Archive for the ‘Health Care In The States’ Category

Half Of Texas Abortion Clinics Close Due To State Law

This story is part of a partnership that includes Houston Public Media, NPR and Kaiser Health News. It can be republished for free. (details)

In just over the past year, the number of abortion clinics in Texas fell from 41 to 20, and watchdogs say that as few as six may be left by September.

Many of those closed because of the requirement that doctors at those clinics obtain hospital admitting privileges within a certain radius of the clinic, and many doctors couldn’t comply. That requirement began November 1. This week marks the one-year anniversary of the law that started it all.

Bitter fighting over the law last summer propelled state senator Wendy Davis into the national spotlight, and she is now running for Texas governor on the Democratic ticket.

“We’re seeing delays,” said Heather Busby, executive director of  NARAL Pro-Choice Texas. “We’re seeing people being pushed further into pregnancy, having to leave the state, having to drive and sleep in their cars in parking lots because of these barriers to access.”

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Friday, July 18th, 2014

Who Shopped The SHOP Exchanges? Very Few Small Businesses

This story is part of a partnership that includes WNYC, NPR and Kaiser Health News. It can be republished for free. (details)

Monteith Illingworth and Chris Abbate both have small public relations firms in Manhattan. Both offer their employees health coverage through Oxford Health, a division of insurance giant United Healthcare. Both faced double-digit premium hikes last year. And both considered hitting the eject button to buy coverage from the New York State of Health, the new insurance marketplace set up under the Affordable Care Act.

Illingworth didn’t.

“My instincts told me it was too soon,” said Illingworth, president of Monteith & Company, which has four employees. “I didn’t want to take the risk the first year.”

Abbate signed up.

“I was willing to take a chance,” said Abbate, president of Novitá Communications, with 10 employees.

She is in a distinct minority. New York’s new marketplace covered almost a million people, with about 600,000 people getting Medicaid, 400,000 people getting individual plans and just 10,000 getting employer-based small business plans, through the Small Business Health Options Program, or SHOP.

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Wednesday, July 2nd, 2014

‘A Uniquely New Hampshire Approach’ To Medicaid Expansion


New Hampshire became the 26th state today to embrace the federal health law’s expanded Medicaid program, with as many as 50,000 low-income residents expected to begin signing up.

Coverage for those who enroll this month will take effect Aug. 15. Initially, most New Hampshire enrollees will join one of two Medicaid managed care plans in the state. That’s the way most other states expanded Medicaid earlier this year.

But New Hampshire officials hope that up to 10 percent of those who sign up will eventually enroll in employer plans — using federal money to subsidize that coverage.

In addition, the state plans to seek federal approval to shift most Medicaid enrollees into private insurance plans sold in the online federal marketplace beginning in 2016. Earlier this year, Arkansas and Iowa took this approach, which has become popular among Republicans because it makes use of the private insurance market.

If the federal government approves that plan, the state would shift all enrollees from Medicaid-only managed care plans to marketplace plans in 2016. The only exception would be those who can take advantage of subsidized employer-based coverage. They would remain in their employer plan, if the state deems it is less costly than a Medicaid managed care plan.

New Hampshire and other states have had an employer-subsidy option for years, though few people have used it because most poor people are not offered coverage at work, or the coverage is not as good as Medicaid, according to study by the General Accountability Office.

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Tuesday, July 1st, 2014

Washington And Other States See New Insurers On Exchanges

This story is part of a partnership that includes Capital Public Radio, NPR and Kaiser Health News. It can be republished for free. (details)

SEATTLE — Washington State’s health insurance exchange is looking to be an attractive marketplace for new health insurance carriers, according to an early analysis of insurer premium rate filings by McKinsey & Company.

Four new insurers have applied to sell individual policies in the state’s exchange next year, making Washington among the states with the highest number of new exchange entrants of the 12 states where preliminary 2015 rates have been filed, according to McKinsey. If insurance regulators approve the new carriers, Washington will have 12 insurers on the exchange in 2015, up from eight participating this year.

Washington’s not the only state attracting new health insurance business. Michigan also has four new exchange applicants, and five new carriers have applied in Indiana, the state so far with the highest number of new insurance carriers showing interest,  according to the real-time tracking of state insurance department rate filings that McKinsey is doing.

“[There’s] definitely an increase in the competition that will be available in the carrier options to consumers,” said Erica Hutchins Coe, associate principal at McKinsey.

UnitedHealthcare of Washington, Health Alliance Northwest Health Plan, and Columbia United Providers are among the new insurance exchange applicants, according to Washington State’s Office of the Insurance Commissioner.

