First Edition: September 29, 2014
Today's headlines include reports about the health law's continuing implementation and issues such as narrow networks.
Kaiser Health News: Scrambling To Prove He’s Eligible For Obamacare
Kaiser Health News staff writer Daniela Hernandez reports: “On Sept. 4 -- five months after the end of open enrollment -- Covered California sent out notices in English and Spanish to 98,000 families who bought plans on the exchange alerting them that their legal status could not be verified. As many as 50,000 households still remain unverified and must meet a Tuesday Sept. 30 deadline to prove that they are citizens or legal U.S. residents, or risk losing coverage. If deemed ineligible, the letters said, applicants could be liable to repay the tax credits they received, plus interest. By the time Mancinelli got his letter, he had only days to comply” (Hernandez, 9/29). Read the story, which also ran in the Los Angeles Daily News.
Kaiser Health News: Texas And Florida Expand Medicaid – For Kids
Kaiser Health News staff writer Phil Galewitz reports: “Republican lawmakers in Florida and Texas snubbed the Affordable Care Act’s Medicaid expansion for adults, but their states did broaden the program this year -- for school-age children. Those states were among 21 – including some big Democratic-led states, such as California -- that were required to widen Medicaid eligibility for children between the ages of 6 and 18 by 2014. That little-known provision of the health law is a key reason hundreds of thousands of kids gained coverage in the state-federal health insurance program for the poor, according to a Kaiser Health News survey of a dozen states” (Galewitz, 9/29). Read the story, which also ran in USA Today.
Kaiser Health News: Capsules: Calif. Governor Vetoes Bill To Protect Assets From Medi-Cal
Now on Kaiser Health News’ blog, Diane Webber and Pauline Bartolone write: “With the stroke of a pen, Gov. Jerry Brown rejected an effort to protect the estates of Medicaid beneficiaries in California, the San Jose Mercury News reported Friday. The bill, which the Democratic governor vetoed on Thursday, would have shielded the assets of people who receive Medicaid, known as Medi-Cal in California, from being recouped by the state after their deaths” (Webber and Bartolone, 9/26). Check out what else is on the blog.
The Wall Street Journal: Health-Law Coverage Expansion Gets Tougher
A nationwide effort to enroll consumers in health insurance under the Affordable Care Act is getting under way, and it is even more complicated than it was in the first year. Insurance companies, states and the Obama administration have two missions for the law's second major enrollment period. They want to draw millions of new, harder-to-attract enrollees to the law's insurance exchanges, while also ensuring that existing customers retain their health plans for 2015. Marketplaces are scheduled to open for enrollment Nov. 15 (Armour and Radnofsky, 9/28).
The New York Times: Costs Can Go Up Fast When E.R. Is In Network But The Doctors Are Not
But even the most basic visits with emergency room physicians and other doctors called in to consult are increasingly leaving patients with hefty bills: More and more, doctors who work in emergency rooms are private contractors who are out of network or do not accept any insurance plans (Rosenthal, 9/28).
Los Angeles Times: Obamacare Doctor Networks To Stay Limited In 2015
Finding a doctor who takes Obamacare coverage could be just as frustrating for Californians in 2015 as the health-law expansion enters its second year. The state's largest health insurers are sticking with their often-criticized narrow networks of doctors, and in some cases they are cutting the number of physicians even more, according to a Times analysis of company data. And the state's insurance exchange, Covered California, still has no comprehensive directory to help consumers match doctors with health plans. This comes as insurers prepare to enroll hundreds of thousands of new patients this fall and get 1.2 million Californians to renew their policies under the Affordable Care Act (Terhune, Poindexter and Smith 9/28).
The Washington Post: Should You Be Able To Choose Any Doctor You Want?
People don't like being told "no," especially when it comes to something as personal as their health care. They also don't like rising health-care costs. And therein lies the health-care system's existential debate about narrow networks. Narrow networks, which place greater limits on patients' choice of care providers, aren't new, but they're emerging as one of insurers' major levers for keeping down costs under the Affordable Care Act. ... In just a few weeks, voters in South Dakota will actually get to weigh in on this question, thanks to a ballot initiative that would require health plans in the state to include any provider that meets their standards and wants in (Millman, 9/26).
The New York Times: For Many New Medicaid Enrollees, Care Is Hard to Find, Report Says
Enrollment in Medicaid is surging as a result of the Affordable Care Act, but the Obama administration and state officials have done little to ensure that new beneficiaries have access to doctors after they get their Medicaid cards, federal investigators say in a new report. The report, to be issued this week by the inspector general at the Department of Health and Human Services, says state standards for access to care vary widely and are rarely enforced. As a result, it says, Medicaid patients often find that they must wait for months or travel long distances to see a doctor (Pear, 9/27).
The Associated Press: Hogan Calls For Wider Probe In Md. Health Exchange
Republican candidate for governor Larry Hogan called for a wider investigation of Maryland’s flawed health care exchange website on Thursday with a focus on political donations from companies and state contracts they received. Hogan said he asked state and federal officials in a letter Wednesday to expand on an audit already underway by the inspector general of the U.S. Department of Health and Human Services. His action served to underscore criticism of his opponent — Democratic Lt. Gov. Anthony Brown — in what has been an increasingly negative campaign for the governorship. Hogan said he sent letters to the Maryland U.S. attorney, the state prosecutor’s office and the state attorney general’s office (9/25).
