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Senate Democrats unveil legislation to reverse high court's Hobby Lobby ruling
The Hill
July 9, 2014
http://thehill.com/homenews/senate/211700-democrats-unveil-bill-to-reverse-hobby-lobby-ruling
Senate Democrats introduced legislation on Wednesday to effectively reverse the Supreme Court’s decision last week exempting some employers from having to provide insurance coverage for contraception.  The law would bar for-profit corporations from seeking exemptions from the Affordable Care Act’s mandate that their health plans cover contraception costs. Religious institutions would still be able to opt out.  “Our bill simply says that your boss cannot get between you and your own healthcare,” Sen. Patty Murray (D-Wash.) told reporters. Murray is the bill’s chief sponsor.  “Last week, we saw the Supreme Court give CEOs and corporations across America the green light to design legally mandated healthcare coverage for their employees. Women across the country are outraged,” she said.  Senate leaders have vowed to fast-track the legislation, but a measure to block the court decision will never pass the Republican-led House.
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Expanding Medicaid called health, economic benefit
The Philadelphia Tribune
July 8, 2014
http://phillytrib.com/news/health/expanding-medicaid-called-health-economic-benefit.html
A recent report released by the White House Council of Economic Advisers has highlighted the importance of expanding Medicaid eligibility.  The report, “Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid” focuses on the economic and health implications of expanding eligibility. Under the Affordable Care Act, Medicaid eligibility could be expanded to all non-elderly individuals in families below 133 percent of the federal poverty level.  According to the report, Medicaid expansion in Pennsylvania would increase the number of people with access to affordable health insurance by 305,000 by 2016, create more than 35,000 jobs from 2014 to 2017 and provide an $8.2 billion net increase in federal dollars to the commonwealth from 2014 to 2016.  If Pennsylvania closed the coverage gap, 11,000 more women would receive mammograms, 17,600 more women would receive Pap smears, and 13,700 fewer people would face catastrophic out-of-pocket medical expenses per year.
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94 percent of Maryland health insurance exchange business went to CareFirst
The Washington Post
July 7, 2014
http://www.washingtonpost.com/local/md-politics/94-percent-of-maryland-health-insurance-exchange-business-went-to-carefirst/2014/07/03/4370d574-02b5-11e4-8572-4b1b969b6322_story.html
The overwhelming majority of Maryland residents who used the state’s troubled online marketplace to sign up for health insurance made possible by the Affordable Care Act have become customers of CareFirst, a massive and well-known insurance provider based in Maryland. State health officials say that of the 72,207 Marylanders who signed up for a plan through the marketplace during the first enrollment period, 67,800 picked a CareFirst plan — which was often the least expensive offering. That’s 94 percent of enrollments. The Kaiser Foundation Health Plan received 3,560 new customers. Evergreen Health, a new cooperative that hoped to get thousands of customers via the exchange, had 525 sign-ups through the site. United Healthcare had 322. All of those customers signed up during the first open enrollment period, from Oct. 1 to March 31. The state’s Web site did not function as expected during that period, which made it much more difficult for many Marylanders to enroll. 
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CMS Proposes Medicare Reimbursement Changes, Increases for 2015
California Healthline
July 7, 2014
http://www.californiahealthline.org/articles/2014/7/7/cms-proposes-medicare-reimbursement-changes-increases-for-2015
CMS has proposed increasing the number of quality measures used in the Medicare Shared Savings program for accountable care organizations, according to its proposed 2015 Medicare physician fee schedule released Thursday, Modern Healthcare reports.  The measures would place an even greater emphasis on patient outcomes.  Specifically, the number of quality measures used to assess ACOs would increase from 33 to 37. ACOs would need to meet the quality performance goals to earn bonus payments under the program. The new measures would include:
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The Health Care Waiting Game- Long Waits for Doctors’ Appointments Have Become the Norm
The New York Times
July 7, 2014
http://www.nytimes.com/2014/07/06/sunday-review/long-waits-for-doctors-appointments-have-become-the-norm.html?_r=0
One small consolation of our high-priced health care system — our $2.7 trillion collective medical bill — has been the notion that at least we get medical attention quickly. Americans look down on national health systems like Canada’s and Britain’s because of their notorious waiting lists. In recent weeks, the Veterans Affairs hospitals have been pilloried for long patient wait times, with top officials losing their jobs. Yet there is emerging evidence that lengthy waits to get a doctor’s appointment have become the norm in many parts of American medicine, particularly for general doctors but also for specialists. And that includes patients with private insurance as well as those with Medicaid or Medicare.  Merritt Hawkins, a physician staffing firm, found long waits last year when it polled five types of doctors’ offices about several types of nonemergency appointments including heart checkups, visits for knee pain and routine gynecologic exams. The waits varied greatly by market and specialty. For example, patients waited an average of 29 days nationally to see a dermatologist for a skin exam, 66 days to have a physical in Boston and 32 days for a heart evaluation by a cardiologist in Washington.
