Some websites and apps can estimate costs of various health plans in the new insurance exchanges. Some are better than others. The Kaiser Family Foundation has a calculator. Zeke Emanuel and Andrew Steinmetz wrote this op-ed describing two fairly sophisticated calculators that do a whole lot of what HealthCare.gov is supposed to do (calculating and shopping options but not all the verification that the government site has to do). One is on the website of Steve Morse. The other is called Value Penguin.
Community health centers
National Association of Community Health Centers Community health centers are expanding, because of the health reform law and funding made available through the 2009 stimulus law. This site has information about where they are, what policy issues face them, and leads about what some of the more innovative centers are trying to do.
Consultants and Legal Groups
Many HR consultancies, investment groups, and law firms have health policy resources (reports, webcasts, etc.) that are available to reporters, often online. Here are just a few of them:
Mercer Not all the benefits and HR data is relevant to health, but some of its work on health care benefit trends and employment is useful.
For background on what a co-op is, and some examples of successful ones that predate the Affordable Care Act, see this 2009 “tool kit” from the Alliance for Health Reform. It was written before the final legislation was passed in the Senate, but is still a useful overview.
Here’ s an HHS fact sheet – it was written before the funds were cut off, but it explains the federal program that applies to those that are going ahead.
Health Affairs and RWJF have published a brief that explains in more detail about how they are set up, and the challenges they face. The brief gives a description of several of the co-ops – here are the top three on the list to give a taste of the variety. (There are more in the brief and the National Alliance of State Health Cooperatives has a full list (PDF).
Congressional Budget Office: The CBO is the official “scorer” – or estimator – of legislation. The website has a huge trove of data, some more technical than other.
There is a section on Selected CBO Publications Related to Health Care Legislation 2090-2010
There is a section on other health policy, including Children’s Health Insurance Program and Physician Payment.
Don’t’ be put off by the daunting title of this March 2011 CBO analysis: “Reducing the Deficit: Spending and Revenue Options.” It has good one- or two-page nonspecialist descriptions of federal programs that could be changed in the ongoing budget debate. Many changes would be felt in local communities. (This is a link to the PDF)
CBO Glossary – Not light reading but still a useful one-stop-shopping for government financial terms.
MACPAC – the Medicaid and CHIP Payment and Access Commission – was established when the Children's Health Insurance Program was renewed in 2009 and it was expanded in the health care law. It reviews state and federal Medicaid and CHIP access and payment policies and makes recommendations to Congress, HHS and the states. Reports are online.
White House report: Trends in health care cost growth and the role of the Affordable Care Act, November 2013 This report analyzes recent trends in health care costs, the forces driving those trends, and their likely economic benefits. It states that health care spending growth is the lowest on record and that, “while the causes of the slowdown are not yet fully understood, the evidence available to date supports several conclusions about the slowdown and the role of the ACA.”
Reference Pricing: Will Price Caps Help Contain Health Care Costs? On Nov. 18, 2013, a panel of experts addressed a new strategy employers have begun known as "reference pricing" to help reduce health care costs. Under this benefit design, employees get insurance plans that set price caps on certain services and procedures. Enrollees are allowed to use any provider. But if they use providers with fees higher than the "reference price," they must pay the difference between the reference price limit, determined by the employer or insurer, and the actual charge. The transcript and video are available here. The event was sponsored by the Alliance for Health Reform and WellPoint.
Online tool uses state, federal data to track marketplace enrollments
The federal government plans to release exchange enrollment figures once a month (here’s the first report), and they’re expected to give more demographic information (i.e. age, metal tier) in future updates. States have different timetables for releasing their statistics. To keep track of it all, the Kaiser Family Foundation has a new tool: the State Marketplace Statistics.
It has both the enrollment numbers as well as some other key stats to watch (when available):
Eligibility determinations, including how many people can enroll in a marketplace plan with financial assistance and how many qualify for Medicaid/CHIP
Zeke Emanuel and Andrew Steinmetz wrote this op-ed describing two fairly sophisticated calculators that do a whole lot of what HealthCare.gov is supposed to do (calculating and shopping options but not all the verification that the government site has to do). One is on thewebsite of Steve Morse. The other is called Value Penguin. When I plugged in the same scenarios in the two sites, I came up with fairly consistent price quotes and options for families without a subsidy. It was a little harder to compare with the subsidy. One gave actual quotes, while the other gave more general price limits with subsidies. The Kaiser Family Foundation also has a calculator that takes into account ZIP code, income, age, family size and other factors.
