California Insurance Department Clears Health Net's 16% Average Individual Premium Hike.

The San Francisco Chronicle (9/8, Colliver) "ChronRx" blog reports that California's Department of Insurance (CDI) announced Tuesday that Health Net's bid to raise individual premium rates "by as much as 24 percent cleared an important hurdle." Axene Health Partners, the "same actuarial firm that found miscalculations in Anthem's now infamous plan to raise rates" up to 39 percent, has "reviewed Health Net's proposal" and found the insurer to be "in compliance" with California's 70-percent medical-loss-ratio law.

        According to the Sacramento Bee (9/8, Calvan), the CDI cleared Health Net's plan to "raise health insurance premiums by an average of 16.5 percent on 38,000 customers" who buy individual coverage. The increases will "range anywhere from 8 percent to 24 percent, depending on the specific plan purchased." Health Net had "planned to raise rates July 1, but delayed the hikes" until the CDI could analyze the filing. The new rates "will go into effect Oct. 1," according to Health Net spokesperson Brad Kieffer.

        The Los Angeles Times (8/9, Helfand) says that the announcement highlights California's "limited power." Although the state "evaluated whether Health Net properly calculated" MLR rates, California has "no say on whether the rates are excessive. 'While we in no way support or endorse the rate increase, Health Net's filing was found to be in full compliance,'" said CDI spokesperson Ioannis Kazanis. Health Net "welcomed the news, saying its rates reflect the rising costs of doctors, hospitalizations, medications and other health care services." Meanwhile, Health Net subscribers are voicing "anger at premium notices that already have begun landing in mailboxes."

Some Insurers May Increase Rates Because Of Healthcare Law.

On its front page, the Wall Street Journal (9/8, A1, Adamy, subscription required) reports that health insurance companies say that they intend to increase premiums for some customers, particularly those with individual policies, because of the healthcare law. For instance, Aetna, Inc., certain BlueCross BlueShield plans, and other insurers have requested hikes of one to nine percent to compensate for changes mandated by health reform. But, the Obama Administration argues that such hikes are simply an excuse. In fact, Nancy-Ann DeParle, director of the White House Office of Health Reform, said, "I would have real deep concerns that the kinds of rate increases that you're quoting...are justified. ... We believe consumers will see through this."

        Insurance Companies Are Cancelling Individual Policies, Citing Healthcare Law. The Dallas Morning News (9/8, Roberson) reports that health insurers such as Grand Prairie-based National Health Insurance Co. are cancelling individual policies, saying that they can "no longer offer individual accident and health insurance policies." In this case, the company "blamed its decision on" its "inability to meet requirements of the health care overhaul signed into law this year." Such cancellations illustrate "one way the new law is reshaping the health care landscape in North Texas and elsewhere. Some health economists say more small insurers may soon buckle under the weight of the law's mandates."

GOP May Attempt To Repeal Healthcare Law Following Midterms.

The AP (9/8, Alonso-Zaldivar) reports, "If you thought passing the health care overhaul was messy, wait until Republicans try to repeal it if they regain power this fall." In fact, "it could come down to who blinks first, with some Republicans raising the prospect of a government shutdown." Yet, "even if Republicans succeed beyond any current predictions and capture both the Senate and the House, they wouldn't have enough GOP votes to overcome President Barack Obama's veto," although "Republicans could still fall back on the congressional power of the purse, denying the administration billions of dollars to carry out the most far-reaching social legislation since Medicare and Medicaid."

Democratic Group To Launch Campaign In Defense Of Healthcare Law.

Politico (9/8, Kliff) reports, "With public support for health reform dwindling, a Democrat-led group is ramping up a multimillion-dollar pitch to support the new law. The Health Information Campaign will go live Wednesday with a $2 million national ad campaign touting the new law's early-to-implement insurance reforms and throwing a pro-reform voice onto airwaves currently dominated by anti-reform messages." These "ads are the Campaign's first move to defend the health reform law but far from its last." Politico notes that the Center was "founded by top Democratic strategists earlier this summer," in "an effort to show off the law's benefits while also batting down what the group considers false claims and misinformation."

