The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers

“From Halbig to Sovaldi, this summer was a busy one for health policy and politics. We’ve made it easy to catch up, collecting all of the top stories you clicked on over the past few months. Together, they tell a story about the state of healthcare in the U.S., and offer clues as to where things may be headed when Congress returns in the fall.
Among them: The political battle over Obmacare has become more complicated for Republicans since the government cleaned up the Healthcare.gov mess, and with midterm elections around the corner, the focus will be on how much either party continues to attack or ignore the law. There are policy, legal and business matters to be settled as well – the employer mandate is under attack from the left and the right, the courts have been a wildcard for the health law to this point and could continue to be so, and employers and employees are finding themselves wading through the on-the-ground impacts of the law. That doesn’t even get to our top three storylines of the summer, so be sure to click through to find out what tops the list.”

“A majority of people are worried about employers moving them on to insurance exchanges, with Republicans reporting the highest level of concern at 72 percent. But once they actually get insurance on the exchange, most Democrats and Independents, 43 percent and 39 percent respectively, think the shift would have “no impact” on their coverage. In contrast, most Republicans, 41 percent, think it would have a “very negative” impact. The majority of Republicans and Independents say they would consider looking for another job if they were shifted onto an exchange, at 62 percent and 52 percent respectively. Democrats reported that they would look for another job at a rate ten percentage points below Independents, at 42 percent.”

“Health insurance companies in California may not refuse to cover the cost of abortions, state insurance officials have ruled in a reversal of policy stemming from the decision by two Catholic universities to drop elective abortions from their employee health plans.
Although the federal Affordable Care Act does not compel employers to provide workers with health insurance that includes abortion coverage, the director of California’s Department of Managed Health Care said in a letter to seven insurance companies on Friday that the state Constitution and a 1975 state law prohibits them from selling group plans that exclude the procedure. The law in question requires such plans to encompass all “medically necessary” care.
“Abortion is a basic health care service,” department director Michelle Rouillard wrote in the letter. “All health plans must treat maternity services and legal abortion neutrally.”
Jesuit-run Santa Clara University and Loyola Marymount University notified employees last fall that they planned to stop paying for elective abortions, but said faculty and staff members could pay for supplemental coverage that would be provided through a third party. The two schools said their insurers, Anthem Blue Cross and Kaiser Permanente, had cleared the move with the state.”

“The state of Oregon filed a lawsuit Friday against Oracle America Inc. and several of its executives over the technology company’s role in creating the troubled website for the state’s online health insurance exchange.
The lawsuit, filed in Marion County Circuit Court in Salem, alleges that Oracle officials lied, breached contracts and engaged in “a pattern of racketeering activity.”
Oracle was the largest technology contractor working on Oregon’s health insurance enrollment website, known as Cover Oregon. The public website was never launched, forcing the state to hire hundreds of workers to process paper applications by hand. The website’s failure became a political problem to Democratic Gov. John Kitzhaber, who is running for re-election.
A related project to modernize functions for social services also was scrapped. The state paid Oracle $240 million for both projects.”

“Taxes? Who wants to think about taxes around Labor Day?
But if you count on your tax refund and you’re one of the millions getting tax credits to help pay health insurance premiums under President Barack Obama’s law, it’s not too early.
Here’s why: If your income for 2014 is going to be higher than you estimated when you applied for health insurance, then complex connections between the health law and taxes can reduce or even eliminate your tax refund next year.
Maybe you’re collecting more commissions in an improving economy. Or your spouse got a better job. It could trigger an unwelcome surprise.
The danger is that as your income grows, you don’t qualify for as much of a tax credit. Any difference will come out of your tax refund, unless you have promptly reported the changes.
Nearly 7 million households have gotten health insurance tax credits, and major tax preparation companies say most of those consumers appear to be unaware of the risk.
“More than a third of tax credit recipients will owe some money back, and (that) can lead to some pretty hefty repayment liabilities,” said George Brandes, vice president for health care programs at Jackson Hewitt Tax Service.”

