Fit to Print. News update 2/5/2016

EHCI News

Leading the News

HHS: 12.7M Enrolled In 2016 Coverage During ACA’s Third Sign-Up Period.

Numerous national and local outlets covered the release of new enrollment figures from HHS for the ACA’s third open enrollment period. The final tally of 12.7 million sign-ups beat officials’ expectations and is seen as a modest success for the Obama Administration.

The New York Times  (2/4, A17, Pear, Subscription Publication) reports that about 12.7 million Americans enrolled in coverage under the Affordable Care Act or had their plans automatically renewed during the law’s third annual sign-up period, the Obama Administration announced on Thursday. HHS Secretary Sylvia Burwell said, “Open enrollment for 2016 is over, and we are happy to report it was a success.” The Times adds that enrollment is expected to decline during the year “as some people fail to pay their share of premiums, and some qualify for Medicaid or employer-sponsored insurance, or drop their marketplace coverage for other reasons.”

The Washington Post  (2/4, Goldstein) reports that 9.6 million consumers selected plans on HealthCare.gov, while another 3.1 million people chose coverage in states that run their own marketplaces. According to the Post, the numbers represent “a modest gain of about 1 million customers for 2016.” Burwell told reporters, “The totals exceed our expectations.”

The Wall Street Journal  (2/4, Radnofsky, Subscription Publication) reports that federal officials were especially encouraged by the 4 million first-time users of HealthCare.gov, suggesting the Administration did better than expected at enrolling the uninsured. “We knocked the lights out this year,” said Kevin Counihan, CEO of the federal exchange.

According to USA Today  (2/4, O'Donnell), the enrollment numbers reported Thursday “place the administration on track to meet Burwell’s estimate of 10 million people with ACA plans at the end of this year.” The article adds that Burwell said 2.7 million of the newly insured were 18 to 34.

The AP  (2/4, Alonso-Zaldivar) says the enrollment figures are “solid,” while adding that “expectations were low at the start of open enrollment on Nov. 1.” Larry Levitt of the Kaiser Family Foundation said, “It’s not the unequivocal success that Obamacare advocates had hoped for, but also not the disaster that critics thought could make it a talking point on the campaign trail.”

The Washington Times  (2/4, Howell) reports that the Obama Administration this year “focused its efforts on cities with high concentrations of uninsured residents.” Counihan “singled out Las Vegas, Yuma, Arizona, and several towns in Texas as places where enrollment grew rapidly.”

Bloomberg Politics  (2/4, Tracer) reports that the new HHS figures include sign-up data through Feb. 1. Some states with their own exchanges “extended their deadlines beyond the end of January, meaning the numbers could still increase.”

Also covering the new enrollment figures are the Huffington Post  (2/4, Young), CNBC  (2/4), CNN Money  (2/4), Forbes  (2/4), The Hill  (2/5, Sullivan), the Arizona Republic  (2/4, Alltucker), the Augusta (GA) Chronicle  (2/4), the Baton Rouge (LA) Advocate  (2/4), the Business Journals  (2/4, Hoover), the Chicago Tribune  (2/4, Shropshire), the Denver Post  (2/3, Olinger), the Fort Myers (FL) News-Press  (2/4), the Los Angeles Daily News  (2/4), the Milwaukee Business Journal  (2/4, Kirchen, Subscription Publication), the Milwaukee Journal Sentinel  (2/5, Boulton), the Naples (FL) Daily News  (2/4), the Newark (NJ) Star-Ledger  (2/4), the Oklahoman  (2/5), the Orange County (CA) Register  (2/4), the Oregonian  (2/5), the Pittsburgh Tribune-Review  (2/5), the Portland (ME) Press Herald  (2/4), the San Diego Union-Tribune  (2/4), the Tennessean  (2/4, Fletcher), the Washington Examiner  (2/4), Kaiser Health News  (2/4, Galewitz), and Modern Healthcare  (2/4, Herman, Subscription Publication).

Legislation and Policy

Employers, Insurers Not Satisfied By Obama’s Proposed “Cadillac Tax” Change.

Bloomberg Politics  (2/4, Keane, Tracer) reports that President Obama’s plan to “dial back” the Cadillac tax “won him no applause from employers, labor unions or health insurers.” The American Benefits Council insisted the tax “cannot be fixed,” while the American Federation of State, County & Municipal Employees “said it still supports ‘nothing less than full repeal’ of the tax.” Bloomberg adds that the President’s proposal “would reflect regional differences in the cost of practicing medicine, reducing the tax’s bite where care is particularly expensive, Jason Furman, the White House Council of Economic Advisers chairman, wrote in the New England Journal of Medicine on Wednesday.”

The Hill  (2/4, Ferris) reports Furman stated, “This policy prevents the tax from creating unintended burdens for firms located in areas where health care is particularly expensive, while ensuring that the policy remains targeted at overly generous plans over the long term if health costs rise faster than the tax thresholds.”

