Saturday, November 30, 2013

How Will We Know If HealthCare.gov Is Fixed?

Listen to the Story 3 min 24 sec Playlist Download Transcript   Enlarge image i

Health care specialist Stacy Chagolla helps William Bishop compare plans at an Affordable Care Act enrollment fair in Pasadena, Calif., this month.

David McNew/Getty Images

Health care specialist Stacy Chagolla helps William Bishop compare plans at an Affordable Care Act enrollment fair in Pasadena, Calif., this month.

David McNew/Getty Images

Saturday is the day the Obama administration set as its deadline for making HealthCare.gov a "smooth experience" for most users.

A tech-savvy team of engineers, database architects and contractors has been working through the holiday to ensure the White House makes good on that promise, but judging the success of their efforts may take some time.

How will we know whether the website is fixed? NPR's health policy correspondent Julie Rovner says that partly depends on how you define "fixed." She joins Weekend Edition Saturday host Scott Simon to explain what that means.

Interview Highlights

What "fixing" HealthCare.gov means

Remember the promise is to have it working for what they call the "vast majority of users," by which the administration means 80 percent of visitors to the site.

That means 1 of every 5 people will still need to use a call center, an in-person counselor, or a paper application due to a technical problem or because his or her individual situation is too complex to be handled online. So Amazon or Orbitz this is not.

But then again, this is not buying a TV or a plane ticket, either. Many people have pointed out that spending a couple of hours buying health insurance online is still a lot faster than the old way, when you might have had a 50-page paper application and a process that literally took weeks.

How the administration has been fixing the website

There was a little show and tell earlier this week, where the White House actually showed reporters some of the 300 or so people who have been working pretty much around the clock from various centers located in the Washington, D.C., suburbs.

They've got a separate hardware team doing upgrades to increase the website's capacity, for example � they're saying it should be able to handle 800,000 separate visits per day going forward.

Then another team is working on software. They're fixing bugs and trying to make the website more user-friendly for consumers.

Will anyone be able to tell if the site is really fixed?

That's the really frustrating part. I'm not sure we will, at least not at first. We do already know it's working better than it was in October � which, frankly, was a pretty low bar to get over. The administration has all kinds of fancy metrics to show how well the website is working, but we don't have our own independent access to them.

We do know a big test is likely to come on Monday, when people who have been talking to relatives over the long holiday weekend � or who wake up and suddenly realize it's December and they want coverage in January � all try to sign on at once.

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Key parts of the site that must wait

Insurance companies are getting increasingly worried. It seems that while so much effort has been going into what they call the "front end" of the site � where consumers go to compare insurance plans and sign up for coverage � some parts of the "back end" of the site � where insurance companies actually get paid � haven't even been built yet.

The administration says it will get that done before money has to begin to change hands sometime in January, but given that nothing up until this point has happened on schedule, that doesn't make insurance companies feel a whole lot better about things.

One piece of the site that will wait an entire year

Small businesses were supposed to be able to sign up online to enroll their employees through the federal website starting this month. That was already delayed from Oct. 1. Now that won't happen online until next November.

They can still compare plans online, but they'll have to use paper applications and go through an insurance broker or agent or an insurance company directly, unless they're in one of a handful of states that's got its small-business exchange up and running.

The administration has been pretty candid about this � they've said their top priority is to make the website work for consumers first, and pretty much everything else is taking a back seat.

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Thursday, November 28, 2013

HealthCare.gov Team Working Through Holiday To Meet Deadline

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HealthCare.gov Team Working Through Holiday To Meet Deadline

More From All Tech Considered TechnologyHealthCare.gov Team Working Through Holiday To Meet DeadlineDigital LifeTech Team Podcast, Episode 3: Inside Video Games And GamingTechnologyI Can Haz Spanish Lessons: Cat Pictures Now Have A PurposeU.S.The Misery Of Holiday Travel, In One Real-Time Map

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Wednesday, November 27, 2013

Emergency Contraceptive Pill Might Be Ineffective For Obese

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Supreme Court Will Hear New Challenge To Health Law

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Tuesday, November 26, 2013

Supreme Court Takes Challenge To Obamacare Contraceptive Rule

Listen to the Story 3 min 9 sec Playlist Download Transcript   Enlarge image i

The U.S. Supreme Court has agreed to take another case involving the Affordable Care Act, this time a challenge to the provision that for-profit companies that provide health insurance must include contraceptive coverage in their plans offered to employees.