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Reform Update: CMS advances quality initiatives in draft payment rule
Modern Healthcare
July 7, 2014
http://www.modernhealthcare.com/article/20140707/NEWS/307079965
The CMS plans to expand public reporting through the Physician Compare website and require more practices to share patient-experience data. The agency also intends to eliminate “topped out” quality measures deemed no longer useful in assessing the performance of accountable care organizations.  Quality and safety experts say these proposals included in the 600-plus-page draft rule for the 2015 physician fee schedule are a step in the right direction toward increasing transparency and improving on the ability to track outcomes in a significant and comparable way.  In 2016, the agency said, the Physician Compare website—which was established under the Patient Protection and Affordable Care Act—should reflect all 2015 data from the Physician Quality Reporting System, Group Practice Reporting Option Web interface, registries and EHR measures for group practices of two or more eligible physicians and accountable care organizations. The rule also recommended requiring that data meet the minimum sample size of 20 patients.
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Why liberals are abandoning the Obamacare employer mandate
Politico
July 7, 2014
http://www.politico.com/story/2014/07/obamacare-employer-mandate-108578.html?hp=t1
Robert Gibbs’ prediction that Obamacare’s employer mandate would — and perhaps should — be jettisoned shocked Democrats back in April. By July, the former aide and longtime confidant of President Barack Obama had a lot more company. More and more liberal activists and policy experts who help shape Democratic thinking on health care have concluded that penalizing businesses if they don’t offer health insurance is an unnecessary element of the Affordable Care Act that may do more harm than good. Among them are experts at the Urban Institute and the Commonwealth Fund and prominent academics like legal scholar Tim Jost.  The employer mandate, Jost wrote in a Health Affairs post in June, “cries out for repair.” Repealing it “might not be such a bad idea,” if it’s replaced with something better for workers and businesses.  Leading Democrats in Congress aren’t bolting from the employer mandate, at least not before the November election. But the White House has delayed it twice in the past year, dubbed it “not critical” and said it will be phased in more slowly when its begins next year.
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Obamacare's next threat: A September surprise
Politico
July 7, 2014
http://www.politico.com/story/2014/07/obamacare-insurance-rates-white-house-108590.html
Obamacare open enrollment closed March 31. The White House’s Obamacare war room did not.
Most state health insurance rates for 2015 are scheduled to be approved by early fall, and most are likely to rise, timing that couldn’t be worse for Democrats already on defense in the midterms. The White House and its allies know they’ve been beaten in every previous round of Obamacare messaging, never more devastatingly than in 2010. And they know the results this November could hinge in large part on whether that happens again.  So they’re trying to avoid — or at least, get ahead of — any September surprise.  Aware that state insurance rate hikes could give Republicans a chance to resurrect Obamacare as a political liability just weeks before the midterms, the White House’s internal health care enrollment outreach apparatus immediately redirected into a rapid-response, blocking-and-tackling research and press operation geared toward preempting GOP attacks on the issue.
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Birth Control Order Deepens Divide Among Justices
The New York Times
July 3, 2014
http://www.nytimes.com/2014/07/04/us/politics/supreme-court-order-suspends-contraception-rule-for-christian-college.html?_r=0
In a decision that drew an unusually fierce dissent from the three female justices, the Supreme Court sided Thursday with religiously affiliated nonprofit groups in a clash between religious freedom and women’s rights.  The decision temporarily exempts a Christian college from part of the regulations that provide contraception coverage under the Affordable Care Act.  The court’s order was brief, provisional and unsigned, but it drew a furious reaction from the three female members, Justices Sonia Sotomayor, Ruth Bader Ginsburg and Elena Kagan. The order, Justice Sotomayor wrote, was at odds with the 5-to-4 decision on Monday in Burwell v. Hobby Lobby Stores, which involved for-profit corporations.  “Those who are bound by our decisions usually believe they can take us at our word,” Justice Sotomayor wrote. “Not so today.”
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Physician fee schedule would modify Medicare ACO measures
Modern Healthcare
July 3, 2014
http://www.modernhealthcare.com/article/20140703/NEWS/307039940
The CMS plans to increase the number of quality measures in the Medicare Shared Savings program for accountable care organizations and put greater emphasis on outcomes.  The changes, included in the 2015 Medicare physician fee schedule (PDF), would increase the number of quality measures from 33 to 37. ACOs must meet quality performance targets to earn bonuses in the program, which includes nearly 350 organizations and is scheduled to expand in January. The program was launched under a provision of the Patient Protection and Affordable Care Act. If adopted in the final rule, the changes would go into effect Jan. 1.  The new measures include whether patients say providers educated them about the cost of medications; the rate of patients who are admitted to a skilled-nursing facility within 30 days of leaving the hospital; and all-cause unplanned readmissions for patients with diabetes, heart failure or multiple chronic conditions.
