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  • Title: Kaiser Health News
    Descriptive info: .. KHN: Kaiser Health News.. NEWS.. BLOG.. Video.. CARTOONS.. Home.. Health Reform.. Medicare.. Medicaid.. Health Costs.. States.. More Topics.. Aging.. California.. Delivery of Care.. Health Disparities.. Health IT.. Hospitals.. Insurance.. Insuring Your Health.. Marketplace.. Mental Health.. Politics.. Public Health.. Quality.. Supreme Court.. Uninsured.. Women's Health.. Email Sign-up.. RSS.. About Us.. Contact.. Search.. Stigma Is A Side-Effect Of HIV-Prevention Medicine.. By.. Jim Burress, WABE.. Truvada is a drug that can help people who are not infected avoid contracting the virus that causes AIDS.. But some patients are worried the medical community is not up to speed.. 10:12AM ET.. Previous.. 1 of 1.. Next.. Washington's $10 Billion Search For Health Care's Next Big Ideas.. Jay Hancock.. A little-known office tests ways to improve care, but some wonder whether its achievements will match its budget.. 5:01AM ET.. To Beat Heroin Addiction, A Turn To Coaches.. Martha Bebinger, WBUR.. A one-year pilot project in Gosnold, Mass.. , provides recovering addicts with daily, sometimes hourly, help from a recovery coach.. 12:58PM ET.. FAQ: The Next Abortion Battle: The Courts And Hospital Admitting-Privilege Laws.. Julie Rovner.. The latest fight centers around if states can require doctors to have admitting privileges at hospitals close to where they perform abortions.. Aug 08.. Short-Term Health Plans Might Offer Some Relief But They Have Significant Gaps.. Michelle Andrews.. These plans, which can last from a month to nearly a year, do not guarantee many of the benefits of regular health insurance.. Read:.. More From "Insuring Your Health".. Vermont Is 'Single-Payer' Trailblazer.. Michael Ollove, Stateline.. Vermont plays the maverick again in trying to be the first state to implement a single-payer health care system.. Obamacare Creates 'Upheaval' At Free Clinics.. Phil Galewitz.. With many of their patients now insured under the law, most W.. Va.. free clinics are choosing to get paid by Medicaid.. Aug 07.. HHS Report Finds Medicare Advantage Plans Exaggerate Members’ Diseases To Make More Money.. Fred Schulte, The Center For Public Integrity.. The study urges changes in federal policies that allow higher payments for sicker patients.. A Tennessee Insurer Uses Its Monopoly To Deliver Bargain Premiums.. Jordan Rau.. BlueCross BlueShield’s near dominance and hospitals’ lack of negotiating clout are key reasons Chattanooga has among the lowest priced  ...   CHIP Enrollments Top 7 Million.. 9:14AM ET.. GOP Efforts To Become 'Party Of Yes' Will Likely Include 'Realistic' Proposals To Change The Health Law.. 9:15AM ET.. New VA Secretary Orders Independent Audit Of Scheduling Practices.. Out-Of-State Clinic Key To Texas Abortion Law Battle.. 9:21AM ET.. Efforts To Treat, Contain Ebola Virus Trigger Policy, Ethical Questions.. State Highlights: Mo.. Drops Many From Medicaid; Mich.. Medicaid Shift Savings.. 9:16AM ET.. View Daily Reports ».. Additional Resources.. What Obamacare Means For You.. We're here to help you navigate your way around what the new health law will mean for you, your family and what health care -- and insurance -- will cost you.. Medicaid: Rolling The Dice On Managed Care.. Obamacare launched a huge expansion of Medicaid that will help millions of people – and the for-profit insurers that will manage most of their care.. Caution flags abound, as this series of stories shows.. Shopping For Coverage.. Michelle Andrews helps you navigate the new insurance marketplaces.. A Consumer Guide To The Health Care Law.. The law contains a number of provisions that are changing the rules of health care for consumers.. Michelle Andrews writes about how changes in health care and health insurance might affect you.. Five Things To Know About Obamacare Premiums: A Guide For The Perplexed.. These pointers will help you make sense of contradictory headlines about how much insurance could cost you when the Affordable Care Act marketplaces open for enrollment in October.. "Patient Protection and Affordable Care Act".. Read the full text of the 2010 federal health reform law.. Health on the Hill.. Kaiser Health News' Mary Agnes Carey and other experts discuss recent and upcoming activities on Capitol Hill and elsewhere in official Washington -- part of a weekly series of video reports.. TODAY'S CARTOON.. 'Mechanic Panic?' By Dave Granlund.. Enlarge Cartoon.. |.. View all cartoons.. PERSPECTIVES.. Letters To The Editor.. New Medical Convenience; 'Copper Plans'; Coverage Issues.. Follow Us.. As Ballet Stretches Her Body s Limits, Insurance Brings Peace of Mind.. When you pirouette for a living, injury is nearly certain.. But one veteran says coverage under the nation s health law provided some relief.. More Videos.. 2014 Henry J.. Kaiser Family Foundation.. All rights reserved.. FAQ..

