First Edition: April 15, 2014

Today's headlines include reports about the Congressional Budget Office's latest estimate of the costs for expanding health insurance.

Kaiser Health News: Doctors Overlook Lucrative Procedures When Naming Unwise Treatments
Kaiser Health News staff writer Jordan Rau, working in collaboration with The Chicago Tribune, reports: "When America's joint surgeons were challenged to come up with a list of unnecessary procedures in their field, their selections shared one thing: none significantly impacted their incomes. The American Academy of Orthopaedic Surgeons discouraged patients with joint pain from taking two types of dietary supplements, wearing custom shoe inserts or overusing wrist splints after carpal tunnel surgery. The surgeons also condemned an infrequently performed procedure where doctors wash a pained knee joint with saline" (Rau, 4/14). Read the story.

Kaiser Health News: Insuring Your Health: Abortion Coverage Details Hard To Find On Marketplace Plans
Kaiser Health News consumer columnist Michelle Andrews writes: When it comes to coverage of abortion services in plans sold on the health insurance marketplaces, opponents and supporters of abortion rights are in complete agreement on one thing: Coverage details need to be clearer" (Andrews, 4/15). Read the column.

Kaiser Health News: Patients Often Win If They Appeal A Denied Health Claim
Capital Public Radio's Pauline Bartolone, working in collaboration with Kaiser Health News and NPR, reports: "Federal rules ensure that none of the millions of people who signed up for Obamacare can be denied insurance -- but there is no guarantee that all health services will be covered" (Bartolone, 4/14). Read the story.

Kaiser Health News: Focus On Marketplace Enrollment Overlooks Millions Who Bought Private Insurance
APRN's Annie Feidt, working in partnership with Kaiser Health News and NPR, reports: "Want to know how many people have signed up for private insurance under Obamacare? Like the health care law itself, the answer is complicated. The Obama administration is tracking the number of plans purchased on HealthCare.gov and on the state exchanges, and this month reported that they had exceeded expectations by signing up 7.5 million people. In addition, federal officials have said that 3 million people have enrolled in Medicaid this year" (Feidt, 4/15). Read the story.

The New York Times: Budget Office Lowers Estimate For The Cost Of Expanding Health Coverage
The insurance expansion under the Affordable Care Act will cost $1.383 trillion over the next decade, more than $100 billion less than previous forecasts, the Congressional Budget Office said Monday. The nonpartisan budget office's report, an update to projections from February, shows the law costing less than in previous estimates in part because of the broad and persistent slowdown in the growth of health care costs. The news might come as welcome to Democrats on Capitol Hill and in the White House who are struggling to defend the law in an election year (Lowrey, 4/14).

Los Angeles Times: Obamacare Cost Forecast Is Reduced 7% By U.S. Fiscal Watchdog
Lower-than-expected health insurance premiums under Obamacare will help cut the long-term cost of the program 7% over the next decade, according to the latest report from the Congressional Budget Office. The government's reduction of $104 billion in subsidies for those premiums was the main factor that led the nonpartisan fiscal watchdog to cut its projection of the nation's federal deficit by nearly $300 billion through 2024 (Memoli, 4/14).

The Wall Street Journal: CBO Estimates U.S. Deficit Will Shrink More Than Expected In 2014
CBO also reduced the government's projected 10-year deficit by $286 billion, to $7.6 trillion, mainly because of lower subsidies related to the health-care law. Future Medicare spending was also revised lower. The estimates come during a brief period of rapidly shrinking budget deficits, forcing both political parties to rethink their approaches to taxes and spending heading into the November midterm elections. The White House and Republican lawmakers have battled over the deficit for years, primarily through protracted debates over how much revenue to collect and how to structure government programs (Paletta, 4/14).

Politico: Smaller Premium Hikes Forecast In 2014 For Obamacare
Coverage through the law will cost the federal government about $5 billion less than expected this year. And overall, the law's 10-year cost for the coverage provisions is pegged at $1.383 trillion -; $104 billion less than prior calculations. Both figures are lower than prior estimates mostly because the CBO and JCT anticipate premium subsidies being smaller (Haberkorn and Norman, 4/14).

USA Today: CBO Lowers Estimate Of Health Care Law Costs
Net costs in 2014 are due almost entirely to subsidies paid out to those who make less than 400% of the federal poverty level who enrolled in the health insurance exchanges, as well as the Medicaid expansion in some states. The government will pay out $1.84 trillion through 2024 for health exchanges and subsidies, Medicaid, the Children's Health Insurance Program and tax credits for small employers. But the budget office expects $456 billion in penalty payments from those who do not have health insurance as well as excise taxes on high-premium insurance plans, income taxes for those who make more than $200,000 a year, and payroll taxes that come from changes in employer coverage (Kennedy, 4/14).

