KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: December 13, 2013

Today's early morning highlights from the major news organizations, including reports about a set of steps taken by the Obama administration in an effort to help consumers avoid coverage lapses as the health law  takes effect.

Kaiser Health News: Thousands In Obamacare's High-Risk Pools Get Month's Reprieve
Kaiser Health News staff writer Phil Galewitz reports: "About 85,000 people with a history of serious illnesses, who are enrolled in high-risk insurance pools created under the health care law, will get a month’s reprieve before they lose that coverage" (Galewitz, 12/12). Read the story.

Kaiser Health News: Health On The Hill: Congress Moves Closer To Changing How Medicare Pays Doctors
Kaiser Health News’ Mary Agnes Carey and Politico Pro’s Jennifer Haberkorn discuss congressional events in which key House and Senate committees approved legislation Thursday to repeal the Sustainable Growth Rate, the formula officials use to pay doctors who treat Medicare patients (12/12). Listen to the audio or read the transcript.

Kaiser Health News: Capsules: Marketplace Plans’ Networks Are Very Small, Study Finds; Californians Continuing To Flock To New Insurance Exchange
Now on Kaiser Health News’ blog, Julie Appleby reports on a new study examining provider networks in exchange plans: "To keep premium prices down for individuals and small businesses buying coverage through new online marketplaces, insurers have created smaller networks of hospitals. But consumers and policy experts have wondered, just how small? Turns out, many are very small" (Appleby, 12/12).

Also on Capsules, Anna Gorman writes about California’s latest exchange numbers: "Enrollment in California’s new health insurance marketplace is picking up speed, with more than 156,000 signed up for coverage through last week, officials announced Thursday. Nearly a third of the enrollees – 49,700 – completed their applications during the first week of December" (Gorman 12/13). Check out what else is on the blog.

Politico: Obamacare: One Punt After Another
Why do Republicans even bother trying to delay Obamacare? President Barack Obama’s doing it all by himself. On Thursday, the Obama administration gave customers permission to pay their premiums as late as Dec. 31 for coverage that starts Jan. 1, and officially gave customers an extra week — until Dec. 23 — to sign up for January coverage. The move was just the latest in a long list of extensions, delays and punts that have plagued the health care law (Nather and Kenen, 12/12). 

The Associated Press/Washington Post: Feds Try To Smooth Bumpy Health Care Transition
Anticipating more health care disruptions, the Obama administration Thursday announced a batch of measures intended to help consumers avoid lapses in their care and coverage as the president’s overhaul takes effect in January. Health and Human Services Secretary Kathleen Sebelius also announced a one-month extension of a special insurance program created by the law for people who cannot get coverage because of health problems. Scheduled to expire at the end of the year, the Pre-Existing Condition Insurance Plan will remain in place through January (12/12). 

Politico: Health And Human Services Addresses Fear Of Jan. 1 Health Coverage Gap
HHS Secretary Kathleen Sebelius said the moves will give consumers "more peace of mind and even more confidence that it [insurance] will be there when they want and need it." She took part briefly in a press call but took no questions. The administration has faced a crisis as millions of people have learned that their current health insurance plan is being cancelled, while problems with and some of the state exchanges have made enrollment difficult. The signup system is better now but still imperfect and it’s an open question whether everyone who needs to sign up this year will be able to do so. Republicans have said more people might lose coverage under Obamacare than gain it, at least in the early months (Norman, 12/12).

The New York Times: Health Plans Urged To Extend Enrollment
With many Americans still foiled in their efforts to buy insurance under the new health care law, the Obama administration moved Thursday to give them more time to sign up and pay premiums, and it extended a program for people with cancer, heart disease and other serious illnesses (Pear, 12/12).

Los Angeles Times: White House Gives Sick Americans More Time To Select A Health Plan
The Obama administration moved Thursday to help tens of thousands of sick Americans who have struggled to enroll in health coverage for next year because of problems with the rollout of new insurance marketplaces created by the president’s health law. The Department of Health and Human Services announced that patients who have been enrolled in special insurance plans for consumers denied coverage elsewhere would be able to stay on those plans until the end of January. Nearly 86,000 people are currently in such plans (Levey, 12/12). 

