First Edition: May 14, 2014

Today's headlines include stories about consumer frustrations about cost and coverage issues that are emerging with the health law's implementation.  

Kaiser Health News: Brew Pub Owner Frustrated That Health Plan Prices Still Jumping
Ideastream's Sara Jan Tribble, working in partnership with Kaiser Health News and NPR, reports: "Until now, if employees were healthy and claims were few (as they are at Fat Head's), the company's cost of insuring those employees was relatively low. But, for a small business, if even one employee was in a car accident or was diagnosed with cancer, the amount the insurance company charged the firm to cover those employees could skyrocket the next year. The insurance industry called this "experience rating," and it is changing under the health law, says Steve Millard, who heads a small business association in Cleveland" (Tribble, 5/14). Read the story.

Kaiser Health News: Capsules: Do Seniors Have Too Many Medicare Plans To Choose From?
Now on Kaiser Health News' blog, Phil Galewitz reports: "While choice may sound like a good thing, many seniors say they find it difficult to compare plans. As a result, they often stick with the same plan even if it is not best suited to them, according to a new report from the Kaiser Family Foundation based on conversations with beneficiaries in Memphis, Tennessee; Tampa, Florida; Baltimore; and Seattle" (Galewitz, 5/14). Check out what else is on the blog.

The Associated Press: Consumers Losing Doctors With New Insurance Plans
Before the law took effect, experts warned that narrow networks could impact patient's access to care, especially in cheaper plans. But with insurance cards now in hand, consumers are finding their access limited across all price ranges. The dilemma undercuts President Obama's 2009 pledge that: "If you like your doctor, you will be able to keep your doctor, period." Consumer frustration over losing doctors comes as the Obama administration is still celebrating a victory with more than 8 million enrollees in its first year (5/13). 

The Wall Street Journal's Washington Wire: Federal Funding And State Health-Care Exchanges
Conservatives have long argued that "first dollar" insurance coverage helps raise the cost of health care, as people tend to overconsume services they perceive as free. Implementation of state insurance exchanges appears to confirm that hypothesis: Several states that used "free" federal dollars to build complicated exchanges may end up scrapping them. Officials in Maryland and Massachusetts are trying to determine whether their tech-troubled exchanges can be salvaged in time for the next open season of the Affordable Care Act. Oregon officials voted last month to scrap the state's problematic exchange and switch to the federal system. In general, states building less complicated exchanges suffered fewer technical glitches. Oregon Gov. John Kitzhaber said last year that "one could argue in retrospect we bit off more than other states" (Jacobs, 5/13). 

The Washington Post's Wonkblog: One Health Insurer Wants To Cut Rates 6.8 Percent. Another Wants To Hike Them 26 Percent. What Gives?
The first Obamacare enrollment period barely just ended, and it's already time for insurers in some states to file information on premiums for 2015. The 2014 rate filings last year became major political stories in a non-election year, so it's safe to assume the same will happen this year. And the 2015 rates will give us a glimpse into the future of the health-care industry (Millman, 5/13). 

Los Angeles Times: Obamacare Brings Expanded Coverage And Higher Costs To California
Enrollment in California's healthcare program for the poor has soared as the state implements President Obama's federal overhaul, pleasing advocates who have sought expanded coverage but also presenting new costs for the state. Nearly one-third of California's total population -- roughly 11.5 million people -- will be enrolled in Medi-Cal next year, according to Gov. Jerry Brown's administration (Megerian, 5/13). 

The Washington Post: What's Obamacare Doing In A Debate Over Fairfax County Water Agency Appointee? 
The national debate over the Affordable Care Act seemed an unlikely topic of discussion at Tuesday's meeting of the Fairfax County Board of Supervisors -; especially since the item on the agenda was whether to reappoint a longtime member of the local water authority. Yet the law was what the supervisors focused on, specifically a letter to members of Congress written last fall by water board veteran Burton J. Rubin, warning that the insurance requirements of the Affordable Care Act would cause the water authority to stop insuring its employees (Olivo, 5/13). 

