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Forbes magazine
Northwestern Mutual team
Wed, 2014-08-27
"Bill Jacobs spent four nights in a hospital in Florida battling pneumonia. His kids visited each day, fluffed his pillows, brought his favorite Sudoku puzzles and got regular updates from his nurses and doctors. Imagine their surprise when they found out that their 86-year-old father was never actually admitted; instead, he was treated as an outpatient under what Medicare refers to as “observation status.” What difference does that make? Actually, more than you might think. If your parents are on Medicare, the difference between being considered an inpatient or an observation patient could be thousands of dollars out of their pocket, if not more. First, Medicare Part A will cover all hospital services, less the deductible, but only if you’re admitted to the hospital as an inpatient. The one-time deductible covers all hospital services for the first 60 days in the hospital. Doctors’ charges are covered under Medicare Part B.
WBUR
Richard Knox
Wed, 2014-08-27
"Every day in intensive care units across the country, patients get aggressive, expensive treatment their caregivers know is not going to save their lives or make them better. California researchers now report this so-called “futile” care has a hidden price: It’s crowding out other patients who could otherwise survive, recover and get back to living their lives. Their study, in Critical Care Medicine, shows that patients who could benefit from intensive care in UCLA’s teaching hospital are having to wait hours and even days in the emergency room and in nearby community hospitals because ICU beds are occupied by patients receiving futile care.
Fox News
Wed, 2014-08-27
"Thought HealthCare.gov had problems? Another federal government-run website created under ObamaCare is suffering the same symptoms as the troubled federal health care exchange -- grappling with delays, data problems and other hiccups as the deadline to take it public nears. At issue is a database known as the Open Payments website. It was created under the Affordable Care Act to shed light on the financial ties between doctors and pharmaceutical companies as well as device manufacturers. The transparency initiative is supposed to include detailed information about drug payments made by doctors as well as the value of gifts and services given by drug makers. Such items can include everything from meals to swanky retreats. The database project, though, is dealing with a minefield of technical problems and confusion over the data. The problems led the Centers for Medicare and Medicaid Services to shut down what is currently a private site for 11 days earlier this month."
Nick Budnick, The Oregonian
Wed, 2014-08-27
"Cover Oregon will hold a special open enrollment period for 1,400 Oregonians who were incorrectly enrolled into the low-income Oregon Health Plan by the state's troubled health insurance exchange. Starting Aug. 31, the people affected will have no coverage through the OHP, the state's version of Medicaid. However, they will have the option to sign up for coverage from private insurers and to qualify for tax credits through Cover Oregon to bring down premiums. Meanwhile, Cover Oregon is contacting at least 700 people who should have been enrolled in the Oregon Health Plan, but were incorrectly enrolled in a commercial health plan instead. If they were receiving tax credits for private plans, those will go away immediately, though they can keep their plan. Cover Oregon is currently negotiating with the federal government over whether those people will have to refund to the IRS all the tax credits they received incorrectly, said Amy Fauver, Cover Oregon communications director.
Wall Street Journal
Peter Loftus
Wed, 2014-08-27
"File this under ‘how ironic.’ Drug makers are asking for more transparency from the government agency that is requiring them to be more transparent about how much they pay doctors. The Pharmaceutical Research and Manufacturers of America, or PhRMA, is calling on the Centers for Medicare and Medicaid Services to further explain why the agency has removed one-third of the payment information from an online database that is due to be made public by Sept. 30. Earlier this month, CMS said it would withhold about one-third of the payment data from the so-called “Open Payments” system. The agency also said it would return the records to drug makers because they were “intermingled,” including the erroneous linking of payment information for some doctors to still other doctors with similar names.
Tue, 2014-08-26
"The Oregon Department of Justice jousted for nearly two months with Oracle America over the state's demand for documents from the California software giant relating to the health exchange debacle. In fact, Oracle flouted state law and stymied the demand, according to DOJ. The state filed papers in federal court Friday that provide a glimpse into high-stakes jockeying that for months took place largely out of public view. DOJ filed its federal papers shortly after the state's lawyers sued Oracle in Marion County Circuit Court on Aug. 22. In its federal filing, DOJ accuses Oracle of "stalling" and attempting to manipulate the legal system by filing its own federal lawsuit against Oregon on Aug. 8."