Health Insurance Marketplace Premiums for 2014
The HHS Office of the Assistant Secretary for Planning and Evaluation released an issue brief summarizing the health plan choices and premiums that will be available in the Health Insurance Marketplace. It contains information, current as of Sept. 18, 2013, on qualified health plans in the 36 states in which the Department of Health and Human Services will support or fully run the Health Insurance Marketplace in 2014. Plan data is in final stages but is still under review, so this information is subject to change. The analysis includes similar information that is publicly available from 11 states and the District of Columbia that are implementing their own Marketplace. Health Insurance Marketplace Premiums for 2014 Databook
Just days after the November elections, states will have to make decisions about whether they are going to run their own health insurance exchange and what that will look like. States also are grappling with decisions about the essential benefits packages and Medicaid expansion. We talk to three experts who are doing hands-on work with both “red” and “blue” states.
A recording of this webcast is now available for AHCJ members. Log in to this page to access it.
This document (PDF) from the Center for Consumer Information and Insurance Oversight gives a good precise of the role and responsibilities of the exchanges, as well as how the states and federal government may divvy up the tasks. Particularly useful is the charge on page 5 explaining the five key functions of the insurance exchange:
Eligibililty (who goes into what program, what subsidies may apply)
Financial Management and the timetable on page 15 that shows what states have to do between now and 2014.
Slashdot.org is a place to track what the self-described tech nerds are saying online about the cyber-infrastructure of the health insurance marketplaces. CAVEAT: We’re listing it here as site you might find interesting – we are not endorsing everything that’s posted on it or asserting that it’s accurate so be forewarned. It isn’t peer reviewed; it’s something that people post on, but those of you who speak tech as well as health might want to peruse it.
Health policy issues
Covering Health Issues, 2011 Update: Written with reporters in mind,"Covering Health Issues" is useful for anyone looking for concise information on health policy issues, and experts from across the political spectrum. Chapters contain fast facts, background, tips for reporters, story ideas and experts with contact information. The book also includes an extensive glossary and ideas for TV and radio reporters.
Guide to health policy acronyms: If there's one thing health policy has in abundance, it's acronyms. So many that CMS (itself an acronym and a truncated one at that; as it stands for the Centers for Medicare and Medicaid Services) has an online acronym guide. There are hundreds of entries, alphabetically arranged. Some are quite obscure.
Health reform topic leader Joanne Kenen has compiled a list of books that journalists might find useful. She says: "Most of these books I’ve read all or part of. A few are new and I haven’t gotten to them yet, and a handful I’m relying on recommendations of others. Disclosure: I know a lot of these authors – friends, colleagues, sources, AHCJ members, even a former professor or two. Finally, there are more books aimed at explaining the new law or providing historical context than there are on how to dismantle or replace it – partly because there’s a larger crop of such books to choose from, and partly because it’s more relevant to this website. But the conservative viewpoint is represented."
The New Wave of Innovation: How the Health Care System Is Reforming: This resource for journalists from The Commonwealth Fund looks at emerging innovations, providing examples from different sectors across the country, to inform journalists and others of the ways in which the system is reforming itself. It may also provide ideas for journalists who are interested in exploring the early effects of health reform and the implications for the future.
Latest innovations in Medicare: Don’t look only to Washington policymakers for strategies to control medical costs and improve care for our aging population. New pilot projects that could accomplish these goals, which are at the heart of health reform, are being tested in communities across the country. In this tip sheet, reporter Susan Jaffe provides an overview of projects sponsored by the Center for Medicare and Medicaid Innovation, directs journalists to helpful resources and supplies an extensive list of potential story ideas.
Perspectives: Options for Reforming Medicare: Experts and policymakers in Washington are considering a broad range of proposals for reforming Medicare. Below, we present perspectives from leading experts on some of the more frequently mentioned policy options. Henry Aaron is a Senior Fellow in Economic Studies at The Brookings Institution, Stuart Butler is the Director of the Heritage Foundation’s Center for Policy Innovation, and Avalere Health is a leading health care policy consulting firm.
