KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: January 6, 2014

Today's headlines include reports about how the health law fits into the Capitol Hill agenda for the year ahead.  

Kaiser Health News: Capsules: New Medicare Data Show Hospitals With High Rates Of Readmissions; Maryland Plan Offers Retroactive Coverage Due To Sign-up Problems
Now on Kaiser Health News’ blog, Jordan Rau reports on hospital readmission rates: "Medicare's new comprehensive measure of hospital readmissions shows that at least 20 percent of the hospitals in Illinois, Maryland, Massachusetts, New Jersey, New York and Rhode Island have higher rates of patients returning than the national average" (Rau, 1/6).

Also on the blog, Jay Hancock reports on steps by one Maryland health plan to sign people up for new coverage: "A consumer-owned cooperative started with federal loans, Evergreen runs four health centers in metro Baltimore and Greenbelt, near Washington, D.C. Since Oct. 1, the company has struggled with Maryland’s dysfunctional online insurance marketplace, Maryland Health Connection, which so far has enrolled 18,257 people in private health plans like the ones sold by Evergreen. The online exchange has gotten ‘mildly better,’ Beilenson said. But even after the New Year launch date of coverage under the health law Evergreen got 'significant numbers of calls — in the dozens of people — who have tried to go on the exchange for between a week and 10 weeks and have been frozen out,' he said. 'Now they're calling us out of desperation'" (Hancock, 1/5). Check out what else is on the blog.

Kaiser Health News also tracked weekend headlines, including how the health law debate rolled on during the Sunday talk shows (1/5), and how the Justice Dept. is defending the overhaul’s birth control mandate (1/5). 

The Washington Post: Defects Leave Many Americans Eligible For Medicaid, CHIP Without Coverage
More than 100,000 Americans who applied for insurance through and were told they are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) remain unenrolled because of lingering software defects in the federal online marketplace, according to federal and state health officials. To try to provide coverage to these people before they seek medical care, the Obama administration has launched a barrage of phone calls in recent days in 21 states, advising those who applied that the quickest route into the programs is to start over at their state’s Medicaid agency (Goldstein and Eilperin, 1/4).

The Associated Press: Skimpy Health Plans Leave Gaps
For working people making modest wages and struggling with high medical bills from chronic disease, President Barack Obama’s health care plan sounds like long-awaited relief. But the promise could go unfulfilled. It’s true that patients with cancer and difficult conditions such as multiple sclerosis or Crohn’s disease will be able to get insurance and financial help with monthly premiums. But their annual out-of-pocket costs could still be so high they’ll have trouble staying out of debt (Alonso-Zaldivar, 1/3).

The Wall Street Journal: U.S. Weighs Tech Fixes After Health-Site Woes 
The Obama administration, stung by the failures of the rollout, is considering loosening hiring rules for technology specialists and creating a new federal unit dedicated to big tech projects, officials said. ... The Centers for Medicare and Medicaid Services initially served as its own general contractor on the project, but its lack of technical expertise quickly became apparent. Only after the site's launch did the White House bring in experts from Silicon Valley as well as a new general contractor (Nagesh, 1/3).

The Washington Post’s The Fact Checker: The GOP Claim That More Americans Have Lost Insurance Than Gained It Under Obamacare
On its face, this claim by the Daily Caller is wrong because the law included a significant expansion of Medicaid, which in just three months has added 3.9 million people to its rolls. The article also incorrectly assumes that everyone whose plan did not meet Affordable Care Act standards but who did not sign up for a plan via the exchanges has been left without coverage. In reality, many people who received notices that their plans were canceled were told they would be automatically enrolled into another plan by the same insurance company (Kessler, 1/6).

FactCheck.Org/USA Today: Fact Check: Workers ‘Losing’ Employer Health Plans? 
Michigan Rep. Fred Upton exaggerated the impact of the Affordable Care Act when he claimed that "perhaps as many as 80 to 90 million Americans with employer-based health care are going to lose their plans" by late this year. Upton doesn't mean that those millions of Americans would no longer have health insurance through their employers. And these workers won't be receiving cancellation notices in the mail. Instead, he's talking about health plans losing grandfathered status, which means they are exempted from some requirements of the Affordable Care Act because they existed before the law was enacted (Robertson, 1/3).

