Kentucky has gotten a lot of attention for the largely unexpected success of its health insurance exchange.
The Washington Post’s Stephanie McCrummen has looked at another aspect of the Kentucky story: Who is getting covered and what is that going to mean?
Her first feature was published Nov. 23 (when most of us were focused on the final week of the “tech surge” to fix HealthCare.gov). She followed up in February. McCrummen looked at the faces behind the numbers – and asked questions about the numbers.
Her stories took her to Breathitt County in the foothills of Appalachia, one of the poorest and unhealthiest counties in the U.S with high rates of diabetes and heart disease. She focused on Courtney Lively, who is a human link between being covered and not being covered. Lively works at a clinic near a fast food joint, helping people get coverage, some for the first time. Among those walking through her office door were “cashiers from the IGA grocery, clerks from the dollar store, workers from the lock factory, call-center agents, laid-off coal miners, KFC cooks, Chinese green-card holders in town to teach Appalachian students.”
The employer mandate was pushed back for 2014 and is being phased in more gradually in 2015-16. What portion of the workforce does this affect?
And what’s going on with that “30-hour” work week? That’s how the Affordable Care Act defines full time, and the GOP has legislation (likely to pass the House in early March – far less likely in the Democratic-led Senate) that would change the definition to the more standard 40-hour week.
As we’ve pointed out before, you hear a lot of talk about how the Affordable Care Act will hurt small business. But if you report those claims, be careful of the definitions. Small businesses with fewer than 50 full time equivalent (FTE) workers are and have always been exempt from the employer mandate. They can, if they wish, get coverage through the new (but still fairly underdeveloped) SHOP exchanges. But whether they choose to and how much they contribute to their workers’ coverage is up to them. Continue reading
The latest ACA enrollment report (and the CBO projection that 6 million people would sign up for exchange coverage by March 31) is a classic half-full, half empty scenario.
Half full because the 3.3 million selecting exchange plans is a way better number than what many expected last fall when the sign-up portals were not working. Remember when only about 100,000 had chosen a plan in the state and federal marketplaces in October?
Half empty because 3.3 million may be on track to 6 million – but 6 million is less than the 7 million that the administration earlier had embraced as a goal. And 6 million or 7 million (plus another 8 million in Medicaid and CHIP) still leaves millions of people uninsured. Continue reading
Blame it on Obamacare.
That’s what you hear, over and over again. Anything in the health care system that someone doesn’t like, it’s Obamacare.
Sam Baker of the National Journal took a look at some of the things people are blaming on Obamacare – high deductibles, narrow networks, employers cutting benefits – and reminds us that they were already part of the health care landscape, before the Affordable Care Act. He writes:
Welcome to the Obamacare era. Continue reading
Yet another study tells us how little the public knows about the Affordable Care Act, and how even the people most likely to benefit from it are often unaware. The study, from The Robert Wood Johnson Foundation and The Urban Institute, found that fewer than four in 10 uninsured adults thought they would get insurance this year. Most don’t realize they may be eligible for subsidies or expanded Medicaid.
We all know that the Affordable Care Act is complicated, and the intense political fighting about it has added to the confusion and the challenges of getting simple apolitical messages across.
But is it all about politics and messaging? How much of a role does “health literacy” – or more specifically “health insurance literacy” play? Continue reading
We get inundated with reports and issue papers, but every once in a while it’s a good idea to pick one up, review what you know and figure out what you have to learn.
A recent report, “Cracking the Code on Health Care Costs” from a state health cost containment commission organized by the University of Virginia’s Miller Center turned out to be useful for that purpose. It didn’t offer me any brand-spanking new huge ideas but it pulled a lot of trends and data together in one (nonpartisan) place – everything from malpractice reform to end-of-life care, and how they can be addressed at the state level.
If you are an experienced health care reporter, the state sections can still give you some story ideas. If you are a newbie, the report is a pretty good and readable overview. Read the executive summary and then follow up on areas that interest you for stories.
Here are five story ideas I came up with in just a few minutes of looking at the report – you will be able to think of dozens more that affect your community. Continue reading
In November, the Fort Worth Star Telegram wrote about several people who were “losing” under the Affordable Care Act. A month later it ended up having to do a pretty significant mea culpa by executive editor Jim Witt.
The flaws in the story caught the attention of health care blogger and author Maggie Mahar. Some of the accounts of people who lost their old policies and were facing stupendous prices for lousy new Obamacare policies didn’t ring true. A 26-year-old woman, even one with multiple sclerosis, wasn’t going to have to pay up to $1,800 a month for coverage that was inferior to what she had before.
So Mahar did a bit of reporting of her own. Continue reading
So did the Obama administration let potentially millions of Americans buy the same kind of “junk” insurance policies that were being canceled because they didn’t meet new requirements of the health law? Not exactly.
In late December the White House said that anyone who had their plan canceled could, if they wished, get a “hardship exemption” from the individual mandate and purchase a catastrophic health plan (if such plans are available in their region).
These plans are far from generous. They aren’t designed to be. But they do have certain basic consumer protections that may meet the needs of some families. A big surge of individuals or families taking up this option could, however, hurt the overall exchanges if lots of healthy people take them. People covered under these plans could “count” toward the goal of getting 7 million Americans covered by the end of March 2014. But they don’t count as part of the exchange risk pools. They are apart. And the insurers fear that they will siphon off some of the healthier people that they need in the pool to keep costs sustainable. Continue reading
(Full disclosure: Kenen is Politico’s health care editor.)
Former AHCJ president and Columbia Journalism Review contributor Trudy Lieberman – in a wonderfully titled piece called “Dropped Coverage” – analyzed media coverage of the Affordable Care Act for the new Politico magazine.
She found that plenty was … dropped. Continue reading