The Alliance for Health Reform publishes "Covering Health Issues: A Sourcebook for Journalists," in English and Spanish.
The Commonwealth Fund's Health Reform Resource Center: Explore the provisions of the Affordable Care Act and find the latest regulations. View the timeline for the highlights of the law, or use the "Find Health Reform Provisions" tool to search for specific provisions by year, category, and/or stakeholder group.
Center on Budget Policy Priorities: CBPP is a well-respected liberal research center with a focus on state and federal fiscal policies and programs that affect low- and moderate-income families and individuals. Issues reports and blog posts on health and entitlements.
U.S. Chamber of Commerce: Health care: The U.S. Chamber of Commerce, which can provide a conservative critique of health reform, has a plan to help businesses get health care costs under control, improve the quality of health care coverage and services, and expand meaningful coverage to the uninsured.
Heritage Foundation's Health Care Initiative: This conservative organization contends that health care is one of the most highly regulated sectors of the American economy and that government financing means government control, and government control means less personal freedom.
Choosing Wisely® is a campaign by the American Board of Internal Medicine to help physicians and patients engage in conversations to reduce overuse of tests and procedures, and support physician efforts to help patients make smart and effective care choices. The medical specialty societies, along with Consumer Reports, have identified tests or procedures commonly used whose necessity should be questioned and discussed. The resulting lists of "Things Physicians and Patients Should Question" provides some guidance about the need—or lack thereof—for many frequently ordered tests or treatments.
U.S. Preventive Services Taskforce: This independent panel of experts reviews scientific evidence for a broad range of clinical preventive health care services (such as screening, counseling, and preventive medications) and develops recommendations for primary care clinicians and health systems. The panel is composed of primary care providers (such as internists, pediatricians, family physicians, gynecologists/obstetricians, nurses, and health behavior specialists).
Section 1115 of the Social Security Act gives the secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs. The waivers give States flexibility to design and improve their Medicaid and CHIP programs. See a list of waivers by state.
With states thinking about using Medicaid expansion dollars to purchase private health coverage for low income people, this paper from the Kaiser Family Foundation explores how this version of “premium” assistance works under the current law.
The Robert Wood Johnson Foundation has done a series of nine reports (March 2014), looking at aspects of state implementation of the ACA including the enrollment systems, insurer participation, outreach and the small business market.
State Health Insurance Exchange Websites: (updated Oct. 7, 2013) This chart, from State Refor(u)m, provides links to the web portals, where consumers can purchase coverage, as well as links to relevant agency websites containing exchange policy and consumer assistance-related information.
KFF State Health Facts: A division of the Kaiser Family Foundation, it is a boon to local reporters, providing free, easy-to-use health data for all 50 states
National Conference of State Legislatures: A bipartisan organization that serves the legislators and staffs of the states and territories. It provides summaries on state implementation of health reform, Medicaid, budgets and other health-related topics.
State Health Reform Assistance Network: A program funded by the Robert Wood Johnson Foundation helping states with technical assistance on coverage expansion under the Affordable Care Act. The network's director, Heather Howard, has contributed useful maps showing where states are on implementing exchanges and the status of funding for each state, as well as a list of resources, as of October 2012.
State Refor(u)m: An online network for health reform implementation that connects health officials from different states, and with outside experts.
State Health Policy Options: This is a new (Oct 2012) website from the National Governors Association on state options for health reform. It includes names (but not contact info) of key state officials, as well as policy resources on cost and coverage, exchange creation, and delivery system reforms such a medical homes.
As you follow the legal fight over whether ACA subsidies can flow through the federal exchanges, or only the state exchanges, these reports from Avalere and RWJF/Urban Institute will help you understand who would be affected. And SCOTUSblog.org can keep you up on the progress of the cases. Use the search box at the top of the site and click on “blog.”
Tax aspects of the ACA
The Internal Revenue Service has released guidance on the tax provisions included in the Affordable Care Act, such as the Premium Tax Credit and the requirement to report the cost of coverage under an employer-sponsored group health plan on an employee’s Form W-2.
