US Medicaid official visits Portland for training on Obamacare insurance exchanges
Posted June 24, 2013, at 3:42 p.m.
PORTLAND, Maine — A federal health official visited Portland Monday as the Obama administration ramps up outreach efforts around Affordable Care Act provisions set to kick in later this year.
Raymond Hurd, regional administrator for the federal Centers for Medicare & Medicaid Services, led a training forum with area health care organizations at Maine Medical Center. The forum aimed to make Maine health care providers familiar with the insurance marketplaces central to the act, commonly known as Obamacare.
Hurd told the BDN Monday morning that many people are unaware that the Affordable Care Act is still on the books, after surviving Republican repeal threats and a challenge before the Supreme Court. Even fewer, he said, realize that open enrollment in the federally mandated exchange begins on Oct. 1 of this year.
At that point, Hurd said, Americans will be able to log onto HealthCare.gov and shop for federally approved health insurance plans through a single Internet portal. The website until then is setup to answer consumers’ questions about the coming changes.
The law’s so-called individual mandate requires everyone — at least those who don’t qualify for certain hardship exemptions — to get health insurance or risk being fined for noncompliance.
The law also aims to make health insurance more accessible by eliminating lifetime caps on payouts, preventing insurance firms from denying people coverage because of pre-existing conditions and limiting the criteria they can use to increase rates, Hurd said. By dramatically increasing the number of customers in the market, he said, the insurance industry’s cost burden will be spread out over a larger number of people and the prices lowered.
Republicans can help make health-insurance exchanges work
Posted June 23, 2013, at 12:13 p.m.
Three months from now, Americans will get their first look at whether Obamacare works. The answer will depend a lot on Republican governors and legislatures — and they should want the law’s exchanges to be successful as much as the president does.
The new state insurance exchanges are supposed to start selling health coverage Oct. 1. The idea behind these marketplaces is that allowing apple-to-apple comparisons between health plans will foster competition and lower prices. Most Republican governors and legislatures, however, have resisted running their own exchanges; 19 states have refused to play any role whatsoever.
Continued resistance could hamper an already fraught process. In a report this week, the Government Accountability Office warned that the federal government is behind schedule in building exchanges in states that have refused to do so. This makes it even more crucial that all states pitch in to help.
Why should Republican opponents of the exchanges change tack now? First, there are the crass politics: Many residents who stand to benefit are their constituents. Federal exchange subsidies are available for people earning between 138 percent and 400 percent of the poverty level, or $32,500 to $94,200 for a family of four. According to 2012 exit polls, 42 percent of people with family incomes between $30,000 and $50,000 voted for Mitt Romney; for those earning between $50,000 and $100,000, the share was 52 percent. If Republican governors think stonewalling exchanges hurts only Democrats, they’re wrong.
Then there are the economic reasons: States with weak exchanges could become less attractive to businesses. John Hickenlooper, the Democratic governor of Colorado, said this week that his state supports its insurance exchange in part to help small businesses, which want healthy and productive workers.
Finally, and most compellingly, there is the human reason — rather, 25 million human reasons. Well-run exchanges will make getting health insurance easier and more affordable. Even philosophical opponents of the Patient Protection and Affordable Care Act must cede this practical point. Obamacare also happens to be the law of the land.
Some Republican governors have already accepted a role in their exchanges. Iowa and Michigan are partnering with the federal government, while Idaho, Nevada and New Mexico agreed to build their own. It’s too late for other states to follow those courses, but there are still meaningful steps they could take.
One thing they can do is smooth the path for “navigators” — people or organizations that will help others shop for insurance on the exchanges. Florida requires navigators to register with the state, and Pennsylvania is considering a similar move. This should be fine as long as registration is quick and straightforward.
Health Exchange Outreach Targets Latinos
Andrea Velandia, 29, is just the sort of person the architects of the new health insurance marketplaces had in mind when they were thinking about future customers.
She's young, in good health, uninsured and Latino.
"We're very healthy. We don't have many issues," she says of her family. For the most part, she and her husband avoid the health system. "It's very expensive to go to the doctor to get a regular checkup," she says. "And you only have an option to go to the emergency room, which is even more expensive."
On Oct. 1, Velandia, who is from Colombia, will be able to sign up her family of four for a subsidized health insurance policy in the new Maryland Health Benefit Exchange, the state's online marketplace for insurance policies created under the Affordable Care Act.
And just as Latinos were crucial to President Obama's re-election in 2012, they are now key to the implementation of his health law.
In First, F.D.A. Rejects Tobacco Products
By SABRINA TAVERNISE
The Food and Drug Administration announced on Tuesday that for the first time it had begun exercising its power to regulate cigarettes and other tobacco products, an authority it was given under a 2009 law supported by President Obama.