The Washington Post: Administration Will Give Some Consumers More Time To Buy, Pay For Health Insurance
The Obama administration announced Thursday it will give some Americans more time to buy health plans through the federal insurance marketplace and urged the insurance industry to make it easier for consumers to make the transition to the new coverage. The revisions come as a Dec. 23 enrollment deadline looms for people who want insurance that begins Jan. 1. Health and Human Services Secretary Kathleen Sebelius did not extend that deadline Thursday, but for the first time directed insurers to give consumers until Dec. 31 to pay (Goldstein, 12/12). 

The Associated Press/Washington Post: Health Website Woes Force Extension For Sickest
Technology problems with President Barack Obama’s health care website are forcing the administration to extend a federal insurance plan for some of the sickest patients by a month. The Pre-Existing Condition Insurance Plan was supposed to disappear Jan. 1, because starting next year insurers will no longer be able to turn away patients with health issues. The administration said Thursday the extension is meant to smooth the transition to new coverage, easing anxiety for tens of thousands of patients with serious illnesses such as heart disease and cancer (12/12).

The Wall Street Journal: Health Insurers Told To Ease Coverage Rules
The government on Thursday announced steps to stave off unpleasant surprises for Americans when the health-overhaul law fully kicks in Jan. 1, including measures to ensure continuous care for people with serious medical conditions. The moves include a one-month extension of a federal insurance program for certain chronically ill people. The Obama administration also asked insurers to take a flexible approach about their rules when patients refill prescriptions or see their existing doctor in the early days of the new year in case new health plans haven't kicked in (Radnofsky, 12/11).

USA Today: HHS Seeks Insurance Deadline Extension
The government asked insurers to grant people extra time to buy health insurance to gain coverage by Jan. 1. "There's still ample time for folks to research their options, talk things over with their families and select a plan," Health and Human Services Secretary Kathleen Sebelius said Thursday. People may sign up until Dec. 23 for Jan. 1 coverage. "We're recommending that insurers extend this deadline further," she said (Kennedy, 12/12). 

Politico: Another Obamacare Extension
The Obama administration moved Thursday to protect some of the sickest patients in the country from the possibility that they would lose health insurance on New Year’s Day. Medically needy patients enrolled in temporary high-risk pools now have an extra month to sign up for new coverage because of early enrollment struggles in Obamacare nationwide, the Centers for Medicare & Medicaid Services announced. The extension seems to be the Obama administration’s first tacit acknowledgement that it can’t guarantee that everybody who wants to obtain coverage starting Jan. 1 will be able to do so (Millman, 12/12). 

Los Angeles Time: California’s Health Exchange Enrolls 159,000 But Few Latinos Turn Out
California's insurance exchange said 159,000 people have enrolled in private health plans through early December, but very few Latinos are signing up. In figures released Thursday, the Covered California exchange also said 179,000 people appear likely to qualify for an expansion of Medi-Cal, the state's Medicaid program for the poor (Terhune, 12/12). 

Los Angeles Times: Many Who Enrolled In Health Plans Still Await Confirmation
Thousands of Californians have overcome long waits and website glitches to sign up for Obamacare insurance, but now enrollment snags may prevent some of them from actually having coverage starting Jan. 1. Some people who picked a health plan as far back as October through the Covered California exchange say insurers are telling them they still have no record of their enrollment. As a result, bills haven't gone out and consumers can't pay their initial premium to ensure coverage takes effect in less than three weeks (Terhune, 12/12). 

USA Today: Insurance Files From Feds Not Quite There Yet
The mixed news comes as insurers, regulators and consumers rush to meet a Dec. 23 deadline for people to sign up for insurance on the federal site if they want policies that take effect Jan. 1. The Department of Health and Human Services said today that it is encouraging insurers to allow consumers to pay premiums late, to cover prescriptions filled after plans expire and to let people with urgent health needs use doctors who may not be on their new health plan during the transition to new plans. Aetna said it would give people until Jan. 8 to send premiums (O’Donnell, 12/12). 

NPR: A Rush To Reconcile Health Enrollment Data, By Hand
With just a few weeks left before a deadline to get health coverage, lingering bugs lurk in the part of that you can't see. And since time is running out to get things right, health officials on Thursday urged insurance companies to cover some enrollees even if their premium checks haven't come in. Under the law's guidelines, consumers have to sign up for a health insurance exchange — and pay their first month's premium — by the end of December if they want coverage in January (Hu, 12/12).

