Uninsured would drop by millions, enrollment would swell if Medicaid expansion holdouts opted in

http://www.healthcarefinancenews.com/news/uninsured-would-drop-millions-enrollment-would-hit-nearly-9-million-if-remaining-medicaid?mkt_tok=eyJpIjoiTXpsak9USm1PR1F4WlRrMCIsInQiOiIrUk84a1NPYTRob3g4OHVJckpIMEtXaldKalB5ck1kZHhcL29lbURhRjZaazdFNXdZbDVucEdpVjFJenhOdDh1Vkl2UVBxOE91Q2tUWktTdDdKc0x1ZFVDdmZPOTBSTXo1dDJyWkdHRlBVUms9In0%3D

Photo by <a href="https://www.flickr.com/photos/dph1110/3460882920"> David Herrera </a>

Nineteen states have yet to expand their Medicaid programs under theAffordable Care Act, and a new study from the Robert Wood Johnson Foundation shows just how much enrollment would increase if they did: 7.8 to 8.8 million, while the number of uninsured would decline between 4.1 and 5 million, the research found.

That’s in addition to about 6.9 million people who would be subtracted from the ranks of the uninsured under the major coverage provisions of the ACA.

More than half of these people would be in three states: Texas (1.2 million), Florida (877,000), and Georgia (509,000). More than four-fifths of the uninsured people gaining Medicaid eligibility would be adult without children, while about 48 percent of the uninsured gaining eligibility would be white non-Hispanic; 52 percent are working either full- or part-time.

Mike Pence’s health policy record is a mixed bag

http://www.healthcarefinancenews.com/news/mike-pences-health-policy-record-mixed-bag

Photo by <a href="https://www.flickr.com/photos/gageskidmore/16502595039"> Gage Skidmore </a>

Indiana Gov. Mike Pence is in the spotlight this week as the man Donald Trump has picked to be his running mate. Pence’s decisions about health and health care in Indiana have drawn attention from within and outside the state. His record could be important in November, because Trump doesn’t have a legislative record at all.

Here’s a quick look at the governor’s history in terms of health policy in Indiana.

Sanders convention speech cites Clinton health care concessions

Sanders convention speech cites Clinton health care concessions

In a Democratic convention speech that revisited the agenda of his surprisingly competitive campaign for the nomination, Sanders reminded the audience that while he may have lost the race, he did succeed in convincing Clinton to support three important proposals: a “public option” for Obamacare, letting people join Medicare early, and a big funding increase for community health centers.

“This campaign is about moving the United States toward universal health care and reducing the number of people who are uninsured or underinsured,” Sanders said. “Hillary Clinton wants to see that all Americans to have right to choose public option in their health care exchange.”

Two Insurance Giants Planning To Jump Into California’s Medicaid Market

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Two of the nation’s largest insurers are reaching out to doctors as they prepare to offer health coverage to low-income residents in California’s Medicaid program.

UnitedHealth and Aetna plan to join Medi-Cal managed care in San Diego and Sacramento counties beginning next year, pending final state approval.

Their participation shows that “Medi-Cal is a good business to be in,” said Stan Rosenstein, a consultant with Health Management Associates and a former Medi-Cal administrator. “Insurers are recognizing that with Medi-Cal covering a third of Californians, [they] really can’t ignore it.”

Seven healthcare questions the candidates aren’t answering

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/seven-healthcare-questions-candidates-aren-t-answering?cfcache=true

Hillary Clinton is quick to tout that she will defend the Affordable Care Act (ACA) and build on it to slow the growth of out-of-pocket healthcare costs while Donald Trump vows to repeal the ACA and have a series of reforms ready for implementation that follow free-market principles.

But when taking a closer look at their proposals, Clinton and Trump are keeping mum about some healthcare issues, and that’s raising some critical questions. Managed Healthcare Executive asked industry experts to comment on what topics presidential candidates are being quiet about, and why they suspect they’re not talking about them.

5 health and medicine issues to watch for at the Democratic convention

5 health and medicine issues to watch for at the Democratic convention

Hillary Clinton led a health care reform effort in the 1990s, promoted medical research as a senator, and has been bashing price-hiking drug companies on the campaign trail and in TV ads.

