Major Provisions In Healthcare Law Take Effect Thursday.

NBC Nightly News (9/22, story 6, 0:30, Williams) reported, "One more note on healthcare reform. It's been six months now since Congress passed the Obama plan," and several of its major provisions "go into effect tomorrow. Among them, dependents will now be covered under their parent's insurance plans up to age 26. Children under age 19 can no longer be denied coverage because of preexisting medical conditions. And insurers will no longer be allowed to put lifetime limits on coverage."

        The New York Times (9/23, A16, Sack) reports, "On Thursday, the six-month anniversary of the signing of the Patient Protection and Affordable Care Act, a number of its most central consumer protections take effect, just in time for the midterm elections." Notably, what is "sometimes lost in the partisan clamor about the new healthcare law is the profound relief it is expected to bring to hundreds of thousands of Americans who have been stricken first by disease and then by a Darwinian insurance system." As of Thursday, "insurance companies will no longer be permitted to exclude children because of pre-existing health conditions." In addition, the "law will now forbid insurers to drop sick and costly customers after discovering technical mistakes on applications," and "it requires that they offer coverage to children under 26 on their parents' policies."

        The Baltimore Sun (9/23, Cohn) notes, "Other provisions will also become effective Thursday that, among other things, ban lifetime benefit caps, require no-cost preventive medical services such as mammograms, and begin to close the so-called 'doughnut hole' for seniors on federal prescription drug plans. The more costly and complex insurance exchanges, which will allow the uninsured to shop for coverage and subsidies, won't go into effect until 2014."

        The AP (9/23, Johnson) reports, "The nation's new healthcare law turns 6 months old Thursday and starts delivering protections and dollars-and-cents benefits that Americans can grasp. But it won't affect all consumers the same way, which may cause confusion." The rest of the piece focuses on answers and questions about how the healthcare will impact individuals. The Concord Monitor (9/23, Leubsdorf) and the Charleston Gazette (9/23, Reese) also cover the story.

        WPost: Major Provisions Of Healthcare Arriving On Schedule. The Washington Post (9/23, Altman) reports, "Six months after its enactment, there are two totally different stories to tell about the health-reform law. The public remains split on the law largely along traditional partisan lines. Confusion and misperception are rampant, with more than a third of seniors still thinking the law contains 'death panels' (it does not)." But, "beneath the political battle lies a success story of early implementation: The federal government that many regard as sluggish and ineffective has turned major elements of the legislation into reality right on schedule."

State Insurance Commissioners Ask Administration To Phase In MLR Provision.

The New York Times (9/23, B5, Pear) reports, "State insurance regulators told the White House on Wednesday that health insurance markets in some states would be disrupted unless President Obama gave insurers a temporary dispensation from one major provision of the new healthcare law," namely, the medical loss ratio (MLR) provision which "requires insurance companies to spend at least 80 cents of every premium dollar on medical care, rather than administrative expenses, executive salaries and profits." As it stands, "if insurers do not meet the requirement in 2011, they will have to pay rebates to consumers in 2012." But, over "30 state insurance commissioners" met with Obama on Wednesday, and urged him "to consider phasing in the 80 percent requirement over several years, to avoid disruption of insurance markets for individuals and small businesses."

        The Hill (9/23, Pecquet) says in its Healthwatch blog, "Insurance commissioners from 32 states, two territories and the District of Columbia met with the Health and Human Services Secretary Kathleen Sebelius, Labor Secretary Hilda Solis and White House Office of Health Reform Director Nancy-Ann DeParle, with President Obama stopping by half-way through."

        CQ HealthBeat (9/23, Norman, subscription required) reports, "Two states -- Maine and Iowa -- have asked the Obama administration for more time in implementing a key provision in the healthcare law that spells out how much health insurers must spend on medical care and quality improvements, state insurance commissioners said after a White House meeting with the president on Wednesday." In addition, "a third state, Florida, is gathering additional concrete information and evidence to submit to the administration to bolster its case."