Kelsey Harkness, The Daily Signal
Wed, 2014-08-13
"Media coverage of the two Supreme Court cases challenging Obamacare’s HHS mandate for employers to provide workers with “free” coverage of abortion-inducing drugs largely focused on Hobby Lobby, the arts and crafts chain founded by the Greens, an evangelical Christian family. The case of another family-owned business also was heard by the high court, though — that of Conestoga Wood Specialties and the Hahns, Mennonite Christians from East Earl, Pa. The Hahns established their business — the manufacture of custom wood kitchen cabinets and parts — on Christian values and say they’re committed to applying those values in the workplace. Why did they go to court, represented by the Alliance Defending Freedom?
Jordan Rau, Kaiser Health News
Wed, 2014-08-06
"CHATTANOOGA, Tenn. — The dominion of Tennessee’s largest health insurer is reflected in its headquarters’ lofty perch above the city, atop a hill that during the Civil War was lined with Union cannons to repel Confederate troops. BlueCross BlueShield of Tennessee has used its position to establish a similarly firm foothold in the first year of the marketplaces created by the health law. The company sold 88 percent of the plans for Tennessee individuals and families. Only one other insurer, Cigna, bothered to offer policies in Chattanooga, and the premiums were substantially higher than those offered by BlueCross. Though insurers have been regularly vilified in debates over health care prices, BlueCross’ near monopoly here has been unusually good financially for consumers. Its cut-rate exclusive deal with one of three area health systems turned Chattanooga into one of the 10 least expensive insurance markets in the country, as judged by the lowest price mid-level, or silver, plan.
Stephanie Armour
Wed, 2014-08-06
"Some states that expanded Medicaid under the Affordable Care Act and set up all or part of their own insurance exchanges have seen a marked drop in the number of uninsured adults. The uninsured rates in states that opted to expand Medicaid, a health program primarily for low-income residents, and set up their own exchanges declined more in the first half of 2014 than in the states that didn’t take that approach, according to a study released Tuesday by Gallup. The survey was based on a random sample of adults through June 30. Arkansas saw the percentage of uninsured drop from 22.5% in 2013 to 12.4% through midyear 2014, according to the survey. Kentucky followed, with its percentage of uninsured dropping from 20.4% to 11.9% during the same time span. The other states with the largest drop in the percentage of uninsured were Delaware, Washington, Colorado, West Virginia, Oregon, California, New Mexico and Connecticut."
Melissa Quinn, The Daily Signal
Wed, 2014-08-06
"It’s one thing for President Obama to win an award for “Lie of the Year” for promising Americans “if you like your [health insurance] plan, you can keep it.” It must sting a bit more when a political ally like Barney Frank, the former congressman, flat out says the president “just lied to people.” In an interview with Huffington Post, the veteran Massachusetts Democrat said he was “appalled” at the “bad” rollout of Obamacare last October. “I don’t understand how the president could have sat there and not been checking on that on a weekly basis,” Frank said, then added: But, frankly, he should never have said as much as he did, that if you like your current health care plan, you can keep it. That wasn’t true. And you shouldn’t lie to people. And they just lied to people.""
Caroline F. Pearson, Avalere Health
Wed, 2014-06-04
"A new analysis from Avalere Health finds that consumers in exchanges receiving federal assistance to reduce their out-of-pocket costs may experience inconsistent reductions in spending depending on the plan they choose."
Caroline F. Pearson, Avalere
Thu, 2014-05-22
"A new analysis from Avalere Health finds that individuals choosing an exchange plan based on premiums are most likely to consider plans from Coventry (acquired by Aetna in 2013), Humana, and WellPoint in regions where they participate."
Matthew Eyles, Avalere
Wed, 2014-05-14
"According to a new Avalere Health analysis, 17 of the 26 states that did not expand Medicaid in the first three months of 2014 still reported growth in Medicaid enrollment, ranging from 0.1 percent in Texas to 10.1 percent in Montana. Since these states had decided not to expand Medicaid eligibility levels under the Affordable Care Act (ACA), these numbers show the impact of the “woodwork effect,” which is when individuals who were previously eligible, but not enrolled in Medicaid, newly sign up as a result of increased outreach and awareness. These enrollees may place a strain on state budgets, since states are required to contribute to the cost of their coverage based on traditional Medicaid matching rates."
