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Daily Archives: August 30, 2013

GOP Lawmakers Demand Information From Groups Getting Navigator Grants

In a move one leading health law expert has described as “intimidation,” 15 Republican members of the House Energy and Commerce Committee are asking recipients of the $67 million in health law navigator grants to brief the panel on how they intend to spend the money. 

The Aug. 29 letter directs the grantees to schedule a meeting no later than Sept. 13 and to provide additional documentation, including a written description of the work they intend to do, the number of employees and volunteers, their duties and how much they’ll be paid.

The committee members are also requesting information about how the navigators will be trained and monitored. “All documentation and communication” related to the grant, including application materials, are requested, including any communication between their organization and federal agencies involved in the health law, such as the Department of Health and Human Services and the Centers for Medicare and Medicaid Services, according to the letter.

In addition, the letter asks for documentation of any contact with Enroll America, a group with close ties to the Obama administration. The organization is trying to educate consumers about new insurance options and drive enrollment in the new marketplaces opening this fall for coverage that takes effect in January.

Navigators will provide assistance on the phone and in person to individuals signing up for coverage in the health law’s insurance marketplaces, as well as for public programs including Medicaid and the Children’s Health Insurance Program. They will receive 20 hours of online training and have to pass a test before they can start working. Their efforts could include help in evaluating health plans for sale on the marketplaces, also known as exchanges. They are not, however, allowed to expressly tell people which policy to choose.

Timothy Jost, a professor at Washington and Lee University School of Law, called the letter “an obvious attempt at intimidation of navigator programs, most of which are nonprofits that don’t have the resources to hire lawyers to fight this, nor the time to respond at this very busy time. … This attempt to bully these programs is shameful.” 

HHS did not immediately respond to a request for comment, and the Energy and Commerce panel did not immediately return a call for additional information about the letter.

The navigator program has raised controversy among opponents of the health law. Critics see navigators as potential competitors to insurance brokers, and some want the navigators to receive more rigorous screening before they can work with consumers. Some lawmakers and state attorneys general have expressed concerns that there are not enough safety guidelines in place to ensure that navigators do not misuse individuals’ personal information.

Hospitals, universities, Indian tribes, patient advocacy groups and local food banks were among organizations awarded $67 million in federal grants to more than 100 groups earlier this month to help people sign up for coverage in new online health insurance marketplaces that open for enrollment Oct. 1.

According to a Commonwealth Fund assessment in July, 14 states, including Florida, Georgia, Ohio, Texas, Virginia and Wisconsin, have passed laws setting requirements for navigators and five others are considering such action.

Navigators will be required to adhere to strict security and privacy standards, including how to safeguard a consumer’s personal information, according to HHS. All types of enrollment assisters – including navigators – are subject to federal criminal penalties for violations of privacy or fraud statutes, in addition to any relevant state penalties. 

Phil Galewitz contributed to this article.

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A glass of wine a day may keep depression away

We have all heard that drinking a glass of red wine in moderation may be good for our health. But now, researchers have found that drinking wine may also reduce the risk of depression, according to a study published in the journal BMC Medicine. Researchers from Spain analyzed 2,683 men and 2,822 women over a 7-year period from the PREDIMED Trial – a study that conducts research around nutrition and cardiovascular risk. All participants were between 55 and 80 years of age, with no history of depression or alcohol-related problems when the study began…

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Major cause of age-related memory loss discovered

Scientists say they have discovered a protein deficiency in the brain that is a major cause of age-related memory loss, according to a study published online in the journal Science Translational Medicine. The researchers, from Columbia University Medical Center (CUMC), say this discovery offers the “strongest causal evidence” that age-related memory loss and Alzheimer’s disease are individual recognizable conditions…

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Jet lag recovery sped up in mice

New research led by the University of Oxford in the UK suggests it may be possible to speed up recovery from jet lag by targeting a mechanism that prevents the body clock adjusting quickly to changes in patterns of light and dark. Working on mice, they found a protein called SIK1 acts as a buffer or brake to limit the effect of light on the body clock. When they blocked the activity of the protein, the mice adjusted faster to changes in their light/dark cycle. One of the team leaders, Dr…