The Washington Post's Wonkblog: These States Rejected Obamacare's Medicaid Expansion, But Medicaid Is Expanding There Anyway
Even states that refused Obamacare's Medicaid expansion are seeing enrollment growth in the health-care program, according to a new analysis. Medicaid enrollment in 17 of the 26 states that hadn't expanded Medicaid as of the end of March saw their rolls increase by a combined 550,300 new beneficiaries, reports the Avalere Health consulting firm. The Affordable Care Act expands the Medicaid program to adults earning under 138 percent of the federal poverty level, but the 2012 Supreme Court decision on the health-care law said states couldn't be forced to expand their programs. About half the states haven't joined, mainly arguing that Medicaid is a broken, unaffordable system (Millman, 5/13). 

The Associated Press: Medicaid Rolls Grow In States Resisting Health Law
States that thus far have refused a federal offer to expand Medicaid are still seeing significant sign-ups for the safety-net program that serves the poor, according to a report Tuesday that raises political and budget implications. The market analysis firm Avalare Health estimated that at least 550,300 more people signed up for Medicaid through the end of March in 17 out of 26 states that have not yet expanded eligibility for the program under President Barack Obama's health care overhaul. The actual number could be markedly higher since Avalere did not report data for populous Florida (5/13). 

The Wall Street Journal: Sen. Marco Rubio Calls For Social Security, Medicare Changes
Sen. Marco Rubio (R., Fla.), considered a likely presidential candidate in 2016, on Tuesday called for structural changes to Social Security and Medicare as a way to control spending for both programs, which are growing steadily as the U.S. population ages. Without changes, the program's financial problems will continue until "the programs will cease to exist certainly as we know them," Mr. Rubio said in a speech at the National Press Club. There were 45.9 million Americans receiving Social Security retirement benefits last year, and the program paid out roughly $638 billion in benefits (Paletta, 5/13). 

USA Today: Marco Rubio Embraces Paul Ryan's Medicare Overhaul
Rubio has previously offered support for Ryan's proposal to transition the entitlement program from a guaranteed benefit to a "premium support" system where seniors are given federal vouchers to purchase insurance on the private market, but his speech offered his clearest policy prescriptives yet on how to shore up the safety net for future generations. He said the changes would not apply to those 55 and older. His policy positions -; including a recent stance that humans are not causing climate change -; are of increasing interest as the senator mulls a 2016 GOP presidential campaign (Davis, 5/13). 

The Wall Street Journal: Task Force Accuses 90 Of Bilking Medicare
A federal task force on Tuesday charged 90 people, including 16 doctors, with generating $260 million of false Medicare billings following raids in cities across the country. The arrests mark the seventh notable crackdown by the Medicare Fraud Strike Force, a joint effort of the Justice Department and the Department of Health and Human Services launched in 2007 (Carreyrou and Steward, 5/13). 

The Wall Street Journal: Brown's Budget Boosts Spending In California
California is enjoying a $4.4 billion surplus this fiscal year, according to Mr. Brown's revised budget, and income-tax revenue remains above forecasts, even though April's take fell 12.6% from a year earlier. But the state also is facing increases in costs from Medi-Cal, the state's Medicaid program, drought relief and education spending. With the governor's revised plan-;which calls for nearly $1 billion more in spending than his draft proposal in January-;budget negotiations with the state legislature now begin in earnest. Mr. Brown is facing pressure from members of his own party to create new spending programs and restore money to social programs cut during the recession (Lazo, 5/13). 

Los Angeles Times: O.C. Clears Way For Court-Ordered Treatment Of Mentally Ill
Driven to action by the death of a schizophrenic homeless man, Orange County on Tuesday became the first large county in California to implement a law clearing the way for court-ordered treatment for the severely mentally ill (Cowan and Esquivel, 5/13).