KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Overlooked Costs For Insurers; Medicaid Disparities; Dropping Doctors From Medicare Advantage

The Wall Street Journal's Washington Wire: How The Sequester Could Cost Obamacare Insurers
In a Think Tank post Thursday, I wrote about how insurers deciding to participate next year in the health exchanges established under Obamacare could be expecting funds that the federal government may not have legal authority to disburse. But that's not the only potential pitfall for carriers: They could also end up on the hook for payment reductions caused by sequestration (Chris Jacobs, 6/23). 

Philadelphia Daily News: Poor Bill Of Health
In one respect, the Affordable Care Act has also become a perfect controlled experiment: Almost exactly half the states have accepted a federal expansion of Medicaid as part of ACA, and the other half -- all ruled by Republicans -- haven't. ... Recently, the Robert Wood Johnson Foundation and Urban Institute studied this petri dish to measure the impact on expansion of Medicaid to the uninsured, by studying 14 big cities around the country, including Philadelphia. Seven of those cities are in states with expanded Medicaid and seven are in states without. While the outcomes of Medicaid expansion should shock no one, the disparity between those states that have expanded and those that haven't is disturbing (6/23).

Roanoke Times: McAuliffe And Medicaid: Beware The Precedent
Democrats may cheer [Gov. Terry McAuliffe's vow to bypass the legislature to expand Medicaid] now, but someday could rue the precedent if a future Republican governor can't get his way with the legislature. Two other governors confronted with legislative opposition have expanded Medicaid through executive action -- Democrat Steve Beshear in Kentucky and, curiously, Republican John Kasich in Ohio, who otherwise opposes Obamacare but bucked his own party because he thought Medicaid expansion was a better deal for Ohioans than the alternative. He explained it to talk show host Laura Ingraham this way last winter: "Conservatism means that you help people so they can help themselves and that they can enter into the economic strength of our country." Those, however, are different states with different laws and different constitutions (6/24).

The San Jose Mercury News: Health Care Challenge: Medi-Cal Insurance Doesn't Guarantee Access
Expanding Medi-Cal is one of the important ways the ACA increases access to health insurance, but providing insurance does not ensure health care will be available. It's important to understand the facts related to access to health care in our state. Thankfully, California is one of the states that committed to expanding government coverage for the poor and uninsured. At this time, the number of Californians served by Medi-Cal is increasing and approaching one-third of our population, or 10 million. Unfortunately, reimbursement rates for providers who serve the poor are declining drastically (Reymundo C. Espinoza, 6/23).

St. Louis Post-Dispatch: UnitedHealthCare Disadvantages Medicare Advantage
One of the major flaws in the Patient Protection and Affordable Care Act is also one of the reasons it was able to pass: It accommodated, and in some ways enhanced, the role of for-profit insurance companies. Last week, the Post-Dispatch’s Tara Kulash reported that thousands of Missouri seniors and hundreds of its doctors had learned that they'd be paying a high price for this accommodation. The patients are among the 95,000 Missourians who purchased a Medicare Advantage plan from UnitedHealthCare (2013 profits: $10 billion). ... The company, the nation's largest seller of Medicare Advantage plans, is reducing the number of doctors in its approved-provider network. It appears to be trying to steer patients into large hospital-affiliated physician groups, where there are economies of scale. By Sept. 1, eight months into the coverage year, patients will have to find new doctors. Had there been the political will to enact a single-payer national healthcare system, this sort of problem could have been avoided (6/24).

Tampa Bay Times: Florida Falling Short For Seniors
Florida has undermined its reputation as an attractive retirement destination for seniors by failing to provide enough resources for their long-term care. A new national study ranks Florida 43rd among 50 states and the District of Columbia in helping seniors live independently and stay out of nursing homes. As baby boomers get older, the need for long-term care services will increase exponentially, and the state is woefully unprepared to keep up with demand (6/20).

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