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  • Title: Headlines - Kaiser Health News
    Descriptive info: In The News.. Print.. Share.. (Story) 12:58PM ET.. (Story) 10:12AM ET.. (Daily Report) 9:41AM ET.. Oracle Corp.. , the primary developer behind Oregon's dysfunctional health insurance website, sued Cover Oregon and accused Gov.. John Kitzhaber of conducting a "smear campaign" against the company.. Meanwhile, Massachusetts officials decided to replace that state's failed exchange with another from a private company, rather than shifting to the federal marketplace.. (Daily Report) 9:40AM ET.. Challengers of a tough Texas law regulating abortion clinics argue that it would soon close El Paso’s sole abortion clinic.. That, critics say, could leave women seeking abortions to drive 550 miles or else go to an out-of-state clinic where those state regulations do not apply, undermining the law’s patient-safety arguments and constituting an "undue burden" on women.. (Daily Report) 9:21AM ET.. A selection of health policy stories from Texas, Missouri, Illinois, Michigan, Florida, Pennsylvania, North Carolina and Minnesota.. (Daily Report) 9:16AM ET.. A push to fast-track an experimental treatment is gaining momentum, but questions persist about this serum's effectiveness, whether the drug should be brought to the places currently confronting outbreaks of the disease and who should have access to its limited supplies.. (Daily Report) 9:15AM ET.. In what is emerging as an aggressive strategy for Congressional Republicans, these proposals would likely follow an early and largely symbolic vote to repeal the overhaul.. Meanwhile, much is at stake in state-level elections.. The Department of Health and Human Services reported Friday that 7.. 2 million people gained insurance through these programs since the health law's eligibility changes began last October.. In addition, Arkansas and New Hampshire offer snapshots of their states' enrollment pictures, while Kansas and Missouri hospitals brace for the price of state decisions not to expand the low-income health insurance program.. (Daily Report) 9:14AM ET.. Robert McDonald promised to fix problems at the Department of Veterans Affairs that kept veterans from getting care.. His comments came in a speech to a Disabled American Veterans conference and after touring the Phoenix veterans hospital at the epicenter of the scandal that prompted a change in VA leadership and a major increase in  ...   to come into the system will present a challenge.. (Daily Report) Aug 08.. The need for up-to-date information on participating providers, more training for navigators and the release of 2015 premium costs are some of the issues that continue to draw headlines.. Emails Sought In House Health Law Probe May Not Be 'Retrievable'.. The Centers for Medicare & Medicaid Services acknowledged to the House Oversight and Government Reform Committee that the agency's director Marilyn Tavenner may have deleted "most but not all" of the emails being sought by the panel in its investigation of problems associated with the rollout of healthcare.. gov.. Political Cartoon: 'Clear?'.. Research Roundup: Medicaid's Hospital Readmissions; CHIP Enrollment.. This week's studies come from Health Affairs, The Urban Institute, JAMA Internal Medicine, JAMA Surgery and The Heritage Foundation.. Ariz.. Gov.. Backs GOP Candidate With Similar Medicaid Expansion Position.. In the meantime, House Speaker John Boehner isn't hammering the health law while making speaking appearances ahead of this year's elections.. Hospitals Slow To Adopt Electronic Health Records.. Few hospitals met strict federal guidelines intended to speed adoption of electronic health records, a new study finds.. Feds Delay Launch Of Database Showing Drugmakers' Payments To Doctors.. The system, which had been expected to go public on Sept.. 30, will show payments from drug and medical device makers to doctors.. The Centers for Medicare & Medicaid Services says it temporarily took down the system to investigate a possible problem.. State Highlights: Partners HealthCare Explains Loss; Conn.. Hospital Contract Fight.. A selection of health policy stories from New York, Massachusetts, Connecticut, Georgia and California.. Marketplace News: Walmart Positions Itself As A Primary Care Provider.. The big-box retailer is stepping up efforts to become a destination for medical services, including chronic disease management.. Viewpoints: Finding Drug Discounts In Canada; Mo.. 's Answer To Rural Doctor Shortage.. Capsules: Exchange Assisters Want More Training To Help Consumers — Even After They Enroll.. Daily Reports.. Read Morning Daily Report.. Editorial Policies.. Recent Reports:.. Monday, August 11.. Friday, August 8.. Thursday, August 7.. Wednesday, August 6.. Tuesday, August 5.. Find an archived Daily Report on a specific date..

