KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

First Edition: January 14, 2014

Today's headlines include reports about the health insurance enrollment numbers released by the Obama administration. 

Kaiser Health News: Some Medical Schools Shaving Off A Year Of Training
Reporting for Kaiser Health News, in collaboration with The Washington Post, Sandra G. Boodman writes: "For Travis Hill, it was an offer too good to refuse. Last year when the 30-year-old neuroscientist was admitted to a new program at New York University that would allow him to complete medical school in only three years and guarantee him a spot in its neurosurgery residency, he seized it. Not only would Hill save about $70,000 -- the cost of tuition and living expenses for the fourth year of medical school -- he would also shave a year off the training that will consume the next decade of his life" (Boodman, 1/14). Read the story.

Kaiser Health News: Insuring Your Health: Health Law Adds Coverage For Services Needed By People With Developmental Disabilities
Kaiser Health News consumer columnist Michelle Andrews writes: "A little remarked upon requirement in the health law expands treatments for people with cerebral palsy, autism and other developmental disabilities. But some advocates and policy experts are concerned that insurers may find ways to sidestep the new requirement. The health law requires that individual and small group plans sold on or off the health insurance marketplaces cover 10 essential health benefits, including 'rehabilitative and habilitative services and devices'" (Andrews, 1/14). Read the column

Kaiser Health News: Emergency Rooms Are Front Line For Enrolling New Obamacare Customers
Kaiser Health News staff writer Sarah Varney, working in collaboration with NPR, reports: "Angela Felan is sitting in the emergency department waiting room at O’Connor Hospital for the second time in a week. A blue surgical mask covers her nose and mouth, and her hoodie sweatshirt is pulled snug over her head. She first came into the emergency room a few days ago with what she thought was bronchitis. The doctor prescribed an inhaler that cost her $56. She works part-time in retail and hasn’t had insurance for at least a decade because she can't afford it" (Varney, 1/14). Read the story.

Kaiser Health News: Nearly A Quarter Of Health Marketplace Enrollees Are Young Adults
Kaiser Health News staff writer Phil Galewitz reports: "Nearly a quarter of the 2.2 million people who have enrolled in health coverage in the health law's insurance marketplaces are young adults — the population that's hardest to reach and yet most vital for the financial stability of the new exchanges, the Obama administration announced Monday" (Galewitz, 1/13). Read the story

Kaiser Health News: Capsules: New York Consumers Frustrated By Insurance Delays
Now on Kaiser Health News’ blog, WNYC’s Fred Mogul, working in partnership with KHN and NPR, reports: "Last weekend, Rob Cuillo had a severe stomach bug, and he began thinking it might be time for a trip to the emergency room near his home on Long Island. … But then he remembered he hadn’t received his insurance card from Empire Blue Cross. He had enrolled in the plan through the New York State of Health, the state exchange for purchasing coverage under the Affordable Care Act" (Mogul, 1/14). Check out what else is on the blog.

The New York Times: Older Pool of Health Care Enrollees Stirs Fears on Costs
People signing up for health insurance through the Affordable Care Act’s federal and state marketplaces tend to be older and potentially less healthy, officials said Monday, a demographic mix that could threaten the law’s economic underpinnings and cause premiums to rise in the future if the pattern persists (Shear and Pear, 1/13). 

Los Angeles Times: More Than 2.1 Million Sign Up For Obamacare Health Coverage
More than 2.1 million Americans signed up for health insurance in the last three months of 2013 through new online marketplaces created by President Obama's healthcare law as a December surge in enrollment helped the initiative recover from its disastrous launch. But the enrollment numbers — released in a government report Monday — lagged behind the Obama administration's target of 3.3 million sign-ups by the end of December (Levey, 1/14). 

The Washington Post: Health-Insurance Sign-Ups By Young Adults Are Off Pace Seen As Key To New Law’s Success
Young adults account for slightly less than one-fourth of the Americans who signed up for health plans during the initial three months of federal and state insurance marketplaces — fewer so far than the government has said will be needed to make the economics of the new exchanges work. The figures, part of a monthly progress report on the marketplaces that was issued Monday, offer the first glimpse into whether the health plans available under the Affordable Care Act are becoming provinces of the old and sick or are managing to attract young, healthy people who have not previously considered insurance worthwhile (Goldstein and Somashkehar, 1/13). 

The Wall Street Journal: Health Sign-Ups Skew Older, Raising Fears Over Costs
One-third of health plan enrollees in new insurance marketplaces are 55 or older, the Obama administration said Monday, a figure that insurers said makes the pool older than they would need to sustain their coverage at current premiums. Administration officials said they are pushing to enroll more young people before a March 31 deadline for most people to get coverage for this year, and some cushions built into the law mean it won't necessarily face trouble right away even if the 2014 pool of enrollees skews older (Radnofsky and Weaver, 1/13).

USA Today: Most Insurance Enrollees Older Than 45, Records Show
More than half of the almost 2.2 million people who bought health insurance on federal and state exchanges in the past three months are older than 45, records released Monday show. If that trend holds, it could skew the health insurance market as older policyholders that use more health care are not balanced by younger policyholders who tend to use less health care. In effect, the younger policyholders subsidize older ones (Kennedy, 1/13).

