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Saturday, October 5, 2013

Health Care Reform Articles - October 5, 2013


Pent-Up Demand for Health Insurance

By 
There were plenty of computer glitches when millions of Americans went online to check out their options for affordable insurance policies on the new health care exchanges that opened for business this week. It was frustrating, but it was also an indication of overwhelming interest that exceeded all predictions.
In the first three days, there were 8.6 million unique visitors to the federal government Web site for health care exchanges, far more than had ever signed on at one time to a popular Web site serving Medicare patients. In New York, the state-run exchange had an astonishing 30 million visits in the first two days, although a large share almost surely consisted of repeat visits by people who were blocked by balky computer systems.
Earlier surveys had shown that most Americans were unaware that the exchanges would open on Oct. 1 and ignorant of what the health care reform law could provide for them. Many thought it was still just a proposal, not a law. (Congressional Republicans who have shut down the government over their demands to defund and weaken health care reform may have inadvertently fanned interest in exchanges by putting them in the news.)
Neither federal nor state officials were willing to say how many people actually enrolled in a health plan the first week, but the numbers are surely low. People need time to ponder their choices, and the computer problems haven’t made it easy. But the start-up problems are sure to be smoothed out as enrollment for coverage in 2014 goes on for the next six months. As federal officials stress, this is not a sprint but a marathon.
The administration’s goal is to enroll some seven million uninsured Americans in health plans on the exchanges in 2014. They hope that 2.8 million will be young people between the ages of 18 and 34, whose participation is needed to help subsidize coverage for older and sicker people. Administration officials estimate that with about 14 million uninsured people in this age group, the plans will need to enroll one in five of them, a goal that should be reachable with an aggressive recruiting effort.
Polls show that most uninsured adults want health insurance and plan to get it; many will do so because the law requires them to obtain coverage or pay a penalty. The penalty an uninsured adult will have to pay is relatively low for 2014, only $95, but it rises to $325 for 2015 and to $695 for 2016.


A Population Betrayed


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It is outrageous that millions of the poorest people in the country will be denied health insurance because of decisions made mostly by Republican governors and legislators. These people will neither qualify for their state’s Medicaid program for the poor nor for subsidized coverage on new insurance exchanges that are being established in every state by the health care reform law.
Their plight is a result of the Supreme Court’s decision last year that struck down the reform law’s mandatory expansion of Medicaid and made expansion optional. Every state in the Deep South except Arkansas has rejected expansion, as have Republican-led states elsewhere. These 26 states would rather turn down incredibly generous federal funds that would finance 100 percent of the expansion costs for three years and at least 90 percent thereafter than offer a helping hand to their most vulnerable residents.
As Sabrina Tavernise and Robert Gebeloff reported in The Times on Thursday, two-thirds of the country’s poor, uninsured blacks and single mothers and more than half of the uninsured low-wage workers live in those states. The reform law originally sought to help poor and middle-income people through two parallel mechanisms. One was a mandatory expansion of Medicaid (which in most states cover primarily children and their parents with incomes well below the poverty level) to cover childless adults and to help people with income levels above the poverty line. Those with slightly higher incomes would be eligible for federal subsidies to buy private policies on the new insurance exchanges.
That approach fell apart when 26 states decided not to expand Medicaid, at least for now. There is no provision in the law to provide health insurance subsidies for anyone below the poverty line because those people are supposed to be covered by Medicaid.
The Times report, based on an analysis of census data, found that eight million Americans who are impoverished and uninsured will be ineligible for help of either kind. To add to the insanity, people whose incomes initially qualify them for subsidies on the exchanges could — if their income fell because they lost a job — end up with no coverage at all.
There are no easy solutions to the difficulties wrought by the Supreme Court decision and the callousness of state officials who seized on that opening to victimize the poor.