Agency officials said they had authorized the sale of two new products — both of them Newport cigarettes made by the Lorillard Tobacco Company — and rejected four others. The law forbade them to name the rejected products, they said.
Before the law, cigarettes were manufactured without any federal regulation. Instead, states decided where and how tobacco products would be sold, but had no authority over the ingredients they contained. Now, the F.D.A. is deciding which new products can be sold. In addition to cigarettes, the agency’s authority covers loose rolling tobacco, chewing tobacco and snuff.
The agency can reject cigarettes and other tobacco products that its scientists believe pose public health risks above and beyond comparable products already on the market, a sharp departure from past practice, when tobacco companies could change existing products and introduce new ones at will.
Advocates said the F.D.A.’s use of this authority was a milestone.
“This is the first time in history that a federal agency has told tobacco companies that they could not market a new or modified cigarette because of the public health problems they pose,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, an advocacy group.
Dr. Margaret A. Hamburg, the F.D.A. commissioner, called the development “historic,” and said that the F.D.A. was the only agency in the world that possessed such powers. Under the law, the agency can also limit ingredients in tobacco products like nicotine. Federal officials say they are currently studying how to exercise this authority.
Our View: Maine kids' health shows value of MaineCare
Even poor children are in better health here thanks to the previous Medicaid expansion.
How we treat the most vulnerable members of our society says a lot about the kind of society we are.Nowhere is that more true than in regard to our treatment of children. How well are they being educated? How many of them are living in poverty? Are they healthy, and are they getting the care they need to stay healthy? Are they being raised in families, neighborhoods and communities that nurture them?
Maine ranked first among the states in terms of the health of its children, according to a private charity's recent report on the status of American children, even while the number of children living in poverty grew.
This speaks volumes to the critical importance of safety-net programs in tough times and to the foresight state lawmakers showed when they expanded eligibility for health insurance under MaineCare to include more low-income children and pregnant women, in one of a series of steps starting in 1999. These decisions have been the focus of much second-guessing over the past few months.
http://www.pressherald.com/opinion/maine-kids-health-shows-value-of-mainecare_2013-06-26.html
Bill Nemitz: LePage win on Medicaid could be short-lived
Posted:TodayUpdated: 6:46 AM
Maybe it's too soon, the temperature outside pushing 90 degrees and all, to talk about January.
Yet there House Speaker Mark Eves sat in the State House this week, doing just that.
"We're just not going to stop fighting to ensure 70,000 Mainers have health care," Eves said in a telephone interview Monday. "To that end, we're going to be bringing forward emergency legislation in January to accept these federal dollars."
(We now pause for the obligatory high-fives amongGov. Paul LePage and Republican lawmakers, who last week drove the final stake into Maine's plan to accept $350 million in federal Medicaid expansion funds over the next three years -- money that will now go to other states while those 70,000 needy Mainers limp along without health coverage.)
Much has been said in recent days about how leaders of the Legislature's Democratic majority a) blew this one, b) did everything humanly possible to get their Medicaid expansion proposal passed, or c) were doomed from the get-go in their effort to hitch Maine to the federal Affordable Care Act.
Should they have tied the Medicaid expansion, quid pro quo, to LePage's top priority of paying off Maine's $184 million debt to the state's hospitals?
And once they linked Medicaid and the hospitals, should the Dems have doubled down on their promise, "No Medicaid expansion, no hospital payment?"
And what about when LePage swatted that threat away by vetoing the whole deal and corralling just enough Republican lawmakers to thwart an override? Were the Dems nuts to split the two issues and watch helplessly as the hospital payment sailed to easy passage while the Medicaid bill, torched by a second LePage veto, went down in partisan flames?
http://www.pressherald.com/politics/lepage-win-on-medicaid-could-be-short-lived_2013-06-26.html
Report says poor Maine kids aren’t getting dental care, but dentists disagree
Posted June 25, 2013, at 5:13 p.m.
AUGUSTA, Maine — Maine is one of 10 states where low-income children are least likely to receive dental care, according to a national report released Tuesday that stands to reignite a months-long legislative debate that has pitted dentists against those who support allowing a new type of dental provider in the state.
The report by the Washington, D.C.-based Pew Charitable Trusts also ranks Maine second for the percentage of its dentists nearing retirement age (48.4 percent are older than 55) and in the top 12 for the share of its population living in certified dentist shortage areas (15.8 percent).
The report’s recommended solution is introducing a new type of dental provider, a dental hygiene therapist, who would perform some procedures, such as extractions and fillings, that are currently performed only by dentists.
The report comes days after the Maine Senate rejected heavily lobbied and hotly debated legislation that would have allowed dental hygiene therapists to open up shop in Maine.
