First Edition: July 25, 2013

Today's headlines include reports about WellPoint's second-quarter profits and the Insitute of Medicine's findings about geographic varitions in Medicare spending. 

Kaiser Health News: IOM Finds Differences In Regional Health Spending Are Linked To Post-Hospital Care And Provider Prices
Kaiser Health News staff writer Jordan Rau reports: "Big health spending variations throughout the country are largely driven by differences in the use of post-acute services such as skilled nursing homes and home health care by Medicare beneficiaries, and by higher prices that some hospitals and doctors charge commercial insurers, according to an Institute of Medicine report released Wednesday" (Rau, 7/24). Read the story.

Kaiser Health News: Capsules: WellPoint Sees Small Employers Dropping Health Coverage; Schizophrenia, Suicide And One Family's Anguish; Current Insurance Costs For Individual Policies Vary Widely
Now on Kaiser Health News' blog, Jay Hancock reports on news from WellPoint: "As the nation prepares to roll out the next phase of Obamacare, the second biggest medical insurer said Wednesday that it expects to lose members in health insurance plans sponsored by smaller employers. At the same time, WellPoint expects membership gains in self-insured employer plans and in the kind of individual plans that will be sold in subsidized exchanges starting Oct. 1" (Hancock, 7/24).

In addition, WNPR's Jeff Cohen, working in partnership with KHN and NPR, reports on a family that had to confront schizophrenia and suicide: "Homer Bell was 54 years old when he committed suicide in April in a very public way -; he laid down in front of a bus in his hometown of Hartford, Conn. It was the culmination of three decades of suffering endured by Bell and his family because of his illness, schizophrenia" (Cohen, 7/24).

Also on Capsules, Julie Appleby details a GAO report examining variations in individual insurance policy costs: "Now, the Government Accountability Office is weighing in with its own analysis of how much it costs now for policies offered in each of the 50 states. The report released Wednesday is based on prices reported by insurers to a government database and shows that consumers face a wide range of premium prices, deductibles and annual exposure to out-of-pocket costs, often depending on their age, health history, family size and where they live" (Appleby, 7/24). Check out what else is on the blog.

Kaiser Health News: Letters To The Editor: In Defense Of Shorter Shifts For Interns, Medicaid Managed Care Oversight, Emergency Room Frequent Flyers And Other Topics
Letters to the Editor is a periodic KHN feature. We welcome all comments and will publish a selection (7/24). Here are readers' thoughts on specific stories.

The Wall Street Journal: New Health-Care Law's Success Rests on the Young
Interviews here with more than two dozen single workers of modest income between 24 and 31 years old suggest that insurance plans will be a hard sell. Subsidies for 26-year-old workers range from $118 a month for someone earning under $16,000 to less than $1 a month for one earning $26,500, according to an analysis of insurance data (Weaver and Radnofsky, 7/25).

The Wall Street Journal: Low-Cost Insurance Offer Limits Federal Subsidies For Portland Buyers
Federal subsidies in the new health-care law will help offset the cost of insurance for lower-income buyers. But in the Portland area, the subsidies will be smaller than expected because of the low prices offered by a regional insurer. The subsidies are based on the cost of the second-cheapest midlevel plan, as well as annual incomes (Weaver and Radnofsky, 7/24).

Politico: Race May Sway Virginia Medicaid Expansion
You won't see it listed on the ballot, but a major piece of Obamacare could be decided by Virginia voters this November. The fate of the Medicaid expansion in Virginia could hinge on whether Democrat Terry McAuliffe or Republican Attorney General Ken Cuccinelli -; who boosted his national profile with his fight against the health care law -; moves into the governor's mansion next year. And the preliminary skirmishes already have drawn tea party attention (Millman, 7/25).

NPR: Full-Time Vs. Part-Time Workers: Restaurants Weigh Obamacare
Many businesses that don't offer health insurance to all their employees breathed a sigh of relief earlier this month when they learned they'd have an extra year to comply with the new health care law or face stiff penalties (Ydstie, 7/24).