        The Hill (9/23, Pecquet) notes in its Healthwatch blog, "Iowa has asked federal regulators to give its individual market health plans until 2014 to comply with the healthcare reform law's medical loss ratio requirement. The law requires the plans to spend at least 80 percent of premiums on care starting next year." In a letter to HHS Secretary Kathleen Sebelius, Iowa's insurance commissioner wrote, "Iowa enjoys some of the lowest health insurance rates in the country. ... Already we are seeing several of our carriers with small numbers of insureds in the individual market announce their intent to cease business in our state. This will impact the choices available to Iowa consumers."

        NAIC Still Grappling With Decision About Insurer Spending On Healthcare. Bloomberg News (9/23, Nussbaum) reports, "The failure by state regulators to decide how much insurers must spend on patient care is scaring investors from health-plan stocks and complicating company decisions on premiums, commissions and cost cutting." Notably, the "National Association of Insurance Commissioners' decision, expected in June, has slipped to October, and US officials must weigh in after that, said Jane Cline, the group's president. How to count federal taxes in the calculation, the most pivotal decision remaining, may cost the industry, led by WellPoint, Inc., an extra $264 million next year, said Ana Gupte, a Sanford C. Bernstein & Co. analyst in New York."

Insurers Working To Implement Provisions In Healthcare Law.

The New York Times (9/23, B1, Abelson) reports on the front page of its Business Day section, "The first big wave of new rules under the federal health care law goes into effect on Thursday, leaving many insurers scrambling to get ahead of the changes." The companies "are cutting administrative staff to lower overhead costs, investing in major technology upgrades and training employees to field the expected influx of customer inquiries." In spite of "the talk among some Republicans of repealing all or part of the law, insurers say they cannot afford to put off the changes," and "many said they are fundamentally altering their business models to cope." Karen Ignagni, the chief executive of America's Health Insurance Plans, stated, "It is really the Manhattan Project because of the scale and the scope."

Obama Defends Healthcare Reform Law.

Media coverage of President Obama's event on healthcare reform (including print outlets and one network newscast) put it in the context of the upcoming midterm election, and of polls that reflect the apparent unpopularity of Obama's overhaul of the health system. As part of a story on the GOP campaign agenda to be released today, the CBS Evening News (9/22, story 2, 2:00, Couric) considered why Obama was "revisiting" the healthcare "topic...when he's been so criticized for initially not focusing on the economy." CBS (Reid) added that the President is "trying to help Democrats who are being just hammered out on the campaign trail on healthcare reform."

        The Los Angeles Times (9/23, Levey) reports, "President Obama, marking major provisions of the new healthcare law that go into effect Thursday, visited with Americans who stand to benefit immediately as he stepped up efforts to repulse Republican attacks on his signature domestic initiative." Obama said, "Obviously, the economy has been uppermost on our minds," but, "healthcare was one of those issues that we could no longer ignore...We said we have to take this on," and "we are now actually able to provide some help to the American people."

        The AP (9/23, Werner) reports that in Falls Church, VA, Obama blamed "himself for coolness to his healthcare overhaul" as he sought to "reintroduce the law to voters who don't much like or understand it six months after he signed it." Noting that a questioner at the event thanked the President for the healthcare overhaul, the AP adds that "such gratitude isn't the norm. A new Associated Press poll finds high levels of misunderstanding about what's actually in the law, and more people opposed than in support. And with crucial midterm elections six weeks away, the only Democrats running ads about the historic legislation are the ones who voted 'no.'" Obama "ruefully told his listeners, 'Sometimes I fault myself for not being able to make the case more clearly to the country.'"

        The Washington Post (9/23, Aizenman, Kornblut), the Wall Street Journal (9/23, Favole, subscription required), Reuters (9/23, Zengerle) also cover the story, as does The Hill (9/23, Lillis) in its Healthwatch blog.

Illinois Has No Intention Of Challenging Healthcare Law.

The AP (9/23, Johnson) reports, "Illinois has no plans to join the 20 states challenging the nation's new healthcare law in court, a key health adviser for the state says. Michael Gelder, Gov. Pat Quinn's senior health policy adviser and chairman of the new Health Care Reform Implementation Council, told The Associated Press Tuesday that if people don't like the law, they should take it up with Congress." Notably, "Illinois, led by Quinn -- a Democrat, has been an active partner in the law's implementation so far. It started a new health plan for people with pre-existing conditions and accepted a $1 million federal grant to put more muscle into state review of health insurance premium increases."