The Associated Press/ABC: Poll: Confused By Issues Of The Day? Join The Club
People who vote regularly, follow news about November's election or simply feel a civic duty to stay informed are most likely to say that issues have become "much more complicated" over the past decade, an Associated Press-GfK poll shows. ... Nearly three-fourths of Americans find [the health care overhaul] difficult, according to the AP-GfK poll, and about 4 in 10 say it's very hard to understand. The law is complex; politicians even say so (Cass, 9/27).
The Associated Press: 5 Republican Goals If They Win The Senate Nov. 4
5. Appeal to conservatives by passing bills to repeal Obama's health care law and achieve other long-frustrated goals. Obama probably would veto such efforts, assuming they survive Democratic filibusters. But GOP lawmakers could argue they're doing all they can, and voters should elect a Republican president in 2016 to complete the work (9/28).
Los Angeles Times: Democratic Candidates Working Hard To Get Women To The Polls
Campaign messages can be tailored to those women and the issues they have been shown to care most about, including pay equity, child care, domestic violence, and access to healthcare, abortion and other reproductive rights (Merl, 9/28).
The Associated Press: It's Pryor V. Cotton V. Obama In Arkansas Race
In a Senate race as pivotal as any in the country, Arkansas Democratic Sen. Mark Pryor is running against Republican Rep. Tom Cotton, who is running against President Barack Obama. ... Cotton is one of the many Republicans to inject Obama forcefully into his campaign in a year the GOP is battling for control of the Senate. Yet the Democrats' multimillion-dollar program to turn out new, midterm election voters in key states will be tested in Arkansas as much as anywhere, ... Georgia Bowen, making calls at the Democratic phone bank in Little Rock, is an enthusiastic supporter of the health care law that Republicans first tagged — scathingly — with Obama's name. "When they're calling it 'Obamacare' they're trying to insert race into something where race doesn't belong," said the former teacher (Espo, 9/26).
The Associated Press: Braley And Ernst Clash In First Iowa Senate Debate
Braley and Ernst clashed on issues such as jobs, health care, environmental policies and abortion, but mainly stuck to established talking points. Both touted their records and sought to tie the other to special interest groups. … The two disagreed on health care. Braley said President Barack Obama’s health care overhaul, the Affordable Care Act, has provided health care to Iowa residents that need it. Ernst said the program should be repealed because it has taken “personal health care decisions out of our hands” (9/28).
The Wall Street Journal: Iowa GOP Candidate For Senate Adjusts Her Message
The dynamic generally has been different among Democrats, many of whom didn't face primaries this year and the demands of their party's activist base. Still, many Democrats are breaking from their party to oppose an immigration-law overhaul and demand changes to the Affordable Care Act and construction of the Keystone XL pipeline. In Iowa, which President Barack Obama won twice, the strategy appears to be working for Mrs. Ernst. She has absorbed months of attacks that she is too conservative for the state, yet held a six-point lead in a Des Moines Register poll released Saturday night, which put her ahead of Mr. Braley 44% to 38% (Williamson, 9/28).
Politico: Sen. Ted Cruz Captivates Values Voter Summit
The Values Voter conference offered an early glimpse of what’s sure to be a spirited battle for the allegiance of Christian conservatives in 2016. ... There were tea party activists in attendance at the summit, but the emphasis was less on small government and more on strict social conservatism. The event drew attendees who oppose same-sex marriage, abortion rights and marijuana legislation; ... Tony Perkins, who heads the Family Research Council and its lobbying arm — the latter is the main sponsor of the event — immediately pointed to Cruz when asked which speakers stood out (Glueck, 9/26).
The Washington Post: Ted Cruz: Democrats Are An 'Extreme, Radical Party'
Heading into a possible 2016 presidential run, Sen. Ted Cruz (R-Tex.) was already a favorite with that key GOP demographic. His performance Friday showed why. In a fiery speech that pulled the crowd to its feet, the first White House contender to take the stage spoke against abortion and same-sex marriage, ... “We’re 39 days from a pivotal election. If you want to defend the First Amendment and religious liberty, vote Harry Reid out,” he said, calling for the elimination of everything from Common Core standards to the Affordable Care Act (Payne, 9/26).
The Wall Street Journal: CVS Settles Medicaid Reimbursement Charges
CVS Health Corp. agreed to pay $6 million to settle allegations its pharmacy benefit manager failed to reimburse Medicaid for some prescription drug costs, the U.S. Department of Justice said Friday. Caremark, operated by pharmacy giant CVS, handles pharmacy benefits for a number of "dual eligible" individuals who receive prescription drug benefits under both a Caremark-administered plan and Medicaid. Under the law, the private insurer must assume the costs of health care for dual eligible (Dulaney, 9/26).
NPR: Will .Health Make It More Likely That You'll Get Scammed?
A new slew of web domains is coming down the pike, like ".health," ".doctor," and ".clinic." They're not required to have any medical credentials. That's deeply worrying to some public health advocates. "When [consumers] see .edu, they consider it an educational institution," says Tim Mackey, director of the Global Health Policy Institute at the University of California, San Diego School of Medicine. He worries that a consumer reading diet.health, for example, will follow its dietary recommendations, without knowing their validity (Bruzek, 9/26).
Check out all of Kaiser Health News' e-mail options including First Edition and Breaking News alerts on our Subscriptions page.
This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.