First Edition: April 8, 2014

Today's headlines include the Obama administration's announcement about Medicare Advantage rates.   

Kaiser Health News: Obama Administration Retreats On Private Medicare Rate Cuts
Kaiser Health News staff writer Jay Hancock reports: "Under intense, bipartisan political pressure, the Obama administration backed down for the second year in a row on proposed payment cuts for insurance companies that offer private plans to Medicare members. After estimating in February that the cuts required by the Affordable Care Act as well as other adjustments would reduce would reduce what it pays insurers next year by 1.9 percent per beneficiary, the Department of Health and Human Services said Monday it would instead give Medicare Advantage plans a raise of 0.4 percent" (Hancock, 4/8). Read the story.

Kaiser Health News: Insuring Your Health: Nevada Offers Rare Bet: Year-Round Sales Of Health Plans
Kaiser Health News consumer columnist Michelle Andrews writes: "For months, consumers have been warned that they have to buy health insurance by the end of open enrollment or remain uninsured until next year. But a little noticed provision of the health law may give some consumers another chance. Insurers that sell individual plans have to offer insurance to all comers during an annual open enrollment period, which this year ended for most people on March 31. However, the health law allows insurers to sell individual plans off the exchange outside the regular open enrollment if they wish to do so, as long as they don't discriminate against people who are sick" (Andrews, 4/8). Read the column.

Kaiser Health News: Capsules: Report: Jails House 10 Times More Mentally Ill Than State Hospitals
Now on Kaiser Health News' blog, Jenny Gold writes: "In 44 states and the District of Columbia, at least one prison or jail holds more people with serious mental illnesses than the largest state psychiatric hospital, according to a report released Tuesday by the Treatment Advocacy Center and the National Sheriffs' Association" (Gold, 4/8). Check out what else is on the blog.

The Wall Street Journal: Medicare Agency Says Payments To Insurers Will Rise In 2015
Federal regulators on Monday said they boosted planned payments to insurers that run private Medicare Advantage plans, issuing final rates that were higher than the cuts regulators proposed in February. The trims were opposed by many Republicans and some Democrats, creating a tough political situation for the Obama administration. These lawmakers said the result could have been higher rates or less choice for some seniors. The insurance industry launched a major lobbying campaign against the reduction (Mathews and Peterson, 4/7).

The Associated Press: Government Hikes Medicare Advantage Pay Estimate
The government has raised its payment estimate for Medicare Advantage plans months ahead of a busy election season during which cuts to the program promise to be a key focus for politicians and voters. The Centers for Medicare and Medicaid Services said Monday that 2015 payments to the plans should increase less than 1 percent overall. That compares to a drop of nearly 2 percent that the government forecast in February (4/7).

The Washington Post's Wonkblog: Obama Administration Reverses Proposed Cut To Medicare Plans
The reversal comes after a major lobbying effort from the health insurance industry and signals that Republicans would use the cuts to attack Democrats in this year's midterm elections. The Medicare Advantage program, according to the Avalere Health consulting firm, now covers about 16 million seniors, or 30 percent of all Medicare beneficiaries, through private health plans that can offer extra benefits, like wellness plans (Millman, 4/7).

Politico: Obamacare's Next Obstacle: Confusion As People Use It
Obama administration officials hoping to exhale after the big finish to Obamacare's first enrollment season may need to hold their breath a while longer. All the confusion and mixed messages out there are bound to combust if people decide they were misled -; an echo of the "you can keep your plan if you like it" fiasco (Villacorta, 4/7).

Politico: Obamacare And GOP Congress Collide
This race will be a high-profile test of what offends voters more: Obamacare or the Republican Congress. Romanoff is running squarely against House Republicans' agenda, and Coffman is banking on the hope that voters will be sufficiently outraged about Obama's health plan to turn out on Election Day (Sherman, 4/8).

The Associated Press: NY State Health Exchange Reports 908,000 
The Department of Health says enrollment for individual and family coverage since October includes nearly 422,000 New Yorkers in the 16 commercial and nonprofit insurers in the exchange and nearly 487,000 in government-funded Medicaid (4/8).

