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POLITICO New York Health Care: Cuomo administration releases insurance rates; experts knock state fact sheet on PFOA

By Dan Goldberg | 08/08/2016 10:00 AM EDT

Good morning! You are receiving the complimentary synopsis of the POLITICO New York Pro Health Care newsletter. Pro subscribers are receiving an enhanced version of this newsletter at 5:45 a.m. each weekday, which includes a look-ahead and robust analysis of health care policy news driving the day. If you would like the Pro version of this newsletter, along with customized real-time insights on New York health care, please contact us here and we will set you up with trial access. Thank you for reading!

written by Dan Goldberg

2017 INSURANCE RATES ARE OUT - The Cuomo administration on Friday announced that health insurance rates on the individual market would increase by a weighted average of 16.6 percent, the largest individual market hike since the Affordable Care Act began in 2014. The new rates take effect in January; open enrollment on the state's exchange begins Nov. 1. Rates in the small group market will increase by a weighted average of 8.3 percent. We made a chart so you can see what each insurer requested, the number of members they had as of May, and what DFS allowed. See it all here: http://politi.co/2au4Vmr

..Five takeaways: First, it is important to remember that increased rates do not necessarily mean increased prices for consumers. More than half of customers in the state are eligible for federal subsidies that will shield them from rate hikes.

-Second, take note of CareConnect's statement following the release of the rates: "Unlike some of its competitors, the company continues to offer its more than 100,000 members access to the same network of 20,000 providers throughout the metropolitan area as before." That's a swipe at Oscar, which saw its rates rise "only" 20 percent but which recently announced it was drastically narrowing its network.

-Third, what will UnitedHealth Group do? It has made no secret of its distaste for Obamacare markets. The company asked DFS for a 45-percent rate hike. It was awarded a 28-percent increase. The company is not a major player in the individual market, so might it pull out of New York? A spokesman did not respond to a request for comment.

-Fourth, more so than any year before, the Cuomo administration acknowledged the pricing problems in the state's individual market. The administration acceded to demands from insurers to raise rates because of medical cost trends, "a flawed" risk adjustment program, the disappearance of the reinsurance program. In short, the Cuomo administration acknowledged its Obamacare marketplace - particularly the individual market - needed help.

-Fifth, new DFS Superintendent Maria Vullo is going to try to do something about the risk adjustment payments insurers in New York must make. She has complained about them before and did so again on Friday. Her challenge will be to change the rules in a way that benefits a company such as CareConnect without angering a company such as UnitedHealth, the largest insurer in the nation, and a company that stands to make hundreds of millions of dollars from the risk adjustment program.

SHARE ME: Like this newsletter? Please tell a friend to sign up. Give them this link: http://politi.co/25oHyoN

AND MAKE SURE YOU FOLLOW Josefa Velasquez and me on Twitter @J__Velasquez & @DanCGoldberg. And for all New Jersey health news, check out @katiedjennings

STATE FACT SHEET ON PFOA EXPOSURE DOWNPLAYS RISK, HEALTH EXPERTS SAY - The Cuomo administration is distributing health information in Hoosick Falls that downplays the risks of having a toxic chemical in the bloodstream, public health experts say. The experts, including one formerly employed by the state health department and three others who have extensively studied the cancer-linked chemical found at high levels in the Hoosick Falls water supply, reviewed the question-and-answer document at POLITICO New York's request. All independently concluded the state health department was minimizing the risks of PFOA in the bloodstream. POLITICO New York's Scott Waldman has more: http://politi.co/2aSTgig

NOW WE KNOW - Sharks get a bad rap because of that ominous music that always seems to be playing when you see them on a screen, according to an article in PLOS One. So, if you're afraid of being eaten or maimed, just remember, it's not because of those giant teeth. It's the soundtrack. http://bit.ly/2aTMWda


WE'D LOVE TO HEAR FROM YOU: This roundup is for you, so please tell us how we can make it even better. Send tips, news, ideas, calendar items, releases, promotions, job postings, birthdays, congratulations, criticisms and corrections to dgoldberg@politico.com.