Reform Turns Real


By 


At this point, the crisis in American governance has taken on a life of its own. Some Republicans are now saying openly that they want concessions in return for reopening the government and avoiding default, not because they have any specific policy goals in mind, but simply because they don’t want to feel “disrespected.” And no endgame is in sight.
But this confrontation did start with a real issue: Republican efforts to stop Obamacare from going into effect. It’s long been clear that the great fear of the Republican Party was not that health reform would fail, but that it would succeed. And developments since Tuesday, when the exchanges on which individuals will buy health insurance opened for business, strongly suggest that their worst fears will indeed be realized: This thing is going to work.
Wait a minute, some readers are saying. Haven’t many stories so far been of computer glitches, of people confronting screens telling them that servers are busy and that they should try again later? Indeed, they have. But everyone knowledgeable about the process always expected some teething problems, and the nature of this week’s problems has actually been hugely encouraging for supporters of the program.
First, let me say a word about the underlying irrelevance of start-up troubles for new government programs.
Political reporting in America, especially but not only on TV, tends to be focused on the play-by-play. Who won today’s news cycle? And, to be fair, this sort of thing may matter during the final days of an election.
But Obamacare isn’t up for a popular referendum, or a revote of any kind. It’s the law, and it’s going into effect. Its future will depend on how it works over the next few years, not the next few weeks.

Wrong Side of History

By TIMOTHY EGAN
Sarah Palin finally got her death panels — a direct blow from the Republican House. In shutting down the government, leaving 800,000 people without a paycheck and draining the economy of $300 million a day, the Party of Madness also took away last-chance cancer trials for children at the National Institutes of Health.
And now that the pain that was dismissed as a trifle on Monday, a “slimdown” according to the chuckleheads at Fox News, is revealed as tragic by mid-week, the very radicals who caused the havoc are trying to say it’s not their fault.
It’s too late. They flunked hostage-taking. About 30 or so Republicans in the House, bunkered in gerrymandered districts while breathing the oxygen of delusion, are now part of a cast of miscreants who have stood firmly on the wrong side of history. The headline, today and 50 years from now, will be the same: Republicans closed the government to keep millions of their fellow Americans from getting affordable health care.
They are not righteous rebels or principled provocateurs. They are not constitutionalists, using the ruling framework built by the founders. Just the opposite: they are a militant fringe of one party in one house of Congress in one branch of government trying to nullify an established law by extortion. This is not the design of the Constitution.

Nor are they Martin Luther King Jr., or Rosa Parks or Winston Churchill — preposterous comparisons made on the floor of Congress by those whose only real fight is with progress.
In truth, they are the Know-Nothings from the 1850s who fought Irish Catholics and other castoffs from distant lands, vowing to keep them from becoming citizens. Their incarnation today is the Tea Party Republicans who call Latinos drug mules and would rather strangle the federal government than take up immigration reform.
They are the opponents of Social Security in 1935 and Medicare in 1965, labeling what are now the two most popular government programs as socialism that would destroy the country. They are the foes of science and modernism, denying evolution, climate change and, on election nights, math.
Over the years, whether Democrat, Republican, Whig or Dixiecrat, the members of this club have one thing in common: they are left at the train station of destiny, and never realize it until it’s too late.
So of course they have no exit strategy. “We have to get something out of this,” said Representative Martin Stutzman, Republican of Indiana. “And I don’t know what that even is.” Truer words have not been spoken by any member of the Crazy Caucus since they took the House in 2010.
You have to step back from the breathless tick-tock of the 24-hour news cycle to put this grim chapter in larger perspective. “Can you remember a time in your lifetime when a major political party was just sitting around, begging for America to fail?” So asked a perplexed Bill Clinton a few days ago.
The answer is no. What kind of failure are we talking about? Not just to equity markets, jobs, the mechanics of daily life in the world’s biggest economy. The shutdown stops research on Alzheimer’s disease, Parkinson’s, cancer treatments. Two-thirds of the employees at the Centers for Disease Control were sent home. Many food inspectors, people who train air traffic controllers, anti-terrorism experts — all furloughed. And shed a tear for Yosemite National 


Congressional pay, health care benefits under scrutiny

WASHINGTON — Paychecks for lawmakers, which continue to flow amid the government shutdown, have been the subject of political criticism and mockery all week. Congressional health plans are being cast as “gold-plated” benefits, a symbol of everything wrong with “Obamacare.”

