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KHN First Edition:November 20, 2015


First Edition

Friday, November 20, 2015
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: UnitedHealth Warns Of Marketplace Exit – Start Of A Trend Or Push For White House Action?
Kaiser Health News staff writer Julie Appleby reports: "UnitedHealthGroup laid out a litany of reasons Thursday why it might stop selling individual health insurance through federal and state markets in 2017 — a move some see as an effort to compel the Obama administration to ease regulations and make good on promised payments. Those problems, including low participation by healthy people, have led to financial losses, according to UnitedHealth. If not addressed, similar issues could affect other insurers, causing more to exit the market in the coming years, some Wall Street analysts and policy experts said." (Appleby, 11/20)

Kaiser Health News: Medicaid Denies Nearly Half Of Requests For Hepatitis C Drugs: Study
Kaiser Health News consumer columnist Michelle Andrews reports: "People with hepatitis C who sought prescriptions for highly effective but pricey new drugs were significantly more likely to get turned down if they had Medicaid coverage than if they were insured by Medicare or private commercial policies, a recent study found. Researchers at the University of Pennsylvania Perelman School of Medicine analyzed the hepatitis C prescriptions from 2,342 patients in Maryland, Delaware, Pennsylvania and New Jersey that were submitted between November 2014 and April 2015 to a large specialty pharmacy that serves the region." (Andrews, 11/20)

The New York Times: UnitedHealth Lowers Forecast, Blaming Affordable Care Act
UnitedHealth Group, one of the nation’s largest health insurance companies, stunned investors on Thursday morning when it significantly lowered its profit estimates, placing the blame for an expected loss of hundreds of millions of dollars on selling individual policies under the federal health care law. In light of the losses, the company warned that it was also weighing whether it would continue to offer individual coverage through the online exchanges for 2017. (Abelson, 11/19)

The Wall Street Journal: Biggest Insurer Threatens To Abandon Health Law
The industry’s woes, and broad rate increases aimed at stanching the red ink, are putting pressure on the Obama administration to tweak aspects of the law; the issues also risk pulling the ACA back into the political spotlight. Republicans, who have remained opposed to the health law, quickly jumped on the news. (Wilde Mathews and Armour, 11/19)

The Associated Press: UnitedHealth Cuts Outlook, Casts Doubt on Overhaul Exchanges
The nation's largest health insurer is questioning its future in public insurance exchanges, the latest signal of major concerns about the online marketplaces that have helped the Affordable Care Act extend coverage to millions of people. UnitedHealth Group said Thursday that it will scale back marketing for plans it sells on the exchanges and decide next year whether it will even stay in that business in 2017. It also cut its 2015 earnings forecast. (11/19)

USA Today: UnitedHealth Warns It May Exit Obamacare Plans
The possible move by UnitedHealth Group raises new questions about the viability of President Obama's signature health law and follows the departure of more than half of the non-profit insurance cooperatives this year. If UnitedHealth drops out, consumers would lose one of the lowest-cost plans available in much of the country, and some wonder how smaller insurers could fill the void. “If they can’t make money on the exchanges, it seems it would be hard for anyone,” said Katherine Hempstead, who heads the insurance coverage team at the Robert Wood Johnson Foundation. (Bomey and O'Donnell, 11/19)

Los Angeles Times: UnitedHealth May Dump Obamacare Plans, Putting California Expansion In Doubt
The announcement comes as UnitedHealth is seeking a toehold in California’s Obamacare market — after snubbing the state two years ago. Nationwide, UnitedHealth has more than 500,000 people enrolled on government exchanges out of about 10 million Americans who have signed up. Rivals Anthem and Aetna both have a bigger presence with a combined enrollment of about 1.6 million people. (Terhune, 11/29)

CQ Healthbeat: UnitedHealth Report Stirs Alarm About Obamacare Exchanges
Health policy analysts and lobbyists were split on Thursday over whether the announcement by the nation’s largest insurer that it may withdraw from health law insurance marketplaces in 2017 signals broader problems with the viability of the exchanges. UnitedHealth Group lowered its expectations for earnings on Thursday, blaming higher-than-expected medical claims from the approximately 550,000 people it covers through the marketplaces created by the 2010 overhaul. Some patients enroll to receive medical care and drop coverage later, company officials said. (Adams, 11/19)

