Category Archives: Healthcare Reform

5 things to know about the Supreme Court case challenging the health law

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Credit: Dan Shirly

Credit: Dan Shirly

By Julie Rovner
KHN

On March 4, the justices will hear oral arguments in King v. Burwell, a case challenging the validity of tax subsidies helping millions of Americans buy health insurance if they don’t get it through an employer or the government. If the court rules against the Obama administration, those subsidies could be cut off for everyone in the three dozen states using healthcare.gov, the federal exchange website. A decision is expected by the end of June.

Here are five things you should know about the case and its potential consequences:

1: This case does NOT challenge the constitutionality of the health law. Continue reading

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Immigration reforms don’t solve health issues

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BorderwallbrownsvileBy Tim Henderson
Stateline

President Barack Obama’s controversial executive action on immigration has highlighted a thorny health care issue for states: Potentially millions of immigrants could legally stay here and work, but still lack health insurance.

Unauthorized immigrants have limited access to health care coverage, and the president’s action likely will make them ineligible for most Medicaid services and bar them from purchasing insurance on the federal and state exchanges created under the Affordable Care Act (ACA).

Some states have sought to solve the problem for low-income immigrants with separate state-funded insurance programs. Those that have not are wrestling with the consequences of a population that is going without routine care, which can drive up costs when preventable illnesses become serious health emergencies.

Millions of immigrants could legally stay here and work, but still lack health insurance.

Treating kidney disease as an emergency condition, for instance, costs almost five times what it would with routine care denied to unauthorized immigrants, according to a Baylor College of Medicine study published by the Texas Medical Association last year.

Unauthorized immigrants without health insurance present other problems for states. In Maryland, for instance, state attorneys face cases of criminally insane defendants who are no longer deportable but can’t get the follow-up care required for release into the community. Continue reading

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Uninsured Ex-Sheriff Who Fought O-care Struggles To Pay Medical Bills

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Arizona FlagFormer Arizona county sheriff Richard Mack, a fierce opponent of Obamacare and a leader in the “constitutional sheriff” movement, is struggling to pay his medical bills after he and his wife each faced serious illnesses. The former sheriff and his wife do not have health insurance and started a GoFundMe campaign to solicit donations from family and friends to cover the costs of their medical care.

via Uninsured Ex-Sheriff Who Fought O-care Struggles To Pay Medical Bills.

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Study: ObamaCare premiums could triple if court tosses subsidies | TheHill

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GavelThe cost of healthcare premiums could rise as much 779 percent if the Supreme Court erases ObamaCare subsidies in a majority of states this year, according to a new study.

A victory for the plaintiffs in King v. Burwell would erase subsidies in 37 states using HealthCare.gov, causing premiums to spike an average of 255 percent, according to new research by the nonpartisan group Avalere Health.

via Study: ObamaCare premiums could triple if court tosses subsidies | TheHill.

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Fewer Americans Have Problems With Medical Bills | Medpage Today

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Twenty-dollar bill in medicine bottleThe percentage of people under age 65 living in a household reporting problems paying medical bills in the past year decreased from 21.3% (56.5 million) in 2011 to 17.8% (47.7 million) in 2014, according to a CDC report.

via Fewer Americans Have Problems With Medical Bills | Medpage Today.

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The Return of the Death of Obamacare – Opinion in Bloomberg Politics

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U.S. Supreme CourtThe immediate effect of a ruling against the ACA would be to hurl the political system, and no small part of the economy, into chaos. Yet there’s little sign that Washington is preparing for that scenario.

Democrats won’t talk about what they would do because they don’t want the court to believe they could contain the fallout.

Republicans don’t want to talk because they’re loath to admit that, even after voting 67 times to repeal or defund the ACA, they have no plan to help the millions who would be affected. (But they’d sure love the court to kill the law anyway.)

Hospitals and insurers understand that bewailing their financial plight might not help their cause. Instead, they’ve channeled their warnings into amicus briefs.

via The Return of the Death of Obamacare – Bloomberg Politics.

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Veterans propose major changes in VA health care

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veteran-affairs-seal-vaA national veterans task force is advocating radical changes in the medical system for America’s former military personnel, including a choice to receive subsidized private care and conversion of the Veterans Health Administration into a non-profit corporation rather than a government agency.

via Veterans propose major changes in VA health care.

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If you want to know who gets health-care handouts, look in the mirror – Opinion in The Washington Post

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cms-logo-200pxDespite all the mockery that oblivious cries of “Keep your government hands off my Medicare!” generated several years ago, older Americans still don’t seem to understand that Medicare is not only the government’s largest health-care program but also one that involves transferring lots of money away from everyone else and toward them — i.e., a subsidy.

Maybe the confusion stems from the fact that Medicare recipients have paid Medicare taxes. Every time I mention Medicare in a column, I’m inundated with irate e-mails proclaiming that seniors “paid for it fair and square” and are therefore not receiving a handout. These claims overlook the laws of arithmetic.

via If you want to know who gets health-care handouts, look in the mirror – The Washington Post.