NPR: Dental Coverage Deciphered, And The Latest On Sign-Up Deadlines
New Year's Day marked the halfway point to sign up for health insurance through the Affordable Care Act for coverage this year. And after a dismal start, things seem to be going a lot better on the website. Federal officials say more than 1 million people enrolled in coverage by the Christmas Eve deadline for coverage that began January 1. People have until March 31 to purchase a plan, or enroll in Medicaid if you're eligible. If you're uninsured after that, you may be subject to a tax penalty in 2015 (Rovner, 1/6).

Los Angeles Times: California Extends Payment Deadline For Obamacare Policies To Jan. 15 
Amid deepening consumer frustration, California's health exchange extended the payment deadline to Jan. 15 for insurance coverage starting Jan. 1 under the federal healthcare law. The state's move late Saturday comes as many enrollees continue to report problems getting an invoice from their insurance company or paying their first month's premium so coverage is retroactive to Jan. 1. Consumers say they have encountered website glitches trying to pay online and jammed phone lines when attempting to get help from their insurer or the Covered California exchange (Terhune, 1/4).

The Washington Post: Kentucky Republicans Aim To Reel In Governor's Power In Wake Of Obamacare Few governors have embraced the Affordable Care Act as openly and ambitiously as Kentucky’s Steve Beshear (D). Even though he faced a skeptical legislature, one chamber of which is controlled by Republicans, Beshear used his executive power both to expand Medicaid and to set up a state-run exchange. Now, top Kentucky Republicans want to rein in the governor’s power to issue new regulations, a move that could limit Beshear’s power during his final two years in office (Wilson, 1/3).

The Washington Post: O’Malley To Push Emergency Health Insurance Legislation
Maryland lawmakers are expected to pass legislation as soon as next week to assist the hundreds of people — or, possibly, thousands — who tried to sign up for health insurance through the state’s new exchange program, encountered problems and were left uncovered when the new year began. Gov. Martin O’Malley (D) and Lt. Gov. Anthony G. Brown (D) said Friday that they plan to introduce emergency legislation that would expand enrollment in the Maryland Health Insurance Plan, a separate state-run program that normally covers high-risk individuals. Those enrolled would have to pay a premium, which is determined by income but is often slightly higher than market rates, and would probably be allowed to stay on the plan for only a few months (Johnson and Davis, 1/3).

The New York Times: House G.O.P. Trims Agenda, Looking To Avert Election-Year Trouble
Expectations for the session are so low that lawmakers say early action on White House priorities like raising the minimum wage, restoring unemployment benefits that expired and overhauling immigration laws are likely to go nowhere. Instead, Congress is likely to focus on more prosaic tasks: finishing negotiations on a farm bill that has languished for two years, agreeing on a law authorizing water projects, passing a spending bill for the current fiscal year and raising the debt ceiling by March. Only then might lawmakers move on to modest, piecemeal immigration measures. The chances are “relatively low in terms of the probability that truly substantive legislation will be advanced through the House,” said Representative Scott Rigell, Republican of Virginia and a critic of Congress’s work pace. That is a stark departure from the last three years, each of which dawned with high expectations from Republicans for balancing the federal budget, shrinking government sharply and repealing President Obama’s health care law (Weisman, 1/5).

Los Angeles Times: Congress Looks Ahead To A Year Of Pre-Election Battles
For Republicans the focus will be a singular one: attacking President Obama's healthcare law. Their campaign aims to convince voters, especially sought-after independents, that the law's troubled launch proves Democrats cannot be trusted to run the government. "Obamacare, Obamacare, Obamacare," said Andrea Bozek, communications director for the House GOP's campaign arm. "That theme really works in the races — from the Northeast to the South to the Midwest to the West." Democrats will counter by trying to turn attention to pocketbook issues. They plan to begin Monday with a test vote in the Senate on a measure to extend unemployment insurance. About 1.3 million jobless Americans lost their benefits Dec. 28 because Congress declined to continue the federal aid (Mascaro, 1/5).