The Washington Post's Wonk Blog: Our Data On Health Premiums Has Been Pretty Bad. Not Anymore.
On Monday, the Government Accountability Office sent back a thick stack of insurance data, broken down by state, explaining the cost of health insurance. Analysts there used data from HealthCare.Gov, a new site created under the Affordable Care Act where insurers post their offerings and how much they cost. The database, the GAO analysts admit, isn't perfect. About 20 percent of insurers don't post their plan data, which means we're missing about one-fifth of the marketplace. There's no enrollment data, which means some of the options listed may not have any subscribers. Still, this is probably the best data set we have on insurance premiums so far (Kliff, 7/24).

The New York Times: Don't Shift Payments by Medicare, Panel Says
Adjusting Medicare payments to reward doctors and hospitals in regions that provide high-quality care at low cost would be a bad idea, the National Academy of Sciences said Wednesday. After a three-year study, the academy's Institute of Medicine rebuffed arguments by members of Congress from states like Minnesota and Iowa who say Medicare has shortchanged their health care providers for decades (Pear, 7/24).

Los Angeles Times: WellPoint Earnings Jump 24% In Second-Quarter As Medical Costs Drop
WellPoint Inc., the country's second-largest insurer, beat Wall Street expectations with a second-quarter profit jump of 24% as lower medical costs partly helped the Indianapolis company post strong results. "We are pleased with our second-quarter results and encouraged by the positive momentum we have across the organization," said Joseph Swedish, WellPoint's chief executive since March (Lopez, 7/24).

The Associated Press/Washington Post: WellPoint's 2nd Quarter Profit Soars 24 Pct; Insurer Details Overhaul Growth Possibilities
Shares of WellPoint Inc. hit an all-time high Wednesday, after the nation's second-largest health insurer trounced second-quarter earnings expectations and detailed how it expects to benefit from the health care overhaul and other growth opportunities over the next few years. The Indianapolis company's stock had already climbed 44 percent so far this year as of Tuesday, as investors have grown more comfortable with both the insurer's current performance and how the overhaul will affect it (7/24).

The Wall Street Journal: Meet The CEO With Most At Stake In Health Law
Now four months into his stint atop the second-biggest U.S. insurer, Mr. Swedish is working to deliver. It is a tall order for the veteran hospital leader, 62 years old, who hasn't been an executive at a health plan before. Much of the federal overhaul law goes into effect next year, and WellPoint may be the company with the most at stake. "It's a revolutionary time in health care," Mr. Swedish said in an interview. "We've got to get this right" (Mathews, 7/24).

Los Angeles Times: Kaiser's Rising Premiums Spark Employer Backlash
For years, Kaiser Permanente has won accolades for delivering high-quality care at an affordable price. The Oakland company's unique HMO model kept a lid on costs, and big employers flocked to enroll their workers to the point that Kaiser has become the largest health plan in California, grabbing more than 40% of the market (Terhune, 7/24).

The New York Times: Mental Health Cuts In Utah Leave Patients Adrift
Still, the changes have shaken providers and recipients of mental health care in Utah while testing the resilience of its safety net as hundreds of Medicaid patients try to find new psychiatrists and counselors and wonder who will fill their next prescription. Some patients said they felt whipsawed by the shift, and were reluctant to part with counselors or support groups they had known for a decade or more (Healy, 7/24).

Politico: Marco Rubio Wants To Be Lead Sponsor On Anti-Abortion Bill
Sen. Marco Rubio said unequivocally Wednesday that he hopes to be the lead sponsor of a bill banning abortions after 20 weeks. &quotIf someone else would like to do it instead of me, I'm more than happy to consider it. But I'd like to be the lead sponsor,&quot the Florida Republican said. &quotI feel very strongly about this issue. And I'd like to be the lead sponsor on it if we can find language that we can unify people behind&quot (Everett, 7/24).

The Washington Post: Lawmakers Won't Weigh In On Chartered Health Plan Settlement
How do you spend $48 million in unbudgeted taxpayer money without getting an OK from elected lawmakers? In the District of Columbia, there's pretty much only one way, and that's the way Mayor Vincent C. Gray is proposing to settle a high-stakes dispute with D.C. Chartered Health Plan. Gray spokesman Pedro Ribeiro confirmed Wednesday that the plan is to pay the District's share of the settlement -; a little over $35 million, with federal Medicaid dollars accounting for the rest -; out of the city's contingency cash reserve (DeBonis, 7/24).