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High Rate of Shopping and Switching in Obamacare Plans Is a Good Sign – NYTimes.com

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Shopping CartFor most customers returning to the Obamacare marketplaces this year, it really paid to shop around. New data shows that a large number of them did. That bodes well for those shoppers and the future offerings of the insurance marketplaces.

via High Rate of Shopping and Switching in Obamacare Plans Is a Good Sign – NYTimes.com.

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Attention, shoppers: Prices for 70 health care procedures now online!

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By Jay Hancock
KNH

Buying health care in America is like shopping blindfolded at Macy’s and getting the bill months after you leave the store, economist Uwe Reinhardt likes to say.

A tool that went online Wednesday is supposed to give patients a small peek at the products and prices before they open their wallets.

Got a sore knee? Having a baby? Need a primary-care doctor? Shopping for an MRI scan?

Guroo.com shows the average local cost for 70 common diagnoses and medical tests in most states. That’s the real cost — not “charges” that often get marked down — based on a giant database of what insurance companies actually pay.

OK, this isn’t like Priceline.com for knee replacements. What Guroo hopes to do for consumers is limited so far.

Guroo.com Demo from Health Care Cost Institute on Vimeo.

It won’t reflect costs for particular hospitals or doctors, although officials say that’s coming for some. And it doesn’t have much to say initially about the quality of care.

Still, Guroo should shed new light on the country’s opaque, complex and maddening medical bazaar, say consumer advocates.

“This has the potential to be a game-changer,” said Katherine Hempstead, who analyzes health insurance for the Robert Wood Johnson Foundation. “It’s good for uninsured people. It’s good for people with high deductibles. It’s good for any person that’s kind of wondering: If I go to see the doctor for such-and-such, what might happen next?” Continue reading

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Your insurance questions answered

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Share your story flat illustrationBy Michelle Andrews
KHN

May I Move My Son From My Insurance Plan To A Better Option On The Marketplace?

Some readers want to figure out how to become eligible for coverage on the health insurance marketplaces, while others want to figure out how to avoid it.

This week I answered questions from both.

I am covered by my employer’s health plan, but I’m not happy with it. My son is 21 and currently covered under my plan. While I realize that I am not eligible for Obamacare, I am curious if I can terminate my son’s policy so that he might be eligible.   Continue reading

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How much does it cost?

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A new website, www.guroo.com, allows you to find out how much care for common conditions will cost. The site provides local, state and national average charges for these conditions. The site was created by the Health Care Cost Institute (HCCI), an independent, non-partisan, non-profit organization that promotes research and analysis on the causes of rising US health spending.

Guroo.com Demo from Health Care Cost Institute on Vimeo.

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States strive to keep Medicaid patients out of ERs

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Sign for an emergency room.By Michael Ollove
Stateline

Nearly half the states use higher copayments to dissuade Medicaid recipients from unnecessary visits to emergency rooms, where care is more costly.

These states require patients to make the payments, which are as high as $30 per visit in Oklahoma, when it is later determined that they did not experience a true medical emergency.

But at least one multistate study has found that charging higher copayments does not reduce emergency department (ED) use by Medicaid recipients.

One reason might be that copays are hard to enforce, since EDs are legally obligated to examine anyone who walks through the doors, whether or not they can pay.

ED doctors and others in health policy also criticize copays as potentially dangerous, since they may lead people to think twice about seeking emergency care when they really need it.

Washington state and some Medicaid managed care plans around the country are trying a different approach. Instead of using financial disincentives, they are trying to keep frequent users out of the emergency department (practitioners prefer the name “emergency department” to “emergency room”) by enrolling them in primary care practices, scheduling appointments for them and, in some cases, making sure they get to the doctor’s office on time. The hope is that giving people comprehensive health care will make many ED trips unnecessary.

Reliable data are still sparse, but the early signs are encouraging: Washington state reported that a year after implementing its program, emergency room visits by Medicaid beneficiaries had declined by nearly 10 percent. Among frequent ED users, the drop was slightly greater. Continue reading

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Top five stories of the week

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Credit: Dan Shirly

Credit: Dan Shirly

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Tax time reprieve for Obamacare procrastinators

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clockBy Phil Galewitz
KHN

The Obama administration said Friday it will allow a special health law enrollment period from March 15 to April 30 for consumers who realize while filling out their taxes that they owe a fee for not signing up for coverage last year.

The special enrollment period applies to people in the 37 states covered by the federal marketplace, though some state-run exchanges are also expected to follow suit.

People will have to attest that they first became aware of the tax penalty for lack of coverage when they filled out their taxes. They will still have to pay the fine, which for last year was $95 or 1 percent of their income, whichever was greater.

Some people may not realize they face a penalty for not having coverage until they file their tax returns.

This year, the penalty for not having insurance coverage is $325 per person or 2 percent of household income, whichever is greater. By signing up during the special enrollment period for 2015 they can avoid paying most of the tax penalty for this year.

The Affordable Care Act requires most Americans to have health insurance or pay a financial penalty.

But some people may not realize they face a penalty for not having coverage until they file their tax returns ahead of the April 15 tax deadline. Continue reading

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