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Employer-Based Insurance Did What? - Health Care Edge

Employer-Based Insurance Did What?

By Sam Baker, Sophie Novack and Clara Ritger


MAKING SENSE OF THE RAND STUDY: The RAND Corporation threw everyone for a loop with its latest report on health insurance. RAND said that 9.3 million uninsured people have gotten coverage in the last year -- which seems like a sign that Obamacare is working. But it also said that the vast majority of those people have gotten covered through employer-based insurance -- not Medicaid or private individual plans, which are the two ways Obamacare directly expands coverage options. The report doesn't cover the entire open enrollment period, so its data aren't complete, but it somehow managed to undercut one of the biggest criticisms of Obamacare (it'll erode employer-based health care) as well as one of its biggest selling points (the exchanges will produce a huge coverage expansion).

Top Health Care News

OBAMACARE'S MEDICAID TRAP: The White House's "tech surge" fixed many of the Affordable Care Act's high-profile problems, but glitches continue to hurt some of the nation's poorest patients. (Sophie Novack, National Journal)

HOW THE RAND ESTIMATES COULD REWRITE THE ACA ENROLLMENT STORY: "Here's what's startling: employer-sponsored insurance—not Medicaid or the exchanges—drove the net reduction in uninsured. An estimated 8.2 million took up employer-sponsored plans, and most of them were previously uninsured. I can't overstate how stunning this finding is if it's true; CBO expected that ESI gains and losses would pretty much break even in 2014 and that employer coverage would decline modestly in future years." (Adrianna McIntyre, Incidental Economist)


THE LIMITS OF MEDICARE DATA: "That [physician and payment] diversity underscores crucial gaps in the new data. Medical groups and policy makers have asserted that the figures lack context needed to show which doctors may be abusing the system and which are simply hard workers and overseers of complicated medical practices, or those whose specialties involve high overhead costs, such as radiation oncology, that lead to bigger bills." (Christopher Weaver, Melinda Beck, and Ron Winslow, Wall Street Journal)

More on Medicare Data

Reporting on the release of Medicare physician payment data continues but grows more cautious, as doctors and medical groups warn the numbers don't tell the full story.

MEDICARE DATA WILL HELP PUBLIC FIGHT FRAUD, OFFICIALS SAY: "'We know that there's waste in the system, we know that there's fraud in the system,' said Jonathan Blum, principal deputy administrator for the Centers for Medicare and Medicaid Services. 'We want the public's help — we want reporters' help — with data that appear to be fraudulent.'" (Kelly Kennedy, USA Today)

WHICH MEDICAL SPECIALTIES COST MEDICARE THE MOST? A graphic of costs by specialty. The insurance program for the elderly and disabled is the biggest U.S. purchaser of health care, spending $77 billion in 2012. (Chloe Whiteaker and Phil Kuntz, Bloomberg)

  • Meet the 7 doctors who got $10 million out of Medicare (Peter Eisler, Meghan Hoyer and Alex Beall, USA Today)

  • The stories behind the data: the top 10 Medicare billers explain why they charged $121 million in one year (Jason Millman, Washington Post)

  • Some top billers have political ties. (Frances Robles and Eric Lipton, New York Times)

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    Health Care Edge is one of my top resources."

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    Great news in short form along with much needed humor."

    Patrick, President of private healthcare consulting firm

    Informative and help[s] me stay on track. "

    Director of Scientific Affairs, Non-profit medicial society

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ANGER AMONG DOCTORS LISTED AS HIGH EARNERS: "Some of those with the highest billings had already drawn public scrutiny as part of government investigations into healthcare fraud. But many more doctors were shocked to see where they ranked, since Medicare hadn't shared the data with physicians before publication. Many of the doctors who sit atop Medicare's list say they support the government's historic move to make physician payments public, but they expressed anger about the possibility of being unjustly vilified over their pay." (Chad Terhune and Doug Smith, Los Angeles Times)

  • "Many other doctors worried that the data released was incomplete and often misleading. In some cases, enormous payments that seem to be going to one doctor are actually distributed to multiple others. But the data tables do not reveal that the money was shared." (Denise Grady and Sheri Fink, New York Times)


WHITE HOUSE LOOKS BACK AT ACA IMPLEMENTATION: "It wasn't for lack of time; it was for lack of time on the right variables," Denis McDonough, the White House chief of staff said in an interview with other officials. (Michael D. Shear, New York Times)