State attorneys general Martha Coakley (Mass.) and Ken Cuccinelli (Va.) debated the Affordable Healthcare Act as a prelude to the Supreme Court’s consideration of the law. National Press Club's "Newsmakers" series hosted the event. The attorneys general addressed several facets of the Supreme Court case, including the health care mandate, the tax basis, the general welfare aspect, expansion of Medicaid, severability, the law’s provisions and other areas.
GAO report: Expert Views on Approaches to Encourage Voluntary Enrollment
America’s Health Insurance Plans (AHIP), the main insurance industry trade group, outlines its views, and summarizes state experiments, at its “The Link” website.
AHCJ has tip sheets, blog posts and a webinar on the topic:
Webcast: To assist reporters across the country who will need to localize the decision and what it means for their states and local communities, AHCJ hosted a one-hour online roundtable of experts to offer you suggestions on stories you can pursue right away and in the weeks ahead.
On the preliminary campaign trail, Republicans vying for their party's president nomination attack Massachusetts' near universal coverage – which was created under then-Republican Gov. Mitt Romney and state Democrats, including the late Sen. Edward Kennedy. In Washington, Republicans are seeking to repeal the national health law that was in part based on the Massachusetts model, while also pushing to turn Medicaid into a block grant, saying they don't have enough flexibility to control costs and innovate. Romney's successor, Democrat Deval Patrick, testified June 23 before the Senate Finance Committee hearing on health entitlements. He addressed all of the above – stressing that his state was able to become a trailblazer within the current parameters on flexiblity.
Three movies about health care – overtreatment, undertreatment, cost, quality, the uninsured, the underinsured, the safety nets – are being launched. Some are being shown in community settings like medical schools – might be a good story to go to one of the screenings and see how it’s received and what people say. “Escape Fire”looks at military medicine too – maybe explore how its message pertains to veteran’s care where you live.
“Money and Medicine,” shot at UCLA Medical Center in Los Angeles and Intermountain Medical Center in Utah, airs on PBS stations starting Sept. 25. (Dates may vary in other communities.)
“The Waiting Room” goes inside a safety net, Oakland’s Highland Hospital, and it premieres Sept 26 in New York.
“Escape Fire” has held a bunch of medical school screenings and goes into wider release next week.
If you are covering comparative effectiveness research, trying to assess the validity of providers’ claims about treatments, procedures, drugs, “breakthroughs,” vitamins, alternative medicines, counterclaims of skeptical insurers or other payers (including public payers like state Medicaid programs) a local medical “arms race,” or patient-centered decision-making (“should I have treatment A or treatment B”), the databases and podcasts in the Cochrane Library can guide you to reviews of the clinical and/or economic evidence. More detail on how to use it.
The HHS secretary made the remarks after touring an Austin, Texas, health clinic on Friday, Oct. 25, 2013. Video courtesy FOX News.
President Obama says that the health insurance that's available to people through HealthCare.gov is high quality and affordable, and his Administration is working around the clock to address problems that make the site slow and difficult to use. October 21, 2013.
Obama CTO Todd Park Refuses To Give A Letter Grade For ObamaCare Website Rollout (November 13, 2013)
Joanne Kenen , Deputy Health Editor for the Politico and Stacey Singer, Investigative Reporter from The Palm Beach Post hosted the seminar "10 Stories on Local Healthcare Reform". This hour long seminar was held this morning at 10:30 the Excellence in Journalism Conference.
Dr. Ezekiel Emanuel shares his thoughts on health care reform in the USA with the Canadian Association for Health Services and Policy Research. Discusses importance of leadership and engagement of health professionals in system transformation.