Politico: Young Adults Make Up One-Fourth Of Obamacare Enrollees
Just under a quarter of Obamacare sign-ups so far have been in the critical 18-to-35-year-old age range, the Obama administration revealed Monday, the first time officials have given demographic data about health plan enrollees. The administration had set a goal of around 38 percent to 40 percent of the enrollees in that age bracket by the time the sign-up season ends March 31 (Cheney and Millman, 1/14).

The New York Times: Mixed Reports On State Health Exchange
New York is enrolling a significant number of young subscribers on its health insurance exchange, but many of those already enrolled have raised questions about rules that limit which doctors they can see, or are having problems finding out if their doctors are covered, according to testimony at a State Senate hearing on Monday (Hartocollis, 1/13).

The Associated Press/Wall Street Journal: Legislators Cite Flaws In NY Health Exchange
State legislators cited problems Monday with the rollout of the federal health overhaul in New York, with constituents complaining about lost insurance coverage, higher premiums and confusion and limitations of medical networks. Nearly 300,000 New Yorkers have been enrolled in private insurance or Medicaid since October with the average cost 53 percent lower than comparable individual insurance coverage, Donna Frescatore, executive director of the state's new health marketplace, New York State of Health, testified at a Senate oversight hearing (1/13).

The Washington Post: Brown Says Health Exchange Problems Were Not Conveyed To Him But Still Accepts Blame
The day before he was to testify about an emergency bill that would help those who were unable to sign up for health insurance through the state’s exchange, Maryland Lt. Gov. Anthony G. Brown (D) said Monday that he was kept in the dark about the severity of the problems that led to the calamitous debut of the state’s online health marketplace (Johnson and Wagner, 1/13). 

Los Angeles Times: State Tells Cigna To Stop Using Covered California Exchange Name
California Atty. Gen. Kamala Harris told insurance giant Cigna Corp. to stop selling health plans bearing the name of California's health exchange because it was deceptive. Cigna opted out of participating in the Covered California exchange when it launched last year. But the company continued selling policies outside the exchange and labeled some of them "Covered California" plans (Terhune, 1/13).

The Washington Post’s WonkBlog: Obamacare’s Narrow Networks Are Going To Make People Furious – But They Might Control Costs
Just the name itself, a narrow network, sounds like a miserable, restrictive health plan that you would just as well avoid. But health-care experts love narrow networks, pointing out that they underpin some of the country's most successful health plans (Kliff, 1/13).

USA Today: Study: Navigator Laws Limit Health Exchange Outreach
States that have not expanded Medicaid as part of the Affordable Care Act and also passed laws limiting the ability of health care "navigators" to advise customers have compromised their residents' ability to gain access to health care, a new study released Tuesday shows (Kennedy, 1/14).

The Washington Post: CMS Replaces Executives Who Departed After Healthcare.gov Troubles
In a letter to employees, CMS Administrator Marilyn Tavenner said the agency promoted Tim Love to serve as chief operating officer and appointed Dave Nelson as its new chief information officer (Hicks, 1/13).

The Washington Post: Survey: Strong Concern About Health Coverage Among Congressional Staffers
The vast majority of congressional staff directors think their employees are worried about their health benefits after a GOP amendment to the Affordable Care Act forced them off their normal federal-worker plans, according to a survey released Monday (Hicks, 1/13).

Politico: Survey: Obamacare Worries Hill Aides
A vast majority of top congressional aides say in a new survey that they are concerned about the effects of Obamacare on their staff, ticking off worries about changes to their benefits, higher costs and whether they’ll have access to local health care providers. Ninety percent of staffers surveyed for a report released Monday by the Congressional Management Foundation said they are concerned about benefit changes under the health care law, while 86 percent are anxious about the financial hit and 79 percent cited worries to access (Kim, 1/13).

The Washington Post: Maine Session Preview: Rehashing A Medicaid Fight
Maine Democrats hope to reopen a debate on expanding Medicaid in that state this legislative session, which began on Wednesday. But expect Gov. Paul LePage (R) to put up a fight. The Democrat-controlled legislature is expected to take up the expansion, under President Obama’s health-care law, despite two vetoes from LePage. And both sides return to the fight with new ammunition (Chokshi, 1/13).

The New York Times: House and Senate Negotiators Agree on Spending Bill
House and Senate negotiators reached accord on a trillion-dollar spending plan that will finance the government through September, reversing some cuts to military veterans’ pensions that were included in a broader budget agreement last month and defeating efforts to rein in President Obama’s health care law. … Republicans do get to point to some conservative victories. The bill would cut $1 billion from the Affordable Care Act’s Prevention and Public Health Fund, which Republicans have long targeted, fearing the administration would use it to bolster the law’s online insurance exchanges. … Otherwise, the bill’s winners and losers seem to follow no patterns. The National Institutes of Health, long a congressional favorite, would get $29.9 billion, down $714 million from the level approved by Congress for 2013. In all, the N.I.H. would end up with only $1 million more than it did last year after the across-the-board spending cuts, known as sequestration, severely curtailed its research grants (Weisman, 1/13).

