Easy Start For Burwell
WELL, THAT WAS EASY: Sylvia Mathews Burwell sailed through her first confirmation hearing yesterday, picking up another Republican endorsement (Sen. Richard Burr) and drawing hardly any legitimately tough questions. A handful of Republicans asked her about parts of Obamacare they don't like, and sought assurances she obviously couldn't give about their preferred alternatives. But overall, the hearing was … boring. That's good news for Burwell, who now seems poised for an easy confirmation following another hearing. But between Burwell's hearing and a House hearing the day before with insurance executives, Republicans' anti-Obamacare campaign seems to be losing steam. The law will certainly still be a big issue in this year's midterms -- and voters still don't like it -- but on Capitol Hill, the fire simply isn't burning as hot as it has in the past.
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BURWELL: The Senate Finance Committee will actually vote on the nominee's confirmation. (Louise Radnofsky, Wall Street Journal)
- Sen. John McCain offered his support in introducing Burwell to the committee. "Regardless of my objections to the Affordable Care Act, the Department of Health and Human Services needs competent leadership in the position of secretary. I believe Ms. Burwell has the qualifications to run HHS," he said. McCain added that he believes Burwell will work better with Congress "than her predecessor." (Jason Millman, Washington Post)
- During the hearing, vulnerable Democrat Kay Hagan of North Carolina condemned her state leadership -- and midterm opponent, state House speaker Thom Tillis -- for opposing Medicaid expansion. (Greg Sargent, Washington Post)
NEW YORK MEDICAID OVERHAUL FUELS RUSH FOR PROFIT: "The state's goal [in moving to Medicaid managed care] was savings, but the changes set off a scramble among managed care companies and service providers to enroll clients requiring minimal care, including residents of adult homes who could be brokered in bulk, an investigation by The New York Times found. Many frail people with greater needs were dropped, and providers jockeying for business bought, sold or steered cases according to the new system's calculus: the more enrollees, and the less spent on services, the more money the companies can keep." (Nina Bernstein, New York Times)
IN ARIZONA, SHIFTING KIDS FROM CHIP TO PRIVATE COVERAGE MEANS HIGHER COSTS WITH FEWER BENEFITS: A new study looks at the impact of Arizona cutting eligibility and phasing out the Children's Health Insurance Program, the only state to do so. If Congress does not extend funding for the program when it expires in October 2015, millions more could find themselves in the same situation. (Phil Galewitz, Kaiser Health News)
A DEEP DIVE INTO EXCHANGE ENROLLMENT DATA: Eighty-five percent of enrollees are receiving financial assistance, ranging from 16 percent in D.C. to 94 percent in Mississippi. The federal government could bear a large portion of the burden of premium increases in states that have high rates of subsidized consumers, according to a new analysis. (Caroline F. Pearson, Avalere Health)
COST ESTIMATE FOR NEW MASSACHUSETTS EXCHANGE WEBSITE IS $121 MILLION: The state has already received $174 million in federal funds to build a site, but about a third has already been spent. Governor Deval Patrick's administration is figuring out how much of the remaining funds have been committed to pay contractors for work that has already been completed. (Kay Lazar, Boston Globe)
STUDY: STATE-BASED EXCHANGES SPENT MORE ON ENROLLMENT THAN THE FEDERAL MARKETPLACE: It cost average of $647 in federal tax dollars to sign up each enrollee in the federal exchange, and an average of $1,503 to enroll each person in the 15 exchanges run by states and D.C, according to a new analysis. State exchange costs ranged from $758 per enrollee in California, to $23,899 in Hawaii. (Julie Rovner, NPR)
- States with high costs had relatively low populations. However, the study includes the cost of setting up the exchanges, which presumably would last into future enrollment periods, and apply to many more enrollees.