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Sen. Lamar Alexander Resurrects Health-Care Fights in Ad
The Wall Street  Journal
July 3, 2014
http://stream.wsj.com/story/supreme-court-health-law-decision/SS-2-24938/SS-2-569523
Mr. Alexander’s campaign on Wednesday released a TV ad that will begin airing statewide Sunday showing him confronting President Barack Obama at a February 2010 White House health-care summit with senators. As Mr. Alexander’s leading opponent, state Rep. Joe Carr, criticizes him in his ads for being insufficiently conservative in votes for the 2013 immigration legislation, this ad aims to remind voters that Mr. Alexander was a public skeptic before the health law was passed.
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Why Obamacare poster child split on same-sex marriage
CNN
July 3, 2014
http://www.cnn.com/2014/07/03/politics/beshear-same-sex-appeal
President Barack Obama invited Kentucky Gov. Steve Beshear to this year's State of the Union address where he praised the Democrat for aggressively carrying out the Affordable Care Act.
"He is like a man possessed when it comes to covering his commonwealth's families," Obama said about Beshear, who boasts that more than 420,000 people have signed up for his state's version of the controversial federal health law championed by Obama Although he's with the President on Obamacare, Beshear has turned from Democrats on same-sex marriage, saying he would appeal a federal court ruling overturning the Kentucky ban.
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Mike Pence submits request for Medicaid alternative
The Washington Examiner
July 2, 2014
http://washingtonexaminer.com/mike-pence-submits-request-for-medicaid-alternative/article/2550414
Gov. Mike Pence on Tuesday asked that the federal government expand health care coverage for Indiana's low-income residents using a state-run alternative to traditional Medicaid.  Pence's proposal, dubbed the Healthy Indiana Plan 2.0, would still rely on billions in federal aid to cover residents earning up to 138 percent of the federal poverty level, like states that approved the Medicaid expansion included in the federal health care overhaul. But Pence and his supporters contend it supports personal responsibility in a way Medicaid doesn't because it would rely on health savings accounts and patient input.  The plan expands on the state's existing Healthy Indiana Plan, which has been covering about 35,000 to 45,000 low-income residents for the past six years. Pence wrote in a letter Tuesday to Health and Human Services Secretary Sylvia Burwell that he wants to expand that concept.
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Health-care exchanges are not properly ensuring applicants’ eligibility, probe finds
The Washington Post
July 1, 2014
http://www.washingtonpost.com/national/health-science/health-care-exchanges-are-not-properly-ensuring-applicants-eligibility-probe-finds/2014/07/01/d7f83672-0127-11e4-8572-4b1b969b6322_story.html
The new health insurance marketplaces run by the federal government and some states are not checking carefully enough that Americans who apply for health plans qualify for the coverage and federal subsidies to help pay for it, according to federal investigators.  A pair of reports, issued Tuesday by the Department Health and Human Services’ Office of Inspector General, conclude that “internal controls” for evaluating applications were not always effective at verifying people’s Social Security numbers, their citizenship, and whether they are eligible to buy health plans through the marketplaces because they cannot find affordable insurance elsewhere.  Such deficiencies “may have limited the marketplaces’ ability to prevent the use of inaccurate or fraudulent information” by consumers drawn to the insurance exchanges created under the 2010 Affordable Care Act, one of the reports said.
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White House, Democrats Plot Response To Supreme Court Hobby Lobby Ruling
The Huffington Post
June 30, 2014
http://www.huffingtonpost.com/2014/06/30/white-house-hobby-lobby_n_5544287.html
The Obama administration and allied Democrats on the Hill quickly began exploring potential responses to the Supreme Court’s decision Monday to dramatically limit the contraception mandate in the president's health care law.  A Senate Democratic leadership aide told The Huffington Post that the party was already crafting a bill to respond to the ruling, which said the government cannot force closely held corporations to pay for contraception coverage if their owners object on religious grounds.  The range of options is fairly limited, aides cautioned, and they all present political hurdles.  Still, Democratic leadership is eager to tackle the matter head-on, confident that public opinion is on their side. Moments after the 5-4 decision came down in the Hobby Lobby case on Monday, Senate Majority Leader Harry Reid (D-Nev.) illustrated that defiant stance when he declared, "If the Supreme Court will not protect women's access to health care, then Democrats will."  In actuality, the leadership aide said, party officials had begun strategizing how best to respond to a possible adverse ruling well before the court’s decision was announced.