THE ZIKA WARRIOR - The Wall Street Journal profiled Dr. Jennifer Rakeman, the city's chief Zika hunter. http://on.wsj.com/2avaBN3

THE QUEER HEALTH WARRIOR - The Guardian profiled Dr. Demetre Daskalakis, whose Twitter profile announces he is a queer health warrior and assistant commissioner at the city's health department. http://bit.ly/2aJkES8

MAKING ROUNDS - Bob de Luna, who has spent a decade working with the media at the United Hospital Fund, has been appointed press secretary and director of media relations at New York City Health + Hospitals.

BREASTFEEDING CARAVAN - Activists and elected officials rallied on the steps of City Hall on Friday to kick off the annual Breastfeeding Caravan, which this year celebrates the 22nd anniversary of a 1994 state law that protects the right to breastfeed anytime, anywhere. http://politico.pro/2aGPWWL

AD CAMPAIGN - Gay Men's Health Crisis has a new ad campaign designed to spread awareness of Pre-Exposure Prophylaxis, or PrEP, a pill that helps prevent the spread of HIV, and remind people that it has to be taken every day. http://politico.pro/2aUpzQp

MAKING ROUNDS - Monique Tula will leave AIDS United at the end of August. She will be the new executive director for the Harm Reduction Coalition, a national nonprofit based in New York City and Oakland.

PHARMA REPORT: Bristol-Myers Squibb said Friday that its highly anticipated drug, Opdivo, had not slowed the progression of advanced lung cancer in the clinical trial, which compared it with conventional chemotherapy. The company lost 16 percent of its value. The New York Times has more: http://nyti.ms/2aHluib

INSURANCE REPORT: POLITICO reports: "Federal Judge John Bates has decided he will continue to hear the DOJ lawsuit challenging Aetna's proposed $37 billion acquisition of Humana. But Bates, a George W. Bush appointee, has passed the suit contesting Anthem's $54 billion acquisition of Cigna over to Judge Amy Berman Jackson, an Obama appointee."

WHAT WE'RE READING:

-ZIKA - The Federal Trade Commission sent 10 warning letters to online marketers selling products that purport to protect people from the Zika virus. The targeted products include wristbands and patches that claim to protect people from mosquitoes carrying the virus. http://bit.ly/2aZ9N7k

...U.S. Sen. Chuck Schumer on Sunday said Congress should come back from recess to fund Zika research. http://nydn.us/2aJp1MV

HOW MIKE PENCE'S SLOW WALK HELPED PROPEL A HEALTH CRISIS - POLITICO reports: "Indiana Gov. Mike Pence signed a pledge last month, along with most of the nation's governors, to combat the opioid crisis, calling it 'one of the deadliest drug epidemics in our nation's history.' But when confronted with a spiraling HIV outbreak in his home state as a result of opioid addicts sharing contaminated needles, Pence dragged his feet before agreeing to lift a ban on programs that distribute sterile needles." http://politi.co/2ay38Nt

-JOBS REPORT - The U.S. added 255,000 jobs in July - and 43,000 were in health care, according to my colleague Dan Diamond.

-NEW RULES - The New York Times explains the Notice Act and how it is intended to protect seniors from surprise bills following a hospital stay. http://nyti.ms/2aJllLa

-THE CASE FOR FLOSSING - Remember last week when the Associated Press wrote how there was no evidence to show flossing helped. Well, a dentist took to the Huffington Post to defend the practice. http://huff.to/2avaL75

-WHEN BLOOD PRESSURE IS POLITICAL - Sandeep Jauhar, a cardiologist and author of "Doctored: The Disillusionment of an American Physician," explains in The New York Times allostasis and its impact on human health. http://nyti.ms/2ay2bEB

TODAY'S TIP - Comes from the state's Department of Health, which reminds us that "most insect stings aren't serious, but they can cause serious allergic reactions in some children." Here's a Q&A for parents: http://www.health.ny.gov/prevention

STUDY THIS:

-BREAST IS BEST - Breast-fed babies have healthier immune systems, score higher on I.Q. tests and may be less prone to obesity than other babies, according to The New York Times. http://nyti.ms/2ay5AmK

MISSED A ROUNDUP? Get caught up here: http://politico.pro/1Vxuqrf

To view online:
http://www.politico.com/states/new-york/tipsheets/politico-new-york-health-care/2016/08/cuomo-administration-releases-insurance-rates-experts-knock-state-fact-sheet-on-pfoa-004795

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