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  • Title: Multimedia - Kaiser Health News
    Descriptive info: Series:.. 2012 Presidential Race.. Health On The Hill.. Newsmakers.. Political Clips.. Stories.. Video.. Video Spotlight.. Topics:.. ,.. Allynne Noelle: Ballerina Gets Insured.. Ballerinas risk injury and high health care costs every time they perform.. Allynne Noelle, 32, principal ballerina with the Los Angeles Ballet, says the new health care law offers some relief.. Video by Heidi de Marco/KHN.. Aug 01, 2014.. Restaurant Owner Struggles To Afford Health Insurance.. Sandra Lopez, 41, owns Las Fajitas, a popular Mexican restaurant in Newport Beach, Calif.. She has to make decisions about health insurance coverage for her family and her business under the Affordable Care Act.. Teresa Martinez: Waiting For Medi-Cal.. Teresa Martinez, 62, from East Los Angeles makes $10,000 a year working as a hairdresser in a Koreatown salon.. With her modest income she is likely to be eligible for health coverage under the Affordable Care Act s Medi-Cal expansion.. She is one of about 800,000 people in California waiting to get her card in the mail and start scheduling overdue medical appointments for the first time in decades.. Apr 21, 2014.. Obama Announces 8 Million Have Enrolled In Marketplace Plans.. In a White House news conference Thursday, President Barack Obama also announced that 35 percent of people who enrolled on the federally run healthcare.. gov marketplace are under age 35.. A transcript follows.. PRESIDENT BARACK OBAMA:.. Before I take questions, I'd also like to say a few words about how the Affordable Care Act is now covering more people at less cost than most would have predicted just a few months ago.. The first open enrollment period under this law ended a little over two weeks ago.. And as more data comes in, we now know that the number of Americans who've signed up for private insurance in the marketplaces has grown to 8 million people.. Eight million people.. Thirty-five percent of people who enrolled through the federal marketplace are under the age of 35.. All told, independent experts now estimate that millions of Americans who were uninsured have gained coverage this year, with millions more to come next year and the year after.. We've also seen signs that the Affordable Care Act is bringing economic security to more Americans.. Before this law added new transparency and competition to the individual market, folks who've bought insurance on their own regularly saw double-digit increases in their premiums.. That was the norm.. And while we suspect that premiums will keep rising, as they have for decades, we also know that, since the law took effect, health care spending has risen more slowly than at any time in the past 50 years.. In the decade before the Affordable Care Act, employer-based insurance rose almost 8 percent a year.. Last year, it grew at half that rate.. Under this law, real Medicare costs per person have nearly stopped growing.. The life of the Medicare trust fund has been extended by 10 years.. And the independent Congressional Budget Office now expects premiums for plans on the marketplace to be 15 percent lower than originally predicted.. So those savings add up to more money that families can spend at businesses, more money that businesses can spend hiring new workers, and the CBO now says that the Affordable Care Act will be cheaper than recently projected.. Lower costs from coverage provisions will shrink our deficits by an extra $100 billion.. So the bottom line is, under the Affordable Care Act, the share of Americans with insurance is up, the growth of health care costs is down, hundreds of millions of Americans who already have insurance now have new benefits and protections, from free preventive care to freedom from lifetime caps on your care.. No American with a pre-existing condition like asthma or cancer can be denied coverage.. No woman can be charged more just for being a woman.. Those days are over.. And this thing is working.. I've said before: This law won't solve all the problems in our health care system.. We know we've got more work to do.. But we now know for a fact that repealing the Affordable Care Act would increase the deficit, raise premiums for millions of Americans, and take insurance away from millions more, which is why, as I've said before, I find it strange that the Republican position on this law is still stuck in the same place that it has always been.. They still can't bring themselves to admit that the Affordable Care Act is working.. They said nobody would sign up.. They were wrong about that.. They said it would be unaffordable for the country.. They were wrong to keep trying to repeal a law that is working when they have no alternative answer for millions of Americans with pre-existing conditions who'd be denied coverage again or every woman who'd be charged more for just being a woman again.. I know every American isn't going to agree with this law, but I think we can agree that it's well past time to move on as a country and refocus our energy on the issues that the American people are most concerned about, and that continues to be the economy, because these endless, fruitless repeal efforts come at a cost.. The 50 or so votes Republicans have taken to repeal this law could have been 50 votes to create jobs by investing in things like infrastructure or innovation, or 50 votes to make it easier for middle-class families to send their kids to college, or 50 votes to raise the minimum wage or restore unemployment insurance that they let expire for folks working hard to find a new job.. The point is, the repeal debate is and should be over.. The Affordable Care Act is working.. And I know the American people don't want us spending the next two-and-a-half years re-fighting the settled political battles of the last five years.. They sent us here to repair our economy, to rebuild our middle class, and to restore our founding promise of opportunity, not just for a few, but for all.. And as president, that's exactly what I intend to keep doing as long as I'm in this office.. Apr 17, 2014.. Obama: 'The Affordable Care Act Is Here To Stay'.. It a statement in the White House Rose Garden, the president Tuesday touted over 7 million sign-ups for health insurance on the health law's marketplaces.. Apr 01, 2014.. Lawmakers Weigh Changes To Medicare.. Lawmakers this week debated a series of changes to Medicare -- including payment shifts in Medicare Advantage plans and a proposed fix to how the program pays doctors.. KHN's Mary Agnes Carey and Politico Pro's Jennifer Haberkorn discuss.. MARY AGNES CAREY:.. Welcome to Health on the Hill, I m Mary Agnes Carey.. Medicare has been a key focus for lawmakers and the Obama administration