Politico: Pol To Sue OPM Over Obamacare
Sen. Ron Johnson plans to file a lawsuit Monday against the Office of Personnel Management over its policy permitting lawmakers and Hill staff to receive Obamacare subsidies for their health plans. The Wisconsin Republican and other opponents of the policy say that the OPM decision to allow the government to fund a portion of members’ and staffers’ health insurance is not authorized in the text of the Affordable Care Act (Haberkorn, 1/6).

The Washington Post: For Obama, A Full 2014 Agenda: Income Inequality, NSA Reforms, Health Care
With millions of Americans receiving health-care coverage under the Affordable Care Act, Obama will try to shift the public’s attention from the disastrous rollout of the Web site to the real-life benefits of the law. Obama plans to do some outside-the-Beltway travel in the weeks ahead to showcase successes, according to administration officials who spoke on the condition of anonymity to discuss the president’s plans (Rucker and Wilson, 1/4).

Politico: The Obamacare Fixer
Phil Schiliro’s work on Obamacare has come full circle. As President Barack Obama’s legislative director, Schiliro helped get the Affordable Care Act through Congress. Now, he’s back as the fixer. Even with the website now working, many Democrats have run out of patience with an administration that has failed to anticipate and address problems before they become political disasters. ... Shortly after his unexpected return last month, Schiliro met with more than a dozen Democratic senators to convince them the White House gets it (Budoff Brown and Allen, 1/3).

NPR: 22 States Curb Access To Abortion In 2013
While much national attention was focused on efforts to restrict abortion in Texas, a new study from the Guttmacher Institute reports that as many as 22 states enacted 70 provisions aimed at curbing access to abortion. That makes 2013 second only to 2011 in the number of abortion restrictions enacted in a single year, according to the think tank for reproductive rights. To put the recent trend in some perspective: The 205 abortion restrictions enacted between 2011 and 2013 were more than the 189 enacted during the entire previous decade (Rovner, 1/4).

The New York Times: Access to Abortion Falling As States Pass Restrictions
A three-year surge in anti-abortion measures in more than half the states has altered the landscape for abortion access, with supporters and opponents agreeing that the new restrictions are shutting some clinics, threatening others and making it far more difficult in many regions to obtain the procedure. Advocates for both sides are preparing for new political campaigns and court battles ... On Monday, in a clash that is likely to reach the Supreme Court, a federal appeals court in New Orleans will hear arguments on a Texas requirement that abortion doctors have admitting privileges at local hospitals — a measure that caused one-third of the state’s abortion clinics to close, at least temporarily (Eckholm, 1/3).

Politico: Administration Faces Tough Fight On Contraception Cases 
As a new round of religion-based challenges to President Barack Obama’s health care law head to the Supreme Court, advocates on both sides of the issue say the administration’s arguments are likely facing a chilly reception. On Friday, the Obama administration urged the court to reject a plea from an order of nuns who say a provision of Obamacare conflicts with their opposition to birth control. Already, the Supreme Court is preparing to hear two cases filed by private companies who say contraception provisions in the law violate their firms’ rights to religious freedom. Together, the cases could recreate a broad left-right coalition on the court that has emerged in the past decade to defend religious rights against alleged government intrusions (Gerstein, 1/4).

The Washington Post: Left Flank Upset With Va. Gov.-Elect McAuliffe Over Cabinet Appointments
Some of the activists who helped launch Terry McAuliffe to victory in November sound as though they’re not savoring the big win in the Virginia gubernatorial election as much as they are working through the stages of grief. “You just have to move on, accept it,” said Katherine Waddell, a Republican who backed McAuliffe (D) largely because of his support for abortion rights. “You believe in the governor and what he said. And you move on” (Vozzella and Weiner, 1/5). 

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