The Wall Street Journal’s Washington Wire: Health Insurers Feel Obama Administration’s Love
The Obama administration has been known to bash health insurers from time to time, but now that it really needs their help, it wants them to feel the love. A top official behind the website offered his praise for insurers at a conference of industry executives in Washington Thursday. “Let me thank you again for all the work you are doing,” said Gary Cohen, director of a unit at the Centers for Medicare and Medicaid Services that is implementing the health-care overhaul. “This is an extraordinary model of a public-private partnership” (Radnofsky, 12/12). 

The Washington Post: Politifact Awards 'Lie Of The Year' To Obama
The fact-checking Web site Politifact has named President Obama's claim that people could keep their health insurance plans if they liked them its "Lie of the Year." Obama in recent years has repeated some variation of the following phrase: "If you like your health-care plan, you can keep it." The problem was, it wasn't true, as millions of Americans with health plans that didn't meet Obamacare's standards got cancellation notice (Blake, 12/12).

The Associated Press/Washington Post: Celebrities And Word-Of-Mouth Push Health Law
bass-heavy music pounds, an actor impersonating President Barack Obama dances, mugs for the camera and raps about the health care overhaul, “So tell a friend or a random guy, I’ve got a game-changer right here that saves lives.” The online video, launched Thursday, is part of a national campaign that entwines Hollywood and social media to encourage Americans, especially young adults, to sign up for insurance coverage (12/13). 

Los Angeles Times: Celebrities And Social Media Promote Healthcare Enrollment
It was just last week when officials at the state's health insurance exchange, Covered California, gave the green light to Obama impersonator Iman Crosson to come up with a rap song to sell young people on the virtues of Obamacare. The turnaround was going to be quick (Reston, 12/12). 

The Washington Post: Md.'s Troubled Health Exchange Prompts Groups To Warn Uninsured About Jan. Coverage
Problems with Maryland’s online insurance exchange, including with paper applications that were supposed to provide a fail-safe backup plan, are so severe that community groups have begun warning uninsured clients that they may not obtain coverage as intended by Jan. 1. State officials began this week to contact all people whose applications are still pending, urging them to contact the state call center, try the state Web site again or get in touch with a certified insurance broker for help (Sun, 12/12).

The Associated Press/Washington Post: O'Malley Confident Health Exchange Will Meet Goal
Despite a rocky start with health care reform, Gov. Martin O’Malley said Thursday he is still aiming to meet the goal of enrolling 260,000 people in private insurance and Medicaid through the state’s health care exchange by the end of March. O’Malley, outlining how the state is addressing challenges to enrolling people, said most of the problems with the exchange’s website have been addressed. He said a computer glitch relating to tax credits should be fixed this week. A more stubborn problem involves screens freezing, and O’Malley says progress has been made diagnosing the matter (12/12). 

The Washington Post: O’Malley Says Md. Closer To Fixing Remaining Major Problems With Health Exchange
Gov. Martin O’Malley (D) acknowledged Thursday that Maryland’s online health insurance exchange had "a very rocky launch" but provided a largely positive prognosis for fixing the remaining glitches and boosting enrollment in coming months. "The bottom line is more people are getting though the site from end to end," O’Malley told reporters during an afternoon briefing (Wagner, 12/12).

The Washington Post: Iowa's GOP Governor Expands Medicaid Program Thursday
The White House welcomed the news Thursday night that Iowa’s Republican Gov. Terry Branstad agreed to expand his state’s Medicaid program under the administration’s health-care law. Under a compromise with the Department of Health and Human Services, the state will be allowed to charge premiums to people who earn between 100 percent and 133 percent of the federal poverty line, to pay a modest premium for health coverage (Eilperin, 12/12). 

The Washington Post: House GOP Conservatives Help Propel Budget Bill
After a sweeping vote by conservative Republicans controlling the House and President Barack Obama’s Democratic allies, a bipartisan budget pact is in the hands of the Senate, where it will encounter stronger but probably futile resistance from Republicans. … The measure would bring a temporary cease-fire to the budget wars that have gridlocked Washington for much of the three years since Republicans reclaimed control of the House. It leaves in place the bulk of $1 trillion or so in automatic cuts slamming the Pentagon, domestic agencies and Medicare providers through 2021 but eases an especially harsh set of cuts for 2014 and 2015 (12/12).