The Associated Press: Stocks End Lower, Dragged Down By Health Care Sector
U.S. stocks closed slightly lower Thursday after spending much of the day wavering between small gains and losses. Several companies reported earnings and outlooks that offered a mixed picture of the economy for investors. Health care stocks were among the biggest decliners, dragged down after UnitedHealth Group cut its full-year earnings forecast. The nation's largest health insurer also raised doubts about whether it will continue to participate in a key piece of the Affordable Care Act. (11/19)

ProPublica/NPR: Brand-Name Drugs Can Raise Costs Without Boosting Patient Satisfaction
In recent days, presidential candidates and even the American Medical Association have griped about rising drug prices, pointing to brand-name blockbusters with splashy ad campaigns. When it comes to patient satisfaction, however, there isn't much difference between brands and generics, according to data collected by the website Iodine, which is building a repository of user reviews on drugs. (Ornstein, 11/19)

The Washington Post's Wonkblog: Specialty Drugs Now Cost More Than Most Household Incomes
The average annual retail cost of specialty drugs used to treat complex diseases such as cancer, rheumatoid arthritis and multiple sclerosis now exceeds the median U.S. household income, according to a report to be published Friday. The study of 115 specialty drugs found that a year's worth of prescriptions for a single drug retailed at $53,384 per year, on average, in 2013 -- more than the median U.S. household income, double the median income of Medicare beneficiaries, and more than three times as much as the average Social Security benefit in the same year. (Johnson, 11/20)

The Wall Street Journal: Doctors Could Be Penalized For Ordering Prostate Tests
Medicare officials are considering a measure that would penalize doctors who order routine prostate-cancer screening tests for their patients, as part of a federal effort to define and reward quality in health-care services. The proposal, which hasn’t been widely publicized, has prompted a flurry of last-minute comments to the Centers for Medicare and Medicaid Services, including more than 200 in the past two days, virtually all in opposition. The official comment period began Oct. 26 and ends Friday. (Beck, 11/19)

The Washington Post: Sanders: Unlike Clinton, I Won’t Seek ‘Reckless Adventures Abroad’
Sanders devoted the bulk of his remarks Thursday to an explanation of what “democratic socialism” is — and isn’t — in his view. The term he uses to describe his politics has become a major topic of conversation, and drawn some derision, as he seeks the presidency. ... Sanders cited his plans to make public college tuition free, to provide universal health care through a “Medicare for all” system, and to raise the minimum wage to $15 per hour. Clinton has proposed addressing many of the same issues that Sanders cited, but she generally advocates programs that are less ambitious and less costly. (Wagner, 11/119)

The Washington Post's Wonkblog: How Bernie Sanders’s Big Speech Could Change Your View Of ‘Democratic Socialism’
Sanders embraces the label, but for decades, "socialist" has been among the meanest insults you can hurl at an American politician. About three in five Americans say they have a negative view of socialism, according to the Pew Research Center. Yet many developed nations have some socialist policies within their free-market systems, in the form of basic services provided by the government. In many European countries, the government provides college education and child care. In the United Kingdom, the government provides medical care through the National Health Service. Sanders is fond of noting that the United States is no exception, with its widely popular Social Security program. (Ehrenfreund, 11/19)

The Associated Press: Oklahoma Governor Seeks End Of Planned Parenthood Contracts
Oklahoma Gov. Mary Fallin is calling on the state to cancel its Medicaid contracts with Planned Parenthood, citing what she called a “high rate of billing errors.” The governor announced Thursday that she’s asking the Oklahoma Health Care Authority to terminate contracts with two Planned Parenthood affiliates in Oklahoma City and Tulsa. (11/19)

The Associated Press: Cancer Patient's Lawyer Says She Can Get Marijuana In Maine
A woman with late-stage lung cancer could get medical marijuana in Maine if New Hampshire health officials issue her an identification card saying she's eligible before the state opens its own dispensaries, her lawyer said Thursday in court documents. Linda Horan wants a judge to order the state to grant her a medical marijuana ID card now so she can buy marijuana legally in Maine. Lawyers for the state argue that would undermine New Hampshire's need to control distribution. (11/19)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.

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