First Edition: September 18, 2013

Today's headlines include reports about the Census Bureau's latest figures on the nation's uninsured as well as Congressional Budget Office long-term deficit projections and how that news fits into events in the ongoing Capitol Hill budget battles. 

Kaiser Health News: FAQ: How Is Employer-Sponsored Health Insurance Changing?
Kaiser Health News staff writer Jay Hancock reports: "Employers are raising deductibles, giving workers health savings accounts that look like 401(k) plans, mimicking the health law's online insurance marketplaces and nudging patients to compare prices and shop around for treatments. Together the moves could eventually affect far more consumers than the law's Medicaid expansion or health exchanges aimed at the uninsured and scheduled to open Oct. 1. Here's a rundown" (Hancock, 9/17). Read the story.

Kaiser Health News: 48 Million Americans Remain Uninsured, Census Bureau Reports
Kaiser Health News staff writer  Phil Galewitz reports: "The rate of uninsured Americans dropped slightly for the second consecutive year in 2012, from 15.7 percent to 15.4 percent, largely a result of more people enrolling in Medicare and Medicaid, the U.S. Census Bureau reported Tuesday.The closely-watched report found that about 48 million Americans were uninsured in 2012, down from 48.6 million in 2011, a change the agency said is not statistically significant. The report is the last look at the uninsured before the major coverage expansions of President Barack Obama's health law take effect in January" (Galewitz, 9/17). Read the story. 

Kaiser Health News: A Guide To The Lawsuits Challenging Obamacare's Contraception Coverage Requirements
Reporting for Kaiser Health News, Kelsey Miller writes: "Even with so much attention focused on the Oct. 1 launch of the health law's state insurance exchanges, one of the Affordable Care Act's most controversial elements is still percolating through the nation's legal system" (9/17). Read about some of the notable cases.

Kaiser Health News: Labor Dept. Mandates Minimum Wage, Overtime Pay For Home Health Workers
Reporting for Kaiser Health News, Susan Jaffe writes: "The U. S. Department of Labor issued new rules Tuesday that mandate home health care agencies pay their workers the minimum wage and receive overtime pay starting in 2015. 'Almost 2 million home care workers are doing critical work, providing services to people with disabilities and senior citizens who want to live in community settings and age in place in their familiar surroundings,' said Secretary of Labor Thomas Perez" (Jaffe, 9/17). Read the story.

Kaiser Health News: Health Plans Won't be Able To Drop Individuals From Coverage (Video)
Insuring Your Health columnist Michelle Andrews helps you navigate the new insurance marketplaces that are scheduled to launch on Oct. 1. Today Andrews answers a questions about whether an insurer can drop a consumer from a planned purchased from the exchange (9/18). Watch the video or watch other videos from this series.

Kaiser Health News: Capsules: Sebelius Makes Third Visit To Florida In A Week; Insurance Marketplace 101: Answering Consumer Questions
Now on Kaiser Health News' blog, The Miami Herald's Daniel Chang, working in partnership with KHN, writes about Health and Human Services Secretary Kathleen Sebelius' latest Florida visit: "As home to nearly four million residents with no health insurance and state legislators opposed to Obamacare, Florida holds a large stake in the outcome of federal healthcare reform, U.S. Health and Human Services Secretary Kathleen Sebelius told students, local health officials and politicians during a visit to Miami Dade College Tuesday" (Chang, 9/18).

Also on the blog, KHN's Mary Agnes Carey and Julie Appleby were hosted by the Washington Post's Charity Brown yesterday for a live discussion with Post readers about how the new online marketplaces will work under the health law. A transcript of that discussion is posted (9/17). Check out what else is on the blog. 

The Wall Street Journal: Medical-Price Inflation Is At Slowest Pace In 50 Years
Medical prices are rising at their slowest pace in a half century, a shift in the health-care industry that could provide relief to government and businesses' budgets while also signaling consumers are being left with a larger share of the bill. The prices paid for medical care in July rose just 1% from a year earlier, the slowest annual rate of growth since the early 1960s, according to Commerce Department data. Health-care increases now trail overall inflation, which itself has been historically slow in recent years (Morath and Radnofsky, 9/17).