The Pew Charitable Trusts was the main force behind the legislation in the Maine State House, registering 13 lobbyists who focused on the dental therapist bill, according to Maine Ethics Commission records. And Pew Charitable Trusts plans to continue pressing future Legislatures to allow dental hygiene therapists in Maine even after the Senate’s rejection of the measure last week, said Mike Saxl, managing principal for the firm Maine Street Solutions, which lobbied lawmakers on Pew’s behalf.
“There’s a huge opportunity here to have a positive impact on kids’ health,” he said. “When Maine is leading the country in the number of kids who don’t have access to care and the number of dentists reaching retirement age, it seems like a no-brainer to pursue strategies to help people get access to care.”
The Maine Dental Association, which has eight registered lobbyists, pushed hard against the dental therapist measure. Jonathan Shenkin, a pediatric dentist in Augusta and a Maine Dental Association member, called Tuesday’s report “substandard” and said it continued a campaign of misinformation Pew Charitable Trusts has used to push the dental therapist bill.
“It’s ineffective at helping policymakers navigate the complicated oral health policy arena,” Shenkin said. “If it does anything, it confuses people more about what’s best to do.”
The Pew report, citing federal government data, ranks Maine sixth in the nation for the percentage of children enrolled in Medicaid — 62.4 percent — who didn’t receive dental care in 2011.
But the Maine Dental Association points to a report from the Medicaid-CHIP State Dental Association that found Maine was one of four states that didn’t include patient visits to about 30 federally qualified dental clinics located across the state in the statistics it reported to the federal government. According to the dental association, those clinics had about 90,000 patient visits in 2011, including visits from thousands of children enrolled in Medicaid.
Vatican signs off on Mercy-EMHS merger
Posted June 25, 2013, at 10:23 a.m.
PORTLAND, Maine — Mercy Health System, which operates the city’s second-largest hospital, has taken another step toward merging with Bangor-based Eastern Maine Healthcare Systems.
The hospitals are on track to complete the deal in September, Mercy President and CEO Eileen Skinner said Monday.
Mercy received approval from the Vatican last week to transfer assets to EMHS, Skinner said. The approval was necessary because Mercy is affiliated with the Roman Catholic Church.
Mercy signed a letter of intent to negotiate its sale to EMHS on Dec. 7, 2012, after previous negotiations fell through with Steward Health Care System, a for-profit Massachusetts hospital chain.
Since then, the proposed sale has made rapid progress.
After inking a “definitive affiliation agreement” in January, Mercy and EMHS received antitrust clearance from the Federal Trade Commission in March. On May 7, the state Department of Health and Human Services held a public hearing on the two hospital networks’ application for a certificate of need to complete the merger.
” That hearing was a love fest,” Skinner said, noting that physicians, patients, and other community members spoke in favor of the merger, while no one expressed opposition.
The certificate of need application is now under review by the state. A decision is expected by September, and if the certificate is granted, it would be the last step before the transaction is completed.
Joining EMHS would represent a major change for Mercy, which was founded in 1918 as Queen’s Hospital and later changed its name after the Sisters of Mercy, a Catholic order of nuns, took over operations. Today, Mercy operates 230 hospital beds at its State Street and Fore Street campuses, as well as primary care clinics and urgent care centers.
Unlike Mercy, EMHS has no religious affiliation, although both networks are nonprofit organizations. EMHS comprises seven member hospitals in central and northern Maine, including its flagship 350-bed facility in Bangor, Eastern Maine Medical Center. The network also includes physician practices, nursing homes and home health organizations.
While the differences in geography and affiliation might make the merger seem an odd pairing, Skinner said the potential partners complement each other.
“The cultural fit is strikingly positive,” she said. “The way [EMHS] approaches goals is almost identical. Working with [EMHS] is almost like working with ourselves.”
According to Skinner, the driving force behind the merger is the federal Affordable Care Act — also known as “Obamacare” — and its creation of “accountable care organizations,” which are health-care networks that are paid on the basis of quality measurements and cost efficiency. The change is putting new economic pressures on hospitals, many of which are teaming up in response.
“This is about population health, and you have to get scale,” she said. “This is not about moving Mercy patients up to Eastern Maine Medical Center.”
Republicans should back a single-payer health care system
By Jack Bernard
The Augusta (Ga.) Chronicle, June 23, 2013
My party, the Republican Party, has staked out amazingly naïve positions on two of the key domestic issues facing us: immigration and health reform. These issues are intertwined.
Health Affairs, one of the most influential professional health care journals, has published a new Medicare study, conducted by Harvard and City University of New York researchers. It found that immigrants were responsible for 8 percent of Medicare expenditures – no surprise there.
