- KFF Health News Original Stories 5
- Covered California Expects 12.5% Average Rate Rise In 2018
- Podcast: 'What The Health?' Now What?
- Little-Known Middlemen Save Money On Medicines — But Maybe Not For You
- Drug Puts A $750,000 ‘Price Tag On Life’
- Denial, Appeal, Approval … An Adult’s Thorny Path To Spinraza Coverage
- Covered California & The Health Law 2
- California To Be Hit With Double-Digit Rate Hikes Amid Uncertainty In Washington
- States Allowed To Intervene Over Federal Subsidy Payments Case, Court Of Appeals Rules
Latest From California Healthline:
KFF Health News Original Stories
Covered California Expects 12.5% Average Rate Rise In 2018
The figure could be higher if President Trump ends an important consumer subsidy, which he has threatened to do. Anthem Blue Cross will pull out of the exchange and the overall individual market in 16 of 19 regions in the state. (Emily Bazar and Anna Gorman and Pauline Bartolone, 8/2)
Podcast: 'What The Health?' Now What?
Health care journalists in Washington, D.C., discuss the next round of national health reform — assuming there is one. (8/2)
Little-Known Middlemen Save Money On Medicines — But Maybe Not For You
Kaiser Health News examines the role of PBMs in the prescription drug-pricing pipeline. (Francis Ying and Julie Appleby and Stephanie Stapleton, 8/2)
Drug Puts A $750,000 ‘Price Tag On Life’
The high cost of Spinraza, a new and promising treatment for spinal muscular atrophy, highlights how the cost-benefit analysis insurers use to make drug coverage decisions plays out in human terms. (Julie Appleby, 8/2)
Denial, Appeal, Approval … An Adult’s Thorny Path To Spinraza Coverage
The FDA granted approval for Spinraza in late December for use on children and adults with spinal muscular atrophy. Insurance coverage is mostly focused on infants and children. (Julie Appleby, 8/2)
More News From Across The State
Covered California & The Health Law
California To Be Hit With Double-Digit Rate Hikes Amid Uncertainty In Washington
All 11 existing insurers will continue to provide plans for next year, but Anthem Blue Cross is significantly reducing its coverage.
The Associated Press:
California Health Premiums To Rise An Average 12.5 Percent
Monthly premiums for California health insurance plans sold under the Affordable Care Act will rise by an average of 12.5 percent next year, the second consecutive year of double-digit rate increases, officials said Tuesday. (Cooper, 8/1)
Los Angeles Times:
Covered California Premiums Will Rise 12.5%, And Anthem Blue Cross Cuts Coverage
Covered California Executive Director Peter Lee said that increases in the cost of providing care were responsible for about 7 percentage points of the state’s 12.5% average rate increase. Another 3 percentage points, he said, reflected a one-time tax adjustment. But another 3 points, he said, accounts for insurers’ overall unease with the ongoing debate over scrapping, or massively modifying, the Affordable Care Act. In negotiating with insurance companies this spring, Covered California put together a kind of hold-harmless agreement. That agreement, which Covered California will take to its board this month, essentially agrees to let health insurers make up losses from unexpected changes to the insurance market that may be caused this year or next by unexpected changes in the basic fundamentals of the Obamacare market. (Karlamangla, 8/1)
Sacramento Bee:
Covered California Announces Insurance Premium Hikes, Possible Surcharge In 2018
“Covered California remains robust and strong, and we are pleased to welcome back all 11 plans to compete in regions across the state,” said Covered California Executive Director Peter V. Lee. “While there is ongoing uncertainty and a lack of clarity at the federal level, consumers who need affordable health insurance will continue to have good choices in Covered California next year.” (Anderson, 8/1)
Bloomberg:
Obamacare Premium Hikes Could Double In California If Trump Ends Subsidies