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Supreme Court rules against Obama in contraception case
CNN
June 30, 2014
http://www.cnn.com/2014/06/30/politics/scotus-obamacare-contraception
Some corporations have religious rights, a deeply divided Supreme Court decided Monday in ruling that certain for-profit companies cannot be required to pay for specific types of contraceptives for their employees. The 5-4 decision based on ideological lines ended the high court's term with a legal and political setback for a controversial part of President Barack Obama's healthcare reform law. It also set off a frenzied partisan debate that will continue through the November congressional elections and beyond over religious and reproductive rights.
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Hatch’s healthier health care option
The Washington Times
June 29, 2014
http://www.washingtontimes.com/news/2014/jun/29/gop-hatchs-healthier-health-care-option
There is no Obamacare retreat in Sen. Orrin G. Hatch’s office. The Utah Republican promises that President Obama’s signature health care law will cease to exist in its current form if Republicans win control of the Senate this fall. Mr. Hatch, who is poised to become chairman of the powerful Senate Finance Committee if Republicans regain the majority, has been chipping away at Obamacare as a ranking member. He has offered numerous amendments to the Affordable Care Act since it became law, such as delaying tax credits and subsidies to certain immigrants and banning abortion coverage.
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Getting Affordable Care Act subsidies
USA Today
June 29, 2014
http://www.usatoday.com/story/money/personalfinance/2014/06/29/getting-obamacare-subsidies/11639003/
The Affordable Care Act (ACA), aka Obamacare, provides subsidies to Americans making up to 400% of the poverty level, about $94,200 for a family of four. Can you juggle finances to best cash in on subsidies? Rather than limiting subsidies to only those with a small net worth, the ACA provides aid to all persons with low incomes, including those early or partial retirees.Imagine a couple, Michael and Lisa, who are both 51 and own a family business. They have two children, 17-year-old Jacob and 14-year-old Emily. Last year their business produced income of about $140,000.
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Medical Boards Draft Plan to Ease Path to Out-of-State and Online Treatment
The New York Times
June 29, 2014
http://www.nytimes.com/2014/06/30/us/medical-boards-draft-plan-to-ease-path-to-out-of-state-and-online-treatment.html
Officials representing state medical boards across the country have drafted a model law that would make it much easier for doctors licensed in one state to treat patients in other states, whether in person, by videoconference or online.  The plan, representing the biggest change in medical licensing in decades, opens the door to greater use of telemedicine and could alleviate the doctor shortage, a growing problem as millions of people gain insurance coverage under the Affordable Care Act.  The draft legislation — in the form of an interstate compact, a legally binding agreement among states — was developed by the Federation of State Medical Boards, composed of the agencies that license and discipline doctors.
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IRS issues rule on small-business health insurance tax credit
Modern Healthcare
June 27, 2014
http://www.modernhealthcare.com/article/20140627/NEWS/306279959
The Internal Revenue Service issued a final rule on tax credits intended to make it more affordable for small businesses to buy health insurance for their employees.  The rule establishes eligibility requirements for a tax credit introduced by the Patient Protection and Affordable Care Act. The credit has been available since the 2010 tax year but was implemented through IRS notices rather than formal rulemaking, according to Timothy Jost, a Washington & Lee University School of Law professor.  The final regulation, which will appear in the Federal Register on June 30, does not differ dramatically from its proposed version released last August. Eligible small employers are defined as those with no more than 25 full-time equivalent employees who have average annual wages of no more than $50,800 each. Employers must contribute at least 50% of the premium cost on behalf of each enrolled employee and in return, they can claim a tax credit of 50% of the premium amount paid.
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Blumenthal, DeLauro Introduce Medicare Advantage Bill
The Hartford Courant
June 26, 2014
http://articles.courant.com/2014-06-26/business/hc-medicare-advantage-bill-blumenthal-delauro-20140626_1_810-primary-care-physicians-fairfield-county-medical-association-unitedhealthcare
The bill, introduced Thursday, requires insurers that offer Medicare Advantage to disclose the reasons for ending contracts with medical providers. It also requires the federal Centers for Medicare and Medicaid Services to redesign the online tool.  U.S. Rep. Rosa DeLauro, D-3rd District, introduced the legislation in the U.S. House and a companion bill was introduced in the Senate by U.S. Sen. Sherrod Brown, D-Ohio, and U.S. Rep. Richard Blumenthal, D-Conn.  Last fall, UnitedHealthcare told an unspecified number of doctors they would be dropped from the insurer's Medicare Advantage network in early 2014. The Fairfield County Medical Association said the change reduced UnitedHealthcare's Connecticut network by 810 primary care physicians and 1,440 medical specialists.  Additionally, about 30 doctors in the New Haven area will be out of UnitedHealthcare's Medicare Advantage network starting July 1. UnitedHealthcare and Yale-New Haven Hospital failed to agree on terms for treating the insurer's Medicare Advantage patients. The hospital has been out of network for those patients since April 1.  Blumenthal said UnitedHealthcare's actions have huge consequences for "our most elderly and frail seniors."
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