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Geriatric Safe Medicines Summit, 6-17 September 2013, London

Call for specialists involved in clinical trials in older people SMi Group reports (August 29, 2013): Call for geriatric specialists: Big Pharma Companies will meet in London to discuss challenges and opportunities for performing clinical trials in older people There are onlyÂ�3 weeks left until leading industry experts will gather in London at Geriatric Safe Medicines Summit (16-17 September) to discuss major challenges faced when performing clinical trials in older people. Through a novel range of case studies, attendees will discover new market gaps, market strategies and much more…

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White House Readies Major Health Law Push

The strategy will feature the president, as well as First Lady Michelle Obama, Vice President Joe Biden and Jill Biden, appearing in key states over the next six months to encourage people to enroll in new coverage options. Politico also looks at how former President Bill Clinton will be part of the effort to sell the American public on the overhaul.

Politico: President Gearing Up For Major New Obamacare Push
Three years after signing Obamacare into law, President Barack Obama finally looks eager to talk about it. The White House is mapping out a strategy to deploy the president, First Lady Michelle Obama, Vice President Joe Biden and Jill Biden in what will be their most coordinated effort yet to sell Obamacare, senior administration officials said (Budoff Brown, 8/30).

Politico: The Obama-Clinton Health Care Bond
Bill Clinton will attempt again next week to do for Obamacare what has long eluded its namesake: Cut through the political noise and change the perception of a law much of the public doesn’t like or understand. His speech at Clinton’s presidential library in Arkansas Wednesday is a continuation of the relationship that benefited the former and current president in the 2012 campaign. It’s a role Clinton has played before on behalf of the Affordable Care Act, which is rooted in the failed effort by he and his wife, Hillary Clinton, to pass comprehensive health care reform two decades ago (Haberman and Millman, 8/30).

Meanwhile, labor unions appear to be making progress in getting the administration to address their health law concerns –

The Wall Street Journal: Labor Official Sees Progress On Health-Law Concerns
Unions are making some progress in getting the Obama administration to address their concerns about the new health law, and Labor Secretary Tom Perez is playing a central role, AFL-CIO President Richard Trumka said Thursday. “We’ve been working with the administration to find solutions to what I think are inadvertent holes in the act. I’m hopeful that we’ll get something done in the very near future,” Mr. Trumka said at a breakfast with reporters sponsored by the Christian Science Monitor (Trottman, 8/29).

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Health Exchange Rate Shock Not So Likely, Study Finds

A study by Rand Corp. researchers concludes that predictions of sharp jumps in insurance premiums for coverage purchased through the new online insurance marketplaces may be overstated.

Bloomberg: Premium Increases Under Obamacare May Be Overstated
Predictions of sharp increases in health-insurance premiums for people getting coverage under the U.S. Affordable Care Act have been overstated and many states will see little to no change, researchers at Rand Corp. found. Out-of-pocket premiums for most individuals who buy health plans through new insurance exchanges will decline because of federal subsidies, the Santa Monica, California-based nonprofit research group said today in a report (Armstrong and Wayne, 8/29).

NPR: Study: Price Shocks On Health Exchanges Appear Unlikely
With new health insurance exchanges set to launch in just over a month, there’s been a lot of chatter about how shocking the rates might be. One possibility is that adding sick people to a more comprehensive benefits package will cause premiums to soar. Last spring, the Society of Actuaries predicted an average increase of 32 percent because of to the law, which prompted an outcry from opponents of the law. But an analysis just out from the RAND Corp. reaches a very different conclusion (Rovner, 8/29).

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Health Law Subsidies Present Calculation Challenges

The Wall Street Journal reports on the challenges of calculating future income and health insurance subsidies — both of which will have an impact on the health law’s new insurance marketplaces. Meanwhile, The Washington Post reports on how executive-branch and legislative-branch employees will have different experiences with the overhaul.  