The Associated Press: CBO: Deficits To Drift Lower ON Lower Health Costs
A Congressional Budget Office report Monday said this year's deficit will now be $492 billion, $23 billion less than previously estimated. Last year's deficit registered $680 billion, the first year in President Barack Obama's tenure that the deficit was less than $1 trillion (4/14). 

Poltiico: Sylvia Mathews Burwell: Do's And Don'ts
Sylvia Mathews Burwell will start her new gig with a lot of goodwill. Everyone knows she's not the Health and Human Services secretary who fumbled the launch of Obamacare, but the competent head of the wonky Office of Management and Budget. And then, something else will break. And then, Burwell could end up the one up on Capitol Hill, taking one for the team at the next round of Obamacare hearings, just like Kathleen Sebelius used to (Nather, 4/15).

The New York Times: Tax Preparers' New Role: Health-Coverage Advisers
The tax system provides both the carrot and the stick for people to obtain coverage. Tax preparers like Jackson Hewitt and H&R Block say they have helped tens of thousands of people apply for tax credits to help defray the cost of private insurance bought through the exchanges. In addition, the big tax service companies and makers of tax preparation software like Intuit's TurboTax are calculating potential penalties for those who do not have insurance (Pear, 4/14).

Los Angeles Times: Last Chance For Obamacare Ends Tuesday For Most Californians
After many deadline extensions and grace periods, Tuesday will mark the end of the first open enrollment for Obamacare in California. California's health insurance exchange is encouraging thousands of people who have started an application to finish before midnight Tuesday (Terhune, 4/14).

The Associated Press: Anti-Tax Group Praises Va. House Speaker
An anti-tax group Americans for Tax Reform is applauding House Speaker William J. Howell for his opposition to Medicaid expansion, praise that comes a year after the group advocated for new leadership in the House of Delegates (4/14). 

The Washington Post's Wonkblog: Medicare Reversed Payment Cuts, And Not Many Are Happy About It
Medicare's recent reversal of a proposed payment cut to private health plans – the second such reversal in two years – hasn't won a lot of rave reviews. Insurance analysts say they still anticipate lower payments to private Medicare Advantage plans in 2015. Some editorial pages and supporters have criticized the Obama administration and lawmakers for easing off on Medicare Advantage cuts ordered by the president's health-care law (Millman, 4/14). 

Los Angeles Times: More U.S. Consumers Are Seeking Medical Care, Report Shows
A historic slowdown in U.S. healthcare spending in recent years may be drawing to a close.An industry report published Tuesday and healthcare experts point to a steady rise in medical care being sought by consumers seeing specialists, getting more prescriptions filled and visiting the hospital. Other factors such as millions of newly insured Americans seeking treatment for the first time and higher prices from healthcare consolidation could also help drive up costs (Terhune, 4/14).

The New York Times: Prices Soaring for Specialty Drugs, Researchers Find
Even as the cost of prescription drugs has plummeted for many Americans, a small slice of the population is being asked to shoulder more and more of the cost of expensive treatments for diseases like cancer and hepatitis C, according to a report to be released on Tuesday by a major drug research firm (Thomas, 4/15).

The Wall Street Journal: Medtronic Prevented From Selling Heart Valve In U.S.
In what doctors called a surprise ruling, a federal court has barred Medtronic Inc. from selling its new artificial heart valve to most patients in the U.S., despite finding that the device is "safer" and has "a lower risk of death" than a competing device. The ruling, issued Friday by U.S. District Judge Gregory M. Sleet of Delaware, would give Edwards Lifesciences Corp. a near-monopoly on the sale of a new type of aortic heart valve that is implanted via a minimally invasive procedure, instead of through open-heart surgery. Medtronic is appealing the ruling, but for now has stopped training new doctors in how to use the devices, and told surgeons already using the valves not to schedule any new procedures, the company said (Walker, 4/14).

The Wall Street Journal: Executive Who Led Wal-Mart Expansion Into Health Care Steps Down
The executive who led Wal-Mart Stores Inc.'s expansion into providing health services has left the company, as the retailer plans to make another push at providing care through its stores. John Agwunobi stepped down from his job running the retailer's health and wellness division after seven years at Wal-Mart, according to an internal memo sent to staff earlier this month. He will be replaced by Labeed Diab, who most recently led Wal-Mart's U.S. Midwest division (Banjo, 4/14).

The Associated Press: NY Gets Final Terms For $8B Medicaid Waiver
New York and federal officials report final agreement allowing the state to reinvest $8 billion in Medicaid savings to support hospital overhauls and expand primary medical care over the next five years. The goal of the Medicaid waiver is to reduce avoidable hospital use by 25 percent while helping financially struggling hospitals shift to more primary and outpatient care (4/14).