KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Final Word On Essential Health Benefits Expected Soon

CQ Healthbeat reports the Office of Management and Budget is reviewing several health law implementation rules including this one, which will determine the types of coverage available to consumers. Meanwhile, a study examines how the health law's caps on out-of-pocket costs will affect consumers next year.

CQ Healthbeat: Final Essential Health Benefits Rule Expected Out Soon
As Office of Management and Budget reviewers do the final check on three significant health rules, lobbyists are anxiously waiting to see whether these regulations will emerge changed, particularly a proposal that outlines the essential health benefits that plans must offer in 2014. Any revisions to the essential health benefit requirements, which were proposed on Nov. 26, 2012, could made a significant difference in the breadth of coverage and affordability of insurance for consumers (Adams, 2/11).

Kaiser Health News: Capsules: Study: One-Third Of Individual Plans Exceed Law's Out-Of-Pocket Cap
Consumers who buy their own health insurance will see the total amount they could pay out of pocket for medical care capped starting next year, but some will likely pay higher premiums as a result (Appleby, 2/11).

Also in the news, reports from the states on Medicaid expansion and health exchanges --

The Associated Press: Fla. Senators To Discuss Medicaid Expansion
Health advocates and hospital executives warned Florida lawmakers on Monday that if they do not expand Medicaid, it will create a coverage gap for those who earn too little to qualify for tax credits to buy insurance from the online exchange but too much to qualify for Medicaid. The decision would also keep Florida from receiving billions of federal dollars to help pay for those health costs while heaping greater burdens on hospitals treating the uninsured (Kennedy, 2/11).

The Associated Press: Medicaid, Exchange Answers Elude W. Va. Lawmakers
Gov. Earl Ray Tomblin has yet to decide whether to open the Medicaid program to more lower-income residents, or how individuals and small businesses will seek coverage through the federal health care overhaul, administration officials told legislators Monday. Several lawmakers questioned whether the Legislature should instead take the lead after seeking updates from Nancy Atkins, head of the agency that oversees Medicaid, and Jeremiah Samples, who's become in the in-house expert on the federal law for the state Insurance Commission (2/12).

The Associated Press: Minnesota House Approves Medicaid Expansion
More than 35,000 low-income Minnesota residents moved closer Monday to becoming eligible for a subsidized health insurance program, part of a state buy-in to the controversial new federal health care law. The Democratic-led state House voted 71-56 to approve an expansion of the state's Medical Assistance program and take advantage of a federal promise to send billions to cover the full cost of the new enrollees for a few years (Bakst, 2/11).

The Associated Press: Doctors, Nurses Ask NC Lawmakers To Grow Medicaid
Several physicians and nurses said Monday the North Carolina General Assembly's choice to cover more uninsured people through Medicaid should be a no-brainer because it will create jobs, save state money and make people healthier. The medical professional spoke at a Legislative Building news conference a day before a House committee takes up a bill to prevent North Carolina from expanding Medicaid under the federal health care overhaul (Robertson, 2/11).

The Texas Tribune: Dallas County To Urge Lawmakers To Expand Medicaid
Dallas County officials will adopt a resolution on Tuesday urging Texas legislators to extend Medicaid benefits to impoverished adults under the Affordable Care Act. And advocates for Medicaid expansion hope the major urban county's decision will spur other counties to adopt similar measures and pressure lawmakers into taking action (Aaronson, 2/12).

And Virginia reduces the hours of part-time workers to avoid triggering a provision of the health law requiring coverage --

The Associated Press: Virginia Struggles With Federal Health Insurance Requirement Regarding Part-Time Workers
State agencies are reducing part-time employees’ hours until officials figure out how to comply with federal health insurance requirements regarding those who work more than 30 hours each week. Gov. Bob McDonnell ordered agencies to cut back part-time employees to no more than 29 hours each week to avoid triggering a provision in the Affordable Care Act that requires health insurance coverage be provided to those who work more hours (2/11). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.