What was astounding to me and many others was that nearly 15 percent of Medicare trust fund collections came from this same group of people. In other words, immigrants put in nearly twice the amount of money that was paid out to them.
In 2009 alone, the net gain to Medicare from immigrants was $13.8 billion, whereas native-born Americans had a deficit of $30.9 billion. Much of this difference can be accounted for because of low birth rates and the aging of our U.S.-born population, while immigrants are a much younger cohort. Further, immigrants cost Medicare less on health care because of a variety of reasons.
The bottom line: We need immigration to balance the books for Medicare, as is also true with Social Security. Without it, we will either have to cut benefits or dramatically raise taxes on a proportionally smaller and smaller work force.
So, at least for these programs, the fiscal side is clear. Immigration is a net plus.
What about the political side?
Many GOP strategists finally are seeing what I have said all along: In 2012, the party shot itself in both feet regarding immigration. Pandering in primaries may win you the nomination, but advocating for ridiculously impractical positions will not win the presidency. In any case, the deportation of 11 million people is something that will never happen, no matter who is president.
By opposing true immigration reform, including a path to citizenship, the uncompromising right wing of the GOP has accomplished two things. Both are long-term negatives for the party.
First, these “nativists” alienated legal immigrants and their families for generations to come. Hispanic voters are being driven to the Democrats, which will cause increased losses in key swing states, such as Texas and Georgia, over time.
Second, as U.S. Sen. Marco Rubio of Florida has correctly stated, by blocking congressional action the right-wingers are in effect continuing unrestrained immigration. Since there has been no national progress on immigration reform, including border security, the illegal problem just gets worse and worse.
Similarly, Republicans have staked out a losing long-term health care position: Just repeal the Affordable Care Act (Obamacare) and simply let competition reign. But voters are skeptical of the same old worn-out GOP slogans: Medicaid block grants, Medicare vouchers and weakened regulations.
None of these measures will significantly stop rapidly escalating systemic health care costs or control premiums. Most simply shift risk and/or expenses to the patient or the states – something voters do not like.
http://www.pnhp.org/print/news/2013/june/republicans-should-back-a-single-payer-health-care-system
The Augusta (Ga.) Chronicle, June 23, 2013
My party, the Republican Party, has staked out amazingly naïve positions on two of the key domestic issues facing us: immigration and health reform. These issues are intertwined.
Health Affairs, one of the most influential professional health care journals, has published a new Medicare study, conducted by Harvard and City University of New York researchers. It found that immigrants were responsible for 8 percent of Medicare expenditures – no surprise there.
What was astounding to me and many others was that nearly 15 percent of Medicare trust fund collections came from this same group of people. In other words, immigrants put in nearly twice the amount of money that was paid out to them.
In 2009 alone, the net gain to Medicare from immigrants was $13.8 billion, whereas native-born Americans had a deficit of $30.9 billion. Much of this difference can be accounted for because of low birth rates and the aging of our U.S.-born population, while immigrants are a much younger cohort. Further, immigrants cost Medicare less on health care because of a variety of reasons.
The bottom line: We need immigration to balance the books for Medicare, as is also true with Social Security. Without it, we will either have to cut benefits or dramatically raise taxes on a proportionally smaller and smaller work force.
So, at least for these programs, the fiscal side is clear. Immigration is a net plus.
What about the political side?
Many GOP strategists finally are seeing what I have said all along: In 2012, the party shot itself in both feet regarding immigration. Pandering in primaries may win you the nomination, but advocating for ridiculously impractical positions will not win the presidency. In any case, the deportation of 11 million people is something that will never happen, no matter who is president.
By opposing true immigration reform, including a path to citizenship, the uncompromising right wing of the GOP has accomplished two things. Both are long-term negatives for the party.
First, these “nativists” alienated legal immigrants and their families for generations to come. Hispanic voters are being driven to the Democrats, which will cause increased losses in key swing states, such as Texas and Georgia, over time.
Second, as U.S. Sen. Marco Rubio of Florida has correctly stated, by blocking congressional action the right-wingers are in effect continuing unrestrained immigration. Since there has been no national progress on immigration reform, including border security, the illegal problem just gets worse and worse.
Similarly, Republicans have staked out a losing long-term health care position: Just repeal the Affordable Care Act (Obamacare) and simply let competition reign. But voters are skeptical of the same old worn-out GOP slogans: Medicaid block grants, Medicare vouchers and weakened regulations.
None of these measures will significantly stop rapidly escalating systemic health care costs or control premiums. Most simply shift risk and/or expenses to the patient or the states – something voters do not like.
http://www.pnhp.org/print/news/2013/june/republicans-should-back-a-single-payer-health-care-system
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