Massachusetts lawmakers, like their colleagues from around the country, are caught up in the controversy over their own compensation during the government closure, which has resulted in furloughs, without pay, for 800,000 federal employees.
The circumstances are especially awkward, since the widespread hardship is the direct result of political failures by officials who are still receiving a salary.
Sensitive to appearances, four of the 10-member, all-Democrat Massachusetts House and Senate delegation said they are either donating their congressional salaries earned during the shutdown or refusing their paychecks. Members make $174,000 a year, or $3,346 a week, before taxes.

David Koch funds day care at MIT

By Carolyn Y. Johnson

 |  GLOBE STAFF
  OCTOBER 04, 2013
CAMBRIDGE — Two and a half years ago, biology researchers at MIT were discussing their work with an outside advisory committee. What could help you in your job, they were asked. One simple answer came from the women in the room: child care.
David H. Koch, a billionaire philanthropist and MIT graduate known as much for his conservative activism as for his generosity, had attended dozens of these meetings, but had never been so moved. “I got a tear in my eye,” he said.
Koch, who had already given the Massachusetts Institute of Technology about $150 million for research and faculty positions, decided to spend $20 million more on day care.
On Friday, the David H. Koch Childcare Center will be dedicated, in a celebration that highlights a major and ongoing shift in universities’ thinking about recruiting and retaining people who do world-class research. The best professors, scientists, and researchers are not just minds, universities have increasingly acknowledged; they have families, too.
The new center will serve 126 infants, toddlers, and preschoolers. It nearly doubles MIT’s day-care slots on campus.


For Med Students, Love From the Drug Rep

By PAULINE W. CHEN, M.D.
In the social and culinary wasteland that was residency training, it had been easy for Cheryl, a bubbly brunette in her mid-30s, to become our den mother. She never tired of listening to our grousing, had unerring taste in take-out, made it a point to come to our parties when invited and every so often brought in a plate of her homemade brownies.
But Cheryl was no den mother. She was a pharmaceutical rep.
That she managed to slip a plug for her wares into every conversation or tuck copies of studies promoting her product into our white coat pockets as we polished off her brownies was awkward. But we always overlooked the salesmanship because it was such a familiar part of our residency routine. As trainees in a large teaching hospital, we knew numerous sales reps by name and the products they pedaled; and it was odd, even disappointing, to go to an educational conference where one of them was not standing next to a table laden with tchotchkes, information brochures and free take-out.
But in retrospect, such docile acceptance was problematic. In an environment where no one, including senior doctors, ever questioned the presence of sales reps, we didn’t think too hard about why they might have been as friendly and helpful as they were. We didn’t ask where the money for all these giveaways was coming from and we were rarely curious about who these reps actually were (I only ever knew their first names).
It wasn’t that I or the other residents preferentially prescribed their products. But I do know that more than once when faced with a decision about what to prescribe, the first thought that came to mind was not what I needed to do to find the latest evidence-based recommendation, but what Cheryl had just told us over lunch.
All of this became painfully clear after Cheryl suddenly disappeared. At first, the other trainees and I thought she had been fired, so we avoided bringing her absence up with the rep who replaced her. But when I ran into someone from her company at a national medical conference a year later, I learned otherwise.
“Oh, she got promoted,” the rep said, smiling broadly. “Now she’s an executive in the central office.”

