Administration Awards Grants To States For Health Insurance Exchanges.

The Los Angeles Times (10/1, Levey) reports, "The Obama administration awarded 49 grants Thursday to states and the District of Columbia to plan for new health insurance exchanges designed to help Americans shop for health plans beginning in 2014." These "state-based exchanges, a key foundation of the new healthcare law, are to become the central Internet-based marketplace for consumers who do not get health benefits at work." Officials "at the Department of Health and Human Services said Thursday that the grants, each about $1 million, would help states begin designing the systems and hiring staff," the Times adds.

        CQ HealthBeat (10/1, subscription required) reports, "HHS has set out specific tasks the money will help pay for," including "assessing current information technology (IT) systems and infrastructure and determining new requirements" and "developing partnerships with community organizations to include the public in the exchange planning process."

        States May Face Staffing Challenges In Implementing Health Reform. The Wall Street Journal (10/1, Mantell, subscription required) says that a report released by the Kaiser Family Foundation on Thursday indicates that states may not have enough staff to establish health exchanges, expand Medicaid enrollment, and implement other requirements in the healthcare law. The report, which focused on Connecticut, Michigan, Massachusetts, North Carolina, and Washington, found that the states do not have enough workers to implement these changes, and that it may be necessary to hire contractors. In addition, many of the states say that a third of their workforce may retire soon, which would further exacerbate the problem.

Insurers Abandon Healthcare Market, Blame Reform Law.

The New York Times (10/1, Abelson) reports that the Principal Financial Group, which "provides coverage to about 840,000 people," has announced that it "planned to stop selling health insurance, another sign of upheaval emerging among insurers as the new federal health law starts to take effect." According to the Times, "Principal's decision closely tracks moves by other insurers that have indicated in recent weeks that they plan to drop out of certain segments of the market." State regulators "say some insurance companies are already threatening to leave particular markets because of the new law," and "some...have asked the Obama administration to give insurers more time to comply with some of the new rules." The Administration "has already issued dozens of such waivers," and Nancy-Ann DeParle, director of the White House Office of Health Reform, "emphasized that the administration had been working closely with insurers and employers to deal with their concerns and objections."

        The Wall Street Journal (10/1, Johnson, subscription required) reports that UnitedHealth Group, Inc. has said that it will pick up the policies of the 840,000 Principal customers as they expire. Notably, DeParle, saying that health reform will increase competition in the insurance industry, pointed out, "Having 30 million new people, many with tax credits to buy health insurance, is going to spur new entrants."

Health Reform Requirements May Impact Limited Benefit Plans.

The AP (10/1, Murphy) reports, "The new healthcare law could make it difficult for companies like McDonald's to continue offering limited insurance coverage to their low-wage workers." Notably, McDonald's "provides its hourly workers with low-cost plans known as 'mini-meds' or limited benefits plans," but "next year, the healthcare law passed by Congress will require insurers to pay minimum percentages of 80 percent and 85 percent of the premiums they collect toward medical care, figures that may be hard to meet for some of these limited plans." A Wall Street Journal article said that McDonald's may drop coverage for its hourly workers if the government does not waive the requirements, but McDonald's has denied that it plans to drop employee coverage. Meanwhile, HHS has stated that it "remains 'committed to implementing the law in a way that minimizes disruption to coverage.'"

Sebelius Decries Assertion That Emanuel "Killed" Public Option.

Lynn Sweet wrote in her Chicago Sun-Times (9/30), "A rap on White House Chief of Staff Rahm Emanuel is that he was instrumental in killing the public option in the healthcare bill -- an assertion that has roiled the progressive community and unions and has implications on Emanuel's run for mayor of Chicago -- which he will launch this weekend." During a discussion with Sweet, HHS Secretary Kathleen Sebelius said that this assertion was untrue, that while working to pass health reform, "Emanuel was 'more in the tactical, how do we get from here to there, you know, what is the pathway, what's the vote look like, who do we need, who don't we have, and he was very hands on in every step of that process.'"

        Likewise, the Christian Science Monitor (10/1, Cook) reports, "Asked by Chicago Sun Times Washington Bureau Chief Lynn Sweet whether Emanuel deserved the blame for killing the so-called public option -- a government sponsored insurance plan -- Sebelius responded 'No. No. No. No.'" The paper says that Emanuel's "role in the fate of the public option came center stage as a result of an interview he gave to the Wall Street Journal during the battle over healthcare legislation, saying the Obama administration had a goal of keeping 'private insurers honest,' but that the path to that goal was 'negotiable.'"

Blog Accuses Sebelius Of "Heavy Handedness" Towards Insurers.

Merrill Matthews writes in the Forbes (10/1) Right Directions blog that HHS Secretary Kathleen Sebelius "is upset that critics are accusing her of 'thuggery' (the Wall Street Journal) and 'soviet tyranny' (Newt Gingrich). My favorite came from the well-respected political analyst Michael Barone: 'gangster government.'" Matthews says that Sebelius is being criticized over her recent warning to insurers to cease attributing premium hikes to the healthcare law. He describes Sebelius' actions as "heavy handedness," and argues that rather than complain about "misinformation" on the part of insurers as Sebelius did in her recent Wall Street Journal op-ed, "she needs to talk to the president -- because it's the administration that's misinforming the public. Heavy-handed warnings and demands that insurers get on the ObamaCare bandwagon are alienating both the healthcare industry and the public."

Recession Contributes To Unprecedented Increase In Medicaid Enrollment.