this week.. There are battles over proposed payment changes to Medicare Advantage plans, and members of both parties say they want to permanently repeal a Medicare physician payment formula, but they disagree over how to finance the fix.. With me today to discuss these issues is Jennifer Haberkorn of Politico Pro.. Thanks for being here.. JENNIFER HABERKORN, POLITICO PRO:.. Thanks for having me.. First let s start with what happened at the beginning of the week.. The Centers for Medicare Medicaid Services, also known as CMS, decided to not implement some changes to the Medicare Prescription Drug Program, which is also known as Medicare Part D.. What were those changes they decided not to move forward with, and why did they make that decision?.. JENNIFER HABERKORN:.. So, CMS had proposed changing the way that some anti-depressants and other kinds of drugs were paid for in Medicare.. It got a ton of opposition from provider groups and patient advocacy organizations who really said that this was going to hurt patients on Medicare.. So CMS said, "We re not going to do that anymore.. We re going to hold off and potentially come back to this decision.. " They could come back and make some changes -- maybe come back after the election.. This got a lot of political opposition, and CMS is under a lot of pressure.. Like you said there s a lot of Medicare changes going on right now and they re facing a lot of political opposition.. To that point, you were at a Medicare Advantage hearing this morning, which I think was the stage of other kinds of opposition too.. Right, we heard a lot of the same arguments we ve heard around proposed payment changes to the Medicare Advantage program.. Again these are these private plans in Medicare.. Almost a third of current beneficiaries are now enrolling in them.. There are some payment reductions in the Affordable Care Act.. There s also some payment adjustments that CMS wants to move forward with.. There s a lot of heat on both sides on this.. You have many Republicans and some Democrats that say if you lower Medicare Advantage payments, it s going to hurt beneficiaries and reduce choices.. Other Democrats come back and say, Now, wait a minute, since the Affordable Care Act was enacted, which has these particular payment changes, that you ve seen premiums drop, you ve seen enrollment increase, that really the sky is not falling.. So I think this narrative that we re going to hear now and through the elections the final Medicare Advantage payment rates are supposed to come out on April 7 but who knows when they will actually be released.. That s the deadline but we ll see I just think we re going to hear a lot of this back and forth in the weeks ahead.. Speaking of back and forth, another big Medicare issue I know you have been following is the sustainable growth rate, we call it the SGR.. It s how Medicare pays physicians.. Everybody agrees they want to get rid of it, and we even have a bipartisan bill on how to get rid of it and how to change the way Medicare pays for services.. But nobody can seem to figure out the pay-fors.. A House bill is moving tomorrow.. How would that finance an SGR repeal?.. JENNIFER HABERKORN.. : The House has decided that they would pay for this by repealing the penalties in the individual mandate under the Affordable Care Act for five years.. That would generate savings because you don t have to buy insurance under the law.. Presumably fewer people are going to do that, and the government would have to pay fewer subsidies.. Like you said, this issue is one that there s bipartisan support for what to do and a lot of opposition over how to pay for it.. And that s really coming to a head now because the next doc fix patch, as we call it, is expiring at the end of the month.. So, Capitol Hill really needs to act before then.. They either have to replace this permanently, which looks very unlikely at this point, or has to come up with another patch to prevent a cut to physicians who treat patients under Medicare.. We re seeing another bill in the Senate that would take the same replacement strategy and not pay for it at all.. So we re going to see those bills come together.. I think we re going to see both the House and the Senate say, We dealt with this, now the other chamber has to act.. It looks unlikely they re going to come together and come up with some kind of bipartisan solution, at least before the end of the month.. MARY AGNES CAREY.. : Maybe we won t get the big picture solution by the end of the month, but they do have to do a patch.. Could it go through the end of the year? Are we talking about a 9-month patch? Any ideas on how they might pay for that?.. : It does look like if they do a patch that it would be nine months.. That would kick the next time that they have to deal with this to the lame-duck session after the next election.. Those are always relatively unpredictable because you have a Congress that -- we may see the Senate flip and that would throw everything on its side.. I think there s some hope among Republicans that if that happens, that they can pay for this through additional cuts to the Affordable Care Act.. Even if the Republicans controlled the Senate, President Obama surely wouldn t sign that into law.. So there is no clear resolution in sight, but they do need to come up with a patch.. Traditionally, Congress has turned to health care providers to do that, and there s no reason to think that they wouldn t this time, too.. : Alright, thanks so much Jennifer Haberkorn of Politico Pro.. : Thank you.. This article was produced by Kaiser Health News with support from.. The SCAN Foundation.. Mar 13, 2014.. How Proposed Part D Changes Are Playing On Capitol Hill.. Officials at the Centers for Medicare Medicaid Services are proposing to remove some drugs from Medicare s prescription drug plans and limit how many plans insurers can offer.. KHN s Mary Agnes Carey and CQ Roll Call s Emily Ethridge discuss.. Click here to listen to audio of the conversation.. : Welcome to Health on the Hill.. I m Mary Agnes Carey.. A series of proposed changes to the Medicare prescription drug program -- also known as Medicare part D -- have been getting a lot of attention on and off of Capitol Hill.. Patient groups and lawmakers in both parties say easing current requirements on what drugs plan must cover could cause hardships for some patients.. There s also bipartisan opposition to a provision that would limit the number of plans insurers could offer.. With me now to discuss these issues is Emily Ethridge of CQ Roll Call.. Emily, thanks so much for coming.. EMILY ETHRIDGE, CQ ROLL CALL.. : Thanks for having me.. : Now CMS currently -- that s the Centers for Medicare Medicaid Services, which oversees the Medicare part D program -- they currently