Citizen Cartwright

No health-care help coming for many poor people

The refusal by about half the states to expand Medicaid will leave millions of poor people ineligible for government-subsidized health insurance under the new health care law — even as many other people with higher incomes get federal subsidies to buy insurance, says The New York Times.

When they passed the health care law in 2010, congressional Democrats intended to expand Medicaid eligibility in every state.

But the Supreme Court ruled last year that the expansion was an option for states and not a requirement. At least 25 states — mainly those with Republican governors or Republican-controlled legislatures — have balked at expanding the program, partly because of concerns about long-term costs.

The history of Medicaid shows that it took several years for some states to sign on in the 1960s, suggesting that additional states may decide to expand eligibility in coming years, says the Times.

The Obama administration is urging people who “need health insurance” to report their phone numbers and e-mail addresses to the government at healthcare.gov so they can be notified of new insurance options.

Obamacare's 'unfixable' gaps and glitches

After big laws are enacted, they typically need changes and tweaks.

But when it comes to the Affordable Care Act, Washington's gridlock means it can't be done.

Not now, anyway.

That's because Republicans don't want to refine the law; they want to repeal it. And Democrats are afraid for their own careers and for the provisions of the law itself if they open it to changes.

The House's 37th vote against Obamacare

Thursday's action gave freshmen their first chance to vote against the law.

Confusion, repetition in the runup to the health care rollout

The White House announced on Thursday a new $150 million initiative to get uninsured Americans covered under President Obama's health care overhaul, as House Republicans prepare for their 37th vote to repeal all of part of the law.

The initiative will funnel money to about 1,200 community health centers to hire and train thousands of workers who will help people obtain coverage through new subsidized online marketplaces and an expanded Medicaid program for the poor.

A new poll from the Kaiser Family Foundation shows that more than 4 in 10 Americans don't know the Affordable Health Care Act still is law or is being implemented. About half say they don't have enough information about the law to know the ways it will affect them.

Under the law, virtually all Americans must carry health insurance starting next year, though most people simply will keep the coverage they now have through their jobs, Medicare or Medicaid.

Coming health care benefits

The Obama administration on Wednesday issued its long-awaited final rule on the essential health benefits that states and insurers must provide in the individual and small-group market under the health care overhaul, beginning in 2014.

The rule is getting a cool reception from insurance and employer groups, which say higher costs could result from the new coverage requirements.

For example, the Department of Health and Human Services estimates that 62 million Americans will gain mental health coverage.

'Rate shocks' as health care law kicks in

Insurers are making an all-out effort to avoid blame for what they predict will be rate increases on policies they have to unveil this spring to comply with President Obama’s health care law, says The Washington Post.

Insurers will be required to offer more comprehensive coverage than many now provide, and they'll be prohibited from rejecting sick people and charging older people higher premiums than they charge the young.

Premiums for plans sold to individuals could go up as much as 50 percent on average and could more than double for groups such as the young and healthy, Aetna chief executive Mark Bertolini said at his company’s recent annual investor conference.

Supporters of the law say that the warnings amount to a smear attack by special interests and political partisans similar to earlier claims that the law would allow "death panels" to deny life-saving care to save money.

"It is important to remember that this is a transition," says Rhode Island Insurance Commissioner Christopher Koller, a supporter of the law. "We are getting to a more stable place."

Difficult implementation of the health care law

Signing up an estimated 30 million uninsured Americans for coverage under the law is going to require the hiring of tens of thousands of workers to walk people through the process, The Washington Post says.

State inactivity in implementing health care law

Thirty-nine states have yet to pass laws or issue regulations on seven aspects of the overhaul, including coverage for people with pre-existing medical conditions, a ban on coverage waiting periods and limits for out-of-pocket consumer costs, according to a report by the nonpartisan Commonwealth Fund.

It's 11 months until the changes are scheduled to take effect under President Obama's Patient Protection and Affordable Care Act, which is opposed by many states with Republican leadership.

Preventive health care less of a money saver than thought

Since about 75 percent of U.S. health care spending is for largely preventable chronic illnesses like Type 2 diabetes and heart disease, more preventive care would be expected to cut costs.

But it doesn't, Reuters reports.

One reason is that some of the best-known forms of preventive care don't actually improve someone's health, according to health economists.

For example, an analysis last year of 14 large studies found that annual physicals for healthy adults don't lower the risk of serious illness or premature death. But about a third of American adults get them, says Dr. Ateev Mehrota, a primary-care physician and health care analyst at RAND — at a cost of about $8 billion a year.

Low growth in health care spending continues

The country's health care spending increased to $2.7 trillion in 2011, an average of $8,700 for every person. A lot of money.

But as a share of the economy, spending was stable for the third consecutive year, according to a study published in the January issue of the policy journal Health Affairs.

It's not clear whether the low growth in health spending is the start of a trend or shows the continuing effects of the Great Recession.