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Health Care Edge

All About Health Spending - Health Care Edge

April 21, 2014

All About Health Spending

By Sam Baker, Sophie Novack and Clara Ritger

HEY, BIG SPENDER: With 8 million sign-ups, it's all but guaranteed the ACA will succeed at its goal of expanding health care coverage to millions more Americans. But it's equally clear what the next big challenge will be for the health care system: cost control. More and more reports continue to point toward a rise in health care spending, particularly in the private market, as the economy recovers and millions of people come into the system for the first time. The rise in spending will surely put pressure on premiums, and that would cause the government's costs to rise in the form of higher subsidies for Obamacare plans. Health care is still expensive, and finding a way to rein in those costs is the next big challenge for policymakers.

 

Top Health Care News

RECENT INCREASE IN HEALTH CARE SPENDING RAISES CONCERNS: Structural changes to the health care delivery system has led to lower health spending in recent years, but the wave of new insurance enrollees under the Affordable Care Act and the increased use of the system has experts concerned about a surge in spending. (Annie Lowrey, New York Times)

  • Fifteen charts that show how crazy U.S. health care prices are. (Sarah Kliff, Vox Media)

GAO REPORT DETAILS OUTSIDE FUNDRAISING FOR ACA ENROLLMENT: Administration officials said private donations were important because Congress gave far less funding than requested to publicize the health care law. (Robert Pear, New York Times)

OBAMACARE ENROLLEES TOLD TO CHANGE PASSWORDS OVER HEARTBLEED BUG: A message posted on HealthCare.gov Saturday informed users they would need to create a new password to access their account. (Chris Francescani, Reuters)

Enrollment

WAY MORE THAN 8 MILLION HAVE SIGNED UP FOR OBAMACARE: The tally more than doubles when you include Medicaid enrollment, young adults on their parents' plans, increase in employer-sponsored coverage, and off-exchange enrollment. (Sarah Kliff, Vox Media)

ENROLLMENT CONTINUES GROWING IN STATES WITH EXTENDED DEADLINES: The special enrollment period for HealthCare.gov ended April 15, but at least eight states plus D.C. are still allowing consumers to sign up for private insurance if they were unable to do so because of technical problems. These include Oregon and D.C., which have an April 30 deadline, and Nevada, with a May 30 deadline. (Elise Viebeck, The Hill)

Exchanges

TIME IS RUNNING OUT FOR STATES TO SET UP THEIR OWN EXCHANGES: Many of the over 30 states under the federal marketplace remain reluctant to adopt their own exchanges next year, despite a November deadline to receive funding assistance from the federal government. (Carla K. Johnson, Associated Press)

ACA HIGH-RISK POOLS ARE REALLY CLOSING THIS TIME: After multiple coverage extensions for the nation's sickest patients, those with pre-existing conditions will have to move onto the Obamacare exchange plans. (Jason Millman, Washington Post)

Politics

DEMOCRATS FACE CONFLICT OF POLITICS OVER ACA: "Democrats could ultimately see some political benefit from the law. But in this midterm election, they are confronting a vexing reality: Many of those helped by the health care law — notably young people and minorities — are the least likely to cast votes that could preserve it, even though millions have gained health insurance and millions more will benefit from some of its popular provisions." (Jonathan Martin, New York Times)

OBAMACARE DEBATE SHIFTS FROM REPEAL TO COST AND CARE: "'Realistically, it's not going to be repealed,' said Bill Hoagland, a former top adviser to Republican Bill Frist, the retired Tennessee senator, in a telephone interview. 'What I think Republicans need to do is move on and focus on those changes in the law that would improve its acceptability to Republicans, as opposed to continuing to talk about repeal.'" (Alex Wayne, Bloomberg)

GOOD NEWS FOR OBAMACARE IS BAD NEWS FOR CONSERVATIVE PUNDITS: "The irony is that, had conservatives been a little less quick to trumpet every nugget of potentially bad news, the administration would be riding a little less high right now—and their own predictions would look a little less silly." (Lucia Graves, National Journal)

TRANSCRIPT SHOWS BILL CLINTON'S OWN 'IF YOU LIKE YOUR PLAN' DILEMMA: Newly released internal documents from the Clinton presidential library show former president Clinton wanted to reassure Americans with a similar "if you like your plan, you can keep it" claim in 1994, as Obama made about the ACA last year. (David Nather, Politico)

Providers and Insurers

ACCELERATION OF PROVIDER CONSOLIDATION RAISES QUESTIONS OF COST AND QUALITY OF CARE: "'The Affordable Care Act is pushing consolidation and working together, but the Federal Trade Commission and the Justice Department seem to be saying, 'Wait a second, there are antitrust laws here,' said Robert Field, a law and health policy professor at Drexel University in Philadelphia. 'The federal government has a schizophrenic attitude toward provider consolidation.'" (Phil Galewitz, Washington Post)

USE OF HOUSE CALLS BACK ON THE RISE: Hospitals are increasingly making house calls part of their palliative care programs, with the aims of offering better treatment and reducing cost. (Milt Freudenheim, New York Times)

INSURERS ARE MORE CONCERNED ABOUT THE HIGH COST OF NEW HEPATITIS C PILLS THAN OBAMACARE: UnitedHealth Group spent more time answering investor questions about the company's expenses for a new Hepatitis C treatment than the impact of the health law. (Bruce Japsen, Forbes)

Medicaid

MEDICAID ENROLLMENT SUCCESS BRINGS CHALLENGES IN WASHINGTON STATE: The Medicaid program in Washington has grown about 25 percent since October, signing up more than 285,000 newly eligible adults -- a target officials hadn't expected to reach for another three years. (Lisa Stiffler, Seattle Times/ Kaiser Health News)

PER-PERSON COST OF ARKANSAS PRIVATE OPTION ON THE RISE: "[But] because of the way that the waiver is designed, there is almost no chance of Arkansas taxpayers paying out money to the feds for potential cost overruns during the private option waiver. Of course, the state should nevertheless attempt to keep costs down and will have some policy tools to do just that in future years." (David Ramsey, Arkansas Times)

UTAH'S MEDICAID EXPANSION EFFORTS GAIN ATTENTION FROM NEIGHBORING STATES: "[Republican Gov. Gary Herbert] is seeking waivers to use the $258 million available for Medicaid expansion in Utah for a state-run plan offering private health insurance to 111,000 low-income Utahns...He wants to require recipients to work and to contribute to the cost of the plan, through making increased copayments for services and picking up at least part of the premium. If Utah succeeds in selling the federal government on what's been called a "block grant approach" to Medicaid expansion, Herbert said other states will want to follow the state's example." (Lisa Riley Roche, Deseret News)

Happening This Week

The administration is expected to release the full, detailed ACA enrollment report this week, including breakdown by state.

Tuesday

NATIONAL FOOD POLICY CONFERENCE: The conference will look at food policy issues facing the industry and consumers, and will go from 8 a.m. to 5 p.m. at the Omni Shoreham Hotel.

Wednesday

NATIONAL FOOD POLICY CONFERENCE: The second day of the conference will go from 8 a.m. to 12:30 p.m.

Thursday

THE ACA AND TEENS EVENT: The D.C. Campaign to Prevent Teen Pregnancy will hold a discussion with HHS Office of Adolescent Health Deputy Director Wilma Robinson; Rachel Arguello, policy analyst at the Kaiser Family Foundation; Athena Cross, Medicaid director of health care reform implementation at Planned Parenthood Federation of America; and Lisa Dubay, senior fellow at the Urban Institute at 9 a.m. at Fraser Mansion.

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