Saul Loeb/AFP/Getty Images

The U.S. Supreme Court has agreed to take another case involving the Affordable Care Act, this time a challenge to the provision that for-profit companies that provide health insurance must include contraceptive coverage in their plans offered to employees.

Saul Loeb/AFP/Getty Images

President Obama's Affordable Care Act will be back before the Supreme Court this spring. This time, the issue is whether for-profit corporations citing religious objections may refuse to provide contraceptive services in health insurance plans offered to employees.

In enacting the ACA, Congress required large employers who offer health care services to provide a range of preventive care, including no-copay contraceptive services. Religious nonprofits were exempted from this requirement, but not for-profit corporations.

Some three dozen of these corporate entities challenged this requirement in court, contending the contraception mandate violates their religious rights. On Tuesday, the Supreme Court agreed to examine the issue, after lawyers on both sides asked for high court review.

The lead plaintiff before the court is Hobby Lobby, a chain of more than 500 arts and crafts stores with more than 13,000 employees. The owners are conservative Christians who object to some forms of birth control and contend that the mandate thus abridges their religious rights in violation of both the Constitution and federal law.

David Green, founder and CEO of Hobby Lobby, appeared in an online video to explain his company's position. "We do everything we possibly can to be a help to our employees of how that they can structure their life based on biblical principles," he says.

Hobby Lobby and the Green family are represented by Kyle Duncan of the Becket Fund for Religious Liberty. Duncan argues that the contraception coverage requirement coerces the corporate owners to violate their religious beliefs. "That forces them to choose between violating their faith or exposing their businesses to severe consequences including, potentially, severe fines," he said in an interview.

The U.S. Court of Appeals based in Denver agreed. The judges on that court pointed to the Supreme Court's controversial 2010 Citizens United decision, which declared that corporations have the same right as individuals to spend money in political campaigns. In view of that decision, said the appeals court judges, they could see no reason that corporations would not be similarly entitled to exercise religious beliefs, as well.

The government, however, points to a long line of Supreme Court cases that take a contrary view. No court has ever found a for-profit company to be a religious organization for purposes of federal law, the Justice Department said in its briefs. Government would be unable to function, the department suggested, if children could be exempt from child labor laws on religious grounds, for example, or if employers refused to pay taxes because of religious objections to how the money was spent.

Indeed, women's rights advocates see the no-copay birth control provision as a civil rights measure for women, ensuring that women can afford to make reproductive decisions for themselves.

If the court were to allow for-profit corporations to avoid civil rights laws based on their religious beliefs, that would "create a very slippery slope, giving for-profit employers their own right to impose their own medical preferences on their employees," said Planned Parenthood President Cecile Richards on Tuesday. She also emphasized that the choice to use birth control "should be between a woman and her doctor. And no employer should be able to take that right away."

All of these views, and more, will be on full display when the Supreme Court hears arguments in Hobby Lobby and a companion case brought by Conestoga Wood Specialties, a 900-employee woodworking corporation owned by a Mennonite family. A decision is expected by summer.