The New York Times: Budget Office Warns That Deficits Will Rise Again Because Cuts Are Misdirected
Annual federal deficits will continue to fall in the short term, the budget office reported in its yearly long-term outlook, because of the recent spending cuts in military and domestic programs and rising tax collections in a recovering economy. … But starting in 2016, deficits are projected to rise again as more baby boomers begin drawing from Medicare, Medicaid and Social Security -; the fast-growing entitlement programs, which Democrats and Republicans cannot agree on how to rein in (Calmes, 9/17).

The Associated Press/Washington Post: Congressional Budget Office Study Warns Of Long-Term Debt Woes In United States
The government has never defaulted on its obligations and Treasury Secretary Jacob Lew warned Tuesday that Congress needs to act to increase the debt limit by mid-October but he warned Republicans that President Barack Obama will never go along with their demand to derail implementation of the new health care law as part of a measure to fund the government or increase the debt limit (9/17).

Los Angeles Times: Treasury's Lew Warns Congress It's Risky To Delay Raising Debt Limit
As the nation fast approaches its debt limit, Treasury Secretary Jacob J. Lew issued his strongest warning yet to Congress about the economic consequences of waiting until just before the deadline to pass an increase. … Republicans are balking at raising the $16.7-trillion debt limit, which Congress must do by as early as mid-October, unless the Obama administration agrees to major concessions including deep spending cuts and a delay in implementing the healthcare reform law (Puzzanghera, 9/17).

Los Angeles Times: Despite Shrinking U.S. Deficit, House GOP Eyes Government Shutdown
The federal deficit has shrunk to its lowest level since 2008, according to a report released Tuesday, but House Republicans will begin the next budget battle this week with a vote that threatens to shut down the federal government unless President Obama agrees to halt his healthcare law (Mascaro, 9/17). 

The New York Times: Percentage of Americans Lacking Health Coverage Falls Again
For the second year in a row, the proportion of Americans without health insurance declined in 2012, even though real household income and the poverty rate were not significantly different from their 2011 levels, the Census Bureau reported on Tuesday (Pear, 9/17).

Los Angeles Times: U.S. Poverty Rate Holds Steady Near A Generational High
The bureau's annual report on income, poverty and health insurance suggests that the economic wounds from the Great Recession are patched up but the economy still is struggling to return to full health. In one respect, the data released Tuesday could be seen as positive because things seemed to stabilize after the devastating recession. For the first time in five years, household income did not decrease and the poverty level did not increase last year, officials said. And there was further improvement in the healthcare coverage of Americans, an important indicator of economic security (Lee, 9/17).

The Washington Post: Household Income, Poverty Rate Are Flat For First Time Since Recession, Census Shows
If there was one bright spot in the census statistics, it was that about 400,000 more children had health insurance last year than in the previous year. Caroline Fichtenberg, director of research for the Children's Defense Fund, said that was largely because of the success of the Children's Health Insurance Program, which provides health coverage to children from families with incomes too high to qualify for Medicaid coverage. The census report said 3 million more people had health insurance in 2012, with the increase coming mostly from people with government health insurance, particularly Medicare. Eight in 10 Americans have health coverage, and more than half get it under employer-provided plans (Morello, 9/17).

Politico: Share Of U.S. Uninsured Falls, Census Data Show
The percentage of Americans without health insurance dipped slightly from 15.7 percent to 15.4 percent, mainly due to somewhat higher enrollments in Medicare and Medicaid, according to 2011-12 U.S. Census Bureau numbers released Tuesday. The rate of private health insurance held steady for the second year in a row after steadily eroding over the past decade (Norman, 9/18).