Los Angeles Times: Budget Deal Rolls Through House
The House overwhelmingly approved a budget deal Thursday designed to avert another government shutdown, a rare bipartisan accord that breaks with the tea-party-driven cycle of brinkmanship and could signal a new era of political pragmatism in Congress. … At the last minute, Republicans tacked on a provision to prevent a scheduled cut in pay for doctors who treat Medicare patients. Many Republicans have decided their efforts should be directed elsewhere — namely, fighting President Obama's healthcare law — rather than revisiting the budget wars that have defined the last several years (Mascaro, 12/12).

The Wall Street Journal: House Passes Budget Agreement In 332-94 Vote
The House passed the bill just before adjourning for the year, trying to wrap up a hodgepodge of year-end issues. It passed a one-month extension of farm programs, to allow more time for lawmakers to conclude House-Senate negotiations on a broader rewrite of farm policy. The budget bill also included a three-month extension of current Medicare doctors' payments, which were slated to be cut by more than 20% at year's end. There is no guarantee that the bipartisan deal signals the end of brinkmanship or that this episode of bipartisanship will reach into other areas. The most immediate test will be the next month's work on appropriations legislation, which must be enacted before Jan. 15 (Hook, 12/13). 

The Wall Street Journal: House, Senate Committees Approve 'Doc Fix' Legislation
House and Senate panels approved legislation Thursday to overhaul how Medicare doctors are paid, although action by the full House and Senate on the bill won't happen until next year. The House Ways and Means committee unanimously approved legislation that would end the way doctors are reimbursed by Medicare and replace it with a system that would reward doctors who meet quality standards. The Senate Finance Committee overwhelmingly approved similar legislation (Schatz, 12/12). 

The Wall Street Journal’s Washington Wire: Rep. Tim Murphy Introduces Mental-Health Legislation
Rep. Tim Murphy (R., Pa.), the chairman of the House Energy and Commerce subcommittee on Oversight and Investigation, introduced a wide-ranging mental health care bill that would change the way mental illness is treated. The “Helping Families in Mental Health Crisis Act of 2013” is the result of a nearly year-long examination of the nation’s mental health care system by the Pennsylvania psychologist and the subcommittee in the aftermath of last year’s school shooting in Connecticut. The man identified as the shooter, Adam Lanza, killed 20 elementary school students and six adults before killing himself last December (Fields, 12/12). 

Politico: HHS To Darrell Issa: We Don't Trust You
The Health and Human Services Department told House Oversight and Government Reform Committee Chairman Darrell Issa that it won’t turn over documents related to the security of the website because it can’t trust him to keep secret information that could give hackers a roadmap to wreak havoc on the system. Issa has issued a subpoena to MITRE, a government contractor, to turn over unredacted copies of security-testing documents by noon Friday. At issue are website development plans MITRE drafted for the Centers for Medicare and Medicaid Services, which is under HHS. Already, Issa has been given access to the documents he seeks “in camera” — meaning committee staff were able to review them in a room but not keep them — but he is seeking physical copies (Allen, 12/12). 

The Texas Tribune/New York Times: Claims Drop Under State-Run Women’s Health Program in Texas
To stop Planned Parenthood clinics from receiving public financing, Texas’ Republican leaders gambled that the state could operate a contraception and cancer-screening program for low-income women without tens of millions of federal dollars. But with the exclusion of about 40 Planned Parenthood clinics — none of which performed abortions — from the Texas Women’s Health Program in 2013, records showed that claims for birth control and wellness exams dropped, as did enrollment numbers (Aaronson, 12/12).

Los Angeles Times: Doctor Pleads Guilty To Fraud Scheme With Homeless 'Patients'
A doctor who conducted unnecessary procedures on mostly homeless patients and billed Medicare and Medi-Cal pleaded guilty Thursday to filing a false tax return and participating in the $1.55-million scheme, authorities said. From 2008 to 2012, Dr. Ovid Mercene, 61, admitted patients, most of them homeless, to a Los Angeles-area hospital for treatment they did not need with the purpose of defrauding taxpayer-funded health programs, according to the U.S. Attorney's office (Barragan, 12/12). 

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