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Tuesday, November 19, 2013

Wisconsin Chooses Its Own Path To Overhaul Medicaid

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Wisconsin Chooses Its Own Path To Overhaul Medicaid

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Saturday, November 16, 2013

New Medical Device Treats Epilepsy With A Well-Timed Zap

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Wednesday, November 13, 2013

Can Young People Get Obamacare For $50 A Month? Sometimes

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Tuesday, November 12, 2013

Clinton To Obama: Honor Promise That People Can Keep Coverage

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Wednesday, November 6, 2013

The President Wants You to Get Rich on Obamacare

From the New York Times –

Tom Scully bolted through the doors and up the stairs to a private dining room on the third floor of the �21� Club. Scully, 56, is slightly taller than average and has tousled graying hair, an athletic build and a lopsided smile. He typically projects a combination of confidence and bemusement, but on this rainy September afternoon, he was frenzied. Scully was scheduled to deliver the keynote address at an event hosted by the Potomac Research Group, a Beltway firm that advises large investors on government policy (tag line: �Washington to Wall Street�). Today�s discussion centered on the most significant change in decades to the nation�s health care policy, the Patient Protection and Affordable Care Act, a.k.a. Obamacare. As Scully walked to the front of the room, some 50 managers from hedge funds, mutual funds and private equity firms tucked into the round tables. Others gathered in the hallway. A hush of anticipation hung in the air.

During the past year, anxiety about the onset of Obamacare has created a chill in some parts of the economy. While large health care businesses � insurance companies, for instance, and hospital chains � have poured significant resources into preparing for millions of new customers, countless investors have appeared spooked by the perpetual threats to repeal, or at least revise, the law. According to Thomson Reuters, private equity investment, usually the lifeblood for entrepreneurialism, has dropped by an astonishing 65 percent in the health care sector this year.

Scully has been trying to assuage these worries, but the nervous questions keep coming at him. Before he even began his speech, one attendee said he feared that only three million new patients, far fewer than estimated, would be signing up for insurance. �No way,� Scully said. �Way more � way more. At least 15 million, maybe 20 million. The Democrats have a huge incentive to make this work.� Another asked if Scully was worried about Congressional repeal. �It�s just not going to happen,� he said. �Don�t pay attention to Rush Limbaugh.� When Scully finally began his speech, he noted that the prevailing narrative among Republicans � assuming that many in the room were, like him, Republican � was incorrect. �It�s not a government takeover of medicine,� he told the crowd. �It�s the privatization of health care.� In fact, Obamacare, he said, was largely based on past Republican initiatives. �If you took George H. W. Bush�s health plan and removed the label, you�d think it was Obamacare.�

Scully then segued to his main point, one he has been making in similarly handsome dining rooms across the country: No matter what investors thought about Obamacare politically � and surely many there did not think much of it � the law was going to make some people very rich. The Affordable Care Act, he said, wasn�t simply a law that mandated insurance for the uninsured. Instead, it would fundamentally transform the basic business model of medicine. With the right understanding of the industry, private-sector markets and bureaucratic rules, savvy investors could help underwrite innovative companies specifically designed to profit from the law. Billions could flow from Washington to Wall Street, indeed.

Scully, who has spent the last 30-some years oscillating between government and the private sector, is hoping to be his own best proof of the Obamacare gold mine. As a principal health policy adviser under President George H. W. Bush, he helped formulate many of those past Republican initiatives � like the shift to private-insurance programs � that Obamacare has put into law. Under George W. Bush, he ran the Centers for Medicare and Medicaid Services and oversaw a host of proto-Obamacare reforms, like Medicare Part D, which introduced competition into the government-supported health care market. After leaving C.M.S. in 2004, Scully began working simultaneously at Welsh, Carson, Anderson & Stowe, a leading health care private equity firm, and Alston & Bird, a law firm and health care lobbying organization. When the Affordable Care Act became law in 2010, he found himself in the rare position of being a lobbyist, private equity executive and former government health care official with access to a serious amount of capital. During the past three years, as other Republicans have tried to overturn Obamacare, Scully searched for a way to make a killing from it.