Ezekiel J. Emanuel is the Vice Provost for Global Initiatives, the Diane v.S. Levy and Robert M. Levy University Professor, and Chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania. He is also an Op-Ed contributor to the New York Times. He was the founding chair of the Department of Bioethics at the National Institutes of Health and held that position until August of 2011. Until January 2011, he served as a Special Advisor on Health Policy to the Director of the Office of Management and Budget and National Economic Council. He is also a breast oncologist and author. After completing Amherst College, he received his M.Sc. from Oxford University in Biochemistry. He received his M.D. from Harvard Medical School and his Ph.D. in political philosophy from Harvard University. His dissertation received the Toppan Award for the finest political science dissertation of the year. In 1987-88, he was a fellow in the Program in Ethics and the Professions at the Kennedy School of Government at Harvard. After completing his internship and residency in internal medicine at Boston's Beth Israel Hospital and his oncology fellowship at the Dana-Farber Cancer Institute, he joined the faculty at the Dana-Farber Cancer Institute. Dr. Emanuel was an Associate Professor at Harvard Medical School before joining the National Institutes of Health. Dr. Emanuel has authored 3 books and co-edited 4 and will have two books forthcoming in 2012. His publications include The Oxford Textbook of Clinical Research Ethics, edited by Dr. Emanuel and members of the NIH Department of Bioethics and Healthcare, Guaranteed, Dr. Emanuel's own recommendations for health care reform and, Exploitation and Developing Countries. His book on medical ethics, The Ends of Human Life, has been widely praised and received honorable mention for the Rosenhaupt Memorial Book Award by the Woodrow Wilson Foundation. Dr. Emanuel has also published No Margin, No Mission: Health-Care Organizations and the Quest for Ethical Excellence and co-edited Ethical and Regulatory Aspects of Clinical Research: Readings and Commentary. Dr. Emanuel developed The Medical Directive, a comprehensive living will that has been endorsed by Consumer Reports on Health, Harvard Health Letter, the New York Times, Wall Street Journal, and many other publications. He has published widely on the ethics of clinical research, health care reform, international research ethics, end of life care issues, euthanasia, the ethics of managed care, and the physician-patient relationship in the New England Journal of Medicine, the Lancet, JAMA, and many other medical journals. He has received numerous awards including election to the Institute of Medicine (IOM) of the National Academy of Science, the Association of American Physicians, and the Royal College of Medicine (UK). Hippocrates Magazine selected him as Doctor of the Year in Ethics. He received the AMA-Burroughs Welcome Leadership Award, the Public Service Award from the American Society of Clinical Oncology, the John Mendelsohn Award from the MD Anderson Cancer Center, and a Fulbright Scholarship (which he declined). In 2007, Roosevelt University presented Dr. Emanuel with the President's Medal for Social Justice. Dr. Emanuel served on President Clinton's Health Care Task Force, the National Bioethics Advisory Commission (NBAC), and on the bioethics panel of the Pan- American Healthcare Organization. Dr. Emanuel has been a visiting professor at numerous universities and medical schools, including the Brin Professor at Johns Hopkins Medical School, the Kovtiz Professor at Stanford Medical School, the University of Pittsburgh School of Medicine, UCLA, and a visiting professor at New York University Law School.
Otis Brawley, M.D., chief medical and scientific officer, American Cancer Society, was the keynote speaker at Health Journalism 2012, the annual conference of the Association of Health Care Journalists.
Brawley, responsible for promoting the goals of cancer prevention, early detection and quality treatment, champions efforts to decrease smoking, improve diet and provide the critical support cancer patients need. He guides efforts to enhance and focus the research program, upgrade the Society's advocacy capacity, and concentrate community cancer control efforts in areas where they will be most effective. He is a leader in the Society's work to eliminate disparities in access to quality cancer care.
At a recent forum, Virginia Attorney General Ken Cuccinelli and Massachusetts Attorney General Martha Coakley offer contrasting perspectives on the constitutionality of the federal Affordable Care Act's requirement that individuals must purchase health insurance. For more health reform news updates, visit http://www.familypracticenews.com/news/practice-trends.html
The health care overhaul law passed by Congress in 2010 sets out national goals and requirements. But many of the key decisions implementing the law are left to the states.
In this video, Robert Field of Drexel University in Philadelphia offers ideas for reporters interested in covering health reform at the state level.
From a Dec. 14, 2011 briefing sponsored by the Association of Health Care Journalists, the Alliance for Health Reform and the Robert Wood Johnson Foundation.
Politico Reporter Sarah Kliff shares the three issues around implementation of health reform that she is watching, during this panel at Health Journalism 2011.
Sarah Kliff of Politico and Julie Appleby of Kaiser Health News discuss some issues reporters should be aware of in states where the federal government will be setting up health insurance exchanges. From Health Journalism 2011.
