What’s New in Health Care Reform: Dec. 30


What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.

Obamacare Reporting Extension Issued for Employers

The Treasury Department gave employers an extension of critical reporting requirements, as it seeks to manage some of the most complicated parts of the federal health care law. Employers had previously faced deadlines in February and March to report 2015 health insurance information to their employees, and also to the IRS. If they need more time, employers can now have until March 31 to get information to their workers and until June 30 in certain cases to get details to the IRS. Via Chicago Business.

Most of Those Without Medicaid are the Working Poor

They toil in America’s fast-food restaurants, call centers and retail stores — yet as many as five million Americans remain not only poor but also uninsured, despite an array of state and federal policies specifically intended to help them get health care. These people are caught in a health care netherworld. Their employers classify them as part-time workers or independent contractors, therefore avoiding any obligation to provide health care. Their state governments have not expanded Medicaid to include low-wage earners. And government mandates set a standard for “affordable” coverage that is not affordable at all for these families. Via USA Today. 

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2015: A Banner Year for Health Care Mergers and Acquisitions

Health care topped the list for biggest deals in a record-breaking year for mergers and acquisitions. Pharmaceutical companies, device makers, and health insurers set a blistering pace throughout 2015, racking up mergers worth $687.5 billion, according to a recent tally by Dealogic, a financial information firm. Via Chicago Tribune.

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Are Democrats Crippling Obamacare?

Obamacare has survived a pair of Supreme Court battles and half a decade of Republican repeal efforts. But as the Obama administration enters its final year, the Affordable Care Act is facing formidable hurdles that are largely of Democrats' making. By voting to delay the so-called Cadillac tax as part of a year-end budget deal, Democrats knocked out an economic pillar critical to achieving one of its central goals — tamping down U.S. health care spending. Obama and the Democrats pursued that goal at great political cost. But if it falls by the wayside, Barack Obama may have his own party to blame for his diminished legacy. Via Politico.

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Obamacare Patients Spend 10% of Income Out of Pocket Despite Government Subsidies

Research from the Urban Institute shows typical single enrollees with incomes between $23,540 and $58,850 spend 10 percent of their incomes on premiums and out-of-pocket costs and the percentage rises if the enrollee has more medical needs. The Institute, which is funded by the Robert Wood Johnson Foundation, said the income figures are 200 and 500 percent of the federal poverty level, which is $11,770. Via Forbes.

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Medicare Payment Changes Lead More Men to Get Screening Colonoscopies

Men are getting more screening colonoscopies since the health law reduced how much Medicare beneficiaries pay out of pocket for the preventive tests, a recent study found. The change, however, didn’t affect women’s rates. Via Kaiser Health News.

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Veterans Still Suffering From Poor VA Care Despite Fixes Touted in Washington

The VA has struggled to meet unprecedented demand as new waves of veterans with complex needs return from the wars in Iraq and Afghanistan at the same time Vietnam veterans are aging and requiring more care. Its failures have played out in crisis after crisis in recent years, from the benefit-claims backlog that reached more than a half million applications in 2013 to the revelation last year that patient wait-time records were manipulated while veterans died waiting for care. Former VA secretary Eric Shinseki stepped down, President Obama installed a new secretary, and Congress passed legislation trying to fix the agency. But on the front lines, it can be hard to tell the difference. Via USA Today.

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New Health Programs for Elderly Poor Make Rocky Start

A federal experiment to curb health spending and improve care for disabled and elderly poor people is off to a rocky start, with enrollment falling short of expectations as patients prove reluctant to switch to the new programs. The struggles experienced by the pilot plans, which aim to streamline care for people who qualify for both Medicare and Medicaid, come despite a growing national urgency about caring for the aging impoverished. The push to simplify their coverage through the Affordable Care Act received rare bipartisan support. Via Wall Street Journal.

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HHS: 1 Million More Insurance Customers Under Age 35 this Year

Of the 6 million people that signed up for coverage on the federal exchanges before last week’s deadline for Jan. 1 coverage, 2.1 million were under the age of 35. And of the 2.4 million total people who purchased insurance for the first time before last week’s deadline for Jan. 1 coverage, about 980,000 were under 35. Via Morning Consult.

2 Million Current ACA Enrollees Ignore Advice to Return to HealthCare.Gov

More than 2 million existing customers with insurance under the Affordable Care Act have had coverage renewed automatically for 2016 by HealthCare.gov, after they ignored government warnings to shop around to avoid surprise spikes in prices of health plans. Via The Washington Post.

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Kelley Schreiber

Kelley Schreiber is a Marketing Channel Manager at Mayo Medical Laboratories. She is the principle editor and writer of Insights and leads social media and direct marketing strategy. Kelley has worked at Mayo Clinic since 2013. Outside of work, you can find Kelley running, traveling, playing with her new kitten, and exploring new foods.