The AP (10/1, Alonso-Zaldivar) reports, "A record number of Americans signed up for Medicaid last year, as the recession wiped out jobs and workplace health coverage," according to "a report released Thursday by the nonprofit Kaiser Family Foundation," which "found that enrollment in the safety-net medical insurance program jumped to more than 48 million -- a record 15.7 percent share of the US population." And, "with the economy barely improving, states are forecasting a 6 percent increase in the rolls next year, meaning another strain on their cash-depleted budgets." The AP adds, "Rising Medicaid enrollment also underscores the growing role of the government in healthcare, a polarizing issue in this year's midterm congressional elections after President Barack Obama and Democrats pushed through a massive overhaul of the nation's healthcare system."

        The New York Times (10/1, A16, Sack) says that "every state showed enrollment growth, with nine above 15 percent, and Nevada and Wisconsin above 20 percent." These "kinds of increases exact a heavy toll on state budgets, as states share the cost of the Medicaid program with the federal government." According to the Times, "The only hopeful news found by the survey was that the growth in enrollment slowed considerably in the second half of 2009," but "two-thirds of the Medicaid officials surveyed said they thought this year's appropriations might not be enough to cover continuing enrollment growth."

Experts Say Medicare Auction Program "Flawed."

In an op-ed in the New York Times (10/1), Ian Ayres, a professor of law and economics at Yale, reproduces a policy brief he co-authored with auction guru Peter Cramton, a professor of economics at the University of Maryland, related to the proposed competitive bidding for Medicare supplies. They say that while the plan to shift to such bidding is a "much better approach," there are a "number of weaknesses" with CMS' plan, including "flawed median-bid pricing rule," and that the "bids are not binding commitments." Medicare "should junk the flawed procurement auction rules and take advantage of the enormous advances that have been made in auctions and market design to fix the auction rules," they say.

BCBS Of Nebraska To Commence Pilot Program Aimed At Cutting Healthcare Costs.

Nebraska's Lincoln Journal Star (9/30, Andersen) reported that "Nebraska's largest health insurer" Blue Cross and Blue Shield of Nebraska is kicking "off a six-month experiment Friday" aimed at "moving toward a system that rewards doctors for making patients healthier rather than paying per procedure." The Star added that the pilot program, which is a "patient-centered medical home concept," will enroll "about 1,200 diabetic patients in nine Nebraska cities, including Lincoln." The Star noted that "Blue Cross will invest as much as $1.5 million in support, rewards and clinic tools over the duration of the pilot" with the hopes that "costs will fall and people will get healthier if doctors walk into exam rooms with better patient information."

US Restaurants, Cigna Request Waivers For Health Reform Provisions.

Bloomberg News (10/1, Armstrong, Helm, et al) reports, "US restaurants have asked the federal government to waive health overhaul rules that may force companies to abandon low-cost 'mini-med' plans that insure 1.4 million minimum-wage and part-time employees." Cigna Corp "has also asked for a waiver on behalf of its 'limited-benefit' customers, and expects to hear back soon from federal officials, Gloria Barone Rosario, a spokeswoman, said." If waivers are not obtained, "mini-med plans would either no longer be offered or lead to a significant increase in premiums, the National Restaurant Association wrote in an Aug. 27 letter to US health officials asking that all of its members be exempted."

Walmart, Humana To Jointly Offer Low-Cost Medicare Prescription Drug Plan.

Bloomberg News (10/1, Nussbaum, Boyle) reports, "Wal-Mart Stores, Inc., the world's largest retailer, said it will team with health insurer Humana, Inc. to offer the cheapest prescription drug plan in the US, as the companies seek to take sales of medications from rivals." These "companies will begin marketing the plan today to Americans in Medicare, the US government health program for the elderly and disabled, William Fleming, a Humana vice- president, said in a conference call yesterday. The policies, which take effect Jan. 1, will cost $14.80 a month, less than half the average premium this year, and will boost sales for both companies, Fleming said."

HealthNet Inc. To Demonstrate Progress Made On "Green" Community Health Center.

Inside Indiana Business (10/1) reports, "HealthNet Inc. says construction is complete on the first phase of its $6.6 million community health center on Indianapolis' near eastside." The new HealthNet People's Health & Dental Center "is set to open early next year and is part of the 2012 Super Bowl Legacy Project." A press release accompanying the story notes that the preview will involve a demonstration of "the latest in green infrastructure techniques being used in the construction of the facility." The release notes that, with the help of capital campaign donors and $5.3 million in federal stimulus funds, the health center "will create jobs and set a new standard for patient care, delivering 42,000 patient visits per year."

HHS Official Says Consumers Can Compare Insurance Plans On Website Starting Friday.

CQ HealthBeat (10/1, Reichard, subscription required) reports, "The top HHS official in charge of overseeing the health insurance industry said Thursday that consumers will be able to compare premiums and benefits for 6,200 plans offered by 300 insurers by the end of the week." Jay Angoff, "director of the HHS Office of Consumer Information and Insurance Oversight, announced the changes to the Healthcare.gov site in a speech to a forum sponsored by the America's Health Insurance Plans."

        USA Today (10/1, Young) says "among the details insurance shoppers will get on each plan" are "monthly premium estimate" and "maximum out-of-pocket cost." Also, "consumers have never had access to information about how often insurers deny individual applications or add surcharges to base plan prices," said Karen Pollitz, deputy director of HHS' Office of Consumer Support.

Healthy Montana Kids Program To Include Children Of State, University-System Employees.

The Missoulian (10/1, Dennison) reports that under new rules taking effect Oct. 1, "Healthy Montana Kids, Montana's government-financed health insurance program for children in low- and moderate-income families, should soon be open to kids of state and university-system employees." These "new rules, approved by state health officials, also increase the program's coverage for dental care and ambulance services." But, "state health officials had to craft the rule changes and submit their proposal to federal health officials for final approval." Nevertheless, "Mary Dalton, Medicaid and health services branch manager for the Department of Public Health and Human Services, said last week the state expects to get that approval this fall."

 

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