Sebelius Warns Insurers To Cease Blaming Premium Hikes On Health Reform.

The AP (9/10, Alonso-Zaldivar) reports, "President Barack Obama's top health official on Thursday warned the insurance industry that the administration won't tolerate blaming premium hikes on the new health overhaul law." In a letter to AHIP, HHS Secretary Kathleen Sebelius wrote, "There will be zero tolerance for this type of misinformation and unjustified rate increases," adding, "Simply stated, we will not stand idly by as insurers blame their premium hikes and increased profits on the requirement that they provide consumers with basic protections." The AP calls the letter to AHIP "the latest volley in a war of words over who gets the blame for rising premiums," and says, "Polls show that many people expect their costs to go up as a result of the law, but there's also widespread mistrust of the insurance industry."

        Similarly, CQ HealthBeat (9/9, Norman, subscription required) reports, "Sebelius and the industry have been at sharp odds off and on during the healthcare battle of the past year and a half, though tensions seemed to have eased in the past couple of months. That may be changing as some of the law restrictions on health insurers approach reality."

        Kate Pickert writes in the Time (9/10) Swampland blog that Sebelius also "said insurers that hike rates for consumer unjustifiably may be locked out from the state exchanges due to be set up by 2014. These exchanges will be the primary means by which small groups and individuals will purchase coverage;" therefore, "being excluded from these marketplaces could be devastating to insurers." Pickert notes, "The overt nature of Sebelius' warning shot means" that "HHS knows that the industry's support during the healthcare reform debate means little now," and it also "means that HHS is tough -- ready and willing to use all means necessary to stop insurers from padding profits and using the Affordable Care Act as an excuse."

        In response, Karen Ignagni, president and CEO of AHIP, said that the additional coverage required by the healthcare law would help to increase overall costs, the Wall Street Journal (9/10, Adamy, subscription required) reports. Still, she acknowledged that higher medical costs and younger, healthier customers terminating their policies due to the recession also contributed to higher premiums. Meanwhile, Sen. Dianne Feinstein (D-CA) wants lawmakers to reconsider a measure which would allow the federal government to restrict premium increases. She stated, "Unless we take action, we can expect health insurance companies to inflate premium rates as much as possible between now and 2014 when health insurance exchanges go into effect."

        The Hill (9/10, Pecquet) says in its Healthwatch blog, "Sebelius acknowledges that the new law will cause an increase in premiums, albeit 'minimal.'" She stated, "According to our analysis and those of some industry and academic experts, any potential premium impact from the new consumer protections and increased quality provisions under the Affordable Care Act will be minimal. ... We estimate that that the effect will be no more than one to two percent." Bloomberg News (9/10, Armstrong) also covers the story.

WSJournal: Democratic Candidates Hoping Voters Forget Health Reform.

The Wall Street Journal (9/10, subscription required) says in an editorial that faced with the prospect of grim losses in the midterms, Democrats are shying away from health reform, and are hoping that voters forget about the new law. Indeed, the only candidates who are mentioning health reform are Republicans who are criticizing it, and several Democrats who are touting the fact that they voted against it. The Journal says that this is a striking development, considering that Democrats fought for so long to pass the healthcare law, and argued that it was one of the greatest achievements of this century.

GAO Says Medicare Brochure On Healthcare Law Is "Not Propaganda."

CQ HealthBeat (9/10, Reichard, subscription required) reports, "A legal opinion issued by the Government Accountability Office concludes that a brochure on the healthcare overhaul law mailed earlier this year by the Department of Health and Human Services to Medicare beneficiaries does not constitute propaganda in violation of federal law." But, the opinion stated "that the brochure contained some exaggerations and that it presents a picture of the law 'that is not universally shared.'" Meanwhile, "Republicans on the House Ways and Means Committee who requested the opinion said that it confirms that the Medicare mailer 'misleads America's seniors by falsely claiming the Democrats' healthcare law would not negatively impact seniors' benefits.'"

Burgess Says Medical Liability Reform Will Not Reduce Healthcare Spending.

The Hill (9/10, Lillis) reports in its Healthwatch blog, "The Republican chairman of the Congressional Healthcare Caucus this week said that medical liability reform is no cure for the nation's skyrocketing healthcare spending." Rep. Michael Burgess (R-TX) "argued that the cost of malpractice to the healthcare system is 'a huge sum of money,' but also conceded that limiting malpractice claims won't translate into instant healthcare savings." He added, "Defensive medicine is a learned methodology, and one that cannot be unlearned quickly, and I believe this contributes significantly to the reason why costs do not decrease quickly and steeply immediately after medical liability reforms are passed. ... Our nation's healthcare system is very complex, and I have never suggested that medical liability reform is a silver bullet."

Sacramento Bee: Schwarzenegger Should Sign Bills To Create California Insurance Exchange.

The Sacramento Bee (9/9, 16A) editorialized, "When Gov. Arnold Schwarzenegger returns Sept. 15 from a six-day trade mission in Asia, he'll have 700 or so bills to sign or veto," which is "why, before he leaves today, he should sign two bills laying the groundwork for California's health insurance exchange -- the major piece of the national health reform legislation signed by President Barack Obama on March 23." The Bee added, "Under the two bills passed by the Legislature, Californians would get standardized information about insurance plans...so they can make informed choices." The paper concluded, "Many Californians would be eligible, based on their income, for a federal premium subsidy to help them purchase coverage through the health benefits exchange," and "California should not leave those federal dollars on the table."

