KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

First Edition: April 18, 2014

Today's headlines include reports and analysis about President Barack Obama's announcement that health law sign-ups hit the 8 million mark.  

Kaiser Health News: Obama Sharply Criticizes Republicans As He Announces 8 Million Have Enrolled
Kaiser Health News staff writers Phil Galewitz and Daniela Hernandez report: “Enrollment in private health insurance on federal and state marketplaces has surged in recent weeks and now totals 8 million, a feisty President Barack Obama said Thursday. … The actual number of people affected is 5.7 million, the administration said. Republican leaders in Florida, Texas and other states argue that even though the federal government is paying the full cost of expansion through 2016, costs in later years would still be too high a burden. They also say they don’t trust Congress to abide by the law and maintain full federal funding. Administration data show 3.8 million people signed up for private plans in the past six weeks --- compared to 4.2 million in the first five months after enrollment began Oct. 1. Enrollment ended March 31, though people who had trouble signing up generally had until April 15 to sign up in the 36 states relying on the federal marketplace” (Galewitz and Hernandez, 4/17). Read the story.

Kaiser Health News: A Reader Asks: How Do We Prove We Have Insurance?
Kaiser Health News consumer columnist Michelle Andrews answers this reader’s question (Andrews, 4/18). Read her response.

Kaiser Health News: Obama Announces 8 Million Have Enrolled In Marketplace Plans (Video)
Kaiser Health News posted this video of Thursday’s White House news conference on enrollment figures. President Barack Obama also announced that 35 percent of people who enrolled on the federally run healthcare.gov marketplace are under age 35 (4/17). Watch it or read the transcript.

Kaiser Health News: Capsules: Biggest Insurer Shocked With Hepatitis C Costs; Incomplete Face-To-Face Doctor Exams Put Home Health Agencies In Tight Spot
Now on Kaiser Health News’ blog, Jay Hancock reports on UnitedHealth Group’s first quarter results: “UnitedHealth Group spent $100 million on hepatitis C drugs in the first three months of the year, much more than expected, the company said Thursday. The news helped drive down the biggest insurance company’s stock and underscores the challenge for all health care payers in covering Sovaldi, an expensive new pill for hepatitis C” (Hancock, 4/17). 

Also on the blog, Lisa Gillespie reports on an OIG report about Medicare’s face-to-face encounter rule: “The cost of caring for homebound patients is rising, and the government is trying to get a better grip on spending by requiring doctors to certify — with face to face examinations — Medicare beneficiaries’ eligibility for home health services, including intermittent skilled nursing care, physical therapy, speech therapy and part-time home health aide services. The OIG estimated that $2 billion in inappropriate payments were made in 2011 and 2012 because of inadequate compliance with the rule” (Gillespie, 4/18). Check out what else is on the blog.

The New York Times: Enrollments Exceed Obama’s Target For Health Care Act
President Obama announced Thursday that eight million people have signed up for health insurance under the Affordable Care Act, including what the White House said were a sufficient number of young, healthy adults, a critical milestone that might counter election-year attacks by Republicans on the law’s success and viability. The total number of enrollees exceeds by a million the target set by the administration for people to buy insurance through government-run health care exchanges. In particular, the number of young people signing up appears to have surged during the final weeks of enrollment (Landler and Shear, 4/17).

The Washington Post: Obama Hails 8 Million Enrollees For Insurance Under Federal Health-Care Law
Speaking at an impromptu news conference, the president described how the law has helped make a difference for ordinary citizens such as a young woman in Pennsylvania with a self-employed husband and two young children who managed to get insurance despite being diagnosed with breast cancer. … Armed with those enrollment numbers, Obama challenged the political dynamic that has grown up around the law and that has unnerved some members of his party. Problems with the law have become a central theme in the Republicans’ efforts to wrest control of the Senate this fall (Eilperin and Nakamura, 4/17).

NPR: Obama: Affordable Care Act Enrollment Hits 8 Million
The latest figures represent a turnaround from the disastrous debut of the HealthCare.gov website last year. The president said it was "well past time" for Republicans to quit trying to repeal the program, something he said they have voted on "some 50 times" (Neuman, 4/17).