The Associated Press/ Washington Post: Republican Opposition To Health Care Law Flares In Both Houses Of Congress
Senior leaders warn the GOP could suffer significant political reverses if the party goes along with the plan and President Barack Obama and Democrats resist, as they have made clear they will, but it is strongly backed by senators with tea party ties and their influential allies outside Congress. Its leading advocate, Rep. Tom Graves of Georgia, said the proposal unifies the rank and file "around two objectives we have, keeping the government open and protecting our constituents from the harmful effects of Obamacare" (9/17).

Politico: GOP Vs. GOP In Hill Obamacare Squabble
A new GOP vs. GOP battle is brewing over Obamacare -; this time, over health care coverage for lawmakers and their staff. A growing number of Republicans are scoffing at Louisiana Sen. David Vitter's push to stop federal contributions that will help pay for health coverage for lawmakers and their staff under the new Obamacare exchanges. Vitter's crusade has effectively put his GOP colleagues in the unenviable position of hurting themselves and their staff financially or siding with another political attack on a law the party universally despises (Raju and Haberkorn, 9/18).

The Associated Press/Washington Post: House Conservatives Unveiling Alternative To 'Obamacare' With Bigger Tax Break For Consumers
A large group of House conservatives intends to unveil legislation providing an expanded tax break for consumers who purchase their own health coverage and increasing the government funding for high-risk pools, according to lawmakers who said the plan marked the Republicans' first comprehensive alternative to President Barack Obama's health care overhaul (9/18).

Politico: Mitch McConnell Gets Support On Obamacare
An outside group boosting Senate Minority Leader Mitch McConnell is preparing to go up with TV ads lauding him for his opposition to the Affordable Care Act, POLITICO has learned. The nonprofit Kentucky Opportunity Coalition plans to spend $325,000 on a week's worth of commercials running statewide, a strategist told POLITICO (Burns, 9/17).

The Associated Press/Washington Post: Hoping To Blunt GOP Complaints, White House Publicizing Health Care Program Security Measures
The Obama administration is planning a high-level effort to reassure Americans about the privacy and security of the information submitted under the new health care law, hoping to blunt complaints from Republican opponents that enough isn't being done to protect consumer data (9/18).

The Wall Street Journal: Health-Law Navigators Blasted In Republican Report
More safeguards are needed to ensure thieves don't impersonate government-funded "navigators" and nab financial details from people trying to sign up for health insurance, according to a report from Republican House investigators. The report raised concerns that official navigators, who get federal funding under the 2010 health law, won't have government IDs or other documentation to prove they are authorized to help enroll people for health insurance. The federal government won't maintain a list of authorized navigators or helpers, making it difficult for consumers to be confident when handing over sensitive personal information such as Social Security numbers, the report said (Schatz, 9/18).

The New York Times: Concern Over Drug Costs
Among the most troubling questions facing consumers as they shop for insurance under the Obama administration's new health care law is whether the plans will cover the drugs they take -; and how much they will have to pay for them. But with less than two weeks remaining until enrollment opens on Oct. 1, the answers are still elusive and anxiety is growing for consumers whose well-being depends on expensive medications (Thomas, 9/17).

The New York Times: Florida Among States Undercutting Health Care Enrollment
As many states prepare to introduce a linchpin of the 2010 health care law -; the insurance exchanges designed to make health care more affordable -; a handful of others are taking the opposite tack: They are complicating enrollment efforts and limiting information about the new program (Alvarez and Pear, 9/17).

NPR: Agreeing On Health Care In The Sunshine State Isn't So Sunny
At a community center named for Florida civil rights pioneer Carrie Meek, a few dozen members of Miami's National Church of God gathered over the weekend for a tea party-;and to hear from a special guest, Monica Rodriguez of Enroll for America. The organization is working to spread the word about the Affordable Care Act, the federal law that will let people without health insurance shop for coverage starting October 1 (Allen, 9/18).

The Washington Post: Maryland Reveals Prices For Small-Business Plans On New Health Insurance Exchange
Maryland insurance officials have approved premium rates for plans to be sold on the state's small-business health insurance marketplace, which will open at the start of next year, according to an announcement Tuesday (Harrison, 9/17).