CMS Issues Guidance On Hospice Benefits To Medicaid, CHIP.

The Hill (9/10, Pecquet) reports in its Healthwatch blog, "The health reform law mandates that state Medicaid programs allow terminally ill children to receive curative treatment even if they elect hospice benefits, the federal Centers for Medicare and Medicaid Services reiterated in guidance released Thursday." Federal Medicaid director Cindy Mann said "in a letter to state health officials" that "states will be required to submit new paperwork to indicate that 'hospice is provided to children concurrently with curative treatment.' The new rules apply to both state Medicaid programs and Children's Health Insurance Programs (CHIP) operating as Medicaid expansions."

Federal Aid Leaves $470 Million Shortfall In Kentucky's Medicaid Budget.

The Louisville Courier-Journal (9/9, Loftus) reported, "Congress' recent effort to help the states financially...still leaves a $470 million hole in the Medicaid budget." The Courier-Journal pointed out, "The shortfall in Medicaid...results from an inaccurate estimate of anticipated federal assistance in the 2010-12 budget approved by the General Assembly in May," when legislators "projected that the federal government would provide an additional $238 million for the Medicaid program. However, the bill passed by Congress provides only about $137 million."

        According to the Lexington Herald-Leader (9/10, Brammer), "That leaves a $111 million hole," Gov. Steve "Beshear (D) said. Since funding for Medicaid is matched by the federal government on a roughly 4-to-1 basis, the gap represents a $470 million total program shortfall," he explained at a Capitol news conference. Currently, "about 800,000 poor and disabled Kentuckians depend on the $6 billion program for health insurance," the Herald-Leader adds.

Grant Money Available To Help Purchase Low-Cost Insurance In Miami-Dade.

The Miami Herald (9/10, Dorschner) reports, "Federal-state funds are available to help low- and moderate-income residents pay for a county-sponsored health insurance, the Miami-Dade mayor's office announced Thursday." The Herald adds, "Money from a special $500,000 grant is available to help residents buy Miami-Dade Blue insurance, a joint effort between Blue Cross Blue Shield of Florida and the county. Subsidies are available for Miami-Dade County residents who earn between $16,245 and $27,075," and "assistance will be provided on a sliding scale based on income."

Illinois Awards HMOs Aetna & Centene Contracts For Medical Care Services.

The Chicago Tribune /Chicago Breaking Business (9/10, Japsen) reports that "Illinois has awarded HMO operators Aetna Inc. and Centene Corp. contracts to provide medical care services to 40,000 seniors and adults with disabilities" in several suburban counties "beginning next year." The article adds that while "officials would not disclose what the HMO operators would be paid," they indicated that the program would save "the state $200 million over the next five years, 'compared to the current fee-for-service delivery system.'"

Many Illinoisans With Pre-Existing Conditions Ineligible For High-Risk Pool.

The New York Times /Chicago News Cooperative (9/10, A21A, Reaves) reports, "At first glance, the new Pre-existing Condition Insurance Plan, commonly known as IPXP, sounds like welcome relief for jobless Illinoisans who have serious medical issues and are struggling with the loss of employer-financed healthcare." But, the plan "is available only to individuals who have not had 'creditable' health insurance coverage for the past six months," which means that many seeking relief from high-premium plans will not qualify. Jessica Santillo, an HHS spokeswoman, "said in an email: 'The statutory language is specific. It's written by Congress.'"

Iowa's High-Risk Insurance Pool Receives Low Number Of Applications.

The AP (9/10) reports, "Only 32 people have applied to a new health insurance program in Iowa for residents with pre-existing medical conditions such as cancer, diabetes and high blood pressure. Such high-risk pools are among the first programs that took effect under the federal health reform law, the Des Moines Register reported Thursday." Notably, the "federal government provided enough money to cover about 975 Iowa residents with pre-existing conditions that made it tougher for them to get affordable coverage." Several other states are also reporting low levels of interest in the high-risk pools.

Paterson Urges Eligible New York Residents To Apply For New York's High-Risk Pool.

The Rosslyn (NY) News (9/10) publishes a letter from New York Gov. David A. Paterson describing the state's temporary, pre-existing-condition insurance option, the NY Bridge Plan, and encouraging those eligible to apply for coverage. NY Bridge is a "valuable product of healthcare reform in that it provides health insurance coverage at a lower price than other options currently available in the individual market," the governor writes. Bridge Plan premiums, notes Paterson, will be "$362/month for residents of upstate counties and $421/month for residents of downstate counties." Coverage, which begins Oct. 1, will be available "until January 2014." Enrollment is "on a first-come, first-served basis," and if the plan "reaches capacity, a waiting list will be established." More information is available on the New York Health Care Reform website.

Commentary: Healthcare Does Not Conform To Free-Market Rules.

Cynthia Tucker wrote in an Atlanta Journal-Constitution (9/9) commentary, "For those Americans who have a religious faith in the free market, healthcare is a frustrating test of that faith," because "it doesn't conform to supposed free market dictates," and "competition doesn't decrease costs." For much of the last 20 years, "healthcare costs have been rising at more than the rate of inflation -- straining the federal budget, eroding workers' wage increases, and even forcing some small businesses to drop healthcare coverage for their employees." In addition, "this year, businesses plan to pass more of the cost increase on to their employees, according to The Wall Street Journal."

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