Los Angeles Times: Obamacare Enrollments Hit 8 Million
The total exceeded the initial forecast by 1 million people and capped a notable comeback after a disastrous debut last fall gave rise to predictions the law would collapse in its maiden year. The health law, often called Obamacare, instead has brought about the largest increase in insurance coverage in the United States in the half a century since Medicare and Medicaid were created (Levey and Terhune, 4/17).

The Associated Press: Obama: 8 Million Have Signed Up For Health Care
The enrollment figure, revised upward from the 7.5 million signups that the administration had announced earlier this month, renewed hopes at the White House that Democrats will be able to overcome the initial rocky rollout of the health law in the fall as they battle to maintain control of the Senate in the midterms this fall. … Republicans, who have fought the law since it was passed by a sharply divided Congress in 2010, escalated their call for the law to be repealed after the problems with the enrollment Web site, which repeatedly broke down in its first few months. Obama's job approval ratings dropped, and Democrats worried that the bad headlines would harm the party at the ballot box (4/17).

The Wall Street Journal: Obama Says Health-Insurance Enrollees Reach 8 Million
Some 35% of those who signed up through the federal health-insurance exchange were in the coveted under-35 demographic, Mr. Obama said. The participation of younger, relatively healthy people is needed to balance out the cost of medical claims from older and sicker ones. The announcement contained few other new details about enrollment. Republicans quickly pointed to missing information—such as the number of people who had actually gained coverage after being uninsured, as opposed to those replacing an existing policy—to suggest the figures could be overblown as a measure of success (Radnofsky and McCain Nelson, 4/17).

USA Today: Obama On Health Law: ‘This Thing Is Working’
Opponents of the law say they're still waiting to hear how many people pay for their policies, if enough healthy people have enrolled to make the exchanges financially workable in the future and how many of the enrollees use a month's worth of benefits to cover medical procedures they couldn't afford before but then discontinue paying for their insurance. Obama spoke shortly after meeting with a group of state insurance commissioners, some of whom reported that the president cited a rush of young people — under age 35 — signing up late (Jackson and Kennedy, 4/17).

Politico: Obama Spikes The Football
But the final enrollment numbers, along with other recent survey findings, are strong enough to give the Obama administration a cushion against some of the most common criticisms of the enrollment trends. Here are the takeaways from Thursday’s announcement (Nather, 4/17).

The Washington Post’s Wonkblog: Here’s How We Got To 8 Million Obamacare Signups
If you tuned into President Obama's news conference Thursday afternoon, you heard him say that 35 percent of people who signed up for exchange plans were under 35. That's true, but there's a number that matters much more to the success of the new insurance markets: how many enrollees are between 18 and 34 years old. In the end, young adults accounted for 28 percent of signups (Millman, 4/17).

The Associated Press: Late Sign-Ups Improve Outlook For Obama Health Law
A surge of eleventh-hour enrollments has improved the outlook for President Barack Obama’s health care law, with more people signing up overall and a much-needed spark of interest among young adults. … Still to be announced is what share of those enrolled were previously uninsured — the true test of Obama’s Affordable Care Act — and how many actually secured coverage by paying their first month’s premiums (4/18).

NPR: Following Enrollment Deadline, Health Care Focus Turns To States
President Obama met Thursday with insurance company executives and a separate group of insurance regulators from the states, discussing their mutual interest in administering the new health care law (Horsley, 4/17).

Los Angeles Times: Obamacare Enrollment Nears 1.4 Million In California Exchange
Covered California signed up more than 200,000 consumers for Obamacare coverage after extending its enrollment deadline by two weeks, bringing the statewide total to nearly 1.4 million people. The health insurance exchange gave people until Tuesday to finish enrolling after the state website faltered at the end of March from a crush of last-minute applicants (Terhune, 4/17).

The New York Times: Health Law Bellwether, UnitedHealth Posts Lower Profit
The UnitedHealth Group, one of the nation’s largest health insurers, reported lower earnings on Thursday, attributing its weak results in part to the federal health care law. It said profits were also weighed down by an expensive new drug to treat hepatitis C that costs $1,000 a pill (Abelson, 4/17).

The Associated Press: UnitedHealth’s 1Q Profit Tumbles 8 Percent
UnitedHealth Group’s first-quarter net income slid 8 percent as funding cuts to a key product and costs imposed by the health care overhaul dented the health insurer’s performance. The Minnetonka, Minn., company said Thursday the overhaul and government budget cuts added about 35 cents per share in costs during the quarter (4/17).