Caroline F. Pearson, Avalere
Thu, 2014-05-08
The federal government will bear a disproportionate burden of premium increases in states with high rates of subsidized enrollees. Double digit premium increases are likely in many markets in 2014. Age distribution among enrollees varies by state, which may influence plans’ interest in each market.
Caroline F. Pearson, Avalere
Wed, 2014-05-07
"A new analysis from Avalere Health finds that exchange enrollment meets or exceeds expectations in 22 states (44%), even after accounting for any attrition due to nonpayment of premiums. Assuming 15 percent of enrollees do not take the final enrollment step and pay their premiums, over 6.8 million people who enrolled through April 19 will have coverage effective as of May 1."
Northwestern Mutual team
Forbes magazine
Wed, 2014-08-27
"Bill Jacobs spent four nights in a hospital in Florida battling pneumonia. His kids visited each day, fluffed his pillows, brought his favorite Sudoku puzzles and got regular updates from his nurses and doctors. Imagine their surprise when they found out that their 86-year-old father was never actually admitted; instead, he was treated as an outpatient under what Medicare refers to as “observation status.” What difference does that make? Actually, more than you might think. If your parents are on Medicare, the difference between being considered an inpatient or an observation patient could be thousands of dollars out of their pocket, if not more. First, Medicare Part A will cover all hospital services, less the deductible, but only if you’re admitted to the hospital as an inpatient. The one-time deductible covers all hospital services for the first 60 days in the hospital. Doctors’ charges are covered under Medicare Part B.
Richard Knox
WBUR
Wed, 2014-08-27
"Every day in intensive care units across the country, patients get aggressive, expensive treatment their caregivers know is not going to save their lives or make them better. California researchers now report this so-called “futile” care has a hidden price: It’s crowding out other patients who could otherwise survive, recover and get back to living their lives. Their study, in Critical Care Medicine, shows that patients who could benefit from intensive care in UCLA’s teaching hospital are having to wait hours and even days in the emergency room and in nearby community hospitals because ICU beds are occupied by patients receiving futile care.
Peter Loftus
Wall Street Journal
Wed, 2014-08-27
"File this under ‘how ironic.’ Drug makers are asking for more transparency from the government agency that is requiring them to be more transparent about how much they pay doctors. The Pharmaceutical Research and Manufacturers of America, or PhRMA, is calling on the Centers for Medicare and Medicaid Services to further explain why the agency has removed one-third of the payment information from an online database that is due to be made public by Sept. 30. Earlier this month, CMS said it would withhold about one-third of the payment data from the so-called “Open Payments” system. The agency also said it would return the records to drug makers because they were “intermingled,” including the erroneous linking of payment information for some doctors to still other doctors with similar names.
Julie Appleby
Kaiser Health News
Wed, 2014-08-27
"While average compensation for top health insurance executives hit $5.4 million each last year, a little-noticed provision in the federal health law sharply reduced insurers’ ability to shield much of that pay from corporate taxes, says a report out today. As a result, insurers owed at least $72 million more to the U.S. Treasury last year, said the Institute for Policy Studies, a liberal think tank in Washington D.C. Researchers analyzed the compensation of 57 executives at the 10 largest publicly traded health plans, finding they earned a combined $300 million in 2013. Insurers were able to deduct 27 percent of that from their taxes as a business expense, estimates the report. Before the health law, 96 percent would have been deductible."
Katrina Trinko
The Daily Signal
Wed, 2014-08-27
"Planned Parenthood Action Fund released today a t-shirt designed by actress Scarlett Johansson that targets the Supreme Court’s Hobby Lobby decision. The front of the pink t-shirt reads “Hey Politicians! The 1950s called…” and the back reads, “They want their sexism back!” “When I heard that some politicians were cheering the Supreme Court’s decision to give bosses the right to interfere in our access to birth control, I thought I had woken up in another decade,” explained Johansson in a statement. “Like many of my friends, I was appalled by the thought of men taking away women’s ability to make our own personal health care decisions,” she added. Um … what? Let’s look at some facts, beginning with that the Hobby Lobby decision was fairly narrow.

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