Insurers requested a 12.5 percent rate increase on average for 2018 Obamacare plans, the state’s Covered California exchange said in a statement Tuesday. Trump, however, has threatened to stop paying what are known as cost-sharing-reduction subsidies -- which insurers get to help lower-income people afford to use their plans. If that happens, insurers would increase rates by another 12.4 percent on mid-level plans, the state said. “We prepared these rates in the midst of great uncertainty,” Peter Lee, Covered California’s executive director, said on a conference call with reporters. “The federal administration has not committed to continuing these payments.” (Tracer, 8/1)
California Healthline:
Covered California Expects 12.5% Average Rate Rise In 2018
That increase would apply only to silver-level plans, the second-least-expensive among the exchange’s four tiers of coverage. That’s because only people enrolled in silver plans can benefit from the so-called cost-sharing subsidies that Trump may end. Lee said the exchange hopes not to tack on the surcharge because “it will cause unnecessary confusion and ultimately cost the federal government billions of dollars more than they would have spent by making the [subsidy] payments directly to health plans.” (Bazar and Gorman, 8/2)
The Mercury News:
Obamacare: Covered California 2018 Average Rate Increase Is 12.5 Percent
For now, the highest average rate hike in the greater Bay Area of 12.5 percent continues to hit consumers along the Central Coast — Santa Cruz, Monterey and San Benito counties. Santa Clara County will see an average rate hike of 10.4 percent, followed by Alameda County at 8.3 percent and Contra Costa County at 8.2 percent. (Seipel, 8/1)
The San Diego Union-Tribune:
Covered California Premiums To Jump By Double Digits For Second Straight Year
The expected increases won’t be felt by most Covered California policyholders because more than 70 percent of them receive income-based subsidies for their premiums, Lee said. Generally speaking, as these enrollees’ premiums rise, so do their subsidies. (Sisson, 8/1)
Fresno Bee:
Health Costs Rise In Valley
Amid turbulence over the future of federal health-care reform, consumers buying insurance in Tulare, Mariposa and Merced counties will see a rate increase for monthly premiums of 24 percent on average in 2018 – nearly twice the statewide hike. In Fresno, Kings and Madera counties, the rate increase is much lower – 4.7 percent – but about 30 percent of consumers will have to find a new plan since Anthem Blue Cross will not be offering coverage in those counties next year. (Anderson, 8/1)
Orange County Register:
Here’s What You Need To Know As Covered California Rates Go Up In 2018
Covered California on Tuesday said insurance rates will jump an average of 12.5 percent for next year, driven in part by uncertainty about the future of Obamacare. Peter Lee, executive director of Covered California, described 3 percent of premium increases as an “uncertainty surcharge,” fueled by the unclear future of the Affordable Care Act. Uncertainty about the law also will prompt a big private insurer, Anthem Blue Cross, to stop selling Covered California plans in Southern California. (Perkes, 8/1)
Reuters:
Anthem To Cut Back Obamacare Plan Offerings In California
U.S. health insurer Anthem Inc is pulling back from 16 of 19 pricing regions in California where it offered Obamacare options this year, state officials said on Tuesday. The move, which takes effect for 2018, means Anthem will offer Obamacare coverage in three pricing regions comprising 28 counties in California. (Erman and Berkrot, 8/1)
KPCC:
Anthem Leaves SoCal As Health Insurance Rates Set To Rise 13 Percent In 2018
Health insurance will cost on average 12.5 percent more in 2018 than it does now. ...The rate release comes amid what Covered California Executive Director Peter Lee calls "unprecedented uncertainty" from the federal government over the future of the Affordable Care Act. (Faust, 8/1)
States Allowed To Intervene Over Federal Subsidy Payments Case, Court Of Appeals Rules
The case, which dates back to the Obama administration, was filed by the Republican-led House against the government in an effort to block the subsidy payments to insurers for the individual plans created by the Affordable Care Act. Sixteen attorneys general, including California's, had filed to defend the subsidies.