The Wall Street Journal: UnitedHealth's Profit Falls Amid Health-Law Changes
UnitedHealth said the health law pushed down earnings by around 30 cents a share, including via taxes and cuts to government payments for Medicare Advantage, which is the private version of the federal benefit program. The company also said it lost around 90,000 customers from its business selling insurance to individual consumers, as it chose to play a very limited role in the law's public marketplaces where consumers shop for coverage. But the law also helped drive an increase of 255,000 people in UnitedHealth's Medicaid plans. … The company also highlighted more than $100 million in costs tied to hepatitis C treatment in the first quarter across its Medicaid, commercial and Medicare segments (Stynes and Mathews, 4/17).

The Washington Post’s Wonkblog: The Nation’s Largest Insurer Things Obamacare Exchanges Are Doing Just Fine
After taking a pretty cautious approach to the launch of the health insurance marketplaces in 2014, the nation’s largest insurer said it’s looking to expand its Obamacare footprint in 2015. UnitedHealth Group, which is participating in just five public exchanges this year, said it’s likely to join more insurance marketplaces in 2015 but didn't offer specifics (Millman, 4/17).

Politico: Obama Tells Democrats: Defend My Law
President Barack Obama has laid out the blueprint he thinks his party should follow on Obamacare as the midterms approach: “forcefully defend and be proud” of the law — and then move on, hitting Republicans for Washington dysfunction and inaction on the economy. The question now is whether Democrats will listen (Dovere and Budoff Brown, 4/18).

The Associated Press: President Defending Health Law Good For Some Dems
President Barack Obama’s full-throated defense of his health care overhaul seems perfectly timed for Democrats who want their party to embrace the law more enthusiastically. At a White House news conference Thursday, Obama noted that health insurance enrollments under the new law are higher than expected, and costs are lower. If Republicans carried out their pledge to repeal the law, he said, it “would increase the deficit, raise premiums for millions of Americans and take insurance away from millions more” (4/17).

The New York Times: Political Attack Ads, Often Negative, Try Instead To Accentuate The Positive
An ad by the group supporting Representative Steve Southerland II, Republican of Florida, focuses on his record of fighting President Obama’s health care law before it concludes, “Thank Steve Southerland for fighting to keep our health care decisions in our hands.” The shift is the product of several factors — the renewed hope that positive commercials can break through the advertising clutter; lessons of the 2012 presidential race, when Mitt Romney and outside Republican groups largely failed to offer an alternate message to an onslaught of negative spots; and the increasing prevalence of stock footage made public by campaigns that makes producing positive ads easier (Parker, 4/17).

The Wall Street Journal’s Washington Wire: N.C. Sen. Hagan’s First Ad Takes On GOP’s Thom Tillis
Democratic Sen. Kay Hagan’s re-election campaign launched its first ad of the cycle on Thursday, targeting remarks by leading GOP candidate Thom Tillis, the speaker of the North Carolina House, about the Affordable Care Act as well as his handling of a sex scandal involving staffers in 2012. The 60-second radio spot, which will air statewide, quotes Mr. Tillis calling the health care law “a great idea.” It also says that Mr. Tillis supported creating a state health exchange in North Carolina. The ad’s voice-over asks: “So Thom Tillis thinks he can attack Kay Hagan over something he called a great idea? Watch close. Seems Thom Tillis wants it both ways” (Ballhaus, 4/17).

The New York Times: Sebelius Says She’s Not Interested In Senate Run
Kathleen Sebelius, the soon-to-be former secretary of the Health and Human Services Department, said through a spokeswoman on Thursday that she was not interested in running for the Senate in Kansas, despite recent entreaties from Democrats (Peters, 4/17).

The Associated Press: Christian Broadcaster Wins Health Care Injunction
Christian radio broadcaster James Dobson has won a temporary injunction preventing the federal government from requiring his ministry to include the morning-after pill and other emergency contraception in its health insurance. A federal judge in Denver issued the injunction Thursday (4/17).

The New York Times: Cost Of Treatment May Influence Doctors
Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care. The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how health care dollars are spent (Pollack, 4/17). 

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