Public on King vs. Burwell Supreme Court Case re Financial Aid +

This issue focuses on Kaiser's tracking poll reaction to Supreme Court King vs Burwell case; but also has articles on Medicaid variations, Retiree benefits, Results-Focused Care; 9 million enrollees


1) From Kaiser Family Foundation: Health Tracking Poll. Lots of very useful information

Majority of Public Says Congress Should Act to Close Gaps if the Supreme Court Bars Financial Help for Purchasing Insurance in States Relying on healthcare.gov; Most in Potentially Affected States Want Their State To Set Up Its Own Marketplace if Needed

Here are a few key charts. Many more in the article.











The following is not surprising but bad news




2) The Goal Was Simplicity; Instead, There’s a Many-Headed Medicaid

3) Ruling Could Send More Retirees Seeking Coverage To Exchanges

4) The New York Times: Industry Group to Back Results-Focused Care 

This complements what HHS just announced as its plans.  I have long advocated for this.

5)  More Than 9 Million Choose Obamacare in Latest Round - NBC

Report by a nearby neighbor

CBO Cuts Cost of ACA; Medicare Transformation

1)    o Budget Office Slashes Estimated Cost of Health Coverage

o   Obamacare cost to be 20% less than forecast, budget office says

Excellent news. 

2)   Medicare to transform how it pays doctors and hospitals

3) o  Obamacare and immigrant tax-filers

 o  Maryland Health Connection: It's Tax Time — Are You Ready?

o  Successfully Navigating the Tax Filing Moment

o  Here's How Obamacare Is Going To Affect Your Taxes

4) Precision Medicine: Improving Health and Treating Disease

5)    Fewer People Having Trouble Paying Medical Bills

6)   Average Obamacare subsidy in California: $436 a month per household. $3.2B in total 2014

7)    Maryland: Risky cut to Medicaid

8)  Learning About Hospice Should Begin Long Before 

You Are Sick

9) High Court Ruling Chips Away At Health Benefits Promised To Union Retirees

ACA Challenge Incredulous; Worker Concerns

1)  Health Law Challenge 'Strains Credulity,' Administration Says

ObamaCare subsidy fight gets personal

2) Families USA:  Health Reform 2.0: A Call to Action  Some useful proposals

3)  Most Workers Continue to be Satisfied With Their Own Health Plan, but Growing Number Give Low Ratings to Health Care System

Americans not confident about the future of health care: EBRI surveys find that Americans are worried about their future ability to get the health care they need. 

“Would Obama’s Paid Sick Leave Proposal Actually Work? Look to San Francisco.”
  
“The Next Big Health-Care Shift Is Coming” Employer coverage will decrease.  

Democrats Defend Health Law's 30-Hour Work Week

4) Childless Adults Face Hurdles Qualifying for Medicaid, Survey Shows 5)         Bid to Force Higher Medicaid Payments Reaches Supreme Court 6)  HHS Pledges To Quicken Pace Toward Quality-Based Medicare Payments  7)      The Invisible Homebound: Setting Quality-Of-Care Standards For Home-Based Primary And Palliative Care 8)  Moving Beyond Wellness ROI Toward Employment-Based Cultures Of Health: Part I. http://bit.ly/1yISJ9X 9)     Healthcare.gov Moves To Shield Consumer Information 10)  Competition In Health Care Markets 11) New Survey: Rise in Access to Care and Affordability in First Year of ACA Enrollment

  

Anti-ACA case unravels; Major Medicaid Benefits

1)   Rationale for anti-ACA case continues to unravel

This is the King vs Burwell case where the issue is whether the ACA subsidizes insurance for consumers nationwide, or only consumers who enroll through state exchanges. 

Republicans Knew Obamacare Subsidies Were Universal. Here's Proof

Adminstration's brief filed in Supreme Court

This is the brief that the Administration submitted.  A friend and former colleague posted this.  

2) Medicaid-Eligible Children Grow Up to Earn More and Pay More in Taxes

3) State Strategies for Integrating Physical and Behavioral Health Services in a Changing Medicaid Environment

4) At Least Half Of New Medicare Advantage Enrollees Had Switched From Traditional Medicare During 2006–11

5) Maryland Health Connect - What to Expect after You Enroll - Video

6) Is Your Data Safe at Healthcare.gov?