require that Part D plans cover the vast majority of drugs in six specific classes.. And they re proposing to drop two of these categories next year, and another might be dropped in 2015.. What are these drugs that could lose this "protected status," as they call it, and why are people so concerned about it?.. EMILY ETHRIDGE.. : The drugs that CMS is proposing to remove from this requirement to offer are anti-depressants and immunosuppressant drugs, and the one that they re thinking about doing later are anti-psychotic drugs.. So we ve had a lot of outcry from patient groups for the communities that take these medications saying we ve been able to have access to all these drugs before on all our Medicare plan formularies, now we re really worried this is going to reduce our access and reduce our ability to get the drugs we need.. They really make the point that these drugs aren t all the same.. So it s important to have a wide range of availability.. : What s CMS s response? What s the rationale for doing this?.. : The CMS administrators have said, "We don t have any problems with the other drugs that aren t in these protective classes," as they call them.. There are about 140 classes of drugs that Medicare has on its formulary plan.. And there are only six that are in the special categories.. They re saying "If you don t have a problem with the other 134, we shouldn t have any problems with a couple of these.. ".. : Did they also suggest that plans have some issue in that they can t really leverage a discount with a drug maker if they have to offer a wide array?.. : Right.. If you have to offer, on your plan, every single antidepressant that s available for purchase, it makes it really hard for you to negotiate because the drug maker knows you re required to offer that drug so they can sell it to you at a higher price.. : Currently, Medicare beneficiaries who are in Part D have something like three-dozen plans, in a particular region, to choose from.. CMS is proposing some limits to those number of plan offerings.. Why are they doing that?.. : CMS says that s because, right now, there are just too many plans.. Seniors are confused.. Do they have such an overwhelming amount of information on all these plans, that it s really hard to make a good choice? They re not going to sit down and compare 36 plans to pick the right one.. They say seniors really don t even move plans that much, even though they have this wide array of options.. They tend to stick with one and stay with it not take advantage of these different options they have.. : So the idea is that these plans are somewhat duplicative and if you narrowed the choices, then people might do more comparison shopping? Is that the thought?.. : Right, it's can you make a smarter, better decision? Can you make this decision process easier for a senior? If you re comparing plan one to plan two, that should be a lot simpler.. It s easier to see the differences than if you re comparing plans one through 36.. We ve talked about two of the proposals in this regulation.. It s a pretty big regulation.. What are some of the areas that are causing some concern on the Hill?.. EMILY ETHRIDGE:.. There is another area that is really important, which is about preferred pharmacy networks.. The rule says that a plan would have to allow any pharmacy that s willing to meet its price to participate in its preferred network.. Right now plans sort of negotiate with -- and they have a certain particular pharmacy.. They say you get a better deal if you go to this pharmacy.. They offer better prices, because they negotiated something together.. CMS would say: If any pharmacy comes to you and offers to meet the terms of that deal, you must accept it.. Emily, one thing I ve been wondering about this is: We know that the administration is currently embroiled in a big battle on Capitol Hill over the Affordable Care Act and its implementation.. Now this particular proposal is also causing a lot of concern -- not only with Republicans but Democrats, as well.. Why do you think CMS made this proposal at this time?.. It is confusing, because it is a lot of change at a time when the Medicare situation is already changing.. We heard a lot from the CMS officials about price and the cost of Medicare Part D, which covers prescription drugs.. It s increasing much higher than the rest of Medicare.. They say this proposed rule would actually save money over ten years.. And they say it would make things simpler for seniors.. They say that because of the law, in some cases, we don t need, maybe, this many plans.. The health care law is reducing that prescription drug doughnut hole, that coverage gap that we ve all heard so much about.. If that s being made smaller, then we don t need all these plans to fill that in -- we don t need all these choices, and we don  ...   to somebody directly, and they can walk you through the application process.. And I guarantee, if one thing's worth the wait it's the safety and security of health care that you can afford or the amount of money that you can save by buying health insurance through the marketplaces.. Once you get on phone with a trained representative, it usually takes about 25 minutes for an individual to apply for coverage, about 45 minutes for a family.. Once you apply for coverage, you'll be contacted by mail -- by email or postal mail about your coverage status.. But you don't have to just go through the phone.. You can also apply in person with the help of local navigators.. These are people especially trained to help you sign up for health care and they exist all across the country.. Or you can go to community health centers and hospitals.. Just visit localhelp.. healthcare.. gov to find out where in your area you can get help and apply for insurance in person.. And finally, if you've already tried to apply through the website and you've been stuck somewhere along the way, do not worry.. In the coming weeks, we will contact you directly, personally with a concrete recommendation for how you can complete your application, shop for coverage, pick a plan that meets your needs and get covered once and for all.. So here's the bottom line: the product, the health insurance is good.. The prices are good.. It is a good deal.. People don't just want it, they're showing up to buy it.. Nobody is madder than me about the fact that the website isn't working as well as it should, which means it's going to get fixed.. And in the meantime, you can bypass the website and apply by phone or in person.. So don't let problems with the website deter you from signing up or signing your family up or showing your friends how to sign up, because it is worth it.. It will save you money.. If you don't have health insurance, if you've got a pre-existing condition, it will