KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: July 7, 2014

Today's headlines include a range of stories related to the implementation of the health law, and the politics surrounding it.

Kaiser Health News: Capsules: Advocates Say California Is Rejecting ‘Free Money’ To Renew Poor People’s Insurance
Now on Kaiser Health News’ blog, Anna Gorman reports: “Consumer advocates and some legislators were surprised and frustrated when California health officials recently refused a $6 million donation to help people re-up their Medi-Cal health coverage. Now two senators have proposed an unusual solution: a bill to force the state to accept the offer from The California Endowment” (Gorman, 7/4). Check out what else is on the blog.

Politico: Obamacare’s Next Threat: A September Surprise
Obamacare open enrollment closed March 31. The White House’s Obamacare war room did not. Most state health insurance rates for 2015 are scheduled to be approved by early fall, and most are likely to rise, timing that couldn’t be worse for Democrats already on defense in the midterms. The White House and its allies know they’ve been beaten in every previous round of Obamacare messaging, never more devastatingly than in 2010. And they know the results this November could hinge in large part on whether that happens again (Dovere, 7/7).

Politico: Why Liberals Are Abandoning The Obamacare Employer Mandate
More and more liberal activists and policy experts who help shape Democratic thinking on health care have concluded that penalizing businesses if they don’t offer health insurance is an unnecessary element of the Affordable Care Act that may do more harm than good. Among them are experts at the Urban Institute and the Commonwealth Fund and prominent academics like legal scholar Tim Jost. ... Leading Democrats in Congress aren’t bolting from the employer mandate, at least not before the November election (Winfield Cunningham and Cheney, 7/6).

The Washington Post: Restaurant-Specific Insurance Exchange Debuts In D.C. 
As a former Matchbox employee married to a Graffiato bartender, Alisia Kleinmann knows a thing or two about the lack of health insurance in the restaurant industry. “My husband is 35 years old. We have two kids. He never had insurance,” said Kleinmann, president of the hospitality trade organization Industree. “I just kept thinking, something has to change. Something has to get better.” Last week Kleinmann, 33, rolled out Industree Exchange, a private insurance exchange geared at Washington-area restaurants and bars with more than 100 employees (Bhattarai, 7/6).

USA Today: Rise In Part-Time Workers Worries Some Experts
Among the few worrisome signs in Friday's generally encouraging employment report was a sharp rise in the number of part-time workers who prefer full-time jobs. The total jumped by 275,000 to 7.5 million, the Labor Department said. ... The Affordable Care Act, which requires firms with at least 50 employees to provide health insurance to those working at least 30 hours, also could be prompting some businesses to hire more part-time workers, [Jim O'Sullivan, chief U.S. economist of High Frequency Economics] (Davidson, 7/6).

The Wall Street Journal: Sign-Ups Not the Only Way To Gauge Health Law's Success
In April, after enrollment for Obamacare had closed, the president announced that 8 million people had signed up ... While sign-ups exceeded expectations, other measures are more important and, at this point, uncertain. For example, relatively few young people signed up. Significantly more females, who are pricier to insure, enrolled than males. And little is known about the overall health of the sign-up group, although early studies suggest they are older and sicker than other insured Americans. To keep up with enrollment projections, twice as many people must sign up next year (McGinty, 7/4).

The Washington Post: What Obamacare Means For Your Investment Portfolio
[The Affordable Care Act s] overhauling the business of health care — for hospitals and insurers, doctors and patients. For investors, that means tracking a new roster of winners and losers across the industry. The nearly $3 trillion industry, long considered a recession-proof holding for investors looking to play it safe, now also exhibits the kind of growth that appeals to investors looking for a hot new stock. Health-care spending in the U.S. accounts for a whopping 18 percent of GDP (Marte, 7/4).

USA Today/The Tennessean: Couple Splits Up To Stay Insured
The day Linda Drain put baby's breath in her hair and said "I do," she had no idea that government policies would tear her apart from her husband. But 33 years later, she and her husband, Larry Drain, separated so she could keep her health insurance. Six months into the full implementation of the Affordable Care Act, the Drains are among 162,000 Tennesseans who got caught in a coverage gap. Their household income is too little to qualify for a government subsidy to buy health insurance, and they live in a state not expanding Medicaid (Wilemon, 7/6).

The Associated Press: Judge To Mull Senator's Suit Over Health Exchanges
A federal judge will hear arguments this week on whether to toss a U.S. senator's lawsuit challenging rules that force congressional members and their staffs to obtain government-subsidized health insurance through small business exchanges. Republican Sen. Ron Johnson of Wisconsin contends that senators, representatives and their employees aren't eligible for the exchanges under the federal health care law because they work for a government that employs millions. Government attorneys have asked U.S. District Judge William Griesbach to throw the case out of court. They argue Johnson hasn't shown how the rules hurt him or his staff (Richmond, 7/6).

The Associated Press: Senate Democrats Try To Pull Focus From Obamacare
North Carolina Democratic Sen. Kay Hagan has her Republican opponent right where she wants him geographically — and, therefore, politically. Thom Tillis is stuck at the state capitol trying to resolve a budget quarrel as speaker of the North Carolina House. It's a spot that helps Hagan emphasize Tillis' role leading a Republican-controlled state government that Democrats contend has gone overboard with conservative zeal by restricting access to abortion and the voting booth while cutting corporate taxes and slashing spending on schools (Babington, 7/6).

