Tagged Obamacare Plans

Must-Reads Of The Week From Brianna Labuskes

On this Friday the 13th, we’re wrapping up another week dominated by the upcoming battle over the next Supreme Court justice and the administration’s scramble to reunite separated families — not to mention new efforts to chip away at the health law.

Don’t feel overwhelmed. Here are some of the best stories on all that news and more.

The battle brewing over Supreme Court nominee Brett Kavanaugh highlights the political complexities of the upcoming midterms. In the Senate, where the battleground favors conservatives, the vote is an albatross around vulnerable red-state Democrats’ necks. But in the lower chamber, the fights are being waged in swing suburban districts around the country, giving Democrats the chance to appeal to independents and moderate Republicans.

The New York Times: Who Might the Court Fight Help in the Midterms? Democrats. and Republicans.

However, Democrats — in what even they say is a classic problem with the party — can’t seem to focus their message. Yes, they’re talking health care (threats to not only abortion but the health law itself). But they’re also focusing on presidential power and unions and LGBTQ rights and … the list goes on.

Politico: Dems Pitch Mixed Messages in Supreme Court Fight

(On that note, my favorite quote of the week comes from Politico’s coverage of Senate Minority Leader Chuck Schumer trying to get his people in line: “I’ll be 71 years old in August, you’re going to whip me? Kiss my you know what,” said Sen. Joe Manchin (D-W.Va.) when asked if Schumer can influence his vote.)

States are also scrambling to make sure they don’t have any centuries-old laws on the books banning abortions … just in case.

The Associated Press: States Brace for Abortion Fights After Kavanaugh Nomination

Even though the government missed the court-ordered deadline, officials have announced that all “eligible” children under age 5 have been reunited with their families. That still leaves 46 “ineligible” kids, plus thousands of older ones still in custody.

The New York Times: U.S. Says It Has Reunited Half of All Migrants Under 5, With Rest ‘Ineligible’

And somehow Health and Human Services Secretary Alex Azar has become the public face (and punching bag) of this crisis.

Politico: How the New Face of the Migrant Crisis Got Stuck With the Job

The health law absorbed a one-two blow this week. Not only did the administration slash funding for navigators (counselors who help people sign up for coverage), but it also froze a program that provides billions of dollars to insurers to help stabilize the marketplace. The reaction to both was fairly tempered, though. (Which might be a sign that upheaval and uncertainty has become the new norm.)

Politico: Latest Obamacare Shake-Up Could Fuel Rate Hikes

Modern Healthcare: CMS Risk-Adjustment Payment Freeze to Hit High-Cost Insurers Hardest

Pfizer’s agreement to roll back its price hikes earned the company flashy headlines. Looking more closely, the move doesn’t really translate to savings for consumers.

Stat: What Pfizer, Trump, and Consumers Got Out of a Surprising Deal

Be sure to check out this deep dive on the CEO who, while having a knack for turning a profit, is described as tone-deaf to the current outrage on drug prices.

Stat: How Pfizer’s CEO Kept on Raising Prices — Until Trump’s Tweet

If all that wasn’t enough news for you, here’s my miscellaneous file for the week: A startling report finds that drug distributors shipped the equivalent of about 260 opioid pills for every person in Missouri in a six-year period; despite New York’s abundance of world-class hospitals and surgeons, thousands of patients needing transplants are languishing on lists because New Yorkers donate organs at a lower rate than anywhere else in the country; and the administration tried to water down a global resolution on breastfeeding, resorting to trade threats and backing off only when Russia stepped in to introduce the measure.

The Washington Post: Companies Shipped 1.6 Billion Opioids to Missouri From 2012 to 2017, Report Says

The New York Times: New York Has World-Class Hospitals. Why Is It So Bad for People in Need of Transplants?

The New York Times: U.S. Opposition to Breast-Feeding Resolution Stuns World Health Officials

And just when we were getting over the romaine lettuce outbreak, we have not one but two more food-related illnesses popping up.

Have a great weekend!

Outrageous Or Overblown? HHS Announces Another Round Of ACA Navigator Funding Cuts

The Trump administration’s decision Tuesday to slash funding to nonprofit groups that help Americans buy individual health insurance coverage sparked outrage from advocates of the Affordable Care Act. Using words like “immoral” and “cold-hearted,” they saw it as the Republicans’ latest act of sabotage against the sweeping health law.

But as the ACA’s sixth open-enrollment period under the health law approaches in November, the lack of in-person assistance is unlikely to be a disaster for people seeking coverage, insurance and health experts say.

“I think alone it will have a very small impact on enrollment for 2019,” said William Hoagland, a senior vice president with the Bipartisan Policy Center in Washington.

But combined with other recent actions by the Trump administration, the decision sets a negative tone, Hoagland said.

“It does send a signal of course that the administration is not promoting enrollment,” he said.

The Centers for Medicare & Medicaid Services announced it is cutting money to the groups known as navigators from $36 million to $10 million for the upcoming 45-day enrollment period.

This reduction comes a year after the Trump administration decreased navigators’ funding by 40 percent from $62.5 million — and cut advertising and other outreach activities.

