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GOP: 33% Haven’t Paid - Health Care Edge: Brought to you by Pfizer RxPathways

GOP: 33% Haven't Paid

By Sam Baker, Sophie Novack and Clara Ritger


REPORT QUESTIONS ENROLLMENT REPORTS: Only two-thirds of people who picked a plan through the federally run Obamacare exchanges have paid their first month's premium, according to a report from Republicans on the House Energy and Commerce Committee. The figure comes from a survey of 160 insurers, but it's a lot lower than what insurers have estimated themselves -- Wellpoint said yesterday that 90 percent of its new customers were paid (the last step to actually having coverage). HHS and White House officials questioned the report's accuracy, but have not answered insistent questions about how many people have made their first premium payment.

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HOUSE ENERGY AND COMMERCE COMMITTEE MEMBERS SAY THEY KNOW WHO HAS PAID THEIR OBAMACARE PREMIUMS: The committee sent a memo and an accompanying state-by-state breakdown for the percent of people who signed up using the federal exchange and have paid their premiums as of April 15. (Erica Werner, Associated Press)

  • White House officials called the report incomplete. "Funny, there are over 300 insurers in the federal marketplace but E+C report seems to only have data from 150," tweeted Tara McGuinness, White House Senior Communications Advisor.
  • And those last two weeks of April are important: payment for coverage beginning May 1 was not due until yesterday. "Almost half of marketplace enrollees signed up after March 1. Many last minute enrollees may have just received their invoices by April 15," tweeted Larry Levitt, senior vice president at Kaiser Family Foundation.
  • Statement from CMS Spokesman Aaron Albright: "These claims are based on only about half of the approximately 300 issuers in the Federally-facilitated Marketplace and they do not match up with public comments from insurance companies themselves, most of which indicate that 80 to 90 percent of enrollees have paid their premium. Additionally, given the significant surge in enrollments at the end of March, it stands to reason that not all enrollees would have paid by the date of this so-called report since many people's bills were not even due yet."
  • Does the House GOP data mean it's time for HHS to come clean on its Obamacare enrollment data? (Philip Klein, Washington Examiner)

3 REASONS WHY OBAMACARE'S OUTLOOK IS ROSY FOR INSURERS: WellPoint's CEO identified three reasons why the ACA is meeting insurer expectations: 90 percent of people are paying their premiums; there is an overall increase in number of customers; and the newly insured are generally older, eligible for subsidies, and buying cheaper plans, but more young people signed up later in the open enrollment period. (Clara Ritger, National Journal)


IS THIS THE HARDEST JOB IN AMERICA? Insurance companies' actuaries have little to go on when predicting health costs and setting premiums. (Anna Wilde Mathews, Wall Street Journal)



- 36% think the law is a good idea

- 46% think the law is a bad idea


- 40% want to see the law modified, 28% want to see major overhaul

- 58% said the law hasn't affected their lives (Louise Radnofsky, Wall Street Journal)

DEAR REPUBLICANS AND DEMOCRATS: BURN YOUR OBAMACARE PLAYBOOK: The next big question is how will the Affordable Care Act look in year two. (Sam Baker, National Journal)

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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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AMERICANS BELIEVE TWO THINGS ABOUT OBAMACARE ENROLLMENT THAT CAN'T BOTH BE TRUE: "People think the law missed its enrollment targets even as they've actually absorbed the data showing the law beat its enrollment targets." (Ezra Klein, Vox)

Burwell Confirmation

SENATE FINANCE COMMITTEE GEARING UP FOR HHS SECRETARY CONFIRMATION: Oregon Democrat Ron Wyden, Chairman of the Senate Finance Committee, met Wednesday with Sylvia Mathews Burwell, the president's nominee for secretary of the Health and Human Services Department. In an emailed statement, Wyden said:

"I continue to be impressed by Sylvia Mathews Burwell - she has the proven ability to forge strong relationships and deliver results at the highest levels. The Finance Committee has received her completed paperwork and it is now being reviewed. When that process is finished, I expect the Finance Committee to schedule a confirmation hearing promptly. There is a great deal of work that needs to be done at HHS, so I hope the Senate confirms her without delay. Given that she successfully navigated the Senate's confirmation process less than a year ago with a 96-0 vote, her confirmation as Secretary of Health and Human Services should come as no surprise."

The Senate Finance Committee has not announced a hearing date.