Continue reading…

The President Wants You to Get Rich on Obamacare

From the New York Times –

Tom Scully bolted through the doors and up the stairs to a private dining room on the third floor of the �21� Club. Scully, 56, is slightly taller than average and has tousled graying hair, an athletic build and a lopsided smile. He typically projects a combination of confidence and bemusement, but on this rainy September afternoon, he was frenzied. Scully was scheduled to deliver the keynote address at an event hosted by the Potomac Research Group, a Beltway firm that advises large investors on government policy (tag line: �Washington to Wall Street�). Today�s discussion centered on the most significant change in decades to the nation�s health care policy, the Patient Protection and Affordable Care Act, a.k.a. Obamacare. As Scully walked to the front of the room, some 50 managers from hedge funds, mutual funds and private equity firms tucked into the round tables. Others gathered in the hallway. A hush of anticipation hung in the air.

During the past year, anxiety about the onset of Obamacare has created a chill in some parts of the economy. While large health care businesses � insurance companies, for instance, and hospital chains � have poured significant resources into preparing for millions of new customers, countless investors have appeared spooked by the perpetual threats to repeal, or at least revise, the law. According to Thomson Reuters, private equity investment, usually the lifeblood for entrepreneurialism, has dropped by an astonishing 65 percent in the health care sector this year.

Scully has been trying to assuage these worries, but the nervous questions keep coming at him. Before he even began his speech, one attendee said he feared that only three million new patients, far fewer than estimated, would be signing up for insurance. �No way,� Scully said. �Way more � way more. At least 15 million, maybe 20 million. The Democrats have a huge incentive to make this work.� Another asked if Scully was worried about Congressional repeal. �It�s just not going to happen,� he said. �Don�t pay attention to Rush Limbaugh.� When Scully finally began his speech, he noted that the prevailing narrative among Republicans � assuming that many in the room were, like him, Republican � was incorrect. �It�s not a government takeover of medicine,� he told the crowd. �It�s the privatization of health care.� In fact, Obamacare, he said, was largely based on past Republican initiatives. �If you took George H. W. Bush�s health plan and removed the label, you�d think it was Obamacare.�

Scully then segued to his main point, one he has been making in similarly handsome dining rooms across the country: No matter what investors thought about Obamacare politically � and surely many there did not think much of it � the law was going to make some people very rich. The Affordable Care Act, he said, wasn�t simply a law that mandated insurance for the uninsured. Instead, it would fundamentally transform the basic business model of medicine. With the right understanding of the industry, private-sector markets and bureaucratic rules, savvy investors could help underwrite innovative companies specifically designed to profit from the law. Billions could flow from Washington to Wall Street, indeed.

Scully, who has spent the last 30-some years oscillating between government and the private sector, is hoping to be his own best proof of the Obamacare gold mine. As a principal health policy adviser under President George H. W. Bush, he helped formulate many of those past Republican initiatives � like the shift to private-insurance programs � that Obamacare has put into law. Under George W. Bush, he ran the Centers for Medicare and Medicaid Services and oversaw a host of proto-Obamacare reforms, like Medicare Part D, which introduced competition into the government-supported health care market. After leaving C.M.S. in 2004, Scully began working simultaneously at Welsh, Carson, Anderson & Stowe, a leading health care private equity firm, and Alston & Bird, a law firm and health care lobbying organization. When the Affordable Care Act became law in 2010, he found himself in the rare position of being a lobbyist, private equity executive and former government health care official with access to a serious amount of capital. During the past three years, as other Republicans have tried to overturn Obamacare, Scully searched for a way to make a killing from it.

Continue reading…

Tuesday, November 5, 2013

Insurance Cancellations: The Price Of Mending A Broken System?

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Saturday, November 2, 2013

Adding To Insurance Confusion, Outside Groups Try To Cash In

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Adding To Insurance Confusion, Outside Groups Try To Cash In

More From Shots - Health News Health CareAdding To Insurance Confusion, Outside Groups Try To Cash InHealth CareSo You Found An Exchange Plan. But Can You Find A Provider?HealthFeds To Ease Restrictions On Flexible Spending AccountsHealthSorry, Red Sox, Heavy Stubble Beats Beards For Attractiveness

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