Healthcare Law May Aid Some Democratic Candidates.

Politico (9/7, Haberkorn) reports, "Congressional Democrats hope to use health care reform to their advantage in the few places they can -- largely safe, left-leaning districts. The law, once championed as the most dramatic social legislation since Social Security and Medicare, has become a black mark in moderate and conservative districts, where some Democrats openly tout their opposition in television ads." Yet, "in the few liberal districts with sitting Republicans or no incumbent running for reelection, such as the Louisiana 2nd, Hawaii 1st and Illinois 10th, Democrats say health care can help them."

Some House Democrats Seek To Benefit From "No" Votes Against Health Reform.

CNN (9/8, Riley) reports, "House Democrats who voted against one of the Obama administration's signature policy initiatives -- health care reform -- are now cashing in on their no votes by using campaign ads to highlight their opposition to the legislation." For the 34 Democrats who voted against the healthcare law, this move "is likely to pay dividends amid a tough political climate and the president's declining poll numbers." CNN notes that Reps. Walt Minnick (D-ID), Stephanie Herseth Sandlin (D-SD) and Glenn Nye (D-VA) are among those who are now touting their "no" votes.

Healthcare Reform Considered Dilemma For Democrats Approaching Midterm Elections.

In response to a query from the National Journal's (9/8, McCarthy, subscription required) expert "Health Care" blog about whether it is "possible for Democrats to win voters over to the health care overhaul before the midterm elections," John C. Goodman, president of the National Center for Policy Analysis, says, "The problem the Democrats now have is that the health reform law is a very bad bill. People don't like it for very good, objective reasons. ... So I predict that no matter how much the Democrats spend, they will not be able to convince people that bad is good and vice versa. And this will be especially true of the elderly, who got sold out by AARP and really taken to the cleaners."

HHS Issues Guidance For Health Plan Waivers From Annual Limit Restrictions.

The Hill (9/8, Pecquet) reports in its Healthwatch blog that HHS "has released guidance for health plans seeking a waiver from the healthcare reform law's restrictions on plans' ability to place annual limits on essential health benefits." The new law "creates temporary restrictions on health plans starting Sept. 23," but it also "allows the annual limits to be waived 'if compliance ... would result in a significant decrease in access to benefits or a significant increase in premiums.'"

Post-Dispatch Says Missouri Voters Want Healthcare Law's Benefits.

The St. Louis Post-Dispatch (9/8) says in an editorial that the "lopsided vote in favor of Proposition C in Missouri last month - we were told - sent a message that Missouri rejects national health care reform." But "what if the feds, as part of the health care reform bill, are willing to shore up health coverage for millions of early retirees? In that case, Missouri loves health care reform." The Post-Dispatch notes that the Federal Government last week "released a list of 2,000 corporations, unions and government entities that have asked to participate in a $5 billion reinsurance program created under the federal health care reform law. Among them: the state of Missouri, where 71 percent of voters in the low-turnout Aug. 3 primary voted to reject the federal law's mandate that individuals buy health insurance."

State Opposition To Obama Healthcare Law Said To Be Increasing.

In an op-ed in the San Francisco Chronicle (9/8), Sally C. Pipes, president and CEO of the Pacific Research Institute, says opposition "to the new health reform law is continuing to grow in the states - just as Congress prepares for its final pre-election legislative session." Colorado "just placed an initiative on the ballot that would, if passed, block many aspects of Obamacare - including the requirement that individuals purchase health insurance." A "similar measure was overwhelmingly approved by voters in Missouri last month. And several states recently announced that they don't believe they have the authority to enforce the new law." With "actions like these, the message to Washington is clear: If Congress doesn't repeal Obamacare, the states just might do it themselves."

Nebraska Education Board Rejects Governor's Call To Support Healthcare Repeal.