CMS Administrator Seema Verma said the navigators that operate in the 34 states that use the federal marketplace — including many health and religious organizations — were ineffective and had outlived their usefulness.

She pointed out that they helped with fewer than 1 percent of enrollments in 2017 — though she counts navigators as “helping” only if consumers sign up in their presence.

CMS also notes that after last year’s navigator funding was reduced, the overall enrollment in Obamacare plans increased slightly (when counting people who paid their first month’s premiums) to 10.6 million people.

Florida Blue, an insurer that enrolls among the largest number of Obamacare consumers nationwide, said it won’t miss the help from the federally funded grass-roots helpers.

“Given our large and unique distribution-channel strategy of utilizing our retail centers along with our telesales efforts, our dedicated field agents and our direct in-market enrollment efforts, we do not depend on navigators to enroll ACA members,” said spokesman Paul Kluding.

Greg Fann, a fellow with the Society of Actuaries, said the role of navigators has been overstated.

“I am a numbers guy, and what really matters to people are the numbers and price of the coverage,” he said. Nearly 9 in 10 people buying coverage on the ACA exchanges qualify for federal subsidies based on their incomes, and the amount those subsidies rose last year because of an increase in silver-plan premiums.

The navigators, Fann added, were needed more in 2013 and 2014 when the marketplaces were in their first years and millions of people who hadn’t bought insurance before were considering the health law’s new options.

Insurers and brokers, Fann said, should step in to make up for navigator funding.

Don’t count on it, said Steve Israel, a Boynton Beach, Fla., insurance agent and past president of the Florida Association of Health Underwriters. He said most independent brokers want nothing to do with ACA plans because insurers have cut their commissions. “We’ve been sending people to navigators,” Israel said.

Some states that operate their own marketplaces, however, are continuing to invest in these grass-roots aides.

Covered California, for example, is holding its navigator funding steady, dedicating $6.5 million to navigators in this year’s budget.

That’s more than half of what healthcare.gov is investing in navigators in 34 states.

California has 1.5 million people in Obamacare plans, second highest in the nation behind Florida, which has 1.6 million.

Death By 1,000 Cuts? 

Trump spent his first year in office trying to repeal the health law and came within one vote in the U.S. Senate of achieving that goal. Immediately after Sen. John McCain (R-Ariz.) cast the deciding vote to block the dramatic repeal effort, Trump implored Republicans to let the law disintegrate.

“Let ObamaCare implode, then deal,” Trump tweeted on July 28, 2017.

But his administration has not stood idly by.

The Republican-controlled Congress in December passed a law that next year will eliminate the requirement that most Americans have insurance, a move likely to drive healthier people out of insurance market and lead to higher prices for those who are left.

Just last week, CMS said because of a pending lawsuit it was suspending a program created by the law to even out the burden on health insurers whose customers are especially unhealthy or sick. That could take millions of dollars away from some insurers, causing them to hike prices or abandon markets.

The Trump administration also issued new rules to try to make it easier for individuals and small businesses to buy health plans that cost less than ACA coverage because they cover fewer medical services. These plans would bypass the law’s protections that prevent companies from charging higher prices to women, older people and those with preexisting medical conditions.

Critics deride such plans as “junk insurance.”

CMS now wants the navigators to promote these policies in addition to steering people toward ACA-compliant plans and Medicaid.

This adds to the concern about the lack of navigator funding.

The availability of such new types of coverage will increase consumer demand for specially trained navigators, said Elizabeth Hagan, a senior consultant with Transform Health, a consulting firm.

She said the problem with reducing consumer assistance is not so much that fewer people will buy coverage but that people will buy policies that don’t fit their needs.

Jodi Ray, who leads the University of South Florida’s navigator program — the largest one in the state — said her staffers do much more than help with enrollment. They also help consumers file appeals with insurers.

“This is how health care disparities are exacerbated — we will be put in the awful position of pitting populations that need assistance against each other in order to prioritize how we can use the resources,” she said.

California Healthline reporter Ana B. Ibarra contributed to this report.

Must-Reads Of The Week From Brianna Labuskes

It’s been a week since a tweet went viral about an injured woman begging fellow train passengers not to call an ambulance for fear of the expense — and the story is still resonating. It was a snapshot of our reality, a shocking but relatable moment, where we all wondered: When is a $3,000 ride to the hospital worth it?

Here are some other stories — and yes, much longer than 140 or so characters — that will make you think as well.

Democrats are walking a tightrope as they strategize for the upcoming Supreme Court nominee battle. They have a base that’s raring for a knock-down, drag-out brawl on one side, and vulnerable red-state candidates that need protection on the other. Help might come from an unlikely source: the health law.

The Associated Press: Dems Want to Focus High Court Fight on Abortion, Health Care

As lawmakers gird for the fight even before a nominee is picked, President Donald Trump mulls over his short list. But we can expect a choice as early as Monday.

The Washington Post: Trump Narrows List for Supreme Court Pick, With Focus on Kavanaugh and Kethledge

“Death spiral” and “doomsday” predictions were thick on the ground last year when it came to the health law marketplaces, but the exchanges are proving to be surprisingly resilient to any attempts to kill them.

