Short Cuts

Health and Human Services Secretary Sylvia M. Burwell announced today $169 million in Affordable Care Act funding to 266 new health center sites in 46 states, the District of Columbia and Puerto Rico for the delivery of comprehensive primary health care services in communities that need them most. These new health center sites are projected to increase access to health care services for over 1.2 million patients. These awards build on the $101 million awarded to 164 new health center sites in May 2015.

The Alabama House of Representatives on Wednesday narrowly approved a deep cut to the state's Medicaid program as lawmakers continue to deadlock on a solution to the budget shortfall.

The budget cut came out of frustration over the stalemate and is largely seen as a way to build pressure on lawmakers to find some sort of compromise. But opponents called it a dangerous gamble with the health care of the state's most vulnerable people.

Rebecca Santiago clutched a stack of papers about Obamacare and chatted up strangers at the health fair, set up on a Hartford street within view of two homeless shelters. She wanted to know if they had health insurance and, perhaps more importantly, if they’d used it.

One was Darin Zollarcoffer, 48. He had coverage, but no primary care doctor.

“Why not?” Santiago asked.

Now that the Supreme Court has rendered its decision in King v. Burwell on federal subsidies under the Affordable Care Act (ACA) and Open Enrollment is approaching, there is no better time to reflect on the important mission of access to affordable and quality health coverage for the residents of all states. Health insurance is complex; it engages a range of stakeholders from state agencies and insurance carriers to brokers and solution providers, it requires eligibility determination, various payment models, and a myriad of funding mechanisms, to name a few.

Senate Republican leaders this week narrowly averted an intra-party battle over ObamaCare by again promising to get a repeal bill to the president’s desk through budget reconciliation.

MAYAGÜEZ, P.R. — The first visible sign that the health care system in Puerto Rico was seriously in trouble was when a steady stream of doctors — more than 3,000 in five years — began to leave the island for more lucrative, less stressful jobs on the mainland.

Now, as Puerto Rico faces another hefty cut to a popular Medicareprogram and grapples with an alarming shortage of Medicaid funds, its health care system is headed for an all-out crisis, which could further undermine the island’s gutted economy.

Now that Congress and the courts have failed to overhaul Obamacare, states are eyeing the only current remaining opportunity to modify the healthcare law — this time from the inside out.

In addition to the normal off-season "Qualifying Life Events" which allow roughly 7,500 people to select a private policy nationally every day, it looks like up to 100K additional people might be added to either the QHP or Medicaid tally over the next month or so:

CMS will offer a special enrollment period to thousands of enrollees who were incorrectly told that they qualified for fewer subsidies than they should have received or none at all, due to a Social Security-related glitch in the eligibility system that inflated household income.

...Tricia Brooks, a senior fellow at Georgetown University's Center for Children and Families who frequently writes on the issue, estimates that the glitch affects around 40,000 households.

A judge has blasted a California software giant's claim that a cabal of campaign advisers are to blame for the decision to tank the state's $300 million Cover Oregon website project.

Oracle in February sued five campaign advisers and consultants to former Gov. John Kitzhaber, who resigned in February. Oracle argued the exchange was ready to roll out in February 2014, but said advisers led by Patricia McCaig pulled the plug on the project for political reasons.

On Monday, Multnomah Circuit Court Judge Henry Kantor issued a written opinion ripping Oracle's legal arguments using language that went far beyond his earlier e-mailed notice of the decision. He called Oracle's arguments "totally unsupported by the evidence provided."

Remember that University of Michigan study I posted about last week which claimed that in spite of all the predictions by ACA opponents that expanding Medicaid would make it impossible for enrollees to actually make a doctor's appointment, the opposite ended up being the case?

A new University of Michigan study shows that the availability of primary care appointments actually improved for people with Medicaid in the first months after the state launched the Healthy Michigan Plan, the state’s Medicaid expansion under the ACA. What’s more, it remained mostly unchanged for those with private insurance.

Well, apparently the Michigan results are not an outlier:

Obamacare enrollees on average have one-third fewer choices when it comes to picking doctors and hospitals than those on regular commercial plans, a new study says.

But its authors claim that’s not necessarily a bad thing. And others in the health-care arena believe the findings are misleading and don’t tell the whole story.

The study from Washington, D.C.-based Avalere Health finds that those under Affordable Care Act plans have roughly 66% of the choices compared with those in commercial plans, and the number of options may vary depending on the type of physician needed.

Under Obamacare, enrollees have access to roughly 58% of the oncologists and cardiologists that commercial plan members have. The average goes up when it comes to hospitals, as those using the public exchanges have access to 76% of those care facilities.

Things weren't looking great eight months ago for Dr. Peter Beilenson and Evergreen Health Co-op, the insurance company he created from scratch.

The brand-new insurance company had been counting on Maryland's health exchange to bring in its first members. But the online marketplace was a nightmare for people trying to sign up. With higher prices and less name recognition than competitors like CareFirst BlueCross BlueShield, Evergreen ended the exchange's open enrollment period with just 400 members.

...Fast-forward to today and business is looking up for Evergreen. The companyshifted focus to small business groupsonce it realized it couldn't rely on the exchange alone. Evergreen lowered its premium prices for 2015 individual plans and is locking in the rates on both its individual and small group plans for two years. About 800 people have signed up for Evergreen health plans through the exchange since it opened in mid-November.