- Looking specifically at spending on consumer-assistance funds -- which applies to enrollees during this enrollment period -- state exchanges accounted for 50 percent of total consumer-assistance funds, yet have only 31 percent of all uninsured, according to the Robert Wood Johnson Foundation. Federal marketplaces accounted for 33 percent of the funding and 63 percent of the uninsured, and the five partnership states received 17 percent of the assistance funding, and have only 6 percent of the uninsured. Calculating by enrollee, Florida spent only $16 to enroll each new Obamacare consumer, while Hawaii spent $920. (Sophie Novack, National Journal)
THE HEALTH-COST PROBLEM IS RETURNING: The Kaiser Family Foundation's CEO writes that health spending is rising again, in part because as the economy improves, more people are seeking care, and without a national policy to address it, Americans are stuck paying the bill. (Drew Altman, Wall Street Journal)
BUT HEALTH SPENDING IS NOT ACTUALLY ON A 10 PERCENT GROWTH PLAN THIS YEAR: The Bureau of Economic Analysis estimated that health care spending increased 10 percent in the last year, but a new study out from Altarum Institute's Center for Sustainable Health Spending finds the increase is just over 7 percent.
"Health spending growth rates have increased rapidly in recent months, but the 7.1% figure observed for March may well mark the end of this acceleration," said Charles Roehrig, director of the center. "This is because of a leveling off in the numbers of newly insured under the Affordable Care Act. The 10% annualized growth rate for the first quarter of 2014 that has received recent media coverage is based upon comparison to the preceding quarter and is not an indicator of annual growth for 2014 as a whole." (Charles Roehrig, Altarum Institute)
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HOW PUBLISHING HOSPITAL QUALITY DATA AFFECTS PROVIDERS: The four hospital system at the University of Utah Health Care in Salt Lake City is soliciting physician reviews from patients and publishing them on the web, to increase transparency and improve care. "We believe that physicians should know what their patients think of them and how they're treated," said Thomas Miller, MD, chief medical officer. "You're going to be judged by the crowds whether you like it or not. It's out of our control, so the best thing we can do is take the great data that we have and use that to tell our story, and make that an open and honest story." (Cheryl Clark, HealthLeaders Media)
WHAT THE U.S. CAN LEARN FROM BRAZIL'S HEALTH CARE MESS: "Universal health care looks very different in Brazil than it does in, say, Scandinavia." (Olga Khazan, The Atlantic)
DID ROMNEYCARE SAVE LIVES BECAUSE OF MASSACHUSETTS' EXCELLENT MEDICAL SYSTEM? The state has the most physicians per capita in the country. It also has some of the best medical facilities. (Philip Klein, Washington Examiner)
VA SECRETARY ORDERS AUDIT AT EVERY CLINIC: The House Veterans Affairs Committee voted earlier Thursday to subpoena Veterans Affairs Secretary Eric Shinseki amidst accusations that his department is responsible for delays in health care at some VA hospitals, which resulted in a series of veteran deaths. (Ashley Fantz, CNN)
PROCEDURAL VOTE ON OBAMACARE TWEAK FOR VETERANS POSSIBLE NEXT TUES OR WED: The bill would allow employers to not count veterans towards the 50 full-time employee threshold to provide health care under the employer mandate, as long as they are covered by the federal veterans health program. (Ramsey Cox, The Hill)
TROOP VISITS TO THE DOCTOR AT A HIGH: A new study (p. 15) found that service members averaged more than 14 outpatient visits in 2013, nearly 60 percent higher than in 2004 and about 4 percent higher than in 2011. (Gregg Zoroya, USA Today)
CONNECTICUT POLICE TRAIN IN MENTAL HEALTH 101: The Fairfield police department aims to train 20 percent of its force to respond to mental health calls, to support families and fully understand cases. (Jeff Cohen, WNPR/Kaiser Health News)
End of Life
HOW TO GET PAID FOR PLANNING YOUR DEATH: Oklahoma senator Tom Coburn is trying to pass a bill that would pay you to write your end of life directive ahead of time. (Alexandra Sifferlin, TIME)
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