"Obamacare: Where's The Train Wreck?"
"Obamacare And The Hard, Central Truth Of Contemporary Conservatism"
Key priority of Burwell: Improving HealthCare.gov, sans the politics. "Sylvia Mathews Burwell, the secretary of Health and Human Services, said Monday in her first major speech that she wanted to move beyond the politics of health care and work with members of both parties to improve the management and operation of HealthCare.gov, the website used by millions of people to sign up for insurance coverage....Ms. Burwell said she wanted to shift the conversation to areas of potential agreement. Polls consistently show that the public remains more negative than positive on the Affordable Care Act, but that Americans want Congress to improve the law rather than to repeal it." Robert Pear in The New York Times.
Explainer: Challenges ahead for Obamacare in its second year. Elise Viebeck in The Hill.
HHS spends $60M to help people navigate marketplaces in second enrollment season. "The Department of Health and Human Services (HHS) divided the money between 90 organizations that will provide in-person assistance to people shopping for health plans....The awards span community non-profits, universities, tribal groups and charities in 34 states. At least two Planned Parenthood affiliates were included.. Elise Viebeck inThe Hill.
Rural enrollment could pose continuing challenge. "Americans living in rural areas will be a key target as states and nonprofit groups strategize how to enroll more people in health law insurance plans this fall. Though millions of people signed up for private insurance or Medicaid in the first year of the Affordable Care Act, millions of others did not. Many live in rural areas where people 'face more barriers,' said Laurie Martin, a RAND Corp. senior policy researcher....Distance is one problem....But the most significant barriers may stem directly from state decisions about whether to expand Medicaid eligibility — more than 20 states chose not to — and whether to operate their own health exchanges." Shefali Luthra in Kaiser Health News.
Narrow-network ACA plans aren't so bad after all, research suggests. "Health economists actually tend to be quite fond of these products, as they help hold down spending. The potential for savings is big: limited choice plans can reduce patient spending by as much as a third, new research from economists Jon Gruber and Robin McKnight finds. Using a natural experiment from Massachusetts, Gruber and McKnight find that patients who switched to narrow network plans had access to a smaller set of equally good hospitals. They used more primary care but went to the emergency room less. And these patients, along with their employers, ended up saving a whole bunch of money." Sarah Kliff in Vox.
Obamacare has let young people stay on parents' plans longer, but studies question overall benefits. "As expected, it increased the rate of health insurance among young adults....But the provision didn't change whether the age group perceived themselves as healthier or whether they thought health care was any more affordable, according to a new study in JAMA Pediatrics....In another study out today, Stanford University researchers...analyzing 2011 data from California, Florida and New York hospitals, the researchers found that the under-26 group had 2.7 fewer ER visits per 1,000 people than the older group." Jason Millman in The Washington Post.
And another study finds Medicaid expansion boosting ER visits overall. "Many people newly insured by Medicaid under the federal health care law are seeking treatment in hospital emergency rooms, one of the most expensive medical settings, a study released Monday concludes....It also found indications that newly insured Medicaid patients admitted to hospitals may be sicker than patients previously covered under the same program, which serves more than 60 million low-income and disabled people. The findings have implications for federal and state policymakers managing the coverage expansion under President Barack Obama's health care law." Ricardo Alonso-Zaldivar in the Associated Press.
McAuliffe retreats on Medicaid expansion in Virginia, puts forth modest expansion. "Gov. Terry McAuliffe of Virginia took only modest steps on Monday to extend health care to the poor and disabled....Mr. McAuliffe, who in June ordered his cabinet to devise a plan for unilateral action by Sept. 1...announced that only 25,000 uninsured Virginians would be receiving coverage, far fewer than the 400,000 he has said are eligible if the state expands Medicaid under the Affordable Care Act. The retreat seemed Mr. McAuliffe’s acceptance that he is politically hemmed in, especially after Republicans took control of both houses of the General Assembly following the surprise resignation of a Democratic senator in June." Trip Gabriel in The New York Times.
KLEIN: GOP governors' cave-in on Medicaid expansion is short-sighted. "In reality, under Obamacare, the federal government only fully pays for the Medicaid expansion through 2016. After that point, states will have to start paying for a portion of the expansion, eventually covering 10 percent of its cost. Though that doesn’t seem like a lot, it’s worth keeping in mind that Medicaid is already a major burden on state budgets....Twenty-one states are 'not moving forward at this time' with Medicaid expansion, according to a tally by the Kaiser Family Foundation. If their governors and lawmakers resist the pressure of hospital lobbyists and withstand liberals’ public shaming campaign, they will be doing a service to future generations." Philip Klein in the Washington Examiner.
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