save you money, and it will give you the security that your family needs.. In fact, even with the website issues, we've actually made the overall process of buying insurance through the marketplace a lot smoother and easier than the old way of buying insurance on your own.. Part of the challenge here is that a lot of people may not remember what it's like to buy insurance the traditional way.. The way we've set it up, there are no more absurdly long application forms, there's no medical history questionnaire that goes on for pages and pages, there's no more getting denied because you've had a pre-existing condition.. Instead of contacting a bunch of different insurers one at a time, which is what Janice and a lot of people who were shopping on the individual market for health insurance had to do, there's one single place you can go shop and compare plans that have to compete for your business.. There's one single phone number you can call for help.. And once the kinks in the website have been ironed out, it will be even smoother and even easier.. But in the meantime, we will help you sign up, because consumers want to buy this product and insurance companies want to sell it to you.. Oct 21, 2013.. Health Plans Won’t be Able To Drop Individuals From Coverage.. Insuring Your Health columnist Michelle Andrews helps you navigate the new insurance marketplaces that are scheduled to launch on Oct.. View Previous Video.. Q: When a consumer enrolls in a marketplace plan is it for a year of coverage or longer? Can an insurer drop a consumer?.. A: As long as you keep up with your insurance premiums and don't lie on your application for insurance by claiming that you're younger than you really are, for example, your insurer can't drop you.. Generally, people will be able to enroll in or change plans once a year during the annual open enrollment period.. This first year, open enrollment on the exchanges will run for six months, from Oct.. 1 through March of next year.. But in subsequent years the time period will be shorter, just a few months long.. There are certain circumstances when people will be able to change plans or add or drop someone from coverage outside the regular annual enrollment period.. This could happen if you lose your job, for example, or get married, divorced or have a child.. More From This Series:.. More Consumer Topics:.. Sep 18, 2013.. Marketplace Premiums Likely To Mirror Plans Sold Privately.. Q: Will the premiums be more expensive than what is offered on the individual market? How about co-pays, are they comparable?.. A: New individual and small-group plans offered both through the health insurance marketplaces and on the private market will all have to offer a package of 10 essential health benefits, including prescription drugs, emergency and hospital care, and maternity care, among other things.. They will also have to meet the same standards for consumer cost sharing.. So experts don't expect that premiums on or off the exchanges will be very different.. Here's how it will work.. There will be four types of plans with different levels of consumer cost sharing.. In a platinum plan, the insurer will pay 90 percent of covered medical expenses and the consumer will be responsible for 10 percent, on average.. In a gold plan, the insurer will pay 80 percent and the consumer 20 percent.. Silver plans will pay 70 percent and bronze plans 60 percent.. Within each type of plan, insurers will generally have some flexibility to vary deductibles, copayments and coinsurance.. Even though premiums may be comparable on and off the exchanges, there's a key difference to keep in mind.. Consumers who buy a health plan through the online marketplaces may be eligible for premium tax credits there that can substantially reduce the sticker price on their policy.. Sep 16, 2013.. Individuals With Medical Conditions Will Not Pay A Penalty On Premiums.. Q: Is everyone who qualifies treated the same in this new marketplace? Do younger people get lower rates and people with pre-existing conditions get higher rates?.. A: Starting next year, no one can be charged higher rates for health insurance because they have pre-existing medical conditions.. But there are a few other individual details that insurers can factor in when setting premiums, including age and tobacco use.. The law allows premiums for older people to be up to three times higher than those of younger people.. That may seem like a lot, but in plans currently sold on the individual market, the differential between the two is often much greater.. The law also allows insurers to charge smokers 50 percent higher premiums for coverage on the exchanges than non-smokers.. Smokers do tend to have higher health care costs than non-smokers.. Still, a handful of states have decided not to implement this surcharge.. They figure that the higher premiums may make coverage unaffordable for some smokers, who typically have lower incomes in the first place.. Besides, they say, evidence is scant that charging people more for health insurance actually encourages them quit smoking.. Sep 15, 2013.. Each Marketplace Plan Must Offer 10 ‘Essential Benefits’.. Q: Is there is basic package of benefits that each insurance company must offer if it is part of a marketplace?.. A: To ensure that plans sold on the state-based marketplaces provide comprehensive coverage, every plan must cover 10 so-called essential health benefits.. The required benefits include prescription drugs, emergency and hospital care, doctor visits, maternity and mental health services, rehabilitation and lab services, among others.. In addition, recommended preventive services must be covered without any out-of-pocket costs to consumers.. If states have additional mandated benefits, for infertility treatment or autism, for example, those services will also generally be included in the plans offered through the state marketplaces.. Sep 13, 2013.. Health Marketplaces Open For Shopping Oct.. Q: When must a consumer enroll in an exchange in order to start getting insurance benefits in January, 2014?.. A: The online marketplaces will open for business on Oct.. That's when people will be able to begin checking out the health plans that are available in their area and signing up.. The open enrollment period will run through March of 2014.. If you want coverage to begin on Jan.. 1, though, you'll generally need to sign up by Dec.. 15 of this year, although some states may allow you a little more time.. Still, consumer advocates that I've spoken with say that it's probably not a good idea to put off applying for coverage until the last minute, because during this first year of operation the exchanges will probably be working out some kinks and the process may take longer than expected.. Sep 10, 2013.. Health