7)   Efforts intensify to sign up Hispanics for health care

Complex: Premium Credits and Cost-Sharing Reductions; Latinos

1) Reporting Changes in Circumstances:  How Changes in Income and Household Size Affect Premium Credits and Cost-Sharing Reductions

CBPP hosted a webinar on 1/21 on the above topic.  This is a very complex topic and CBPP presented a very useful analysis of this complex but very important topic. 

Other webinars by CBPP can be found at CBPP: Health Reform - Beyond the Basics 

The 1/21 webinar guides navigators and consumers on how to make comparisons between plans on premiums, deductibles, copays, etc.  What I had not realized is that there are so many variables that one must consider in making such comparisons.  I think this is very hard to do for a navigator let alone a consumer.  I feel that a tool needs to be developed to make such comparisons easier for all and that it takes into account a consumers individual  or family needs. I recommend that you review this webinar.  Very well done but raises lots of concerns for me. 

On Friday, I received the following from Washington Consumer Checkbook in answer to my concerns.  

CHECKBOOK's Help for the New Health Insurance Marketplaces

This is the perfect answer to my concerns. Checkbook has been doing this kind of analysis on Federal Health Plans for many years and they have always provided extremely useful analyses.  I am very grateful to them for this latest product.  

2) Latino Enrollment Is Obamacare Priority

Efforts Intensify to Sign Up Hispanics for Health Care
3) Parents earning more than $3,760 are ‘too rich’ to qualify for Medicaid in Texas

4) National Health Spending In 2013: Growth Slows, Remains In Step With The Overall Economy 

5) Pay-For-Performance Schemes That Use Patient And Provider Categories Would Reduce Payment Disparities

6) Big Data In Health Care: Using Analytics To Identify And Manage High-Risk And High-Cost Patients

7) Is Your Data Safe at Healthcare.gov? 8) Next Goal For Abortion-Rights Backers: Reducing Stigma 9) Obama Administration Offers Supreme Court Robust Defense Of Health Law

Venture Capital and HealthPlan Finder Website

Here are several articles about Healthcare IT and Venture Capital.  These provide suggestions for investments.  Welcome comments on the merits of these investments. 

Health-care IT investment boom: Who's the next winner?

How Health Care is Leading New Venture Capital Investment

Bryan Roberts: Health care venture capital's billion-dollar man

I am interested in advice on Venture Capital Firms that can assist in marketing Steve Morse's website. Perhaps as discussed in the NY Times article below.  Please suggest Health IT Venture Capital firms to thausner@gmail.com. I plan to write 

to some of the companies mentioned in the articles above.  

Steve Morse has developed a website that helps consumers select the best health insurance plans, which participate in the Affordable Care Act to meet their needs.  

Here is his website

​

http://stevemorse.org/obamacare/obamacare.html 

Here are some of my blog posting about his site.  They reference two articles from two of the top news sources in the health policy field.  

Morse's site is lead article in CQ HealthBeat  A great comparison healthplan shopping site.  [CQHealthBeat is published by Congressional Quarterly]

 Zeke Emanuel in Politico:  Whoneeds Healthcare.gov.  Easy to use planfinder sites.   Zeke Emanuel was a  key player in developing the Affordable Care Act. 

The following article suggests ways in which Morse's site can be of particular use.  

http://mobile.nytimes.com/2015/01/19/technology/insurance-via-internet-is-squeezing-agents.html

By way of background, I spent 26 years working at the U.S. Centers for Medicare and Medicaid Services (see my resume at http://healthreformaction.blogspot.com/

on my blog) and have spent the last 5 years as a volunteer with the ACA in various capacities.  Several Health Connectors in Maryland have found Morse's site extremely useful. 

I have also written about investments in the health care field. See  Investment implications of the ACA – expanded

Medicare at 50: Origins and Evolution

Medicare at 50: Origins and Evolution  Part I in New England journal of Medicine

Here is what I said previously.

So does Medicaid!!

For their 25th anniversary, I was on detail to the House Aging Committee and wrote a report for Committee's hearing.  