OBAMACARE MAY HELP CLOSE HEALTH DISPARITY GAP: An interview with J. Nadine Gracia, deputy assistant secretary for minority health and director of the Office of Minority Health at HHS, about what the ACA means for minority health. (Janelle Ross, National Journal)


STAKEHOLDERS OFFER SOLUTIONS TO PRESCRIPTION DRUG ABUSE: The Alliance to Prevent the Abuse of Medicines -- a partnership of the American Medical Association, Cardinal Health, CVS Caremark, the Healthcare Distribution Management Association, Prime Therapeutics, and Teva Pharmaceuticals — released a set of federal policy recommendations yesterday to address the problem of prescription drug abuse. Announced at a briefing with House Energy & Commerce Health Subcommittee Chair Joe Pitts and Ranking Member Frank Pallone, the recommendations are intended to help lawmakers craft legislation to reduce prescription drug abuse, and focus on prevention and education, early intervention, monitoring, treatment, and disposal. Read all nine solution proposals here.

CALL FOR EXPENSIVE TREATMENT FOR HEPATITIS C: New guidelines from the World Health Organization strongly endorse two new Hepatitis C medicines: Gilead Science's Sovaldi and Olysio from Janssen Pharmaceuticals. But the recommendation was made without considering the high costs: $1,000 per pill/$84,000 for a 12-week course of Solvadi and $66,360 for a three-month course of Olysio. (Richard Knox, Kaiser Health News)


HOUSE DEFEATS BIPARTISAN OBAMACARE BILL: "The House on Wednesday rejected a bipartisan bill that would have changed how expatriates and their insurance carriers comply with Obamacare, amid strong opposition from senior Democrats who said it created large loopholes in the health law...Republican leaders brought the bill to the floor under suspension of the rules, a procedure that requires support from two-thirds of members voting. It's usually used for noncontroversial legislation, but opposition to this bill mounted all day, leading to its surprise defeat." (Jennifer Haberkorn, Politico)

HOUSE GOP: WE'LL HAVE THAT OBAMACARE ALTERNATIVE SOON! REALLY! "You know that Obamacare alternative, the one that House Republicans promised to unveil in April? Their leaders announced on Tuesday that it's not ready just yet. This should surprise exactly nobody." (Jonathan Cohn, New Republic)


MORE KIDS ARE GETTING HEALTH INSURANCE: A Robert Wood Johnson Foundation study found that the rate of uninsured children fell from 9.7 percent in 2008 to 7.5 percent in 2012. Researchers say the decline was driven by an increase in coverage through Medicaid and the Children's Health Insurance Program. (Clara Ritger, National Journal)

MAINE GOV. VETOES MEDICAID EXPANSION: The move was expected, as Republican Gov. Paul LePage has been an adamant opponent of Medicaid expansion. The Legislature will likely cast votes to override LePage's veto this week, but the bill's vote indicates that expansion supporters – mainly Democrats – do not have the needed two-thirds majority. (Steve Mistler, Portland Press Herald)


HEALTH SPENDING RISES: According to the latest brief released by the Altarum Institute, "National Health Expenditures (NHE) in February 2014 grew 6.7% over February 2013, the highest rate since March 2007, just prior to the recession, which officially began in December 2007. While governmental data attribute a portion of the growth in January and February 2014 to newly insured individuals under the Affordable Care Act, much of the acceleration in growth occurred during 2013, prior to ACA's expanded coverage."


THE PSYCHOLOGICAL TOLL OF 12 YEARS OF WAR: How our nation's military has become an experiment in how prolonged conflict affects mental health. (Clara Ritger)

REPUBLICANS WANT TO FIRE SOMEONE TO STOP PREVENTABLE VETERAN DEATHS: But VA officials warn against widespread punishment for what they see as a limited problem. (Jordain Carney, National Journal)

Happening Today

SEBELIUS TESTIFIES BEFORE SENATE FINANCE: The committee will hear testimony from the HHS Secretary on the President's FY 2015 Budget at 10 a.m.


Don't Miss Today's Top Stories

Health Care Edge is one of my top resources."

Meghan, Associate Specialist

Great news in short form along with much needed humor."

Patrick, President of private healthcare consulting firm

Informative and help[s] me stay on track. "

Director of Scientific Affairs, Non-profit medicial society

Sign up form for the newsletter
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