Marketplaces Are Open To Nearly Everyone.. Q: How does someone qualify to enroll in a marketplace? Are the rules the same in every state?.. A: Almost anyone can shop for health insurance through the online state marketplaces, sometimes called exchanges, that will open in October.. The only real exception is immigrants who are in this country illegally.. They can't buy coverage on the exchanges under any circumstances.. That's true whether your state is running its own exchange or letting the federal government do so.. Even though practically anyone can shop for coverage on a state exchange, only certain people will qualify for subsidies to make coverage more affordable there.. Subsidies will be available to people with incomes up to 400 percent of the federal poverty level.. That's about $46,000 for one person or $94,000 for a family of four.. Subsidies will only be available to people who don't have good coverage available elsewhere.. So if you're eligible for Medicare or Medicaid, you can't get subsidies on the exchanges.. Likewise, if your employer offers good coverage you won't qualify for subsidies.. Good coverage in this case means a plan that doesn't cost more than 9 1/2 percent of your income and pays at least 60 percent of your covered medical expenses.. If your employer plan comes up short in either of those areas, you could qualify for subsidized coverage on an exchange.. Sep 08, 2013.. Health On The Hill: 'It's A Fire Sale On The SGR'.. With the Congressional Budget Office projecting a reduced cost for a long-term "doc fix," Congress may seize the opportunity to end the annual adjustments to Medicare reimbursement rates.. Mary Agnes Carey and CQ Roll Call's Emily Ethridge discuss.. Listen to their conversation here.. Amid the partisan battles over the 2010 health care law known as Obamacare, lawmakers may be close to bipartisan consensus on another health care issue overhauling how Medicare pays physicians.. Three Capitol Hill committees are discussing how to replace the Sustainable Growth Rate known as the SGR.. For years, Congress has passed last-minute patches to the formula to prevent Medicare physician payment cuts.. And while there isn t a unified approach or agreement on how to finance a fix, many analysts say Congress appears closer than ever to replacing the SGR.. With us to discuss the latest developments is Emily Ethridge, a health care reporter for CQ Roll Call.. Hi Emily.. : Hi Mary Agnes.. : It s great to have you here.. : Sure.. Give us a little bit of background on the Medicare SGR.. When was it created, what was its purpose, and why are people talking about repealing it?.. : So this was part of the 1997 Balanced Budget Act.. If you go all the way back to then, and we really thought this was a formula that would keep the payment rates for Medicare physicians more in line with the overall growth of the economy.. For a few years, it worked out pretty well.. For the first five years, it seemed OK.. It basically puts a limit on how much physician payments can grow.. Around 2002, things started to get bad.. It started calling for cuts.. Every year since 2002, it has called for more and more cuts.. Drastic now I think it s about 25 percent cuts to Medicare physicians if we let this formula take place.. However, Congress hasn t let it actually take place in the past 10 years.. They keep doing these short-term patches, which is what everyone knows as the doc fix.. That makes it actually more expensive every time they don t let the cuts happen, they give physicians instead this tiny little raise and that means that every year the formula calls for deeper and deeper cuts.. : So, as we know, before the August break, the House Energy and Commerce Committee passed a bill to repeal and replace the SGR.. How would that measure work and how would they pay for it?.. : We don t know how they ll pay for it and that is the biggest sticking point right now.. That is going to be the thing that really makes or breaks whether this bill happens.. Because it s a pretty big price tag.. Only repealing the SGR just taking away the SGR for 10 years is about $140 billion.. That s doing that without doing anything else you might want to do.. Any other kind of payment models, any other Medicare reforms you might want to try to make.. So we re looking at a pretty big price tag on this bill and right now we have no idea how they make up for that cost.. But the Energy and Commerce bill, it would get rid of the SGR which is a huge goal for everybody.. Then we would have a little transition period of five years, where they would just set small payment updates for all Medicare physicians.. Then after that, physicians would be able to move into these alternative payment models.. The idea here is to get away from the fee-for-service Medicare that most stakeholders and health care economists really hate.. : That s traditional Medicare.. : That s traditional Medicare, that s what we have now, fee-for-service.. You perform a service, Medicare pays the doctor.. People say it encourages volume of services over really good quality care.. So they would try to put in these new models, under the Energy and Commerce bill, to get away from that and start rewarding the quality of care.. Or having better outcomes while saving money for Medicare overall.. : And also, there are other committees.. In the House, we have the Ways and Means Committee working on the issue.. In the Senate, it s the Finance Committee.. Do we know enough now to tell how those approaches might be different from each other and from what Energy and Commerce has done?.. : Everyone says Energy and Commerce has a pretty good base of a bill and they like it.. However, those other committees don t like it enough to say that we re just going to take that up, maybe make a few tweaks here and there and send it along on its way, which would be the fastest option.. They seem to each have more, bigger changes in mind.. Everyone really wants to put their own stamp on this bill.. So I feel like we re going to get similar-looking bills but not the exact same bill from all three committees.. : Now as we both know -- you and I have reported on this for years -- the SGR has been with us for a long time.. What s the reason for all this momentum right now, and is this Congress really going to act to make a change?.. : As you said this is really the closest we ve ever gotten to having the SGR go away.. The Energy and Commerce Committee marking up a bill and approving it unanimously 51 to 0 so it s bipartisan support to get rid of this is farther than we ve ever come in the history of the SGR.. The reason that really put the momentum behind this is, yes, Congress has been working on this for a long time, but earlier this year we got a very favorable score from the CBO, that $140 