As Some Companies Turn to Health Exchanges, G.E. Seeks a New Path


By 


CINCINNATI — Although the new federal health care law is designed to help people buying individual policies, even people with employer-provided policies are beginning to see changes in their coverage as companies rethink health care for their workers, discontinuing it in a few cases and redesigning it in many others.
They are motivated by a need to rein in health care costs, which continue to rise faster than overall inflation, but the federal health care law is also changing how some view their obligations to their employees.
Some major firms, like Walgreen, the drugstore chain, are giving those who qualify money to buy insurance on a private health exchange. Aon Hewitt, a benefits consultant that will oversee health plans on Walgreen’s behalf, said 18 large employers had signed up so far, including Sears and Darden Restaurants.
But here in Cincinnati, General Electric is taking the opposite approach.
One of the largest employers in the nation, it spends more than $2 billion a year offering coverage to 500,000 employees and retirees and their families. And it is using its considerable clout in places like this — where its giant aviation business gives it a major presence — to work directly with doctors and hospitals to improve care and reduce costs.
“I don’t know anybody who isn’t trying almost everything,” said Helen Darling, president of the National Business Group on Health, which represents employers providing benefits. “We’re going to see a lot of activity in the next couple of years.”
Over the last few years, G.E. has pushed for the creation of so-called medical homes, in which an individual medical practice closely coordinates a patient’s care by having access to all of the patient’s medical records.
In Cincinnati, about 118 doctors’ practices have converted to medical homes, and all five of the major health systems are making their primary care practices move in that direction. G.E. has also pushed for greater transparency of results.
“If we don’t take accountability ourselves for figuring this out, we’re part of the problem,” said Sue Siegel, a senior executive at G.E., who sees transformation of health care both as a business opportunity and a business necessity.
“We have to be involved in the solution,” she said. “We can’t just wait for someone to tell us that it is going to be fixed.”
What distinguishes the effort by G.E. is its direct focus on hospitals and doctors. Companies looking to the private exchanges are largely hoping to save money and want to be freed from the headache of administering health benefits.

Obamacare meets extra resistance in Oklahoma

Hurdles including a scarcity of accurate information about the Affordable Care Act have left many Oklahomans in underserved rural areas like Choctaw County confused about whether to sign up.

By Maeve Reston
5:47 PM PDT, October 3, 2013
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HUGO, Okla. — The nation's healthcare law was written with the residents of rural counties like Choctaw in mind. A quarter of the Oklahomans who live in the ranch country near the southeastern corner of the state are uninsured, one of many reasons their health ranks near the bottom of Oklahoma's 77 counties. But that does not mean people here want Obamacare.
The state attorney general is leading one of the last state challenges against the law in federal court. The state insurance commissioner issued a sharply worded warning to federally funded "navigators" who are helping people sign up for insurance. And frightening rumors about the law — uncountered by any positive spin — are dissuading some residents from considering it.
At the Hugo livestock auction, the busiest spot in town last Friday, owner David Minyard waved his hand in disgust when asked about the law. If what he's heard about it is true, he said, "I'm going to have to lock up and shut my door."
LIVE UPDATES: Day four of the shutdown
"There isn't nobody who's read it or understood it," Minyard said as ranchers pulled up their cattle trailers to unload in the yard outside. "No two people comprehend it the same way. You're hearing one thing. I'm hearing another. He's hearing another.
"Forty-thousand pages?" he said, vastly exaggerating its size. "Hell yes, it'll be confusion."
Minyard, a respected business owner in Hugo, says that no one — from his neighbors to his ranch hands — is turned away when they go to the local emergency rooms. "If they need medical care, they're going to have it," he said. "Why force somebody to do something they don't want?"
Standing silently nearby was 26-year-old Chad Austin, who is coordinating the navigators working in 63 Oklahoma counties. Austin is trying to stay clear of the politics. But he knows what he's up against.
"Bad news travels, and to a lot of Oklahomans right now, this is bad news," said the former high school baseball coach, who worked until recently at a local funeral home. "We're not offering any opinion on that; our goal is to help our community members."
As the Obama administration and its emissaries began coaxing Americans to sign up for health insurance this week, they were facing not just countless misconceptions about the law in red states like Oklahoma, but also a stigma — its attachment to a president unpopular here — that may drive potential consumers away.
States like California are spending millions to promote the law, but here it is difficult to find a trace of information about it beyond cable news. Officials at two organizations that received grants for outreach say they are still training navigators on what they can and cannot do.
There are no billboards along the highways, no public service announcements on the radio. At a number of health clinics, there were no fliers last week about the law's insurance marketplaces.
That's just fine with many leaders in a state where Obama lost every county. During an interview at his office facing the state Capitol, Atty. Gen. Scott Pruitt, a Republican, said he was more concerned about "public protection" and privacy concerns related to the law than whether people know where to sign up for insurance.
"Folks want something to be done because they are fearful," said Pruitt, who said the lawsuit might offer the "last best hope" to topple the Affordable Care Act.
http://www.latimes.com/nation/la-na-obamacare-oklahoma-20131004,0,6034123,print.story


