First Edition: January 21, 2014

Today's headlines include news on the health law's implementation at both the federal and state levels.

Kaiser Health News: As HHS Moves To End Overload Of Medicare Claims Appeals, Beneficiaries Will Get Top Priority
Reporting for Kaiser Health News, in collaboration with The Washington Post, Susan Jaffe writes: "Medicare beneficiaries who have been waiting months and even years for a hearing on their appeals for coverage may soon get a break as their cases take top priority in an effort to remedy a massive backlog" (Jaffe, 1/21). Read the story.

Kaiser Health News: Consumers Expecting Free 'Preventive' Care Sometimes Surprised By Charges
Kaiser Health News consumer columnist Michelle Andrews writes: "The new health-care law encourages people to get the preventive services they need by requiring that most health plans cover cancer screenings, contraceptives and vaccines, among other things, without charging patients anything out of pocket. Some patients, however, are running up against coverage exceptions and extra costs when they try to get those services. Advocates and policy experts agree that more federal guidance is needed to clarify the rules" (Andrews, 1/21). Read the column. 

Kaiser Health News: Michigan Republicans Rethink Medicaid Expansion
Reporting for Kaiser Health News, in partnership with NPR, Eric Whitney writes: "Nationally, Republican party leaders say their number one campaign issue for the midterm elections is opposition to Obamacare. But at the same time, a growing number of Republican states are now embracing a major provision of the law – expanding Medicaid, the government-funded health benefit program for the poor. The Supreme Court made doing that optional for states in 2012 and most Republican-led states said "no". But now, some states like Ohio, Iowa and Michigan are forging compromises with the White House on Medicaid" (Whitney, 1/20). Read the story.

Kaiser Health News: Capsules: Is The Health Law's Insurance Website Not Spanish Friendly?
Now on Kaiser Health News' blog, listen to the audio of KHN's Daniela Hernandez and CNET en Espanol's Laura Martinez on NPR's Tell Me More Friday morning to talk about how Spanish speakers are struggling with the federal website to buy health insurance (1/17). Check out what else is on the blog.

Kaiser Health News also tracked weekend health policy headlines, including reports that many Healthcare.gov users say they have had health insurance before and other news about the health law's implementation (1/20). 

The New York Times: Patients' Costs Skyrocket; Specialists' Incomes Soar
Ms. Little's seemingly minor medical problem -; she had the least dangerous form of skin cancer -; racked up big bills because it involved three doctors from specialties that are among the highest compensated in medicine, and it was done on the grounds of a hospital. Many specialists have become particularly adept at the business of medicine by becoming more entrepreneurial, protecting their turf through aggressive lobbying by their medical societies, and most of all, increasing revenues by offering new procedures -; or doing more of lucrative ones (Rosenthal, 1/18).

The Hill: Document: ObamaCare Contractor Faces Mid-March Deadline Or Disaster 
If the ObamaCare contractor brought on last week to fix the back-end of the HealthCare.gov portal doesn't finish the build-out by mid-March the healthcare law will be jeopardized, according to a procurement document posted on a federal website. It says insurers could be bankrupt and the entire healthcare industry threatened if the build out is not completed (Easley, 1/18).

The Washington Post: Study: Allowing People To Stay In Existing Insurance Plans Unlikely To Disrupt Exchanges
Plans to allow people to keep their individual health insurance policies, even if they don't meet the requirements of the health-care law, are unlikely to threaten the short-term viability of the new health insurance marketplace, according to a new Rand Corp. study. The study, released Tuesday, examines the impact of President Obama's decision in November to allow consumers to keep their insurance plans, even if those plans don't meet the requirements of the Affordable Care Act (Sun, 1/21). 

NPR: Taking The Pulse Of Latino Health Concerns
Latino immigrants to the U.S. say the quality and affordability of health care is better in the U.S. than the country they come from, according to the latest survey by NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health. But many report having health care problems (Neighmond, 1/21). 

USA Today: Co-Ops The Underdog In Health Insurance Marketplace
Consumer-run health insurance cooperatives, which were included in the Affordable Care Act to stimulate competition and lower prices, have been stymied by the insurance industry and a lack of publicity, industry and health care experts say. The consumer-operated and run insurance companies, called co-ops, are often funded by government loans. Cooperatives can sell their policies through the state and federal health insurance exchanges where Americans can buy coverage (Kennedy, 1/19). 

