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Health Care Edge

Strong Start For Medicaid's 'Private Option' - Health Care Edge

April 22, 2014

Strong Start For Medicaid's 'Private Option' 

By Sam Baker, Sophie Novack and Clara Ritger

ARKANSAS CLAIMS SUCCESS: Arkansas' privatized version of Obamacare's Medicaid expansion -- seen as a model for other red states -- seems to be working. Nearly 70 percent of eligible residents signed up for the program within the first six months, the state Department of Human Services said. That's a strong start for the program, which uses federal funding from the health care law's Medicaid expansion to move low-income residents into private insurance plans. It's widely seen as a model to bring other red states into the Medicaid expansion, and Arkansas still has all year to bring more people into the system.

 

Top Health Care News

ANTI-OBAMACARE AD LANDS AT THE SUPREME COURT: "The billboard never went up, and the candidate it would have attacked lost anyway. But the election-year spat has mushroomed into an argument about freedom of speech that could have serious long-term implications." (Sam Baker, National Journal)

  • The case also reopens the debate over whether the Affordable Care Act includes taxpayer funding for abortion. (Paige Winfield Cunningham, Politico)

WHY MANY DECLINED TO GET COVERED UNDER THE HEALTH LAW: "A common thread running through stories of the unenrolled is cost. Many people either do not qualify for federal subsidies or believe that the assistance is not enough to make insurance affordable, interviews with consumers and experts suggested. According to enrollment counselors in several states, people who have gone without health insurance or major illness for years can be especially resistant to investing in coverage. To be sure, some of those who chose not to sign up were motivated by ideological opposition to Mr. Obama, to the law's mandate that they buy insurance, or to both. And for many others, confusion and lack of understanding, including about whether they could get financial help buying coverage, were the overriding reasons." (Abby Goodnough, New York Times)

Medicare and Medicaid

UPHILL BATTLE AHEAD FOR MEDICARE'S ACCOUNTABLE CARE ORGANIZATIONS: A new study published in the Journal of the American Medical Association looks at the state of fragmented care prior to the ACO model and finds that one-third of Medicare beneficiaries were not assigned to the same ACO in 2010 as in 2011 and that much of the specialty care received was provided outside the ACO. Getting seniors to stick with the ACO providers may be tough in the years ahead, the researchers say. (J. Michael McWilliams, JAMA Internal Medicine)

FEMALE MEDICARE DOCTORS MAKE HALF OF WHAT MEN MAKE: Researchers crunched the Medicare payment data and found that the large pay gap is the result of male doctors treating more patients annually and male doctors dominating the high-paying surgical positions in the field. (NerdWallet)

MANY LEFT WAITING FOR MEDICAID COVERAGE TO BEGIN: "Nearly 2 million Californians have gained coverage with the expansion of the Medi-Cal program for poor and disabled people, including those who transitioned from temporary programs like Healthy Way LA. But roughly 800,000 more applications are pending from people presumed to be eligible for the program. While hospitals are required to accept patients with emergencies, private doctors, health clinics, pharmacies and specialists have discretion over whether to treat patients for non-urgent health needs while they await acceptance into the program." (Anna Gorman, Kaiser Health News/Orange County Register)

MAKING THE GOP PAY FOR MEDICAID OBSTRUCTION: Even wobbly red state Democrats see political gain in backing Medicaid expansion, and they're right. (Joan Walsh, Salon)

Implementation

ACA STILL HAS LONG WAY TO GO IN GOAL OF REDUCING UNINSURED: "Questions of affordability, eligibility, immigrant access and the response from employers and state legislatures — obstacles that existed before the Affordable Care Act took effect — mean considerable work lies ahead." (Judy Lin, Associated Press)

CMS SEARCHING FOR NEXT ACA VENDOR: "CMS is in the early stages of determining if a smaller vendor could take over HealthCare.gov when Accenture's one-year contract expires. The federal agency has released a "sources sought" notice soliciting information from small companies, defined as those with annual revenue under $25 million, that are capable of taking over the site. Responses are due May 2." (Virgil Dickson, Modern Healthcare)

NEW CVS SERVICE HELPS CUSTOMERS PAY INSURANCE PREMIUMS IN STORES: "Millions of Americans have enrolled in health insurance this year for the first time and we want to help with this transition by providing an easy way to pay their premiums in our stores," said Josh Flum, Senior Vice President of Retail Pharmacy at CVS Caremark in a statement. "Providing customers with this level of unprecedented access to manage their insurance premiums is part of our commitment to delivering innovative solutions to help people on their path to better health."

Drugs

NOVARTIS ANNOUNCES MULTI-BILLION DOLLAR DEALS WITH PHARMACEUTICAL COMPANIES: The company will acquire the oncology unit of GlaxoSmithKline for around $14.5 billion, sell its vaccines unit to Glaxo for $5.25 billion, and sell its animal health division to Eli Lilly and Company for about $5.4 billion. (Marta Falconi and Hester Plumridge, Wall Street Journal)

  • "Taken together, the deals will reduce Novartis' sales by about $4 billion, from $60 billion down to $56 billion, [Novartis CEO Joseph Jimenez] said, but the company's 'absolute profit goes up and that's partly because we're acquiring the oncology products and we are divesting products that have lower profit.'" (John Heilprin, Associated Press)

CANCER VACCINE WORKS WELL IN HIV PATIENTS: A new study found that vaccines against cervical cancer are effective in sexually active women with HIV, and that women who have one or two strains of the virus can still be protected against others. (Donald G. McNeil Jr., New York Times)

CDC DIRECTOR ON TOBACCO, ANTIBIOTICS, AND HEALTH: "Tobacco is really the number one enemy of health in this country and around the world," said Center for Disease Control director Tom Frieden, in an interview with Ezra Klein. (Ezra Klein, Vox Media)

NEW POLL FINDS SKEPTICISM OVER SCIENCE AND HEALTH ISSUES: According to a new Associated Press - GfK poll, 4 percent of Americans doubt smoking causes cancer, 6 percent are skeptical that mental illness is a medical condition affecting the brain, 8 percent question that cells contain a genetic code, and 15 percent doubt the efficacy and safety of vaccines for children. (Seth Borenstein and Jennifer Agiesta, Associated Press)

Providers

15-MINUTE DOCTOR VISITS TAKE A TOLL ON PATIENT-PHYSICIAN RELATIONSHIPS: As more patients start to use their newly purchased ACA health coverage, doctors' time is only expected to be stretched thinner. (Roni Caryn Rabin, PBS NewsHour)

Spending

SOME THOUGHTS (TWEETS) ON HEALTH CARE SPENDING: "Private health spending is driving the growth. Medicare (due to the ACA and insensitivity to the economy) is still growing slowly." (Larry Levitt, Kaiser Health News)

Happening Today

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

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.

SCOTUS HEARS OBAMACARE CASE: The Supreme Court will hear arguments in a First Amendment case that stems from an anti-Obamacare ad accusing then-Rep. Steve Driehaus of voting for taxpayer-funded abortion because he voted for the ACA. Ohio has a law that attempts to restrict false speech in campaign ads, which may be unconstitutional.

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