First Edition: February 25, 2014

Today's headlines include stories exploring the political dynamics governors face regarding the health law's Medicaid expansion.

Kaiser Health News: New ACA Insurance Causes Headaches In Some Doctors' Offices
Kaiser Health News staff writer Jenny Gold, working in collaboration with NPR, reports: "Sheila Lawless is the office manager at a small rheumatology practice in Wichita Falls, Texas, about two hours outside of Dallas. She makes sure everything in the office runs smoothly – scheduling patients, collecting payments, keeping the lights on. Recently she added another duty--incorporating the trickle of patients with insurance plans purchased on the new Affordable Care Act exchanges. Open enrollment doesn't end until March 31, but people who have already bought Obamacare plans are beginning to use them. 'We had a spattering in January-;maybe once a week. But I think we're averaging two to three a day now,' says Lawless. That doesn't sound like many new customers, but it's presented a major challenge: verifying that these patients have insurance" (Gold, 2/25). Read the story.

Kaiser Health News: Insuring Your Health: Readers Ask About Whether Some Practices By Doctors, Insurers Are Acceptable
Kaiser Health News consumer columnist Michelle Andrews writes: "This week, I answer readers' questions about the limits of acceptable practice on and off the exchanges" (2/25). Read her responses.

Kaiser Health News: Capsules:Rep.John Dingell, Long-Time Champion Of Health Legislation, Will Not Seek Re-Election; Arkansas Medicaid Fight All About The Math, Governor Says
Now on Kaiser Health News' blog, Mary Agnes Caret writes about Rep. John Dingell's big announcement: "Another health care legend is retiring on Capitol Hill. Rep. John D. Dingell, a Michigan Democrat who was a key player in many health care battles in Congress, including enactment of the 2010 health care law and his push for a "Patient's Bill of Rights" in the late 1990s and early 2000s, said Monday he will retire at the end of his current term" (Carey, 2/24). 

Also on Capsules,Phil Galewitz reports on Arkansas Gov. Mike Beebe and his states' Medicaid expansion plan: "Arkansas Gov. Mike Beebe says his strategy to win over state lawmakers skeptical about continuing the state's Medicaid expansion is to show them the money. 'It's arithmetic, it's not even math,' Beebe said Monday at a media briefing sponsored by Kaiser Health News and Health Affairs. The Democratic governor said if the Arkansas legislature opts against going forward with the expansion, it would leave an $86 million hole in the state budget, and cost the state's hospitals and employers tens of millions of dollars" (Galewitz, 2/24). Check out what else is on the blog.

The Wall Street Journal: Rising Premiums May Hit Small Firms
A federal actuarial report predicts that 65% of small businesses will see their health-insurance premiums increase under part of the Affordable Care Act. The report, from the Centers for Medicare and Medicaid Services Office of the Actuary, is the latest piece of bad news for the president's signature domestic achievement. While the law was designed to curb rising health costs, some consumers have seen their premiums or other out-of-pocket costs increase this year, or had their plans canceled altogether (Corbett Dooren, 2/24).

The Associated Press/Washington Post: Premiums May Rise For 11 Million Workers: Report
The new health care law may raise insurance premiums for 11 million small business employees and lower rates for 6 million others. That's an estimate from a report by the Centers for Medicare & Medicaid Services, part of the Department of Health and Human Services (2/24).

The Wall Street Journal: Health Law Already Has Impact On Bottom Lines
The Affordable Care Act's impact on the bottom line is starting to ripple across corporate America. More than 80 public companies told investors the new health-care rules were, or could be, a financial boost or drag on their quarterly earnings, though they were often uncertain of the magnitude, according to a Wall Street Journal search of earnings-call transcripts for the most recent quarter provided by FactSet (Knox, 2/24).

The Washington Post: Republicans Seek Political Cover To Accept Medicaid Expansion Money
In the bitterly partisan debate over the Affordable Care Act, few House members criticized the proposed legislation as harshly or as often as then-Rep. Mike Pence. But now, nearly four years after the measure passed on a party-line vote, Pence, now Indiana's governor, is asking the federal government for ACA money to expand a program that provides coverage to low-income Hoosiers. But he wants to do it outside the confines of the health-care law (Wilson, 2/25).

Politico: Pro-Medicaid GOP Governors Well Placed For Reelection
Conservative activists threatened revenge for Republican governors who boosted Obamacare. Now it looks like they were mostly blowing smoke. Around the country, Republicans who defied the base and embraced Obamacare's massive expansion of Medicaid are better positioned for reelection than those who did not. None has garnered a serious primary challenge so far, and even Democrats have struggled to field strong contenders to take them on (Cheney and Hohmann, 2/25).