billion I mentioned earlier.. That s the lowest score, the lowest price tag for getting rid of the SGR that we ve ever seen, really, in the past, I d say, five years.. So everyone said basically it s a fire sale on the SGR.. Let s go for it and strike while the iron s hot.. Get rid of this before CBO changes its mind.. : While it s only $140 billion in Washington language it still is a $140 billion.. So what are the likely ways for financing? What are the options?.. : Traditionally, when they do these small patches they take money out of Medicare somewhere else.. They find other ways to cut provider payments elsewhere, maybe cut specialty doctors instead of physicians, or hospitals.. They look to Medicare to try to move money from one pile to another.. That could definitely happen here, although again $140 billion, plus more most likely, is a big ask.. Republicans would love to cut that money from the health care law, from the overhaul, I don t really think Democrats will be on board with that, but maybe if they could get some of it from it from the health care law, that might be part of a bigger compromise that could happen.. There s also a lot of talk about tax reform -- tax code overhaul in some of these committees right now, in Ways Means and Finance.. So it s possible they might find some things in the tax code that produce savings, and they might just tack that on to pay for it instead.. : Speaking of the health care law, we know the House Republicans voted several times to defund all or part of that measure.. Are we going to see more of those votes this fall?.. : I definitely expect to see more votes in the House on repealing or trying to de-fund the health care law.. Right now you have a big group of Republicans who want to de-fund the law stop it all together and are willing to put some things at risk to get that to happen.. You don t have House leadership on board with that yet, and we really haven t reached a critical mass of those Republicans who want to de-fund the law yet.. It s about a third of the House Republican caucus.. So it remains to be seen whether we actually will see that vote this month or possibly next month.. But it s something they re really working on.. And I think if they don t get that de-fund vote, they ll get some other repeal votes or delay votes just to keep everybody satisfied.. : And I think you re talking here in the sense of de-funding as part of the continuing resolution to fund the government, correct?.. Exactly.. : So if that one doesn t occur, you may see some more of these rifle shots to de-fund pieces of the ACA.. : Especially when we have a debt ceiling fight again in October, this could certainly come up as part of that.. : Thanks so much, Emily Ethridge of CQ Roll Call.. : You re welcome, thank you.. This was produced by Kaiser Health News with support from.. Sep 04, 2013..

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    Descriptive info: Medicare.. (Story) Aug 07.. Questions Arise About Hospice Companies As Discharge Rates Increase.. When so many patients leave a hospice alive, it could signal problems such as inadequate care or companies seeking financial gains by enrolling people who should not have been considered hospice patients, The Washington Post reports.. (Daily Report) Aug 07.. Medicare Benefits From Immigrants, Study Says.. A study by the Partnership for a New American Economy concluded that immigrants make a substantial contribution to the Medicare Hospital Insurance Trust Fund -- putting more into the system than they take out.. Also in the news, the Center for Public Integrity examines how Medicare Advantage plans may routinely overbill the health insurance program for older Americans.. Capsules: First Look At Medicare Quality Incentive Program Finds Little Benefit; Fast Track For Primary Care Docs At One Calif.. University.. Check out what's new on the blog.. Viewpoints: Higher Costs Don't Mean Better Health Quality; States And The Uninsured.. (Daily Report)  ...   for some fee-for-service claims.. First Edition: August 6, 2014.. Today's early morning highlights from the major news organizations, including reports about the Gallup-Healthways Well-Being Index that details how politics play a role in the nation's health care gap between red and blue states.. Costly Specialty Drugs Drive Up Medicare Tab.. ProPublica and The New York Times look at the explosive spending growth related to an obscure medication for treating multiple sclerosis and a rare kidney disease -- and how several top prescribers have links to drugmaker, Questcor Pharmaceuticals.. The Wall Street Journal examines the impact of new drugs to treat hepatitis C.. (Daily Report) Aug 05.. Viewpoints: Treating Ebola Patients In The U.. S.. ; Medicare Costs; Discouraging Medicaid Enrollment.. First Edition: August 5, 2014.. Today's early morning highlights from the major news organizations, including coverage of a partnership between two of California's largest insurers in which they will join forces to create a database of patient medical records..

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    Descriptive info: Aging.. Medicare Drug Premiums To Rise $1 A Month In 2015.. The modest increase of the monthly premium to $32 comes even as officials are concerned about the impact of expensive specialty drugs, such as Sovaldi, which cures hepatitis C but costs $1,000 a pill.. (Daily Report) Aug 01.. Longer Looks: Pittsburgh's 'Frayed Safety Net'; Curing Cancer.. Every week KHN reporter Marissa Evans finds interesting reads from around the Web.. (Daily Report) Jul 31.. Insuring Your Health: Medicare Experiment Could Signal Sea Change For Hospice.. What happens when hospice patients can keep getting life-extending treatment? Palliative care expert Diane Meier discusses the new program.. (Daily Report) Jul 29.. Medicare Experiment Could Signal Sea Change For Hospice.. (Story) Jul  ...   Jul 22.. For Medicare, Good News For Future, Changes In Hospice Rules.. And a new report by a conservative group identifies Medicare Advantage cuts by congressional district.. (Daily Report) Jul 21.. State Highlights: Iowa Invests In Autism Program; Rural Docs Feel The Pinch Of Wisconsin's Low Medicaid Payments.. A selection of health policy stories from New York, Missouri, Texas, Massachusetts, Maine, Georgia, Pennsylvania and Minnesota.. Viewpoints: Problems In Training Docs; Impact Of HHS' Territory Decision; What Halbig Decision Might Mean.. A selection of opinions and editorials from news organizations around the country.. State Highlights: Concerns Continue About Coakley-Partners Antitrust Settlement.. A selection of health policy stories from Massachusetts, Oregon, Wisconsin, Maine, New York and Texas.. (Daily Report) Jul 18..

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