (Ross, 11/12)

The Orlando Sentinel: New ACA Enrollment Center Opens On I-Drive
A new center on International Drive is hoping to help more Central Floridians sign up for insurance coverage during the third enrollment period of the Affordable Care Act. SRA International, a federal contractor, has opened the Orlando Enrollment Assistance Center at 5628 International Drive. Trained enrollment specialists will help individuals and families review their coverage options and find out if they quality for financial assistance. (Miller, 11/12)

5. Silver-Level Health Insurance Plans' Coverage Of HIV Drugs Limited, Study Finds

Only 16 percent of the popular plans cover all 10 of the most common drug regimens and charge less than $100 a month in consumer cost sharing, according to a report by Avalere Health. Elsewhere, Connecticut's co-op is staying in business but plans changes to sustain operations.

Kaiser Health News: Study Finds Marketplace Silver Plans Offer Poor Access To HIV Drugs
In most states, consumers with HIV or AIDS who buy silver-level plans on the insurance marketplaces find limited coverage of common drug regimens they may need and high out-of-pocket costs, according to a new analysis. In 31 states and the District of Columbia, silver-level plans cover fewer than seven of the 10 most common drug treatment options or charge consumers more than $200 a month in cost sharing, according to an analysis of 2015 silver plans by consultant group Avalere Health. Only 16 percent of those marketplace plans cover all 10 of the top HIV/AIDS drug regimens and charge less than $100 a month. (Andrews, 11/13)

6. Alabama Governor Says He Is Weighing Medicaid Expansion

Gov. Robert Bentley, a doctor, says his administration is "looking at" expanding the program for low-income residents under the federal health law. Meanwhile, Kentucky awaits details from the governor-elect on how he wants to change the state's health insurance marketplace and Medicaid.

The Associated Press: Alabama Governor Says He Is 'Looking' At Medicaid Expansion
The conservative Republican governor of Alabama, a Deep South state where "Obamacare" is often reviled, said Thursday that his administration is mulling an expansion of the state's Medicaid program under the federal health care law. Gov. Robert Bentley, a dermatologist turned governor, emphasized that he was in the exploratory stages— and said funding the state's share of costs could be a major stumbling block — but his comments were the strongest to date about the possible acceptance of expansion dollars in the deeply red, high-poverty state. (Chandler, 11/12)

AL.com: Gov. Bentley On Expanding Medicaid: 'We Are Looking At That. We Have Not Made A Final Decision'
In perhaps his most direct comments to date, Gov. Robert Bentley said Thursday his administration is looking at expanding Medicaid, the health care program that serves one million Alabamians. "We are looking at that (Medicaid expansion). We have not made a final decision on that yet, exactly on how that will work," said Bentley in response to a question from an audience of lawyers he addressed this morning in Montgomery. (Dean, 11/12)

Louisville Courier-Journal: Health Clinics Fear Loss Of Kynect
Just a few years ago, Louisville's Family Health Centers were on the brink of closing clinics and laying off staff. ... Then the Affordable Care Act kicked in. Enrollment in health plans surged through kynect, Kentucky's award-winning health insurance exchange created under the federal law also known as Obamacare. Now Family Health Centers' budget is in the black, with more than 80 percent of patients enrolled in health coverage and able to pay for care. ... health advocates are alarmed that changes proposed by Gov.-elect Matt Bevin threaten to undermine major public health advances under the health law in a state with abysmally poor health rankings. (Yetter, 11/11)

Louisville Courier-Journal: Medicaid And Kynect: Facts As Bevin Eyes Cuts
Could Gov.-elect Matt Bevin end the Medicaid expansion in Kentucky under the Affordable Care Act that has added about 400,000 people to the state's Medicaid plan? Yes. Gov. Steve Beshear authorized the federal Medicaid expansion through an executive order and Bevin, as governor, could terminate it through his own executive order after he becomes governor Dec. 8. But Bevin has said he has no plans to do that and instead will ask the federal government for a waiver that would allow Kentucky to create its own Medicaid plan with more cost-sharing by consumers. (Yetter, 11/12)

And in New Mexico --

The Santa Fe New Mexican: Report: More Insured Means Less Costs For Indigent Care
For years, the No. 1 issue for hospital executives in New Mexico — whether talking with state lawmakers or county commissioners — was the cost of providing care to patients who showed up at the emergency room without insurance. Unlike other health care providers, hospitals are required under federal law to provide emergency care to patients without regard for their ability to pay. But a new report by the Legislative Finance Committee shows that for the first time, hospitals are spending less money on indigent care because more and more patients have some type of private insurance or government-issued Medicaid coverage. (Krasnow, 11/12)


7. Doctors, Consumer Groups Urge Antitrust Regulators To Block Insurer Mergers

Two consumer groups are forming a coalition with New York labor unions to oppose the proposed megamergers of Aetna with Humana and Anthem with Cigna. The American Medical Association has also asked the Justice Department to stop the acquisitions.

Reuters: Consumer Coalition Forms To Fight U.S. Health Insurance Mergers
Two U.S. consumer groups announced the formation of a coalition with New York labor unions on Thursday to press antitrust regulators to oppose big insurance mergers that would cut the number of nationwide for-profit health insurers from five to three. The Coalition to Preserve Patient Choice, made up of the Consumer Federation of America, Consumer Action and others, was formed because of concern about Anthem Inc's purchase of Cigna Corp for $47 billion and Aetna Inc's decision to buy Humana Inc for $37 billion, the group said in a statement. (11/12)