Questions Often Asked About Health Law

By 
Millions of consumers rushed to the online health care exchanges on Tuesday only to be greeted with long waits and frustrating error messages.
Those who managed to create accounts or peruse the plans offered in their state left with many questions about the Obama administration’s health care plan. Among them: What does all of this mean for my 26-year-old child, who is now too old to remain on my own policy? The premium subsidies are based on my income, but what if I have no idea what I may earn next year? How is “modified adjusted gross income” calculated anyway?
Last week, my column addressed the broad outlines of how the exchanges will work, from how the different tiers of coverage would be structured to what types of individuals would qualify for tax credits on their premiums.
Dozens of additional queries landed in my in-box this week. Here’s are some of the most frequently asked questions and an attempt at answering them:
Q. I haven’t seen any discussion about students. My son will be 26 next month, and thus can no longer be on my plan. He is a full-time student in another state and fully dependent on my financial support. Do you know where he fits into this system?
— Mark Alper, Berkeley, Ca.
A. Adult children lose coverage through a parent’s policy on their 26th birthday. But they can then immediately enroll on the exchange — even outside the open enrollment period, which ends on March 31. Individuals under age 30 may also qualify for a “catastrophic” plan, which carries a lower premium but a very high deductible (equivalent to the out-of-pocket maximum, or $6,350 for a single person, in 2014). Tax credits, however, cannot be applied to catastrophic plans.
Q. My difficulty and confusion is I don’t actually know what my annual income is or will be in the coming fiscal year. I am a freelance classical musician, meaning I have seasonal employment from as many as 20 employers in a year and I file tax returns in seven states and three countries.
— gibarian, San Francisco
A. The experts I spoke with said you needed to make your best educated guess when estimating your income. The exchange will verify it by checking your tax return from last year as well as your current income. (The federal government has contracts with firms that provide that information.) If your self-attested income varies by more than 10 percent when compared to those two sources, you will be asked to provide more documentation, according to a spokeswoman at the Department of Health and Human Services.
Q. I have very little annual personal income, but am fortunate to have other savings/resources that would allow me to pay for one of the better plans with higher premiums. (I have no access to any employer-sponsored plan). I am willing to enroll in one of these better plans on my state’s health exchange even if I don’t get any subsidy for it. (I seem to earn too little to qualify for a subsidy anyway.) Will I be allowed to do this, and do this without penalty or added taxes?
— KRyan, New York City
Q. I am currently unemployed but have a sizable trust fund. Do I qualify for discounts/tax credits when buying health insurance? Will I be required to show my federal tax return?
The shutdown of many federal operations and activities this week has obscured widespread problems in the opening of insurance exchanges under President Obama’s health care law, giving the administration time to work out the kinks, members of both parties say.
In a stark contrast, the exchanges — online markets where consumers can shop for insurance — opened on Tuesday as much of the government was closing because of an impasse between Mr. Obama and Congressional Republicans over federal spending.
Millions of people were still frustrated Friday when they tried to#GetCovered, as instructed on Twitter by Mr. Obama, Lady Gaga and other celebrities.
Since the federal exchanges opened Tuesday, 8.6 million people have visited its Web site, and its telephone call center has received 406,000 calls, officials said Friday. They declined to say how many people had enrolled in health insurance plans. A section of the Web site where people apply for coverage will be taken down for several hours a day over the weekend so technicians can upgrade its capabilities, the administration said.
The law is at the center of the stalemate that has blocked funds for many federal programs.
Republicans want to repeal or delay it or make major changes, but Mr. Obama refuses to negotiate over the future of the law, which converts coverage from a privilege to a right, starting in January.
Lawmakers and lobbyists say the law’s Republican opponents may have overplayed their hand this week, making it easier for supporters to brush aside criticism.
E. Neil Trautwein, a vice president of the National Retail Federation, said the standoff had “hardened the positions” of House Republicans, Senate Democrats and the White House, reducing the chances for changes that could make the law more workable for employers.