The Wall Street Journal: House Centrists In Both Parties Are Under Attack
Rep. Collin Peterson plays in a rock band named the Second Amendments. His staff includes a former GOP state legislator. He voted against the Affordable Care Act, and he worked with House Speaker John Boehner (R., Ohio) to hash out part of this year's farm bill. For more than two decades, Mr. Peterson's conservative bent and focus on agricultural policy has helped him maintain his hold on the western Minnesota district he flies himself around in a Beechcraft Bonanza single-engine plane. But as one of just seven Democrats running for re-election in districts lost by President Barack Obama in 2012, he faces a new level of scrutiny this election cycle as he seeks his 13th term in the House. As the ranks of centrist lawmakers in both parties have thinned, political operatives' efforts to oust them have intensified (Peterson, 7/6).

The New York Times: The Health Care Waiting Game
One small consolation of our high-priced health care system — our $2.7 trillion collective medical bill — has been the notion that at least we get medical attention quickly. ... Yet there is emerging evidence that lengthy waits to get a doctor’s appointment have become the norm in many parts of American medicine, particularly for general doctors but also for specialists. And that includes patients with private insurance as well as those with Medicaid or Medicare (Rosenthal, 7/5).

NPR: For Many Americans, Stress Takes A Toll On Health And Family
Stress is part of the human condition, unavoidable and even necessary to a degree. But too much stress can be toxic – even disabling. And there's a lot of toxic stress out there. A national poll done by NPR with our partners at the Robert Wood Johnson Foundation and the Harvard School of Public Health finds that more than one in every four Americans say they had a great deal of stress in the previous month (Knox and Neighmond, 7/7). 

USA Today: Feds Push Electronic Records That Make Fraud Easier
The federal government is rewarding doctors and hospitals for moving to electronic health records — and will soon punish them if they don't — even though these records currently make it easier for health care providers to defraud government-paid health programs, fraud experts say (O’Donnell, 7/6).

The Wall Street Journal: House Attorneys Seek Dismissal Of SEC Suit
Lawyers for the U.S. House of Representatives asked a federal judge to reject a lawsuit the Securities and Exchange Commission filed against Congress in June, saying the suit amounts to "a remarkable fishing expedition for congressional records." The move late Friday is the latest in a power struggle between two branches of government in a possible insider-trading case (Ackerman, 7/4).

The New York Times: Obama Weighs Steps To Cover Contraception
The Obama administration, reeling from back-to-back blows from the Supreme Court this week, is weighing options that would provide contraceptive coverage to thousands of women who are about to lose it or never had it because of their employers’ religious objections. ... One proposal the White House is studying would put companies’ insurers or health plan administrators on the spot for contraceptive coverage, with details of reimbursement to be worked out later (Pear and Liptak, 7/4).

The Associated Press: Nonprofits’ Contraceptive Cases Next For Justices
How much distance from an immoral act is enough? That’s the difficult question behind the next legal dispute over religion, birth control and the health law that is likely to be resolved by the Supreme Court. The issue in more than four dozen lawsuits from faith-affiliated charities, colleges and hospitals that oppose some or all contraception as immoral is how far the Obama administration must go to accommodate them (7/6).

The Washington Post: High Court’s College Birth-Control Ruling May Further Outrage Democrats, Mobilize Them
Democrats have crafted much of their strategy in 2014 — a midterm year in which securing a House majority seems improbable and they may lose control of the Senate — around the imperative of turning out women voters, especially unmarried women. ... Within hours of the Hobby Lobby decision, progressive and left-leaning groups that focus on women’s issues, such as Planned Parenthood and EMILY’s List, were using it for midterm fundraising. On the right, the Hobby Lobby decision galvanized groups that saw it as an opportunity to file many more lawsuits such as Wheaton’s (Lowery, 7/4).

The Wall Street Journal: Christian School's Relief On Contraception Coverage Could Embolden Others
Thursday's order, which sets no legal precedent and applies only to Wheaton, allows the school to avoid covering birth control without filing a form with its insurer asserting religious objections to emergency contraception—which would trigger the third-party coverage. The order will expire once a federal appeals court rules in the school's case. Dozens of religious nonprofit schools, organizations and business owners have pursued legal challenges to the health care law's birth-control-coverage requirements. ... But entities could request arrangements like the one spelled out in the Wheaton injunction while their cases are pending in federal courts (Bravin, 7/4).

Kaiser Health News also tracked headlines over the weekend related to this development (7/4).

The Associated Press: Free Birth Control Is Emerging Standard For Women
More than half of privately insured women are getting free birth control under President Barack Obama's health law, a major coverage shift that's likely to advance. This week the Supreme Court allowed some employers with religious scruples to opt out, but most companies appear to be going in the opposite direction. Recent data from the IMS Institute document a sharp change during 2013. The share of privately insured women who got their birth control pills without a copayment jumped to 56 percent, from 14 percent in 2012. The law's requirement that most health plans cover birth control as prevention, at no additional cost to women, took full effect in 2013 (Alonso-Zaldivar, 7/6).

The Wall Street Journal: Illinois Supreme Court Rules Against Cuts In Retiree Health Benefits
A ruling by the Illinois Supreme Court Thursday is casting new doubts on an overhaul of the public employee retirement system that passed last year to prop up the state's deeply underfunded pensions. The court ruled health-insurance subsidies for retired state workers are protected under the Illinois Constitution, siding with public-sector unions who challenged cuts to the benefits passed by lawmakers two years ago. The decision set off renewed debate over the constitutionality of a larger overhaul of the retirement system, which passed last fall and is being challenged by state workers and retirees on similar grounds (Peters, 7/3).

Los Angeles Times: San Francisco Is Likely To Approve Laura’s Law Mental Health Program
Family members of those who have suffered multiple mental health crises and refuse help or fail to stick with it are begging for a Laura's Law program — which could court-order the intractably ill into outpatient treatment. Police officers and firefighters who see the same people cycle through hospitalizations and jail want it too. Then there are the mental health consumers who are well enough to speak of the trauma inflicted by coercive care. It doesn't work, they say. It drives people from treatment (Romney, 7/6).

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