From the Aging in the 21st Century workshop held by the Association of Health Care Journalists in Coral Gables, Fla., in October 2009. More at http://www.healthjournalism.org/aging
The new health reform law benefits people on Medicare in a number of ways. This three-minute video explains some of the ways, such as ending out-of-pocket expenses for recommended screenings, checkups and other preventive services. Featuring John Rother, president of the National Coalition on Health Care.
This video is part of a series produced by the non-partisan Alliance for Health Reform in Washington, DC (allhealth.org). Our aim is to explain simply and in concrete terms the major provisions of the health reform law (the Patient Protection and Affordable Care Act of 2010). The series is supported by the Robert Wood Johnson Foundation. To suggest questions that you would like to have answered in this series, please send an email to BillErwin@allhealth.org
Avalere Health CEO Dan Mendelson presents on how the changing health care landscape affects the healthcare industry, and the implications for investors. Find out more about Avalere Health at www.avalerehealth.net.
On Monday, the Supreme Court agreed to hear arguments next spring on the constitutionality of the health care reform law. Jeffrey Brown discusses the political and legal implications with The National Law Journal\'s Marcia Coyle and NPR\'s Julie Rovner.
Most people think the new health reform law simply increases the number of people with health coverage in the U.S.
But it does more. It also contains a number of provisions to help people get long-term supports and services at home, or if need be, in a nursing home.
This video outlines some of the ways in which the Affordable Care Act promotes long-term care. Featuring Bruce Chernof, MD, president and CEO of The SCAN Foundation, dedicated to helping seniors receive integrated medical treatment and human services in the setting most appropriate to their needs.
July 18, 2013: UPDATED ANIMATION NOW AVAILABLE. View the newest YouToons video, "The YouToons Get Ready for Obamacare" on YouTube: http://youtu.be/JZkk6ueZt-U
Health care reform explained in "Health Reform Hits Main Street."
Confused about how the new health care reform law really works? This short, animated movie -- featuring the "YouToons" -- explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014. Written and produced by the Kaiser Family Foundation. Narrated by Cokie Roberts, a news commentator for ABC News and NPR and a member of Kaiser's Board of Trustees. Creative production and animation by Free Range Studios.
Also let the YouToons illustrate how health insurance coverage will work under reform. Visit: http://healthreform.kff.org/profiles.aspx
Timothy D. McBride, Ph.D., professor and associate dean for public health in Washington University's Brown School, discusses the impact of health reform on rural communities. From a panel at the Rural Health Journalism Workshop 2011, presented by the Association of Health Care Journalists.
About 70 percent of Americans over age 65 will eventually need some form of long-term care.
This can mean nursing home care. But more commonly, it means help at home with activities such as dressing, cooking and eating.
Many people think Medicare covers long-term services and supports. With limited exceptions, it does not, as this video points out.
Featuring Bruce Chernof, MD, president and CEO of The SCAN Foundation, dedicated to helping seniors receive integrated medical treatment and human services in the setting most appropriate to their needs.
This video is part of a series produced by the Alliance for Health Reform, a nonprofit, nonpartisan health policy education group in Washington, DC. See more videos at www.allhealth.org.
¿Esta confundido acerca de cómo la nueva ley de reforma de salud realmente funciona? Este video explica los problemas relacionados con el sistema de salud actual, los cambios que están sucediendo ahora, y los cambios importantes que se anticipan para el 2014.
Confused about how the new health reform law really works? This short, animated movie -- featuring the "YouToons" -- explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014. Watch the English-language version here: http://www.youtube.com/watch?v=3-Ilc5xK2_E
In the first of a new series of briefings for health care journalists, a panel of experts offered updates and analysis about implementation of the Affordable Care Act in the states.
The Dec. 12 Chicago AHCJ chapter event was co-sponsored by the Alliance for Health Reform and the Robert Wood Johnson Foundation.
In California Friday, President Barack Obama praised the health law benefits already in place and talked about the state's health insurance marketplace. He also placed a special emphasis on touting the law to the state's Latino population.
In California Friday, President Barack Obama praised the health law benefits already in place and talked about the state's health insurance marketplace. He also placed a special emphasis on touting the law to the state's Latino population.
Upcoming events on Health Reform from the AHCJ calendar.