The New York Times: Obamacare Is Proving Hard to Kill

The Washington Post: More Americans Pay for ACA Health Plans, Despite Trump Administration Moves to Undercut Law

True to his word, Kentucky Gov. Matt Bevin announced the state is cutting benefits for Medicaid recipients as “an unfortunate consequence” of a judge’s ruling on Kentucky’s work requirements waiver. But, it might be a little more complicated than that: Some say the announcement is actually misleading and people will continue receiving limited coverage.

Modern Healthcare: Questions Arise Over Kentucky’s Medicaid Cuts Following Work Requirement Rejection

Is the convenience of getting prescription pills at your door worth handing over a ton of your personal health care information to Amazon? The company is in a league of its own when it comes to analyzing consumers’ shopping behaviors and preferences — and critics wonder what will happen when it is handed sensitive health care data.

The Wall Street Journal: Amazon’s PillPack Deal Gives It Access to Sensitive Health Data

In the miscellaneous file this week: the heartbreaking story of the unclaimed AIDS victims buried during the height of the crisis on a small island in New York; revelations about a persistent weakness in the nation’s food-safety system — with a lot of fingers pointing at the Food and Drug Administration; in an experiment right out of pulp fiction, scientists have shown that zapping the front part of someone’s brain can actually curb aggressive tendencies; and people are rushing to get their genes checked for dangerous mutations — but are failing to read the small print where it says those results could be completely and totally wrong.

The New York Times: Dead of AIDS and Forgotten in Potter’s Field

Politico: Victims Blame FDA for Food-Recall Failures

Stat: Can Zapping Brains Reduce Violence? Controversial Study Sees Potential

The New York Times: The Online Gene Test Finds a Dangerous Mutation. It May Well Be Wrong.

In news that cheered many a journalist in this newsroom (though not me, because I don’t drink coffee), a new study finds that you should indulge in that cup of joe in the morning: You might live longer for it.

Must-Reads Of The Week From Brianna Labuskes

It’s been a week since a tweet went viral about an injured woman begging fellow train passengers not to call an ambulance for fear of the expense — and the story is still resonating. It was a snapshot of our reality, a shocking but relatable moment, where we all wondered: When is a $3,000 ride to the hospital worth it?

Here are some other stories — and yes, much longer than 140 or so characters — that will make you think as well.

Democrats are walking a tightrope as they strategize for the upcoming Supreme Court nominee battle. They have a base that’s raring for a knock-down, drag-out brawl on one side, and vulnerable red-state candidates that need protection on the other. Help might come from an unlikely source: the health law.

The Associated Press: Dems Want to Focus High Court Fight on Abortion, Health Care

As lawmakers gird for the fight even before a nominee is picked, President Donald Trump mulls over his short list. But we can expect a choice as early as Monday.

The Washington Post: Trump Narrows List for Supreme Court Pick, With Focus on Kavanaugh and Kethledge

“Death spiral” and “doomsday” predictions were thick on the ground last year when it came to the health law marketplaces, but the exchanges are proving to be surprisingly resilient to any attempts to kill them.

The New York Times: Obamacare Is Proving Hard to Kill

The Washington Post: More Americans Pay for ACA Health Plans, Despite Trump Administration Moves to Undercut Law

True to his word, Kentucky Gov. Matt Bevin announced the state is cutting benefits for Medicaid recipients as “an unfortunate consequence” of a judge’s ruling on Kentucky’s work requirements waiver. But, it might be a little more complicated than that: Some say the announcement is actually misleading and people will continue receiving limited coverage.

Modern Healthcare: Questions Arise Over Kentucky’s Medicaid Cuts Following Work Requirement Rejection

Is the convenience of getting prescription pills at your door worth handing over a ton of your personal health care information to Amazon? The company is in a league of its own when it comes to analyzing consumers’ shopping behaviors and preferences — and critics wonder what will happen when it is handed sensitive health care data.

The Wall Street Journal: Amazon’s PillPack Deal Gives It Access to Sensitive Health Data

In the miscellaneous file this week: the heartbreaking story of the unclaimed AIDS victims buried during the height of the crisis on a small island in New York; revelations about a persistent weakness in the nation’s food-safety system — with a lot of fingers pointing at the Food and Drug Administration; in an experiment right out of pulp fiction, scientists have shown that zapping the front part of someone’s brain can actually curb aggressive tendencies; and people are rushing to get their genes checked for dangerous mutations — but are failing to read the small print where it says those results could be completely and totally wrong.

The New York Times: Dead of AIDS and Forgotten in Potter’s Field

Politico: Victims Blame FDA for Food-Recall Failures

Stat: Can Zapping Brains Reduce Violence? Controversial Study Sees Potential

The New York Times: The Online Gene Test Finds a Dangerous Mutation. It May Well Be Wrong.

In news that cheered many a journalist in this newsroom (though not me, because I don’t drink coffee), a new study finds that you should indulge in that cup of joe in the morning: You might live longer for it.