Modern Healthcare  (2/5, Subscription Publication) also reports the story.

Health Insurers Move To Limit ACA Special Enrollments.

Kaiser Health News  (2/4, Hancock) reports that big health insurers, “stung by losses under the federal health law,” are looking to “sharply limit” how policies are sold to individuals. Anthem, Aetna, and Cigna recently announced they will stop paying sales commissions to brokers for signing up most customers who qualify for new coverage outside the standard enrollment period. Last year, “these ‘special enrollment’ clients were much more expensive than expected because lax enforcement allowed many who didn’t qualify to sign up, insurers said.”

Obama Administration Nears Goal On Tying Medicare Payments To Value.

The Hill  (2/4, Ferris) reports that the Obama Administration “is nearing the finish line on its ambitious push to change the way Medicare providers are paid, focusing federal dollars on value rather than volume.” HHS Secretary Sylvia Burwell announced last year that 30 percent of all Medicare payments would be tied to value by the end of 2016. Dr. Patrick Conway, chief medical officer for the Centers for Medicare and Medicaid Services, said Tuesday, “We think we’ll reach that goal.” According to The Hill, “That 30 percent commitment marks the most dramatic shift in Medicare payments in the program’s 50-year history.”

Public Health and Private Healthcare Systems

Judge Hears Arguments In Alaska Medicaid Expansion Case.

The AP  (2/4, Bohrer) reports that Superior Court Judge Frank Pfiffner in Anchorage “heard arguments Thursday in a lawsuit challenging Alaska Gov. Bill Walker’s [I] authority to expand Medicaid without legislative approval.” The case was brought by the Republican-led Legislative Council, which argues it was unlawful for Walker to unilaterally expand the program. Judge Pfiffner “said it was unlikely that he could issue a decision before the end of March.”

The Juneau (AK) Empire  (2/4) reports that the lawsuit “argues the expansion population is an optional group that cannot be covered unless approved by the Legislature.”

The Alaska Dispatch News  (2/4) and Alaska Public Radio Network  (2/4) also cover the story.

Also in the News

Companies Enter Data-Sharing Alliance To Keep Down Costs Of Employee Healthcare Benefits.

In a 1,000-word article on the front of its Business & Tech section, the Wall Street Journal  (2/5, B1, Radnofsky, Subscription Publication) reports that 20 companies have entered into a data-sharing alliance called the Health Transformation Alliance in an effort to keep down costs of employee healthcare benefits.

CMS Defends Biosimilar Reimbursement Policy.

Congressional Quarterly  (2/4, Young, Subscription Publication) reports that Center for Medicare and Medicaid Services director Sean Cavanaugh “stuck with the agency’s view that future copycat versions of biotech drugs should deliver the same benefits as the original products, and thus the follow-on medicines in this class can be lumped in a group for the purpose of reimbursement.” Although “lawmakers in both parties clearly remained skeptical of the approach,” Cavanaugh, who testified before the House Energy and Commerce health subcommittee, said, “They are going to compete against the reference product and each other.” Janet Woodcock, the director of the Food and Drug Administration’s Center for Drug Evaluation and Research, said the agency was “not going to approve biosimilar drugs that we don’t think have the same performance as the innovator.”

Congressional Hearing On Drug Prices Prompts Outrage, But Offers Few Solutions.

Major television and newspaper sources provided extensive coverage of the House Committee on Oversight and Government Reform hearing on prescription drug prices. The CBS Evening News (2/4, story 7, 1:20, Pelley) reported that among the witnesses present was former Turing Pharmaceuticals CEO Martin Shkreli, who has become known by some as a “poster boy for price gouging.”

According to ABC World News (2/4, story 8, 1:20, Bruce), Shkreli “arrived on Capitol Hill armed with his silence,” which NBC Nightly News (2/4, story 5, 1:50, Thompson) said “provoked a lot of anger on Capitol Hill.”

On the front of its Business Day section, the New York Times  (2/4, B1, Pollack, Huetteman, Subscription Publication) reports that Shkreli “repeatedly exercised his Fifth Amendment right to avoid self-incrimination” throughout the hearing, which focused on decisions by Turing and Valeant Pharmaceuticals International to drastically increase the prices of certain drugs the companies had acquired. According to the Times, the “particular price increases” focused on at the hearing “account for little in terms of overall drug spending compared with smaller but still substantial increases made by other companies.” The Times adds that “little of substance was discussed on what to do about the increases,” with lawmakers instead taking turns “berating Mr. Shkreli, Turing and Valeant.” Valeant interim CEO Howard Schiller, also present at the hearing, indicated that his company recognized it had been too aggressive in increasing drug prices, saying, “Where we’ve made mistakes, we’re listening and we’re changing.”

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