Politico: Democratic Governors:Obama Needs To Sell Obamacare
With the battle over Obamacare moving from Washington to the states and a deluge of ads battering the law on TV, Democratic governors delivered a message to President Barack Obama this week: We need help.
Four years out from passage of the Affordable Care Act, it's state executives in Obama's party who may be bearing the heaviest load when it comes to making the law work and selling it to voters. They've grappled with their own glitch-ridden enrollment sites and fought their own legislatures over Medicaid expansion (Burns, Cheney and Dovere, 2/25).

The Washington Post: In Va., Fight Over Medicaid Expansion Continues
Gov. Terry McAuliffe hit the road to sell Medicaid expansion Monday, touring a Northern Virginia hospital to make the human and business case for insuring more poor and working people -; and to pressure House Republicans who have pledged to block the effort (Laris and Vozzella, 2/24).

The Associated Press/Washington Post: Business Groups Clash On Va. Medicaid Expansion
The Virginia Chamber of Commerce and state business leaders renewed their call Monday for Republican House lawmakers to accept billions in federal Medicaid funds, saying it would be a boost for the state's economy (2/24). 

The Wall Street Journal's Washington Wire: Arkansas Governor Again Prods Legislature to Fund Medicaid Program
Arkansas Gov. Mike Beebe said he hoped the possibility of "severe and draconian cuts" to state services will spur state lawmakers to fund a program that buys private health insurance for residents who newly qualify for Medicaid (Corbett Dooren, 2/24). 

Los Angeles Times: California Website For Obamacare Back Up After 5-Day Outage
California's enrollment website for Obamacare coverage was restored Monday after a five-day outage due to software problems. The online troubles frustrated many consumers, enrollment counselors and insurance agents who wanted to use the Covered California website. The state had been signing up more than 7,000 people per day, on average, in February. The online enrollment system went down late Wednesday and the state continued to work on it throughout the weekend (Terhune and Karlamangla, 2/24). 

The Washington Post: Maryland Fires Contractor That Built Troubled Health Insurance Exchange
The Maryland Health Benefit Exchange voted late Sunday to terminate its $193 million contract with Noridian Healthcare Solutions. Columbia-based Optum/QSSI, which the state hired in December to help repair the flawed exchange, will become the prime contractor, and Noridian will assist with the transition (Flaherty and Johnson, 2/24).

The New York Times: Connecticut Plans to Market Health Exchange Expertise
Connecticut has been so successful in getting people to sign up for health insurance through its online marketplace that it is setting up a consulting business to help other states build and operate websites where people can compare and buy private insurance policies. And the Obama administration has encouraged the effort, in the hope that more states will run their own exchanges in 2015 or 2016 (Pear, 2/24). 

Los Angeles Times: L.A. Community Colleges Urge Students To Sign Up For Obamacare
Danielle Alberts fell and broke her right ankle in three places in 2012. Alberts, who earns about $9,000 a year, went to the hospital and was charged nearly $4,000 for a shot and some pain medication. Alberts did not have health insurance. She refused a cast because it would have cost $500 more and she didn't have the money from her jobs as a security guard and caregiver. The ankle healed poorly, leaving her with a limp, and she wears a brace to keep the swelling down (Song, 2/24).

The Washington Post's The Fact Checker: An Attack Ad Against Obamacare, Featuring A Man On Medicare
An irritated reader who lives in Michigan wrote The Fact Checker about this ad, which seeks to bolster Rep. Justin Amash (R-Mich.) as a fighter against the Affordable Care Act, a.k.a. Obamacare. The reader asked how such as an elderly-looking gentleman could be on the Affordable Care Act. Instead, the reader surmised, the man must be on Medicare, which is actually a single-payer government-run health care system (Kessler, 2/25).

The Wall Street Journal: Health Insurers Rally As Fears Over Medicare Cuts Ease
Shares of Humana Inc. and other U.S. health insurers rose Monday as the proposed Medicare reimbursement cuts for 2015 weren't as bad as had been feared. The Centers for Medicare and Medicaid Services issued its proposal late Friday for the rates it will pay health plans in 2015. Cuts had been expected, with some set to phase in automatically under the federal health-care law. Humana, in a filing Monday to the Securities and Exchange Commission, said it expected CMS' proposal to cut Medicare Advantage funding for 2015 by 3.5% to 4%. Humana previously had said it expected a decline of 6% to 7% (Stynes and Mathews, 2/24).