Reuters:
Court Allows Democratic States To Defend Obamacare Payments
A U.S. appeals court on Tuesday allowed Democratic state attorneys general to defend subsidy payments to insurance companies under the Obamacare healthcare law, a critical part of funding for the statute that President Donald Trump has threatened to cut off. The U.S. Court of Appeals for the District of Columbia Circuit granted a motion filed by the 16 attorneys general, led by California's Xavier Becerra and New York's Eric Schneiderman. (Hurley, 8/1)
The Washington Post:
Court Ruling Could Help Keep Obamacare Subsidies
Led by the Democratic attorneys general of New York and California, the motion that the court granted is the most recent twist in the gnarled legal and political history of the subsidies. In practical terms, the ruling could make it more difficult for the Trump administration and House Republicans to abandon the payments without a court fight. (Goldstein, 8/1)
Modern Healthcare:
Appeals Court Rules States Can Fight To Preserve ACA Subsidies
In May, 16 state attorneys general from both Republican- and Democratic-led states, led by California and New York, asked the federal appeals court for permission to intervene in the case. The lawsuit was originally brought by House Republicans to block federal payment to insurers to fund the Affordable Care Act's cost-sharing reduction subsidies for low-income exchange plan members. (Livingston, 8/2)
The Hill:
Court Rules Allowing Dem States To Defend Obamacare Payments
Insurers have threatened to leave the ObamaCare market exchanges if the payments are not continued, which could potentially leave millions without healthcare coverage options during the transition. "The states have shown a substantial risk that an injunction requiring termination of the payments at issue here ... would lead directly and imminently to an increase in insurance prices, which in turn will increase the number of uninsured individuals for whom the states will have to provide health care," the order stated. (Roubein and Seipel, 8/1)
California Nurses Association Sunk More Than $500K To Influence Single-Payer Bill Decisions
The California Hospital Association and the California Medical Association are the only other groups in health care that spent more money than the nurses to influence officials.
Sacramento Bee:
Special Interest Lobbying Spending Spikes In California
Between April 1 and the end of June, lawmakers in Sacramento passed a controversial gas tax, put the breaks on universal health care and began negotiations on a cap-and-trade deal to extend the state’s marquee climate change program. During the same period, business groups, unions, nonprofits and other interests shelled out $91.2 million to influence officials. That’s $10 million more than they spent in the second quarter of the last legislative session. (Luna and Miller, 8/1)
Troubled Blood-Testing Startup Theranos Settles Lawsuit With Walgreens
The details of the settlement haven't been released.
Los Angeles Times:
Theranos Settles Lawsuit Brought By Walgreens Over Blood Tests
Theranos Inc., the once highflying blood-testing firm, said Tuesday it settled a lawsuit filed against the company by the drugstore chain Walgreens and its parent, Walgreens Boots Alliance Inc. Terms of the settlement were not disclosed, but Theranos said there was “no finding or implication of liability” and Walgreens’ lawsuit will be dismissed. (Peltz, 8/1)
Charter Schools Not Keeping Up With Public Ones On Vaccination Rates
Officials think it has more to do with how the schools are structured than them flouting state requirements.
KPCC:
'No Shots, No School'? Vaccination Rates Lag In California Charter Schools
A KPCC analysis of recently-released state vaccination rate data shows students in charter schools are much less likely than their peers in traditional, district-run public schools to be up-to-date on all of the shots California law says they should receive by seventh grade. ...Overall, 98.4 percent of California's seventh graders met immunization requirements in the 2016-17 school year, a 1.8 percentage point increase over the last three years, according to data the state Department of Public Health released recently. (Stokes, 8/2)
In other public health news —
KQED:
Contra Costa’s At-Risk Youth Suffer From Shortage Of Psychiatrists
At a Family and Human Services Committee hearing on Monday, county officials responded to a civil grand jury report claiming that there is on average a 1-to-310 ratio of psychiatrists to cases of children with moderate to severe mental health issues. ...According to [Cynthia] Belon, only two full-time and seven part-time psychiatrists are currently working in the county’s three mental health clinics for children in Richmond, Antioch and Concord. (Saldaña, 8/1)
KPCC:
Air Pollution Deaths Could Rise With Global Temperatures
Over the next century the world could see an uptick in the number of deaths related to air pollution because of climate change, according to a new study from the University of North Carolina at Chapel Hill. ...Currently, about 6.5 million deaths worldwide can be linked to air pollution every year. (Margolis, 8/1)
The San Diego Union-Tribune:
Moderate To Heavy Drinkers Are More Likely To Live To 85 Without Developing Dementia
UC San Diego claims in a new study that certain people who regularly consume moderate to heavy amounts of alcohol are more likely to live to 85 without developing dementia and other cognitive problems compared to people who don’t drink at all. The long-term study was largely based on white, middle-class men and women living in Rancho Bernardo, a master-planned community in North County. ...The new UC San Diego paper says, in part, that “Moderate and heavy drinkers had 2-fold higher odds of living to age 85 without cognitive impairment relative to non-drinkers.” (Robbins, 8/1)
Senators To Hold Bipartisan Hearings To Try To Protect Insurer Subsidies Threatened By Trump
The Senate Committee on Health, Education, Labor, and Pensions will hold sessions beginning the week of Sept. 4, in a bid to “stabilize and strengthen” the individual health insurance markets.