The Hill (9/8, Lillis) reports the Nebraska State Board of Education "this month rebuffed a request from Gov. Dave Heineman (R) to support a direct repeal of the Democrats' new healthcare reform law." Instead, Board members "passed a much tamer resolution that registers their opposition to 'unfunded mandates' without ever mentioning healthcare at all - a change that's being cheered by children's welfare advocates wary of efforts to pit children's health coverage against their education funding." The episode "began late last month, when Heineman sent a letter to state education leaders - including the members of the State Board - warning that the Medicaid expansion in the new healthcare reform law represents a threat to education funding, and therefore to education jobs."

California Department Of Insurance Seeking Almost $10 Billion In Fines From PacifiCare.

The Los Angeles Times (9/8, Helfand) reports that the California Department of Insurance is "seeking fines of up to $9.9 billion from health insurer PacifiCare over allegations that it repeatedly mismanaged medical claims, lost thousands of patient documents, failed to pay doctors what they were owed, and ignored calls to fix the problems." In particular, the regulatory body "says PacifiCare violated state law nearly one million times from 2006 to 2008 after it was purchased by UnitedHealth Group, Inc., the nation's largest health insurance company by revenue." In addition, "regulators said the companies broke promises to maintain smooth operations for 130,000 of PacifiCare's customers, resulting in what insurance officials nationwide believe is the largest fine ever sought against a US health insurer."

Pawlenty Asks Sebelius For Additional Medicaid Funds.

Ben Smith writes in his Politico (9/8) blog, "Tim Pawlenty's decision to turn down some of the money associated with the health care overhaul was probably good national Republican politics, but it seems to have proved a headache at home, and today he announced that he's asking for $260 million in federal funds." His "letter to [HHS Secretary Kathleen] Sebelius says the Medicaid dollars 'reflect current and longstanding Minnesota policy objectives and commitments.' He also notes that Minnesota pays more to the federal government than it gets back."

        The Minneapolis Star Tribune (9/8, Stassen-Berger) reports, "The governor, who issued an executive order limiting Minnesota's take from the overhaul last week, told the secretary that his order was fueled by concern about 'overspending' and 'unbearable burdens that spending will place on our economy.'" Yet, in spite of "that 'concern,' Pawlenty said Minnesota would accept the federal cash from another bit of legislation -- the extension of the stimulus act. The governor, who has also trashed the stimulus act, said the money reflects, 'current and longstanding Minnesota policy objectives.'" The AP (9/8, Bakst), the Minneapolis-St. Paul Business Journal (9/8, Hammerand), and Minnesota Public Radio (9/8) also cover the story.

Treatment Poses Payment Problems For Hospice Patients.

NPR (9/8, Andrews) reports, "Seniors with terminal illnesses often face a tough choice: If they choose to get Medicare hospice benefits, they have to give up conventional medical treatments that aim to cure their disease. As a result, many people forgo hospice care until the very latest stages of their illness, and less than 40 percent of people are in hospice when they die." Notably, "the federal law overhauling health care eliminates the need to make such difficult choices for some seniors cared for at 15 sites that will test an approach that allows terminally ill patients to receive hospice benefits and curative treatment at the same time." However, "some hospice centers already offer concurrent care to Medicare patients. These 'open access' centers cover the cost of conventional therapies if a patient wishes them, even though Medicare may not."

Oregon County Allows Children Of Low-Income Families To Enroll In Healthy Kids Plan.

The Oregonian (9/8, Gregory) reports "children of low-income Washington County [OR] families are now eligible for enrollment in the state's Healthy Kids plan." The "plan allows no-cost, comprehensive coverage for children in families with income below $44,000 per year, and premiums that average $50 per month for two children in families of four" whose annual income is "between $44,000 and $66,000."

North Carolina ER To Check Patients' Credit.

The Herald (Johnston County, NC) (9/8, Nagem) reports, "Soon, hospital workers will check the credit histories of emergency-room patients in Smithfield and Clayton." At their August meeting, Johnston Health leaders "agreed to run credit checks to gauge patients' ability to pay their medical bill. But even patients with bad credit will get medical treatment in emergencies, they said." Other hospitals "check their patients' credit reports too, said Edward Klein, chief financial officer for Johnston Health. The question hospital leaders debated is whether to notify patients when the hospital runs a credit check."

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