The Wall Street Journal: Subsidies for Older Buyers Give Health Insurers A Headache
But the federal subsidies that make this possible for older people are causing headaches that insurers are struggling to understand. The programs reverse a long-standing tenet of the insurance business: That riskier customers pay more. The subsidies can be far more generous to older people than younger ones, the analysis of Ohio’s marketplace shows (Weaver and Radnofsky, 8/29).

The Wall Street Journal: A New Kind Of Insurance Head-Scratcher: Estimating Future Income
Under the health law, millions of Americans will face a new test of their fortunetelling skills: precisely predicting their next year’s income. The federal health-care overhaul creates a potentially rich new class of benefits for people — namely, federal subsidies they can use to buy insurance on the new marketplaces created in each state. Eligibility for subsidies is based on income (Radnofsky and Weaver, 8/29).

The Washington Post: Obamacare Affects Executive And Legislative Employees Differently
Executive-branch employees won’t automatically lose their existing health coverage when they become eligible soon for the insurance exchanges forming under President Obama’s health care law, according to the federal personnel office. Agency officials began driving that point home this week amid continued confusion and concerns about how the so-called Obamacare legislation will affect health-benefits for federal employees (Hicks, 8/30).

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California Releases Ads For Insurance Marketplace; Aetna Pulls Out Of N.Y. Exchange

Many of the California advertisements will be in Spanish to persuade consumers unfamiliar with the law to sign up, the Los Angeles Times reports. Meanwhile, Aetna did not give many details about its decision to not compete in New York’s exchange.

Los Angeles Times: California Unveils Ads For New Health Insurance Market
The state faces the daunting challenge of trying to reach more than 5 million people who are uninsured or don’t receive health insurance at work. Now officials are preparing to advertise on television and radio, in print and online — much of it in Spanish — to persuade consumers unfamiliar with the federal health law to sign up. The state is purposefully avoiding Hollywood stars in its opening sales pitch. Instead, the state’s ads revolve around people worrying about getting care and paying their medical bills in hopes that those stories will counter persistent political attacks and widespread confusion about the Affordable Care Act (Terhune and Gorman, 8/29).

Reuters: Aetna Pulls Out Of Another Obamacare Health Exchange
Aetna Inc has decided not to sell insurance on New York’s individual health insurance exchange, which is being created under President Barack Obama’s healthcare reform law, the fifth state where it has reversed course in recent weeks. The third-largest U.S. health insurer has said it is seeking to limit its exposure to the risks of providing health plans to America’s uninsured, but did not give details about its decision to pull out of specific markets. … Aetna and its newly acquired Coventry Health unit, a low-cost provider that caters to individuals and Medicaid beneficiaries and provides private Medicare policies, still have applications to sell coverage in 10 states, based on publicly available information (Humer, 8/29).

In other state exchange news –

The Associated Press: Health Exchange Board Delays Vote On Plans Again
The board for the [Washington] state health exchange on Thursday once again delayed a vote on approval of 31 plans proposed to be part of the system. After previously delaying a vote last week, the board of the Washington Health Benefit Exchange voted 6-2 to delay the final vote until next Wednesday, to coincide with an already scheduled meeting to consider additional companies that are appealing exclusion by Washington’s insurance commissioner (La Corte, 8/30).

Seattle Times: State Board Delays Certifying Exchange Health Plans
“We don’t need to rush a vote today,” Teresa Mosqueda told fellow board members. Mosqueda, legislative and policy director of the Washington State Labor Council and chairwoman of the Healthy Washington Coalition, warned that if the board proceeded with certification Thursday, some members might vote against certifying plans already approved by the state Office of the Insurance Commissioner (OIC) because they believe those that were rejected have not received a full hearing (Snow Landa, 8/29).

