Obama Administration Urges States to Cut Health Insurers’ Requests for Big Rate Increases

New York Times, Aug. 3, 2015

WASHINGTON — Hoping to avoid another political uproar over the Affordable Care Act, the Obama administration is trying to persuade states to cut back big rate increases requested by many health insurance companies for 2016.

In calling for aggressive regulation of rates, federal officials are setting up a potential clash with insurers. Some carriers said they paid out more in claims than they collected in premiums last year, so they lost money on policies sold in the new public marketplaces. After finding that new customers were sicker than expected, some health plans have sought increases of 10 percent to 40 percent or more.

Administration officials have political and financial reasons for wanting to hold down premiums. Big rate increases could undermine public support for the health care law, provide ammunition to Republican critics of the measure and increase costs for some consumers and the federal government.

Kevin J. Counihan, the chief executive of the federal insurance marketplace, is urging states to consider a range of factors before making their decisions


CCOs Effective in Integrating Healthcare and Housing

Pilots around the state show early success with “habit of collaboration”

The Lund Report, August 12, 2015
by Jan Johnson

When Kenny La Point’s son was diagnosed with Type 1 diabetes, Oregon’s first “housing integrator” was then a member/user on the Central Oregon coordinated care organization’s community advisory council.

La Point was involved with the rehab of a 70-unit apartment building in Bend to add washers and dryers to each apartment, freeing space once used as a laundry room for Housing Works to partner with Mosaic Medical, a federally qualified health clinic, to establish a community-based medical clinic.

“We can’t keep working in silos. It’s the same exact clients,” said La Point.

In the mental health realm, Greater Oregon Behavioral Health Inc. and Umpqua Health Alliance, the Douglas County CCO, last winter each provided $28,000 to rent apartments for those with mental illness coming out of incarceration through the county mental health/drug court. The Douglas County Housing Authority finds available, low- barrier housing. Community Health Alliance and ADAPT provide intensive wraparound case management.

If the clients succeed, they get to keep the apartment, said Kevin Campbell, CEO of GOBHI. “We know where they are, we know they have a roof over their heads. We can avoid higher costs later with a smaller investment earlier.”


Many confused by tax filing requirements could lose their ACA tax credits

Physicians for a National Health Program, Aug 7, 2015
Quote of the Day, by Don McCanne MD

Comment: Forty percent of the 4.5 million households that received tax credits in 2014 for the health plans offered in the ACA exchanges have failed to complete the tax filing requirements for these credits and thus will be ineligible for tax credits for 2016, unless they follow through with their delayed filings.

In a health care system already heavily burdened with administrative excesses, it is unfortunate that the Affordable Care Act significantly increases the administrative burden. In this instance, the additional hassle of the tax filing requirements for those receiving subsidies under ACA may be confusing enough that many may fail to file correctly, and thus they may become disqualified for tax credits to which they are entitled and which many need just to be able to afford the premiums for the exchange plans.

Many of ACA’s provisions and regulations apply specifically to individuals and families, creating sometimes complex administrative requirements in each individual case. In contrast, a single payer system requires simple registration only once in a lifetime, and the financing requires nothing more than compliance with the existing tax system, with rates set based on ability to pay.

For the individual, a single payer system is hassle-free, whereas for the entire nation, single payer frees up enough administrative waste to pay for the care that people are not currently receiving but should be.


Agate shareholders sue Register-Guard and state to try to prevent records release

by Sherri Buri McDonald
The Register-Guard, August 6, 2015

Several shareholders in the Eugene company that manages services to about 95,000 Lane County Oregon Health Plan patients have sued the state and Guard Publishing Co., publisher of The Register-Guard, to try to stop the state from releasing public records.

Shareholders of Agate Resources Inc., the parent company of Trillium Community Health Plan — the coordinated care organization in Lane County — allege that disclosing the names and ownership interest of Agate shareholders would invade their personal privacy and threaten their professional reputations without serving any public interest.

They are seeking class action status, for themselves and more than 200 other Agate shareholders, the lawsuit said.

Agate had submitted the names and ownership stakes of the shareholders to the Oregon Department of Consumer Services as part of the department’s review of Agate’s proposed sale for up to $130 million to Centene Corp., a large health care company based in St. Louis. The sale proceeds would go to individual Agate shareholders based on each one’s ownership stake.

Bill Moyers Essay: Everyone Should Be Entitled to Medicare

Moyers was an aide to President Johnson when he signed the bill for Medicare.

Moyers and Johnson, 1965

Moyers and Johnson, 1965

From the transcript, August 3, 2012

BILL MOYERS: I read a news story this week that sent me on a nostalgic trip down memory lane. This past Monday, July 30th was the 47th anniversary of Medicare, and to celebrate it, the “Raging Grannies,” as they’re known, gathered outside the county office building in Rochester, New York to protest rumored cuts to their Medicare coverage.

RAGING GRANNIES: This old grey granny now needs a test or two --

BILL MOYERS: They praised Medicare in song as “the best deal we have in the country,” and even called for expanding it Medicare into universal health care for everyone.

It seems the Republican Speaker of the House, John Boehner, was coming up from Washington to raise funds for Republican congressional candidate Maggie Brooks. The “Raging Grannies” wanted to make certain Ms. Brooks didn’t sign on to the GOP budget which includes cuts to Medicare.

For myself, the “Raging Grannies” channeled a familiar voice, the Texas twang of my boss back in 1965, Lyndon Baines Johnson. I was a White House assistant at the time and had been working with the President and others on the team trying to get Medicare through Congress. Even with overwhelming Democratic majorities in the House and Senate, it was one tough fight. Others had tried before us.

Watch the video