The Associated Press/Washington Post: Md. Approves Policies, Rates For Small Business Health Exchange
Thirteen carriers have been approved to sell health benefit plans to small businesses through the new exchange, state health officials said Tuesday (9/17).

The Washington Post: Most States With Few Insured Citizens Aren't Expanding Medicaid Under Obamacare
States whose citizens are most likely to be uninsured are also more likely than not to refuse extra aid under the president's health-care law. Six of the 10 states with the lowest rates of coverage have no plans to expand low-income aid under Obamacare, according to an analysis of new Census data. Meanwhile, eight of the 10 states with the highest rates plan to allow the expansion (Chokshi, 9/17).

The New York Times: Reaping Profit After Assisting On Health Law
Washington's health care revolving door is spinning fast as the new online health insurance marketplaces, a central provision of President Obama's health care law, are set to open Oct. 1. Those who had a hand in the law's passage are now finding lucrative work in the private sector, as businesses try to understand the complex measure, reshape it by pressing for regulatory changes -; or profit from it (Stolberg, 9/17).

The Associated Press/Washington Post: AP Sources: House GOP Leaders May Try To Link 'Obamacare' Attack To Must-Pass Spending Bill
Moving on to Plan B, House GOP leaders appear likely to give tea party lawmakers a chance to use a routine temporary government funding bill to try to muscle the Democratic-controlled Senate into derailing President Barack Obama's health care law. It's a strategy fraught with political risk for Republicans, who could find themselves bearing the blame for any partial government shutdown that results from an impasse with the Senate (9/18).

The Wall Street Journal: Walgreen To Give Workers Payments To Buy Health Plans
Rising health-care costs and a climate of change brought about by the new federal health law are prompting American corporations to revisit the pact they've long had with employees over medical benefits. Walgreen Co. is set to become one of the largest employers yet to make sweeping changes to company-backed health programs. On Wednesday, the drugstore giant is expected to disclose a plan to provide payments to eligible employees for the subsidized purchase of insurance starting in 2014. The plan will affect roughly 160,000 employees, and will require them to shop for coverage on a private health-insurance marketplace. Aside from rising health-care costs, the company cited compliance-related expenses associated with the new law as a reason for the switch (Martin and Weaver, 9/17).

Los Angeles Times: Access To Healthcare For The Poor Varies Widely Among States
Access to affordable, quality healthcare for poor Americans varies dramatically among the states, according to a new study that found a wide disparity in measures of health between states with the best healthcare systems and those with the worst. In the highest-performing states, low-income, less educated residents are more likely to be covered by health insurance, to have a regular source of medical care and to get recommended preventive care, such as cancer screenings (Levey, 9/17).

USA Today: Study: State's Poor Health Care Affects All Income Levels
High-income people who live in states that generally do poorly in health care are worse off than low-income people in states with high health care scores, according to a Commonwealth Fund study released today (Kennedy, 9/18).

The New York Times: U.S. To Include Home Care Aides In Wage And Overtime Law
Advocates for low-wage workers have pushed for this change, asserting that home care workers, who care for elderly and disabled Americans, were wrongly classified into the same "companionship services" category as baby sitters -; a group that is exempt from minimum wage and overtime coverage. Under the new rule, home care aides, unlike baby sitters, would be covered under the Fair Labor Standards Act, the nation's main wage and hour law (Greenhouse, 9/17).

The Associated Press/Washington Post: Home Health Care Workers Could See Higher Wages Under New Rules Extending Minimum Wage, OT Pay
The Obama administration approved new rules Tuesday that extend minimum wage and overtime pay to nearly 2 million home health care workers who help the elderly and disabled with everyday tasks such as bathing, eating or taking medicine (9/17).

The Wall Street Journal: Labor Department Adds Protections for Home-Health-Care Workers
The Labor Department's new rule will take effect on Jan. 1, 2015. Many home-health workers already are paid more than the federal minimum wage-;currently $7.25 an hour-;but don't get paid time-and-a-half when they work more than 40 hours a week. Many have no health-care coverage themselves, the Labor Department said (Trottman and Maher, 9/18).