The Washington Post: Lawmakers Unveil Massive $1.1 Trillion Spending Bill In Bipartisan Compromise
Given barely a month to complete work on the package, Mikulski and Rogers were able to overcome early partisan disputes over funding for the Affordable Care Act, Obama’s signature legislative achievement, and payments due to the International Monetary Fund, a frequent target of conservatives. To sweeten the package, they agreed to include a provision that would exempt disabled veterans from a modest pension reduction for military retirees enacted last month to help cover the cost of the sequester repeal. … The National Institutes of Health would receive $29.9 billion, $1 billion more than under the sequester but $714 million less than the agency was due to receive last year before the sequester hit last March. … The measure also continues a ban on the use of federal funding to perform most abortions, including abortions in the District and for federal prisoners. But Republicans agreed to jettison other contentious proposals, including a ban on new federal regulations for greenhouse gases and the “global gag rule,” which sought to prohibit U.S. funding for organizations that give women information about abortion (Montgomery and O’Keefe, 1/13).

The Wall Street Journal: House, Senate Negotiators Seal $1 Trillion Spending Deal
Negotiators dropped many of the policy riders Republicans had pushed to reverse or block administration policies on environmental regulation, abortion and other issues. However, the bill didn't include funding for administration priorities conservatives opposed, such as construction of high speed rail. The bill held funding for the agency responsible for implementing the 2010 health care law at 2013 levels, and cut $1 billion from a related public-health fund (Hook, 1/13).

USA Today: Lawmakers Release $1 Trillion Spending Bill
The "omnibus" spending bill is a sweeping piece of legislation that includes all 12 of the annual bills that provide funding for all discretionary federal spending. It does not include mandatory spending on entitlement programs like Social Security and Medicare (Page, 1/13).

Politico: $1.1 Trillion Spending Bill Unveiled
Under pressure from Republicans, the measure keeps a tight rein on new funding for Wall Street regulators and effectively freezes appropriations for President Barack Obama’s health care program at the reduced, post-sequester level (Rogers, 1/13).

Politico: No Appetite For Another Obamacare Fiscal Battle
The debt limit will have to be hiked sometime between late February and early June, depending on various government estimates. But congressional Republicans from across the ideological spectrum are already skeptical of trying to extract concessions from Democrats on the Affordable Care Act — a dynamic that triggered an unpopular government shutdown last fall (Kim, 1/13).

The Washington Post’s The Fact Checker: Rubio’s Claim That Medicaid Funds Will ‘Go Away’
Sen. Rubio made this comment while defending a proposal to “streamline most of our existing federal anti-poverty funding into one single agency,” which would distribute funds as a cash grant to states for their own “creative initiatives that address the factors behind inequality of opportunity.” Rubio was asked what would happen if states simply opted out of providing programs for the poor, as nearly half the states have done with the Medicaid expansion envisioned in the Affordable Care Act, a.k.a. Obamacare. Rubio countered that his plan would be funded. “It wouldn’t be something where states are told you get the money for a few years then we’ll back away,” he said. Is this really how the Medicaid expansion is funded? A bait and switch? (Kessler, 1/14).

The New York Times: California Democrat To Retire From House
Representative George Miller, Democrat of California, announced Monday that he would retire at the end of his term, after 40 years in Congress. … “Now, I look forward to one last year in Congress fighting the good fight," Mr. Miller said in a statement on Monday. He added that he had a “tall agenda” remaining as he serves out his 20th term. He hopes to extend long-term unemployment insurance benefits; raise the minimum wage to at least $10.10 per hour by 2016; further carry out President Obama’s signature health care law, and push through a broad overhaul of immigration laws — all key Democratic goals for the coming session (Parker, 1/13).

Los Angeles Times: San Francisco Area Rep. George Miller To Retire From Congress
Rep. George Miller, a San Francisco Bay area liberal and dean of the California congressional delegation, announced Monday that he will retire when his term ends, closing a 40-year career on Capitol Hill. The veteran Democrat’s departure will leave just one lawmaker, Rep. Henry Waxman (D-Los Angeles), in the House who was elected in the Watergate class of 1974 to serve continuously in the chamber since then. Also, Miller's retirement will further shake up the state’s 53-member delegation that underwent a large turnover in 2012 due to a spate of retirements and defeats (Simon, 1/13).

The New York Times: Supreme Court Won’t Hear Arizona Appeal on Abortion Ban
The Supreme Court on Monday declined to hear an appeal from Arizona officials seeking to revive a state law that barred most abortions after 20 weeks of pregnancy. The justices offered no reasons for turning down the appeal, as is their custom (Liptak and Santos, 1/13).

Los Angeles Times: With Arizona Case, Supreme Court Postpones Major Abortion Ruling
The Supreme Court's refusal Monday to revive an Arizona law that largely banned abortions after 20 weeks put off for at least another year a clear constitutional ruling on whether conservative states may adopt new restrictions on women seeking to end their pregnancies. The decision, marking the third time this term that justices have declined to take up an abortion case, suggested the closely split court is not anxious to jump into the divide between red states and blue states over abortion rights (Savage and Serrano, 1/13). 

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