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Navigators' Big Role - Health Care Edge: Brought to you by America's Biopharmaceutical Companies

Navigators' Big Role 

By Sophie Novack and Sam Baker


10 MILLION SOUGHT IN-PERSON HELP: Navigators and in-person assisters helped more than 10 million people make sense of their options under Obamacare, according to a new report from the Kaiser Family Foundation. Kaiser's survey of navigators and other in-person aides found that their roles were bigger in states that set up their own exchanges -- generally the states that were the most eager to promote coverage. Sixty-five percent of people who relied on navigators said they had technical difficulties, and more than 80 percent said they needed help understanding their options and understanding the health care law, according to the survey. HHS has set aside $60 million for navigator grants for 2015 open enrollment.

Top Health Care News

NAVIGATORS: In D.C. and the 16 states running their own exchanges, Navigator programs helped around twice as many people, relative to the uninsured population, as they did in the 29 states participating in the federal exchange. (Abby Goodnough, New York Times)

STATES REACH DEADLINE TO OFFER PLANS TO RESOLVE MEDICAID BACKLOGS: CMS gave six states until Monday to explain how they plan to fix enrollment issues that are preventing over a million individuals from accessing Medicaid coverage, but some states say they are being unfairly targeted for a problem that is the fault of the federal exchange as well. There is no clear deadline for states to actually fix the backlogs. (Judi Lin, Associated Press)


CMS OFFERS $100 MILLION TO STATE MEDICAID PROGRAMS: The agency announced the new Medicaid Innovation Accelerator Program Monday, which is aimed at helping states to improve patient care and reform their payment systems. (Ferdous Al-Faruque, The Hill)


REID SCHEDULES PROCEDURAL VOTE ON HOBBY LOBBY BILL: A vote is expected in the Senate Wednesday on a bill to reverse the Supreme Court's ruling, in order to end debate on the legislation and move forward with a vote. A companion bill was introduced in the House as well, but is not expected to pass. (Ramsey Cox, The Hill)

Senate Democrats have been promoting the Not My Boss's Business Act on social media to rally support around the issue. Advocates are working to make women's reproductive health a major issue in key midterm races.

MAJOR DOCTOR GROUP ENDORSES BILL TO OVERRIDE HOBBY LOBBY DECISION: The American Congress of Obstetricians and Gynecologists said that it supports legislation introduced in the Senate and House last week that would require employers to provide contraception coverage regardless of religious belief. The Senate plans to take up its bill Wednesday. (Laura Bassett, Huffington Post)


SENATE TO CONSIDER ABORTION-RIGHTS BILL: The Senate Judiciary Committee will hold a hearing today on legislation that would eliminate TRAP laws that restrict abortion access in many states. Antiabortion groups have come out strongly against the legislation. (Elise Viebeck, The Hill)


NORTH CAROLINA'S OBAMACARE DISCONNECT: The state has high enrollment in the health care law, but low political support. (Jennifer Haberkorn, Politico)

SOME DOCTORS REFUSE OBAMACARE COVERAGE: Some physicians are refusing to honor ACA exchange coverage even when they are included in the plan's network, because they're concerned they won't be paid by the insurer or patient, and insurers are not adequately informing doctors of their inclusion in plan networks. (Daniel Chang, Miami Herald)

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LAW GIVES NURSE PRACTITIONERS NEW FLEXIBILITY: NPs in Kentucky who have finished a four-year collaboration with a physician will be permitted to prescribe routine medications without a doctor's involvement, beginning July 15, after the passage of a long-debated law. NPs are fighting for more treatment autonomy in other states as well, as the ACA strains the already-existing doctor shortage and increases the need for primary care physicians. (Lisa Gillespie, Kaiser Health News)

SOME ERS ARE TAKING APPOINTMENTS: The new scheduling systems are intended only for patients who do not have life-threatening conditions. (Anna Gorman, Kaiser Health News/Southern California Public Radio)

HOW INCOME INEQUALITY AFFECTS HEALTH CARE DELIVERY: Paying big bucks allows some patients to move to the front of the line for care. (Christopher Flavelle, Bloomberg View)


AHIP: DRUGMAKER WILL HAVE A 'HECK OF A TIME' DEFENDING SOVALDI'S PRICE: According to Securities and Exchange Commission documents uncovered by the Senate Finance Committee's investigation into the high price tag for new hepatitis C drug, the original developer, Pharmasset, Inc., expected to profitably sell the drug in the U.S. for $36,000 for a course of treatment. Gilead, which bought Pharmasset in 2012, is now selling it for $84,000. (Brendan Buck, AHIP)


STUDY: ALZHEIMERS RATE DROPPING: An American over age 60 has a 44 percent lower chance of developing dementia today than one did about 30 years ago, according to the longest study of these trends in the U.S., presented at the Alzheimer's Association International Conference in Copenhagen Tuesday. (Marilynn Marchione, Associated Press)

STUDY DISCOUNTS TESTOSTERONE THERAPY FOR EARLY PROSTATE CANCER: "There are so many side effects associated with this therapy, and really little evidence to support its use," said Dr. Grace L. Lu-Yao, lead author of the report, published on Monday in JAMA Internal Medicine. "I would say that for the majority of patients with localized prostate cancer, this is not a good option." (Anahad O'Connor, New York Times)

Studies and Reports

A report from CMS called "Medicaid Moving Forward" discusses improving care and delivery in the program.

A study published in the Annals of Internal Medicine finds that changes in appearance of generic drugs is associated with inconsistent use of the medications by patients with cardiovascular disease after myocardial infarction.

A report from the Robin Wood Johnson Foundation and Athena Health finds that doctors have not seen an increase in new patient visits over the first five months of 2014, compared to the same period in 2013.

The Center for Health and Economy released its updated estimates of the ACA's cost to the federal budget, and insurance coverage.

Happening Today

We're monitoring the U.S. Court of Appeals for the D.C. Circuit for a decision on Halbig v. Sebelius, which could come any day now. The lawsuit challenges the legality of government subsidies for ACA plans on the federal marketplace, and if successful, could have a devastating effect on the health care law. The D.C. court has been known to release decisions on Tuesdays and Fridays between 10 and 11 a.m.

Senate Judiciary Committee hearing on the Women's Health Protection Act at 10 a.m.

Senate Finance Committee hearing on chronic illness and unmet patient needs at 10 a.m.

House E&C Committee markup of several health care bills at 10 a.m.

A coalition of 90 health organizations will release a report and hold a Hill briefing on the the consequences of Congress' cuts to public health funding at 12 PM.


Don't Miss Today's Top Stories

Health Care Edge is one of my top resources."

Meghan, Associate Specialist

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