The Wall Street Journal: House Democrats Offer Different Budget Path
Democrats emphasized that their budget would not reduce spending for federal safety-net programs, including Medicare and Medicaid. In the GOP budget, Mr. Ryan proposes offering seniors a choice between traditional Medicare and private plans subsidized by the government, starting in 2024. He would also transfer much of the federal government's role in Medicaid to the states (Peterson, 4/7).

The Associated Press: House Democrats Unveil Budget Plan With Tax Hikes
Van Hollen's plan leaves in place so-called Obamacare and leaves the current Medicare system in place, whereas Ryan would repeal the law's benefits and set in motion a dramatic overhaul of Medicare for future retirees who are presently 55 or younger. It calls for extending refundable tax breaks for the working poor and providing them to childless workers as Obama calls for (4/7).

The Associated Press: Medical Assn. Won't Stop Medicare Doc Data Release
The nation's largest doctors' group said Monday it won't try to block Medicare's release of billing records for 880,000 physicians, although it continues to oppose the government's recent decision to open up the massive data trove. An official of the American Medical Association told The Associated Press that the group won't go to court ahead of Wednesday's scheduled release. The official spoke on condition of anonymity because the organization's policies allow only certain designated representatives to make on-the-record comments (4/7).

The Washington Post: MedStar Faces Tensions With Community Clinics Over Primary-Care Expansion In District
For a quarter-century, Mary's Center, a community health center in Adams Morgan, has served patients too poor to be treated elsewhere. Like many other ¬safety-net providers, which are required by the government to treat patients regardless of their ability to pay, the center has struggled constantly for money. … But in November, regional hospital giant MedStar Health opened a pair of clinics two blocks away offering just those services -; and wide-screen TVs, to boot -; so Mary's Center dropped its plans. It shelved proposals to offer radiology services, because MedStar was providing them. And then it began losing patients and doctors to MedStar. … The tension is an unintended consequence of the health-care law, which has set off an intense competition for a growing number of privately insured patients, who tend to be the best-paying customers (Sun, 4/7).

The Washington Post: Ex-Transportation Secretary Connaughton Picked To Lead Health-Care Association
A prominent hospital association has picked former governor Robert F. McDonnell's hard-charging transportation secretary to lead the organization as it continues to push House Republicans to expand Medicaid. The selection of Sean Connaughton as the next president of the Virginia Hospital and Healthcare Association surprised and upset some people on both sides of the Medicaid debate (Vozzella, 4/7).

The Associated Press: Arkansas AG Asks court To Reconsider Drug Ruling
Arkansas Attorney General Dustin McDaniel asked the state Supreme Court on Monday to reconsider its decision tossing out a $1.2 billion judgment against drugmaker Johnson & Johnson, saying justices did "significant harm" to the state and broke from 170 years of precedent. McDaniel filed a petition for rehearing over the high court's decision last month that the state misapplied the Medicaid fraud law in its lawsuit against New Jersey-based Johnson & Johnson and its subsidiary Janssen Pharmaceutical Inc. over the marketing of the antispyschotic drug Risperdal. McDaniel said last week that he would ask the court to revisit the ruling (4/7).

The Associated Press: Va. Govenror Signs Mental Health Bill
A key part of Sen. Creigh Deeds' efforts to fix Virginia's mental health system is now law. Gov. Terry McAuliffe signed legislation Monday that extends the length of time allotted for finding a psychiatric bed for those under an emergency custody order from six hours 12 hours. And after eight hours of searching, if no private beds can be found, a state hospital will now be required to admit those under an emergency custody order (4/7).

The Wall Street Journal's Metropolis: New York Officials Restore Millions For Spinal Cord Injury Research
New York state budget officials have restored nearly $7 million in annual funding for spinal cord injury research after an influential lobby of paraplegics put pressure on Albany lawmakers and Gov. Andrew Cuomo's administration. The group, New Yorkers to Cure Paralysis, had tried unsuccessfully since 2010 to restore about $8.5 million in annual state funding for the research, which they argued is required to be spent by state law. Roughly $2 million was restored last year, and Mr. Cuomo's original 2014 budget earmarked a total of $4.9 million (Kravitz, 4/7).

http://www.kaiserhealthnews.orgThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.



The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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