House Passes Measure To Increase HHS IG's Oversight Of Medicare, Medicaid Fraud.

CQ HealthBeat (9/23, Reichard, subscription required) reports, "In a week devoted to dislodging entrenched public suspicions of the healthcare overhaul law, House Energy and Commerce Democrats on Wednesday showcased little-noticed provisions designed to keep fraudsters out of Medicare and Medicaid -- and punish them more severely if they do wiggle their way in and sap the finances of the programs." Notably, the "House passed legislation (HR 6130) championed by Reps. Pete Stark, D-Calif., and Wally Herger, R-Calif., that would give the Department of Health and Human Services Office of the Inspector General the power to ban individual corporate executives from doing business with the Medicare program if their companies are convicted of fraud."

Colorado WellPoint Unit To Repay Policyholders.

The Wall Street Journal (9/23, Johnson, subscription required) reports that a Colorado WellPoint Inc. subsidiary agreed to reimburse policyholders $20 million following an investigation that concluded several premium increases were unjustified. WellPoint's Colorado unit, Anthem Blue Cross & Blue Shield will credit 90,000 policyholders on their December premium statements or issue them a check.

Missouri Issues Over $1 Million In Fines To Fake Insurers.

The AP (9/23) reports, "The Missouri insurance department says it has issued more than $1 million in fines in a crackdown on bogus health insurance plans." The insurance department accuses 14 companies and individuals of defrauding "consumers by selling plans that appeared to include comprehensive medical insurance, but actually did not." Consumers "found that the coverage was less than what they were led to believe, or had difficulty reaching anyone to cancel their contracts."

        The Kansas City Business Journal (9/23) reports, "Missouri Insurance Director John Huff said. ... the groups market their products largely through junk faxes, using phrases such as 'control your health care costs,' 'group health plan' and 'dependent coverage.'" The insurance department said "it knows of at least 150 Missouri consumers who paid these companies for services."

Small Businesses Expected To See Higher Premiums Under Health Reform.

The Wall Street Journal (9/23, Needleman, subscription required) reports that, as the first major provisions of the healthcare law go into effect today, small businesses will begin offering additional benefits to their employees, and this will most likely increase cost. Consequently, many small business owners say that insurance premiums will go up next year. Commenting on the changes, AHIP spokesman Robert Zirkelbach said, "Small businesses that don't have many of these benefits today are going to see a bigger increase in their premiums as a result of the new mandates than those that already have them. ... It's a basic principal of economics."

        Small Massachusetts Businesses Struggling With Rising Health Insurance Costs. The Boston Globe (9/23, A1, Ailworth) reports, "Many small Massachusetts businesses are grappling with major increases in health insurance costs." Because "of premium increases that in some cases top 30 percent, companies say they are reducing coverage to save money, and using more independent contractors instead of payroll employees to avoid having to offer insurance." After "regulators rejected what they deemed 'excessive or unreasonable' increases, the state's three largest health insurers this summer agreed to limit basic rates for individuals and small businesses - raising them 12.9 percent at most, and often less, depending on the company." But smaller businesses are vulnerable to variables that push the base price of a premium higher such as "size, age, and health of a company's workforce, and the type of work performed."

Minnesota Sees Record Numbers On Welfare, Health Programs.

The Minneapolis Star Tribune (9/23, Olson) reports, "The economic recession, whether it is over or not, has pushed record numbers of Minnesotans into state-subsidized welfare and health insurance programs, according to figures published this week by the Department of Human Services." The "number of Minnesotans eligible for Medical Assistance" rose by "the largest one-year increase in at least the past decade and represents more than one in 10 Minnesotans." Enrollment "rose as well for the state's various welfare-to-work programs and for MinnesotaCare, a subsidized health insurance plan." The enrollment increase is expected to "exacerbate the state's budget and economic woes for years to come, even though federal stimulus money reduced the financial impact of the spike in Medical Assistance cases in 2010."

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