“CARMICHAEL, Calif. — The lobby of Rosewood Post-Acute Rehab, a nursing home in this Sacramento suburb, bears all the touches of a luxury hotel, including high ceilings, leather club chairs and paintings of bucolic landscapes.
What really sets Rosewood apart, however, is its five-star rating from Medicare, which has been assigning hotel-style ratings to nearly every nursing home in the country for the last five years. Rosewood’s five-star status — the best possible — places it in rarefied company: Only one-fifth of more than 15,000 nursing homes nationwide hold such a distinction.
But an examination of the rating system by The New York Times has found that Rosewood and many other top-ranked nursing homes have been given a seal of approval that is based on incomplete information and that can seriously mislead consumers, investors and others about conditions at the homes.
The Medicare ratings, which have become the gold standard across the industry, are based in large part on self-reported data by the nursing homes that the government does not verify. Only one of the three criteria used to determine the star ratings — the results of annual health inspections — relies on assessments from independent reviewers. The other measures — staff levels and quality statistics — are reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value.”

“JUPITER, Fla. – Beverly Hires, a former nurse running for Congress here in one of the nation’s rare competitive House races, ticks off her problems with the federal health care law: higher premiums, cancelled policies and employers cutting full-time jobs.
“The Affordable Care Act is not making insurance more affordable,” she said in an interview, citing many of the same criticisms as her five GOP opponents in the Aug. 26 primary, who are vying for the chance to oust first-term Democrat Rep. Patrick Murphy.
Hires’ messaging on Obamacare in this South Florida district targeted by the GOP tracks a pattern around the country as Republican candidates follow a focus-group tested script recommended by pollsters.
“The messages that work best are succinct, clear statements about the effects of Obamacare on consumers directly,” by increasing costs, taxes and taking away jobs, said Whit Ayres, president of North Star Opinion Research, a Republican polling group that’s surveyed likely voters to determine the best way to attack Obamacare.
Heading into the first congressional election since millions of Americans gained coverage under the health law, many Republican candidates are taking a more nuanced approach to how they criticize the law. Rather than just calling for repeal, they are following Ayres’ recommendations to focus on arguments about how the law is hurting consumers, government budgets or the economy.”

“Verizon is making a bet that telemedicine — a term for virtually administered medical care — could provide a big business opportunity.
The company recently announced it was providing private network services to the University of Virginia and Stanford University for a study on a so-called “artificial pancreas” — a series of devices that could monitor glucose levels in Type 1 diabetics and automatically release insulin into the body.
For the past few years, Verizon has been supporting universities as they perform clinical trials on telemedicine, providing them with the required network services. Verizon declined to share the financial terms of these agreements, though it said it was providing a private wireless network and data center services, among other services.
The artificial pancreas uses a tiny glucose monitor, inserted under the skin, which relays glucose levels to a smartphone. There an application can communicate with an insulin pump to release insulin into the body as needed. (Diabetics often manage this process manually by periodically measuring glucose levels and injecting themselves with glucose, according to the study.)”

“Supporters of President Obama’s health care law have been touting proposed insurance rates for 2015 — arguing that they aren’t as high as some of the dire warnings of the law’s critics.
But it’s worth considering some additional context.
Data compiled by the Health Research Institute of PricewaterhouseCoopers from about 29 states plus the District of Columbia show that the average premium increase for insurance starting next year is currently 8.2 percent. But within that average, there’s a wide range.
In Arizona, for instance, the average premium increase submitted was 11.2 percent, but rates ranged from a decrease of 23 percent to a spike of 27 percent. In Arkansas, where the average increase was 11.2 percent, some consumers could see their premiums soar by 50 percent.
Defenders of Obamacare argue that rates typically went up annually before the law went into effect.
However, it’s important to keep in mind that it was Obama himself who repeatedly promised that premiums would go down by an average of $2,500 per family.”

“A clinic in Minneapolis that provides medical care to thousands of uninsured and underinsured people is closing its doors next week, in large part because more people are obtaining health insurance through the Affordable Care Act and seeking care elsewhere.
When the Neighborhood Involvement Program shuts down Aug. 29, the 3,000 patients that visit its Uptown clinic will be without a medical provider. But its dental and mental health clinics, as well as its senior and youth programs, will continue operating in Uptown.
But managers of the NIP Community Medical Clinic say many people still need the low-cost care and customer service they provide. Medical bills at the clinic on Hennepin Avenue are as easy to understand as a restaurant check, with a price list like a menu: $10 for a strep test, for example, and $80 for a basic doctor visit. If a patient’s monthly income is less than $1,900 dollars, those fees drop considerably.”