The Wall Street Journal: Tenet Healthcare Swings To A Loss
The broader hospital sector has been consolidating as the industry is poised for major changes related to the U.S. health-care overhaul. Tenet last year completed its acquisition of Vanguard Health Systems Inc., a move that aims to broaden its geographic reach. Hospitals also continue to face a slowdown in patient traffic that has been viewed as tied-;at least partly-;to the recession and its aftermath. In the latest quarter, Tenet reported adjusted admissions fell 0.5%, as inpatient admissions fell 2.3% (Prior, 2/24). 

The Associated Press/Washington Post: Dingell, Longest-Serving Congressman, To Retire
The Michigan Democrat, who was elected to his late father's seat in 1955 and has held it ever since, announced his decision while addressing a chamber of commerce in Southgate, near Detroit. Afterward, he told reporters that he will not run for a 30th full term because he could not have lived up to his own standards (2/24).

The New York Times: John Dingell To Retire After Nearly 60 Years In House
No member of the House has served as long as Representative John D. Dingell, Democrat of Michigan. So it resonated when Mr. Dingell announced on Monday that he would not seek re-election to a seat he has held since the Eisenhower administration in part because the institution he once revered had become "obnoxious," riven by acrimony and marked by lack of productivity (Hulse and Parker, 2/24). 

Los Angeles Times: John Dingell, Dean Of The House, Plans To Retire
During his long House career Dingell was a champion for Democratic priorities, foremost among them universal healthcare. At the start of each new Congress Dingell would introduce a bill to establish a universal healthcare system; he was at President Obama's side when he signed the Affordable Care Act into law in 2010 (Memoli, 2/24).

The Wall Street Journal: Michigan Rep. John Dingell To Retire
In his 58 years in Congress, Mr. Dingell has been known for his fierce protection of Michigan's auto industry, putting him at odds with the Democratic caucus's commitment to tougher antipollution standards. But he championed liberal policies elsewhere. He had a hand in some of Congress's landmark legislative efforts, including Medicare, the 1990 Clean Air Act, the Affordable Care Act, and the 1964 Voting Rights Act-;which he said in June was the "single most important vote I cast" (Ballhaus and Peterson, 2/24). 

The Washington Post: In John Dingell's Departure, A Changing Of The Guard And The End Of An Old Style Of Power
Yet on other issues, Dingell is an ardently old-style liberal. His most cherished cause was expanding health care coverage, which came to fruition with the passage of the Affordable Care Act (Tumulty and Kane, 2/24). 

The Associated Press/Washington Post: Vets Benefits Bill Should Win Initial Senate Vote
A sprawling Democratic bill expanding health, education and other benefits for veterans seems ready to clear an initial hurdle in the Senate. Yet the election-year measure faces an uncertain fate as Republicans try to make it smaller and find ways to pay for it. The legislation, which sponsor Sen. Bernie Sanders, I-Vt., says would cost $21 billion over the coming decade, could confront GOP lawmakers with an uncomfortable campaign-season test over curbing spending for the nation's 22 million veterans and their families (2/25). 

The Washington Post: Pentagon Budget Would Cut Military Health Benefits And Commissary Funds
The Pentagon's 2015 budget proposal would raise health-care costs for certain members of the military community and drastically trim subsidies for the commissaries that provide discounted groceries to troops and their families (Hicks, 2/24). 

The Washington Post: Little Uniformity In Military Health Care
A new series of critical reports highlights the need to speed up unification of the military services' separate approaches to health care, which is one of the fastest-growing budget items but still lacks common standards for dealing with some medical issues (Pincus, 2/24). 

The Washington Post: How To Find Out If Your Doctor Is In Good Standing. It Takes Some Digging.
Recently a reader wrote me to ask how patients can perform background checks on their doctors, to make sure that they're in good standing. He had a reason for asking: A few years ago, he said, he'd agreed to have a spinal fusion performed by an apparently well-regarded surgeon. The operation left him worse off than when he started, and he later discovered that there were numerous malpractice lawsuits pending against the surgeon (Aschwanden, 2/24). 

Los Angeles Times: New Bill Brings Medical Malpractice Fight To The Legislature
Seeking to avert a costly initiative battle, state Senate President Pro Tem Darrell Steinberg (D-Sacramento) has introduced a bill to serve as a vehicle for a legislative compromise on California's medical malpractice law. The measure is brief: just one sentence stating the Legislature's intention to "bring interested parties together to develop a legislative solution to issues surrounding medical malpractice injury compensation" (Mason, 2/24).