Hutchins Coe said McKinsey hasn’t drawn conclusions about what brought new carrier interest to the state. But Washington Healthplanfinder officials said the interest shows their exchange is working.

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Monday, June 30th, 2014

Medicare Penalties For Hospital Infections Will Hit Alaska Hard


The four largest hospitals in Alaska are facing Medicare payment penalties for the quality of their care. Providence, Alaska Regional, Alaska Native Medical Center and Fairbanks Memorial are all in the bottom 25 percent nationally for the number of infections and serious complications patients get in their hospitals, according to data analyzed by Kaiser Health News. The penalties are part of a focus on quality care that’s included in the Affordable Care Act.

Providence estimates it will lose more than $500,000 in federal payments starting in October. Fairbanks Memorial Hospital calculates its lost payments could be as much as $400,000. Both Alaska Regional and Alaska Native Medical Center estimate their penalties will cost them around $200,000. That is 1 percent of their Medicare payments.

Central line infections are one of three measures that Medicare tracked to decide which hospitals will be penalized. Central lines are IV’s inserted in veins that lead right to a patient’s heart, and infections there are serious. In 2012, Providence Alaska Medical Center in Anchorage had 17 of them in their intensive care units.

“There was no one single thing, there’s no smoking gun, ‘we were not doing x,’” said Dr. Dick Mandsager, Providence’s hospital administrator. He says the hospital had already begun to address the infections with emphasis on safety for patients with central lines. In 2013, Providence had six central line infections instead of 17.

“It’s making sure that the whole bundle of care is done every single time, all the time, regardless of how pressured you are, regardless of how many things you’ve got on your mind,” Mandsager said.

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Friday, June 27th, 2014

Colorado’s 2015 Premiums: Up, Down And Holding The Line


Health insurance companies in Colorado are starting to talk about their proposed premiums for 2015. State regulators on Monday released the draft prices, which the state now has 60 days to approve or deny.

Carriers generally aren’t proposing big changes in premiums for 2015, nothing that’s dramatically out of line with trends of the last several years.

“Most of the premiums are falling in a range of anything from a 10 percent decrease to a 10 percent increase. That’s where the bulk of them are sitting right now,” said Vincent Plymel, a spokesman for Colorado’s Division of Insurance.

While the proposed rates are public, they are not easy to compare to 2014 rates.  Consumer advocates are digging into the data and analyzing trends. Most insurers are also talking publicly about their proposed prices.

Colorado’s dominant carrier, Kaiser Permanente, is asking for about a 7 percent premium increase, according to consumer advocates.

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Friday, June 27th, 2014

How Your State Rates In Terms Of Long-Term Care


This copyrighted story comes from ‘s Shots blog. All rights reserved.

In just 12 years, the oldest members of the huge baby-boom generation will turn 80. Many will need some kind of long-term care. A new study from AARP says that care could vary dramatically in cost and quality depending on where they live.

The study was motivated by a simple fact: The number of available family caregivers is declining. In 2010, there were potentially seven for each person 80 years old or older. By the time baby boomers reach that age, there will be only four potential caregivers for each of them. And those numbers are expected to continue declining. Chalk it up to longer lives and smaller families.

Susan Reinhard, a senior vice president at AARP, says the study can show states where they need to improve. “The gradual pace of improvement has to pick up,” she says. “We don’t have the time to get ready for the demographic imperative that is before us.”

The study looked at 26 different variables in each state, from affordability and access to whether care is delivered in private homes or more expensive nursing homes. Reinhard says states that encouraged more care at home got higher marks. “It’s a philosophy, it’s a value that states have and they work hard to make that happen,” she says.

AARP calls its study a scorecard. So, if you’re keeping score, the state with the highest marks was Minnesota, followed by Washington, Oregon, Colorado and Alaska. Bringing up the rear were Indiana, Tennessee, Mississippi and Alabama, with Kentucky coming in last.

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Thursday, June 19th, 2014

Future Uncertain For VA Rural Health Pilot Program

TOPEKA — Sen. Jerry Moran, R-Kan., said a U.S. Department of Veterans Affairs pilot program offering timely, quality health care to rural veterans is being allowed to expire in a few months, even as major legislation moves through both houses of Congress that would have similar goals as the pilot program.

The pilot program is called Access Received Closer to Home, or ARCH. It’s offered at five sites — Pratt, Kansas; Caribou, Maine; Farmville, Virginia; Flagstaff, Arizona, and Billings and Anaconda, Montana. The program allows veterans to get health services from community providers if they live at least one hour from a VA health facility.