Kaiser Health News: Capsules: HHS Will Allow ‘Unbanked’ People To Use Prepaid Debit Cards On Exchanges
At the urging of advocates for low-income consumers, the Obama administration said Wednesday that it is moving ahead with a rule requiring health plans accommodate households that do not have traditional bank accounts. One in four of the uninsured eligible for federal insurance subsidies does not have a bank account, according to a report released earlier this year by the tax preparation firm Jackson Hewitt (Varney, 8/29).

The Associated Press: Ready Or Not, Health Law Outreach Training Begins
It wasn’t easy writing the training program for the 800 outreach workers who will help Illinoisans sign up for insurance under President Barack Obama’s health law. Washington was still shaping the regulations. Illinois lawmakers were still amending bills. Then the Obama administration delayed part of the law affecting some businesses. Every change meant more revisions. All the moving parts made it a challenge, but so far everyone who has taken the course has passed the test required for certification, said Elizabeth Calhoun, a University of Illinois at Chicago professor who led the effort under a $910,000 contract between the university and the state (8/30).

Also in state health law news –  

Kansas Health Institute: Kansas Lawmakers Urged To Consider Medicaid Expansion
The chief executive of one of the state’s largest medical centers this week urged Kansas legislators to consider expanding eligibility for the state’s Medicaid program. The original intent of the Affordable Care Act, commonly known as Obamacare, was that all states would expand their Medicaid programs effective Jan. 1, 2014 to include all adults with incomes at or below 138 percent of federal poverty guidelines (Ranney, 8/29).

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White House, GOP Senators Throw In The Towel On Budget Talks

Over past weeks, the Republicans had moved away from the kind of “grand bargain” sought by the president, which would have combined higher tax revenues with cuts to programs like Medicare. Republicans said the talks had yielded “no common ground.”

The New York Times: Talks To Avert A Fiscal Crisis In The Fall End With No Result
Over the past weeks, the Senate group — which called itself the “sounding board” — had moved away from the kind of “grand bargain” Mr. Obama had sought, which would combine higher tax revenues and changes to social programs like Medicare to produce trillions of dollars in deficit reduction. Instead, they aimed simply to replace the automatic across-the-board cuts known as the sequester over the next eight years with other budget changes. Mr. Obama, in his most recent budget plan, had accepted $200 billion in sequester savings over eight years, and both sides appeared ready to leave in place small cuts to entitlement programs in the sequester legislation (Weisman, 8/29).

The Washington Post: White House, Republican Senators Give Up On Budget Talks
The end of the talks comes just over a week before Congress is to return from its summer break to confront a series of imminent deadlines, including the risk of a government shutdown Oct. 1 and potential default on the national debt a few weeks after that. … Through multiple meetings with White House Chief of Staff Denis McDonough, Deputy Chief of Staff Rob Nabors and Budget Director Sylvia Mathews Burwell, the group discussed a range of options, including a “grand bargain” that would involve a complete restructuring of Medicare, according to people familiar with the meetings, who spoke on the condition of anonymity to describe the private talks. The group also discussed a smaller deal that would replace much of the remaining sequester savings — about $500 billion over the next eight years — with narrower reforms to Medicare, Social Security and other ­mandatory-spending programs, such as farm subsidies (Montgomery, 8/29).

The Associated Press/Washington Post: Republican Senator Says Budget Talks With White House Officials Yield ‘No Common Ground’
But the budget talks have always split over Obama’s insistence that any reduction in programs such as Social Security or Medicare be accompanied by tax increases or closed loopholes for the rich that would generate more revenue. Obama did win more than $600 billion in tax increases over 10 years on wealthier taxpayers earlier this year and Republicans have said they would not cede more (8/29).

The Wall Street Journal: Budget Talks Fail To Bridge Divide
Republicans have offered to replace the bulk of the sequester cuts—$518 billion over eight years—with other, more targeted cuts to Medicare, Medicaid and other entitlement programs, according to a GOP official familiar with the discussions. They offered to raise revenues to reduce the deficit, the official said, but not, as the White House wanted, to replace the sequester (Hook, 8/29).

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