Medicare and Medicaid's 25th anniversary - much promised, accomplished, and left unfinished : a report presented by the chairman of the Select Committee on Aging, House of Representatives, One Hundred First Congress, second session. 
We had quite a party after the hearing with Burt Lancaster, John Rockfeller, and Gail Wilensky. 

The above report and a few other of my publications can be found at
https://uky.academia.edu/tonyhausner

My CV can be found at this site as well as on the side of this blog.  30 years at USDHHS, 26 of which were at CMS.

ACA greatly improves access and lowers costs

The Rise in Health Care Coverage and Affordability Since Health Reform Took Effect

For the first time, The Commonwealth Fund’s Biennial Health Insurance Survey—fielded since 2001—finds sharp declines in uninsured rates for working-age Americans. The number of people reporting that costs were a problem in accessing care also fell, as did the number of people with trouble paying medical bills.

Fewer People Are Having Trouble Paying Medical Bills, Thanks To Obamacare

Repeal the medical device tax? A new report challenges the economic reasoning of the move: http://khne.ws/151LwpM


Web First - Medicare Per Capita Spending By Age And Service: New Data Highlights Oldest Beneficiaries. http://bit.ly/1DGzktn This Web First is part of our re-established DataWatch series, which features timely health-related data and surveys. New analysis of Medicare spending from 2000-11 found that in 2011 per capita spending increased with age, from $7,566 for beneficiaries age seventy to $16,145 at age ninety-six, and then declined for even older beneficiaries.

End-of-life instructions find no place in electronic health records 

Performance Based Financing: main lessons from two recent scientific studies


From CBPP

On health reform, Judy Solomon highlightednew studies showing that millions more Americans will be uninsured and premiums will jump if the Supreme Court disallows health reform subsidies for people getting coverage through the federal marketplace.  Paul Van de Water reiterated that arguments for repealing health reform’s medical device tax are as weak as ever.

Tavenner To Leave CMS; Burwell Lays Out 'To Do' List With GOP Lawmakers 

My impression is she did an excellent job under very difficult circumstances.  

• 
  
• States Prepare No 'Plan B' Ahead Of High Court Subsidy Ruling

• More Hospitals, Doctors, Subscribing To Smartphone Services

I think there is so much more that smartphones can do with medical information. Kaiser has a very comprehensive electronic system that allows one to read their entire medical record.  

States Prepare No 'Plan B' Ahead Of High Court Subsidy Ruling

High Court Rejects Challenge To The Health Law's Individual Mandate

High Court Rejects Challenge To The Health Law's Individual Mandate http://khne.ws/14QJqK7

Doing More for Patients Often Does No Good 

IPAB: Ditching the Dog That Didn't Bark

• Medical-Device Tax Has Modest Effects, Report Says 16 minutes ago

Improved Management of Chronic Illness; Health Care Inflation

1) Managing Chronic Illness: Physician Practices Increased the Use of Care Management and Medical Home Processes

This is very encouraging. If I read the summary right, this is the first positive news re Pay for Performance, Medical Homes, etc and some of the other innovations being explored. 

2) Health Premiums Rise More Slowly, but Workers Shoulder More of Cost
Commonwealth Fund says: The good news: Health insurance premiums are rising more slowly than they were pre-ACA. The bad news: Workers are shouldering more of the costs of coverage and care.

3) No, the ACA Isn’t Forcing Firms to Cut Workers’ Hours




4) Giving Patients Control of Their EHR Data

5) Steve Brill "America's Bitter Pill"

Just watched Steven Brill on 60 minutes Sunday evening.  In the interview, he was very critical of the ACA as having done nothing about health costs.  As has been pointed out previously, health care inflation is at its lowest point since 1960.  It is not certain that the ACA has made a difference because inflation has been relatively low for several years.  However, I know there are provisions in the law that have the potential to lower costs.  Hospital readmissions are down significantly and that is very highly probable because provisions in the law pushed readmissions down.  I have listed a number of other provisions that are likely reducing costs in previous posts.

I have not read the book but from what I have heard, I have other concerns with his book.  I liked his Time magazine article as that focused more on the drug industry's high costs for medicines.  That is a different ballgame.  There I would be more in agreement.