Five senators sent a letter to the VA secretary, asking why the program is ending. The letter reads, in part: “For reasons we do not understand, the Veterans Health Administration (VHA) is choosing — at VHA’s own initiative — to end this successful program despite the more than 90 percent satisfaction rate communicated by veterans. … All along, the VHA gave us the impression that they were waiting on analysis about the success of ARCH to inform their decision about extending the program — this is a misleading storyline at best. We are deeply disappointed by this breach of trust because those who suffer from this recklessness are veterans.”

In addition to Moran, the letter to Acting VA Secretary Sloan Gibson is signed by fellow Sens. Jon Tester, D-Mont., Angus King, I-Maine, Susan Collins, R-Maine, and John McCain, R-Ariz.

While VA officials have told members of Congress that no decision has been made on whether to let ARCH expire, Moran said veterans and VA employees in Kansas have told him that the national program director for ARCH directed the five pilot sites several months ago to begin contacting veterans who participate in ARCH to let them know the program would be ending. Moran suspects the VA is motivated by financial concerns.

“If they pay for services outside the VA, it’s less money that they’ve had to use within the VA, and of course the focus ought to be on the quality of service and the timely access to care that this kind of program can provide,” Moran said.

Moran said bipartisan legislation based on the ARCH program is moving through Congress, a response to the VA waiting times scandal. That legislation offers some veterans the opportunity to seek care outside of the VA system. It would cover some of the same services vets have been receiving under ARCH, but Moran and the other senators are concerned that ARCH vets could see a lapse in care if the VA doesn’t extend the pilot program. He’s calling on Gibson to halt plans to dismantle the program.

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Thursday, June 19th, 2014

Obamacare Credited For Big Drop In Minnesota’s Uninsured Rate

This story is part of a partnership that includes MPR, NPR and Kaiser Health News. It can be republished for free. (details)

The website malfunctioned. The exchange chief was fired. And many people had to sign up the old fashioned way: pen, paper, with a person. So, Minnesota’s launch of the Affordable Care Act was a clear failure, right? Not so much.

A less modest state might call it the Minnesota Miracle: The rate of uninsured people in Minnesota tumbled to less than 5 percent, despite all the problems with its Obamacare website, a new study shows.

How did Minnesota do it? It wasn’t miraculous. The state started out ahead with a rate of uninsurance roughly half the national average. Then it used the health law to strengthen and publicize a health care safety net that was already more complete and generous than most other states.

The number of uninsured Minnesotans fell by nearly 41 percent since September and the rate of uninsurance in the state fell from 8.2 percent to 4.9 percent, according to the study from the University of Minnesota’s State Health Access Data Assistance Center.
The university crunched the numbers at the request of MNsure, the state’s troubled health insurance marketplace. “This is a pretty historic change in insurance coverage in Minnesota,” said Julie Sonier, the report’s lead researcher. “We have never seen anything like the change that we have seen between last fall and May 1st of this year.”

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Monday, June 16th, 2014

Arizona Offers ‘Sneak Peak’ At Costs Of Shifting Kids Off CHIP

Families of Arizona children who were forced to switch from the Children’s Health Insurance Program (CHIP) to private plans sold in the federal marketplace are likely paying more and getting fewer benefits, according to a study released Thursday.

Millions of families who are ineligible for Medicaid could soon face the same choice if Congress chooses not to extend funding for the state-federal CHIP program when it expires in October 2015. Arizona was the first and only state to end its children’s insurance program — because its state legislature acted before the 2010 Affordable Care Act banned states from reducing children’s health coverage.

“Arizona provides us a sneak peak of what would happen if CHIP goes away,” said Joan Alker, executive director of the Georgetown University Center on Children and Families which produced the report.

Nationally, CHIP covers about 8 million lower income children, whose families’ income exceeds Medicaid’s eligibility guidelines. If the program ends, many CHIP enrollees would likely have to seek coverage in the new health insurance marketplaces created by the health law.

But many advocates fear that private health plans sold in the exchanges would offer fewer benefits at higher costs and not all families would qualify for Medicaid, even in states that expanded eligibility.

Arizona froze enrollment in CHIP in 2009 and officially closed the program in February — with 26,000 kids shifted to the expanded Medicaid program and the families of the rest offered the option of buying coverage on the federal exchange.

The report found that most Arizona families who shifted from CHIP to private plans would face higher out-of-pocket costs for their children.

Families with the lowest incomes who don’t qualify for Medicaid and those with more than one child would be among the hardest hit, it said. Most children would also face higher costs for dental coverage, the study found.

Arizona’s CHIP program paid the full cost of covered services, meaning there were no deductibles, copays or co-insurance. But such cost-sharing is common in private health plans.

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Thursday, May 8th, 2014

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