First Edition: October 2, 2015
Today's early morning highlights from the major news organizations.
Kaiser Health News:
Newly Insured Treasure Medicaid, But Growing Pains Felt
The Affordable Care Act unleashed a building boom of community health centers across the country. At a cost of $11 billion, more than 950 health centers have opened and thousands have expanded or modernized. In San Diego, new clinics have popped up on school campuses and busy street corners. Cramped storefront clinics have been replaced with gleaming, three-story medical centers with family medicine, radiology and physical therapy on site. They are outfitted to care for new immigrants in dozens of languages from Spanish to Somali. (Varney, 10/2)
Kaiser Health News:
Hospital Care Unaffected By Quality Payments, GAO Finds
Medicare’s quality incentive program for hospitals, which provides bonuses and penalties based on performance, has not led to demonstrated improvements in its first three years, according to a federal report released Thursday. (Rau, 10/2)
Kaiser Health News:
Insurers Find Out-of-Network Bills As Much As 1,400 Percent Higher
It’s common knowledge that consumers have to pay more money if they choose doctors or hospitals outside of their insurance plan’s network. But a new analysis prepared by the insurance industry seeks to show just how much more in each of the 50 states. Out-of-network providers charged patients on average 300 percent more than the Medicare rate for certain treatments or procedures, according to the analysis of 2013 and 2014 claims data released Thursday by the America’s Health Insurance Plans. (Gorman, 10/1)
The Wall Street Journal:
Health Law’s Program To Ease Insurers’ Risks Has Shortfall
An Affordable Care Act program meant to ease risks for health insurers in the law’s new marketplaces will initially pay many companies less than they expected, likely putting financial strain on some. Federal authorities said that insurers will at first receive only about 12.6% of the money that they requested from the program, known as risk corridors, for 2014, its first year of operation. Insurers have requested approximately $2.87 billion in payments from the program based on their 2014 results. But the pool available to make those payments is just $362 million, which came from collections from other insurers that did relatively well on their marketplace business. (Wilde Mathews and Armour, 10/1)
The Washington Post:
Health Insurers To Receive A Fraction Of What They’re Owed Under ACA Program
Health insurers in the marketplaces created by the Affordable Care Act will be reimbursed this year only 13 percent of the money they are owed under a program designed to help cushion the burden of covering large numbers of people who need expensive medical treatment. ... A senior official with the Centers for Medicare and Medicaid Services said the agency would attempt to pay more of what it owes next year and, if necessary, the year after. But the official, briefing reporters on the condition of anonymity, acknowledged that the ability to fully pay hinges on Congress’s willingness to provide additional money. (Goldstein, 10/1)
The Associated Press:
Insurers Face Health Overhaul Losses For 2014
The insurance industry was disappointed at what its officials called a significant shortfall. "Stable, affordable coverage" depends on adequate funding of the program, said a statement from Marilyn Tavenner, CEO of America's Health Insurance Plans, the industry lobby. "It's essential that Congress and (the administration) act to ensure the program works as designed and consumers are protected." ... Despite the concerns of insurers, the Republican-led Congress is unlikely to allocate any additional money for the program, a temporary stabilization fund that lasts three years. (Alonso-Zaldivar, 10/1)
The Wall Street Journal:
Bill Waiving Insurance Rules For Midsize Businesses Clears Senate
A bill waiving the federal health law’s insurance rules for tens of thousands of midsize businesses cleared the Senate Thursday in a rare example of congressional agreement to undo part of the 2010 Affordable Care Act. The legislation had already passed the House, and the White House appears open to signing it. ... The Senate used a fast-track process that avoided an up-or-down vote on the measure, which would free companies with 51 to 100 workers from requirements on coverage standards and pricing. ... The issue is separate from another provision in the Affordable Care Act that requires businesses with 50 or more full-time workers to offer them coverage or pay a penalty. (Radnofsky, 10/1)
The New York Times:
Health Law Revision Is Approved
At issue is a provision of the health care law that expands the definition of a “small employer” to include companies with 51 to 100 employees, subjecting them to stringent insurance regulation starting Jan. 1. States have historically defined small employers as those with 50 or fewer employees. ... The bill, approved this week in the House and the Senate by voice vote, eliminates a provision of the law that would have imposed tough, potentially costly new requirements on businesses with 51 to 100 employees. (Pear, 10/1)
The Associated Press:
Congress Passes Bill Easing Small Business Health Law Rules
Under current law, companies considered small businesses must offer certain required benefits. Business groups complained that increasing the number of firms classified as small businesses would increase health care costs for many employers whose benefits today are less generous. (10/1)
The Wall Street Journal:
Foes Of Tax On ‘Cadillac’ Health Plans Gain, But Challenges Remain
There is more support than ever on Capitol Hill for rolling back the health law’s tax on high-cost employer health plans—notably from some Democrats usually opposed to paring back the law, as well as from many Republicans. But divisions among legislators still could stall efforts to tweak the tax or eliminate it completely. (Armour and Radnofsky, 10/1)
The Wall Street Journal:
Treasury’s Lew Says Congress Must Raise Debt Limit By Nov. 5
Rep. Mick Mulvaney (R., S.C.) said he had “encouraging conversations” with GOP colleagues over the past month on demanding changes to entitlement programs as part of any debt-ceiling package. “Spending for the sake of spending is going to be a real difficult vote,” he said. Still, it isn’t clear what such a package would look like, and several Senate Republicans who face close elections next year have resisted proposals for big changes to popular programs like Social Security and Medicare. (Timiraos and Peterson, 10/1)