Nevertheless, his criticism of the industry may lead to more efforts to address costs which could be a good thing.

6) Maryland Health Connection - Real-Life Stories (Grace)

7) GOPAs Health Law Becomes More Entrenched, GOP Divided Over Strategy Health-Law Suit Hints at G.O.P. Divide

8)  Medicaid

MEDICAID REIMBURSEMENT CASE COULD SET PRECEDENCE FOR FUTURE CHALLENGES
Supreme Court Battle Brewing Over Medicaid Fees
 ‪#‎Medicaid‬ expansion boosts kids' incomes and government tax revenue http://bit.ly/1KCHqFq? via Vox

Tax Credit is Important; Women Benefit

The Rand Corp.: The Effect Of Eliminating The Affordable Care Act's Tax Credits In Federally Facilitated Marketplaces 

 Infographic: How Many Women Are Benefiting from the Affordable Care Act?
 For millions of women, lifetime limits on their health insurance plans are a thing of the past. 

JAMA: Effect Of An Enhanced Medical Home On Serious Illness And Cost Of Care Among High-Risk Children With Chronic Illness   Very encouraging results  

HLM: Healthcare Quality Issues for 2015
This is HLM's perspectives on top quality issues.  I agree with several of the issues, not so much others, and see some important measures left out.  But progress is definitely being made. 

Data book on dual-eligible beneficiaries from MedPAC and MACPAC
An excellent source of information on this most important group of beneficiaries, the most costly group in these programs.

This data book is organized into the following sections:overview of dual-eligible beneficiaries

• characteristics of dual-eligible beneficiaries

•  eligibility pathways, managed care enrollment, and continuity of enrollment

•  dual-eligible beneficiaries’ utilization of and spending on Medicare and Medicaid services

• Medicare and Medicaid spending for dual-eligible beneficiaries by LTSS use

• trends in dual-eligible population composition, spending, and service use 

Medical Debt Among Insured Consumers
A very useful report 

What to Expect After You Enroll
Quick video explains billing, insurance cards and doctor. From Maryland Health Connection.

From Alliance for Retired Americans 

So does Medicaid!!

For their 25th anniversary, I was on detail to the House Aging Committee and wrote a report for Committee's hearing.  

Medicare and Medicaid's 25th anniversary - much promised, accomplished, and left unfinished : a report presented by the chairman of the Select Committee on Aging, House of Representatives, One Hundred First Congress, second session. 
We had quite a party after the hearing with Burt Lancaster, John Rockfeller, and Gail Wilensky. 

The above report and a few other of my publications can be found at
https://uky.academia.edu/tonyhausner

My CV can be found at this site as well as on the side of this blog.  30 years at USDHHS, 26 of which were at CMS.

No to changing ACA work requirement; Supreme Court case; Taxes

Why Changing the Definition of Full-Time Work Under the ACA Will Put More Workers at Risk and Increase Federal Spending
 Glad to see this article.  I did not realize all the consequences of this possible change.  

CBPP: Republican Leaders Deploying Untruths on 40-Hour Health Bill

GOP, Now In Control Of Capitol Hill, Takes Aim At Health Law's Employer Mandate 
President Rejects GOP Change to ObamaCare 
 He would veto

Small Businesses Snub Health Exchanges for Coverage

Five Things Governors Want the Do-Nothing Congress to, Well, Do

How A Stray Remark By A Republican Governor Could Save Obamacare From The Supreme Court
Hope CAP is right on this.

Conservatives Know the Latest Obamacare Challenge is Weak – That’s Why They’re Trying to Spin John Roberts

Meet The New Health Law Tax Form Statements by Secretary Lew and Secretary Burwell on preparing for the upcoming tax season

False Tax Claims  
GOP Governors Seek Flexibility from Obama on Medicaid Work Rules   Pharma, Biotech Stocks Avoid Much Of Early New Year's Malaise

‘America’s Bitter Pill,’ by Steven Brill  
Brill wrote a great Time magazine article "Bitter Pill: Why Medical Bills are Killing Us."  This review of his new book by a similar title in NYTimes is quite positive.  I have read another review that is less so.