Author Archives: Joanne Kenen

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at She welcomes questions and suggestions on health reform resources and tip sheets at

Things to consider when covering recent departures from the ACA marketplace

Photo: Peg via Flickr

Photo: Peg via Flickr

Decisions by United Healthcare, Humana and now Aetna to shrink their footprint in the ACA exchanges – along with the collapse of the most of the co-ops – are likely to significantly decrease competition in some parts of the country next year.

Among the states likely to be most affected are: Alaska, Arizona, Oklahoma, Alabama, Georgia, the Carolinas, and probably parts of Florida. Continue reading

A new take on premium trends gets pushback from ACA critics

premium-trendsHere’s an argument that premiums under the Affordable Care Act actually have dropped. Loren Adler and Paul Ginsberg of the Brookings Institution argue this in a recent Health Affairs post, summing up their findings. But not everyone agrees.

Conservatives have attacked both the methodology and the conclusions in “Obamacare Premiums Are Lower Than You Think.” Given that it contradicts some earlier studies, even some ACA supporters say they’d like to see more research on some of the points made by Adler and Ginsberg. More on the critics below, but first let’s look at pair’s findings. Adler and Ginsberg write: Continue reading

Medicaid and mental health: A Tennessee approach

Photo: Don via FlickrNashville cemetery statue

Last week we posted an update on mental health coverage under the Affordable Care Act, so let’s follow up with a look at what’s going on in Tennessee, courtesy of Holly Fletcher at The Tennessean.

Tennessee is among the 19 states that have not taken up Medicaid expansion under the ACA. This summer a Tennessee legislative task force put forth a proposal for a partial expansion program, with the first stage focusing in large part on people with mental illness or substance abuse disorders. If approved – which isn’t certain – it could later be expanded, but only if it meets cost and quality objectives. As Fletcher reported, that’s not so easy. Gov. Bill Haslam, a Republican, last year tried to enact a market-based version, only to be blocked by a more conservative legislature, as one commentator noted in the newspaper. Continue reading

Efforts proceed slowly to expand the mental health coverage gains made in ACA

Photo: Jennifer Durban via Flickr

Congress recently passed a bill to combat opioid abuse (although it’s still fighting over funding it), and there’s a good chance lawmakers also will pass legislation updating a lot of the federal mental health programs in the fall – although lack of bipartisanship has reduced the scope of what could pass.

President Obama last month signed the opioid bill despite reservations about the lack of funding. Continue reading

Pros and cons of health payment reform: Capitation

Photo: Yann via Flickr

Photo: Yann via Flickr

The Urban Institute and the Catalyst for Payment Reform have collaborated on a series of briefs about various forms of health payment reform. Over the summer we’ll look at some that are receiving a lot of attention from policymakers and payers.

Let’s start with capitation. The recent Centers for Medicare & Medicaid Services (CMS) announcement about Comprehensive Primary Care Plus (CPC+) isn’t a switch to a fully capitated system. But this five-year model, scheduled to launch in January, does offer a degree of capitation, and moves further toward shifting more payments to a per-patient fee. Let’s look at what Urban/Catalyst says about the benefits and drawbacks of a capitated primary care payment system. Continue reading