The Associated Press:
GOP Shows Signs Of Reaching Out To Democrats On Health Care
Republicans showed signs Tuesday of reaching out to Democrats for a joint if modest effort to buttress health insurance markets, four days after the GOP effort to unilaterally uproot and reshape the Obama health care law crumpled in the Senate. The Republican chairman of the Senate health committee, Tennessee's Lamar Alexander, said he'd seek bipartisan legislation extending for one year federal payments to insurers that help millions of low- and moderate-income Americans afford coverage. (8/1)
The New York Times:
Republicans In Congress Bypass Trump To Shore Up Health Law
In the House, two Republicans, Representatives Tom Reed of New York and Charlie Dent of Pennsylvania, teamed with Democrats to promote incremental health legislation that would also fund the cost-sharing subsidies. The moves were a remarkable response to the president’s repeated threats to send health insurance markets into a tailspin. They offered tangible indications of cooperation between the parties after Republican efforts to scrap the Affordable Care Act collapsed in the Senate last week, all but ending the seven-year Republican quest to overturn President Barack Obama’s signature domestic achievement. Lawmakers from both parties concede that the health law needs improvement, as consumers face sharp premium increases and a shrinking number of insurance options in many states. (Pear and Kaplan, 8/1)
USA Today:
With Obamacare Repeal Stalled, Senate Panel To Focus On Stabilizing Insurance Market
Sen. Lamar Alexander, R-Tenn., said the Senate Health, Education, Labor and Pensions Committee, which he chairs, will hold hearings starting Sept. 4 “so that Americans will be able to buy affordable health insurance.” "If your house is on fire, you want to put out the fire, and the fire in this case is the individual health insurance market," Alexander said. (Gaudiano and Collins, 8/1)
NPR:
Lawmakers To Hold Hearings To Stabilize Insurance Markets
The next cost-sharing payments are due to be paid in a few weeks and the president has said he'll announce this week whether he'll pay the money or keep it in the Treasury. "In the absence of the CSR, the rate increases could be astonishing," says Dr. Marc Harrison, CEO of Intermountain Healthcare, which operates nonprofit hospitals and clinics and insures more than 800,000 people across Utah. (Kodjak, 8/1)
The New York Times:
‘Time To Move On’: Senate G.O.P. Flouts Trump After Health Care Defeat
Senate Republicans are not pretending to have missed the tweets anymore. They have abandoned well-worn phrases, like “growing pains” and “sea legs,” that sustained them through the endless winter and spring. And if a few months ago President Trump’s scattershot demands might have sent the chamber into a lather, compelling lawmakers to honor his megaphone, the collective shrugs at his rage over last week’s failed health care repeal vote have signaled a new phase in this shotgun marriage of unified Republican rule. (Flegenheimer and Kaplan, 8/1)
Modern Healthcare:
Trump's Threats To End Cost-Sharing Subsidies Could Lead To Premium Hikes And Litigation
Even though Senate Republicans' push to repeal the Affordable Care Act fizzled out last week, health insurers are still grappling with uncertainty over whether the federal government will continue to fund crucial subsidies that help low-income Americans pay for health coverage. Insurers and lobbying groups have warned over the last few months that premiums will increase if the cost-sharing reduction subsidies go unfunded in 2018. Now the Trump administration could also face new litigation if it fails to make the subsidy payments, as President Donald Trump has repeatedly threatened to do. (Livingston, 8/1)