Los Angeles Times: How I Made It: Blue Shield Of California CEO Paul Markovich 
As chief executive of Blue Shield of California, Paul Markovich leads one of the country's largest nonprofit health insurers, and he is a major player in the state's rollout of Obamacare. ... Markovich doesn't have to go far to hear complaints nowadays. Frustrated customers are venting about poor customer service in the transition to new health plans as part of the Affordable Care Act. Blue Shield recently apologized for its "unacceptable" performance. "Exchanges and health plans in California and across the country have been overwhelmed by last-minute volume and deadline extensions, which is causing serious delays," Markovich said. "I believe we will work through all of this soon and ultimately make the Affordable Care Act a success" (Terhune, 1/19).

The Wall Street Journal: Bills Proposed In Several States Would Nullify Affordable Care Act 
The nullification trend in statehouses seems to be spreading. ... The latest target is the Affordable Care Act. Conservative lawmakers in at least seven states have proposed laws that would prohibit state agencies and officials from helping the federal government implement the federal healthcare law and would authorize the state's attorney general to sue violators (Gershman, 1/17).

The New York Times: Nonprofit Clinic Offers 'Bridges of Health' To Philadelphia's Illegal Immigrants
Like many other immigrants, Mery Martinez has no legal status in the United States, no health insurance and no money. But she does have leukemia, and has been struggling to find treatment for the disease ... With rising anxiety, and a rash that she attributed to her illness, Ms. Martinez walked into a clinic last week run by Puentes de Salud, a nonprofit group of doctors, nurses and medical students that provides primary care to Philadelphia's undocumented, uninsured and impoverished Latino immigrants. A co-founder, Dr. Steve Larson, said the organization distinguished itself from other community-health groups by addressing the underlying causes of illness, like poor nutrition, illiteracy or urban violence (Hurdle, 1/19).

Los Angeles Times: Immigrants Without Legal Status Remain Mostly In Healthcare Limbo 
When Alva Alvarez gets sick, she buys over-the-counter medicine from the grocery and takes as much as she can until she feels better. The mother of five resorts to this because she can't afford a visit to the doctor to figure out what's ailing her. Although scenarios like this are supposed to disappear as millions of Americans become newly insured under the national healthcare law, Alvarez's situation isn't likely to improve and could get worse. The San Bernardino resident represents the biggest -; and mostly invisible -; group of people left out of the Affordable Care Act: immigrants in the country illegally (Karlamangla, 1/19).

The New York Times: Peace Of Mind Is First Benefit For Many Now Getting Medicaid
As health care coverage under the new law sputters to life, it is already having a profound effect on the lives of poor Americans. Enrollment in private insurance plans has been sluggish, but sign-ups for Medicaid, the federal insurance program for the poor, have surged in many states. Here in West Virginia, which has some of the shortest life spans and highest poverty rates in the country, the strength of the demand has surprised officials, with more than 75,000 people enrolling in Medicaid. While many people who have signed up so far for private insurance through the new insurance exchanges had some kind of health care coverage before, recent studies have found, most of the people getting coverage under the Medicaid expansion were previously uninsured (Tavernise, 1/20).

The Washington Post: Terry McAuliffe's Push To Expand Medicaid Rankles The GOP Lawmakers He Seeks To Woo
Gov. Terry McAuliffe intends to wrest the power to expand Medicaid away from a legislative commission and put it in his own hands, one of several moves threatening to undermine the new governor's courtship of the GOP-controlled General Assembly. McAuliffe (D) announced Monday that he will seek that authority through a proposed budget amendment if the Medicaid Innovation and Reform Commission does not agree within the next 60 days to enroll 400,000 more Virginians into the federal-state health-care program for the poor (Vozzella, 1/20). 

The Associated Press/Washington Post: McAuliffe Wants Authority To Expand Medicaid
Gov. Terry McAuliffe wants lawmakers to give him the authority to expand Medicaid eligibility on his own if a state commission doesn't act by the end of the 2014 legislative session. The Democratic governor has made expanding the publicly funded health insurance program for the poor and disabled to an additional 400,000 Virginians a top issue for his new administration. But the proposal is staunchly opposed by Republicans in the GOP-controlled House (1/20). 

The Associated Press/Washington Post: Md. Senate Advances Bill On Health Exchanges
The Maryland Senate has advanced a measure to provide insurance for people who were unable to enroll in the state's health exchange website due to computer problems. The Senate voted 36-8 late Monday to adopt a favorable report on the measure. That sets the stage for a vote Tuesday to send the bill to the House (1/20). 

The Washington Post: Maryland Welcomes Wrong People To Medicaid
As many as 383 Medicaid enrollees in Maryland received welcome packets in the mail this month that contained the names and birth dates of strangers, health officials announced Sunday evening. They blamed the mix-up on a "programming error" caused by the chief IT contractor hired to build a health-insurance marketplace for the state. Officials at the Maryland Department of Health and Mental Hygiene said they learned of the problem Friday after a customer contacted a Medicaid enrollment broker and reported receiving the wrong packet in the mail (Johnson, 1/19).