The Associated Press:
Administration Backs High Court Review Of Contraception Case
The Obama administration is acknowledging that the Supreme Court should step into the latest battle over the president's health law. At issue are claims from faith-affiliated charities, colleges and hospitals that object to rules allowing them to opt out of covering contraceptives for women who are part of their health plans. (10/1)
USA Today/Detroit Free Press:
ACLU Sues Catholic Hospital System Over Abortion Policy
A federal lawsuit accuses a Catholic health system with 86 hospitals nationwide of “denying appropriate emergency care to women suffering pregnancy complications.” The American Civil Liberties Union and the American Civil Liberties Union of Michigan filed an amended complaint Friday against Trinity Health, headquartered in Livonia, in U.S. District Court in Detroit. (Anderson, 10/1)
The Wall Street Journal's Washington Wire:
Planned Parenthood Gets Lift From Prank Gifts
It’s the thought that counts. As the 2016 campaign has launched into high gear over the past few months, so has another season: that of prank giving. Planned Parenthood – which provides women’s health services, including abortions — has received over a thousand individual donations in the names of politicians who oppose abortion and have been calling for the defunding of the organization. Sen. Ted Cruz (R., Texas), former Hewlett Packard executive Carly Fiorina, former Florida Gov. Jeb Bush and former Arkansas Gov. Mike Huckabee are among some of the most popular honorees, according to Planned Parenthood. Mr. Cruz is far and away the most popular donor, at 442 donations to Ms. Fiorina’s 83, Mr. Huckabee’s 77 and Mr. Bush’s 70, the group says. (Court, 10/1)
The Associated Press:
Here They Come Again: Broader Health Care Debate For 2016
After seven years of the political drama known as "Obamacare," you might think voters would be tired of big ideas for revamping health care. If so, the presidential candidates seem to have missed the memo. The 2016 hopefuls in both parties are offering a full spectrum of options, from a system wholly run by the federal government to dialing back Washington's lead role. Much is promised by the candidates, but each approach has pitfalls. (Alonso-Zaldivar, 10/2)
The Washington Post:
Bernie Sanders Tells Latino Lawmakers: Undocumented Immigrants Should Benefit From Obamacare
Democratic presidential candidate Bernie Sanders supports allowing some of the nation's undocumented immigrants to obtain health-care coverage under the Affordable Care Act, he told Democratic lawmakers on Thursday. The Vermont senator, who is running a competitive race against Democratic presidential front-runner Hillary Rodham Clinton, made the comments during a 45-minute meeting with members of the Congressional Hispanic Caucus, according to attendees. (O'Keefe and Wagner, 10/1)
Politico:
Planned Parenthood Critics Have New Target — Universities
Officials of the nation’s leading universities have watched with dread as the fallout from the Planned Parenthood sting videos has threatened to engulf labs that depend on fetal tissue for research. Now the abortion wars are raging on their doorsteps as lawmakers in Wisconsin and Ohio try to ban such research and other states limit access to the tissue. More than three dozen of the universities, including Harvard, Yale and Johns Hopkins, have been drawn into the fight despite their traditional deep aversion to an issue that can divide faculties and donors and draw the ire of anti-abortion advocates nationwide. (Norman, 10/2)
The Washington Post's Fact Checker:
The Repeated, Misleading Claim That Planned Parenthood ‘Provides’ Mammograms
Readers asked us to fact-check Planned Parenthood supporters’ claims that the organization “provides” mammograms. Maloney’s statement above appeared to contradict comments by Planned Parenthood President Cecile Richards’s repeated claim at a Sept. 29 congressional hearing that the organization does not, in fact, offer mammograms or have mammogram machines in its clinics. (Lee, 10/2)
The Washington Post:
Congress To VA: $1.6 Billion Denver Hospital Will Be Funded … This Time
Despite a last minute fight over funding for the Department of Veterans Affairs vastly over budget hospital in Denver, Congress agreed to fund the rising sticker price of the $1.6 billion medical facility, thought to be one of the most expensive hospitals in the world. Throughout the week, tensions increased over whether Congress would fund the last $625 million needed to finish the complex, whose price tag has ballooned to nearly three times the $604 million the VA originally budgeted for. The project is widely known as “the biggest construction failure in VA history.” (Wax-Thibodeaux, 10/1)
Los Angeles Times:
Why Your Doctor Might Start Asking A Lot More Questions
Many residents of Los Angeles County might soon find they are getting more attention and questions from their doctors. That's because L.A. Care Health Plan -- a public health plan in L.A. County with more than 1.8 million members -- received a $15.8-million federal grant this week to help change the way physicians interact with patients and deliver care. (10/1)
Los Angeles Times:
As California Goes... But Will Nation Follow State's Lead On Healthcare For Immigrants?
Like many blue states, California enthusiastically embraced Obamacare, signing up millions for health insurance. Now, it's venturing into a potentially costly and controversial new frontier of health policy: offering medical coverage to hundreds of thousands people living in the country illegally. In a matter of months, the number of California counties committed to providing low-cost, government-run medical care to such residents jumped from 11 to 48. And in June, Gov. Jerry Brown signed a state budget that for the first time funds healthcare for such children. (Karlamangla, 10/2)
The Associated Press:
Report: $11 Million In Questionable Medicaid Payments
A long-delayed pilot study of Delaware’s Medicaid program has identified more than $11 million in possible waste, fraud and abuse. Officials said in releasing the report Thursday that they are recovering clearly erroneous payments and collecting more information on claims needing further review. (Chase, 10/1)