Maryland’s health insurance Web site stumbles badly in first days

By , Published: October 4

Barely 24 hours after President Obama signed his landmark health law, Gov. Martin O’Malley promised that Maryland would “lead the nation” in putting it in place.
In the three years since, Maryland has been at the forefront of implementing the Affordable Care Act. It established six policy work groups. It trained more than 5,000 people to help consumers enroll in new health-coverage options. When its online insurance exchange passed a critical test in the summer — one of the first in the country to do so — a top official gave an emotional speech thanking workers. If any state was going to be ready for Oct. 1, when millions of uninsured Americans would be able to start buying coverage under the health law, it would be Maryland.
But when Tuesday arrived, Maryland’s Web site stumbled badly. People couldn’t log on, forcing state officials to delay the opening of the exchange for four hours. Even after it opened, many frustrated users were unable to create accounts, the first step in buying coverage. All told, fewer than 100 people have managed to enroll.

Lazarus: GOP will stop at nothing to deny Obama his due on healthcare reform

The outlandish rhetoric over the Affordable Care Act has nothing to do with healthcare or the role of government. It's about not giving Obama credit for it.

David Lazarus
3:46 PM PDT, September 30, 2013
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"All of this would be funny if it weren't so crazy."
That was President Obama commenting the other day about some of the irresponsible, outlandish and just plain idiotic things critics have been saying about the Affordable Care Act.
We've now reached an important milestone: Pre-enrollment begins Tuesday for people to sign up for insurance through the online exchanges created by the healthcare reform law. Actual coverage will begin Jan. 1.

This is crunch time. Republicans know that once people get a taste of the benefits they'll receive under the Affordable Care Act, there will be no turning back. So the GOP is working overtime to misinform, frighten and dupe people into keeping their distance.
Think that's an exaggeration? Rep. Michele Bachmann (R-Minn.) said the Affordable Care Act must be repealed "before it literally kills women, kills children, kills senior citizens."
Literally. Kills. Children.
In reality, the law extends health coverage to 95% of kids and, among other things, blocks insurers from placing limits on coverage and prohibits them from taking insurance away if a child gets sick.
"Extremists are allowed to say whatever they want," said Glenn Melnick, a healthcare economist at USC. "So you're going to get people saying extreme things, whether or not they're true."

Our View: Riverview fight with feds not just about money

Posted:Today
Updated: 12:02 AM 

The state’s legal battle should not overshadow the mental health system’s underlying faults.

There’s one thing to remember as the state and federal governments continue their fight over Medicaid funding for Riverview Psychiatric Center in Augusta: There are still patients there.
Health and safety concerns about the patients at Riverview were what led to the federal government to threaten to pull the hospital’s Medicaid funding in March; ever since, the state has been scrambling to fix the deficiencies found in a federal audit, including by rushing a bill through the Legislature in a special session. State officials filed an improvement plan that was accepted by the federal government, pending a follow-up audit. But after last month’s audit, Medicaid officials concluded that Riverview had failed to live up to its promises and would lose $20 million in federal funding.

Feds will repair health overhaul website this weekend

Posted:Today
Updated: 12:16 AM

Millions of Americans rushed to the website to buy or explore their insurance options, but technical problems overwhelmed Tuesday's launch.

The Associated Press
WASHINGTON – Bedeviled by technology glitches that frustrated millions of consumers, the Obama administration is taking down its health overhaul website for repairs this weekend.

Enrollment functions of the healthcare.gov site will be unavailable during off-peak hours, the Health and Human Services Department said Friday. The department did not release a schedule for hours of operation, but an HHS spokeswoman said the site would be taken down at 1 a.m. EDT each night for a few hours.
The website will remain open for general information.
Technology problems overwhelmed the launch of new health insurance markets Tuesday, embarrassing the administration just when the health care law known as “Obamacare” was supposed to be introduced to average consumers.
“Americans have seen once again that Obamacare is not ready for prime time,” Rep. Eric Cantor of Virginia, the No. 2 House Republican, said in a statement. “A dysfunctional website is the least of that law’s problems.”