The Associated Press/Washington Post: Programming Error Affects Md. Medicaid Packages
Maryland health officials are blaming a programming error for causing some Medicaid enrollment packages to be sent to the wrong address. The state Department of Health and Mental Hygiene attributed the error Sunday to Noridian, the prime contractor for the Maryland Health Benefit Exchange (1/19). 

Los Angeles Times: Obamacare Lawsuit Forces Order Of Nuns Into The Public Eye
Except for their soliciting of donations, the members of the "begging order," as it's sometimes known, have largely stayed out of the spotlight. But that changed in September when the order became one of the plaintiffs in a lawsuit filed against the so-called contraceptive mandate of the Affordable Care Act, placing them at the center of a debate over healthcare and religious freedom (Hamedy, 1/18). 

Los Angeles Times: Supreme Court to Hear 1st Amendment Challenge To Labor Unions
The Supreme Court will hear a 1st Amendment case this week involving Chicago-area in-home care providers that could end up dealing a major blow to public-sector labor unions. Illinois, California, Maryland, Connecticut and other states have long used Medicaid funds to pay salaries for in-home care workers to assist disabled adults who otherwise might have to be put in state institutions. The jobs were poorly paid and turnover was high. Over the last decade, more than 20,000 of these workers in Illinois voted to organize and won wage increases by joining the Service Employees International Union. But the National Right to Work Foundation, an anti-union advocacy group, sued Gov. Pat Quinn and the SEIU, accusing the state and union of conspiring to relabel private care providers as state employees so they could collect more union fees (Savage, 1/20). 

The Washington Post: Unions Circling The Wagons On Court Case
It was a "win-win-win" situation when home-care providers in Illinois unionized, says the lawyer who will represent the state and the public-employee union in Supreme Court arguments this week. Pay and benefits increased for the employees, the state negotiated with a unified and more stable workforce, and clients found that workers were more willing to stay in the demanding jobs, Washington lawyer Paul Smith said (Barnes, 1/19). 

The New York Times: Parties Seize On Abortion Issues In Midterm Race
When the Republican National Committee gathers for its winter meeting here on Wednesday, the action will start a few hours late to accommodate anyone who wants to stop first at the March for Life, the annual anti-abortion demonstration on the National Mall. And if they need a lift to the meeting afterward, they can hop on a free shuttle, courtesy of the Republican Party (Peters, 1/20). 

Providence Journal: Chafee's $43-Million Cut In Medicaid Program Touches Many Sectors Of Health Care In Rhode Island
Rhode Island enthusiastically embraced the expansion of its Medicaid program allowed by the Affordable Care Act. But at the same time, Medicaid is where Governor Chafee has turned to make the biggest cuts as he seeks to close a $150-million budget hole. Chafee's budget would slash $43 million from Medicaid, the health plan for the poor, in the fiscal year that ends June 2015. It's the only expenditure cut that even gets into the double digits (Freyer, 1/17).

The New York Times: North Carolina: Judge Blocks Ultrasound Requirement
A federal judge on  Friday declared unconstitutional the state's ultrasound requirement for women seeking abortions, saying it violated the First Amendment by requiring doctors to display a fetal image and describe it even to women who covered their eyes and ears (Eckholm, 1/18).

Los Angeles Times: New Mexico Judge Affirms Right To 'Aid In Dying'
Now, a New Mexico judge has ruled that terminally ill patients like Riggs have the right to "aid in dying" under the state constitution. "Such deaths are not considered 'suicide' under New Mexico's assisted suicide statute," ruled Judge Nan G. Nash of the 2nd District Court in Albuquerque last week. The state's assisted suicide law classifies helping with suicide as a fourth-degree felony (Hamedy, 1/19).

The Washington Post: Mental Health Advocates Try To Seize The Moment In Va.
They were not as easy to pick out as the gun rights advocates with the bright orange stickers that read "Guns Save Lives" or the medical marijuana legalization supporters. But close to 200 advocates for the mentally ill wound their way through the Virginia General Assembly Building on Monday to try to make the most of a moment they know may not last (Shin, 1/20). 

The Wall Street Journal: Circumcision Coverage Comes Into Focus
Saleem Islam, a pediatric surgeon in Gainesville, Fla., was surprised a few years ago when he started receiving a steady stream of referrals for older boys from low-income families to be circumcised. … Like a dozen other states, Florida ended Medicaid coverage of routine circumcisions for newborns after the American Academy of Pediatrics issued a lukewarm statement on the practice in 1999. While the organization concluded that removing the penis's foreskin has potential benefits, it found the data were insufficient to recommend it as a routine procedure (Campo-Flores, 1/20).