REPUBLICANS TO PUSH ANTI-OBAMACARE MESSAGE IN U.S. SENATE HEARINGS: "'The confirmation process is likely to focus on all of the Obamacare-related disasters,' said Brook Hougesen, a spokeswoman with the National Republican Senatorial Committee. ...

"Republicans also intend to use the hearings to pressure vulnerable Democrats into breaking ranks with the White House by voting against the Obama nominee, joining an expected majority of Republican senators." (David Morgan, Reuters)

Health Spending

OBAMACARE PUTS A FLOOR UNDER THE U.S. ECONOMY IN THE FIRST QUARTER: "Healthcare spending increased at a 9.9 percent annual rate, the quickest since the third quarter of 1980, and it contributed 1.1 percentage points to GDP growth. ...

"The gauge of healthcare spending published on Wednesday is simply an estimate based on Medicaid benefits, ACA insurance exchange enrollments, and other related information. Firm data will not be available until June, and the government could well revise its figures for both healthcare and overall GDP." (Lucia Mutikani, Reuters)

ADMINISTRATION SAYS HIGHER HEALTH SPENDING MEANS ACA IS WORKING: "A lot of the utilization was people who didn't have health insurance who are now able to go to the doctor and afford drugs," said Jason Furman, chair of the Council of Economic Advisors, in response to reports suggesting health care costs are growing faster. (Sarah Kliff, Vox Media)

YOUR GUIDE TO THE LATEST FREAK OUT OVER HEALTH SPENDING: "Who could have predicted that a recovering economy, higher incomes and a rise in the number of people with health coverage brought about by Obamacare would increase how much Americans are spending on medical care? Well, pretty much anyone. And they did." (Jeffrey Young, Huffington Post)

WHO REALLY PAYS FOR HEALTH CARE MIGHT SURPRISE YOU: It's the government and employers, mostly. (Jay Hancock, Kaiser Health News)

ENVISIONING THE END OF EMPLOYER-PROVIDED HEALTH PLANS: A new report projects that by 2020, 90 percent of American workers who have employer-provided health plans will be shifted to the health insurance exchanges to buy their coverage. (Neil Irwin, New York Times)


STATE EXCHANGES DON'T WANT RESPONSIBILITY FOR ACA EXEMPTIONS: A number of states have criticized a proposal from the administration that would shift responsibility for granting exemptions from the health law's individual mandate to the state exchanges in the 2015 enrollment period. (Jason Millman, Washington Post)

STATES STEP INTO BREACH ON E-CIGARETTES: The federal government is behind when it comes to regulating e-cigarettes--three dozen states already ban the sale to minors and six other states have similar legislation in the works. (Natalie Villacorta, Politico)

Women's Health

MEMBERS OF CONGRESS ASK FOR GAO REPORT ON INCLUSION OF WOMEN IN NIH STUDIES: "Participation of women in clinical trials is vital to improving our understanding of how women are affected by diseases and conditions that impact their health and lifespan," the coalition writes.

Rules and Recommendations

CMS ISSUES PROPOSED RULE FOR HOSPITAL INPATIENT PAYMENT: The Centers for Medicare and Medicaid Services announced a proposed 1.3 percent payment bump to acute care and long-term care hospitals for FY 2015.

WORLD HEALTH ORGANIZATION: NO, SERIOUSLY, STOP ABUSING ANTIBIOTICS: In a new report, the agency said it fears the world is heading back into an era where common infections can kill. (James Hamblin, The Atlantic)

CMS PANEL VOTES AGAINST PAYING FOR CT SCANS FOR HEAVY SMOKERS: "The members of the Medicare committee, which advises CMS on coverage determinations, indicated that they had little confidence that the benefits of subjecting Medicare beneficiaries to regular scans outweighed the risks of the psychological trauma or unnecessary surgeries that could result from false positives." (Virgil Dickson, Modern Healthcare)

Happening Today

HOUSE COMMITTEE CONSIDERS THE BENEFITS OF TELEHEALTH: The House Energy and Commerce Subcommittee on Health holds a 10 a.m. hearing titled "Telehealth to Digital Medicine: How 21st Century Technology Can Benefit Patients."

CITY HEALTH OFFICIALS COMMENT ON FDA E-CIGARETTE REGULATIONS: The Big Cities Health Coalition meets with Democratic Senator Dick Durbin at 2 p.m. in the Senate Visitors Center Room 203-02 to talk about how the FDA's proposed guidelines for e-cigarettes fits in with what cities are already doing on smoke-free laws.


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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