New Hampshire off to slow start in pitch for health care law

Posted:Today
Updated: 12:07 AM

The state got approval only Monday to accept a $5 million grant to reach out to residents on Obamacare.

The Associated Press
CONCORD, N.H. — As enrollment gets underway in new online insurance markets nationwide, a significant outreach effort is just getting off the ground in New Hampshire.
The New Hampshire Health Plan, which currently runs the state’s high-risk insurance pool, got approval only Monday to accept a $5 million federal grant for state-specific outreach and education about President Barack Obama’s health overhaul law. It chose six organizations that will serve as so-called marketplace assisters and plans to hire another company to develop a state website and advertising campaign.
Some of the marketplace assister organizations say they’ve already been working to figure out how best to reach out to the public. And while they wish the funding had come through earlier, they are building on existing resources and starting with outreach to consumers they already serve. “We’re excited to jump into it,” said Shawn LaFrance, executive director of the Foundation for Healthy Communities. “I think we’ll all be learning something ... but I think it’s great that we can build on some existing infrastructure in New Hampshire to carry forward.”

State rules Anthem may not exclude CMMC from new insurance network

By Sun Journal,
Posted Oct. 04, 2013, at 6:55 p.m.
LEWISTON, Maine — Central Maine Healthcare has won.
On Friday evening, Superintendent of Insurance Eric Cioppa ruled that Anthem Blue Cross and Blue Shield can not exclude Central Maine Medical Center and its partner hospitals from a new, so-called “narrow network” insurance policy with MaineHealth.
Anthem will have to redraft and present a new plan to the state for approval.

Despite ACA’s improvements, many big holes and problems will remain

By Steffie Woolhandler, M.D.
"To the Point," KCRW – PRI radio, Oct. 1, 2013
The following text represents the comments of Dr. Steffie Woolhandler, one of PNHP’s co-founders, taken from an unofficial transcript of a radio program that was broadcast by KRCW in Santa Monica, Calif., and Public Radio International on Oct. 1. The host was Warren Olney. The panelists were Mary Agnes Carey of Kaiser Health News, Harold Pollack of the University of Chicago, Dr. Fitzhugh Mullan of George Washington University, and Dr. Woolhandler, who is professor of public health at the City University of New York.
Warren Olney: Dr. Woolhandler, you’re concerned about the Affordable Care Act, as I understand it. Why?
Dr. Steffie Woolhandler: Let’s be clear. The Affordable Care Act is going to leave 31 million people uninsured, and even if the Red state governors had never stepped in, even if the Supreme Court had never stepped in, Obamacare as written was designed to leave 25 million people uninsured. So it’s a very partial solution that, even if enacted as written, would have left half of uninsured Americans still uninsured. And 25 million uninsured is unacceptable to me as a physician, as is 31 million uninsured. We should have gone to a single-payer system, also known as nonprofit national health insurance, also known as expanded and improved Medicare for all, and then the money we spent on health care would have been enough to cover 100 percent of everyone and then we would also have enough to remove co-payments and deductibles from people who have insurance already. So our group, Physicians for a National Health Program, is still pushing for single-payer national health insurance, like they have in Canada and most of Western Europe.
WO: What are the prospects, though? The Affordable Care Act doesn’t even include a public option.
SW: Well, I think as soon as people see the problems in Obamacare – and I do want to agree with the other panelists, there are some improvements that we got through Obamacare. Certainly a lot of people ended up getting Medicaid that didn’t have it before. But there’s still a lot of holes and problems, not the least the 31 million uninsured, not the least the fact that that you end up paying a lot of money for very skimpy coverage on those insurance exchanges -- including policies with deductibles of $2,000, co-insurance of 20 percent. When people actually see Obamacare in action, they’re going to say we need to move forward to single payer, we have not solved the problem yet, and single payer is still necessary.
WO: Would single payer eliminate the insurance companies and the amount that’s spent on their overhead?






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