So there’s every reason to expect her to make health care a major theme when she accepts the Democratic presidential nomination in Philadelphia on Thursday night. What she says about the future of medical research, public health, and the uninsured will give a valuable preview of what her priorities would be — and how far she’s willing to go to co-opt the ideas of her defeated rival, Bernie Sanders.

Here are the five biggest things to watch in health and medicine:

Five Health Issues Presidential Candidates Aren’t Talking About — But Should Be

http://khn.org/news/five-health-issues-presidential-candidates-arent-talking-about-but-should-be/

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References to the Affordable Care Act — sometimes called Obamacare — have been a regular feature of the current presidential campaign season.

For months, Republican candidates have pledged to repeal it, while Democrat Hillary Clinton wants to build on it and Democrat Bernie Sanders wants to replace it with a government-funded “Medicare for All” program.

But much of the policy discussion stops there. Yet the nation in the next few years faces many important decisions about health care — most of which have little to do with the controversial federal health law. Here are five issues candidates should be discussing, but largely are not:

Cleveland Clinic CEO: Affordable Care Act is here to stay

http://www.fiercehealthcare.com/finance/cleveland-clinic-ceo-aca-appears-mostly-safe?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTm1VMU5HUmlOakEzTWpVMyIsInQiOiI5XC9mUGloUlREa3Rtam9UaXdnaG0zeXZlWitYYVRuR3R3eFAzMDc1WWFURHlZMVBcL005SG42T2IwY2FhOFY0MFJDYzFHSGpDTmRQVkVqWXE3TTRORFEyNlpBdDFUR2k2N3RaNXNBdkh0NXJnPSJ9

capitol building above treescapitol building above trees

The Republican National Convention pulled up stakes after it concluded yesterday, but a visitor to the convention floor says that the Affordable Care Act is here to stay.

In an interview with CBS This Morning, Cleveland Clinic Chief Executive Officer Toby Cosgrove, M.D., said that it was unlikely that the ACA would be uprooted, even if Republican Donald J. Drumpf is elected President and there are GOP majorities in both houses of Congress.

“I don’t think you will see something now six years into the process totally dismantled,” Cosgrove said, adding that the healthcare reform law has led to insurance coverage for 20 million more Americans. Cosgrove suggested that it was more likely that the ACA would undergo continuing improvements such as “more wellness activities.”

Nondiscrimination And Chronic Conditions — The Final Section 1557 Regulation

http://healthaffairs.org/blog/2016/07/20/nondiscrimination-and-chronic-conditions-the-final-section-1557-regulation/

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Before the Affordable Care Act (ACA), those with serious or chronic health conditions were often denied health insurance coverage or paid high prices for substandard plans with coverage exclusions. Many went uninsured and untreated. For them, the ACA’s new coverage opportunities and protections against discriminatory practices by health insurers serve as an essential lifeline.

Under the ACA, insurers can no longer charge higher premiums or deny coverage for people with pre-existing conditions. However, some insurers have tried to circumvent ACA protections by designing benefits that discourage enrollment by persons with significant health needs.

NHeLP and The AIDS Institute filed a landmark complaint with the Department of Health and Human Services’ Office for Civil Rights after four Florida insurers placed all HIV medicines, including generic drugs, on the highest cost sharing tiers. Researchers found that this practice—called “adverse tiering”—is widespread. A New England Journal of Medicine study found that one-in-four insurers placed all drugs to treat HIV in the highest tiers. Another study in Journal of the American Medical Association found that up to 15 percent of plans in the federal marketplace lack in-network physicians for at least one specialty, making access to care significantly more expensive for those with specialized care needs.

The Department of Health and Human Services (HHS) recently finalized regulations for the cornerstone non-discrimination provision of the ACA — Section 1557. For the first time, the provision applies civil rights protections against discrimination on the basis of race, ethnicity, national origin, sex, age, and disability specifically to health programs and activities administered by or receiving federal funding.

Health advocates and patient advocacy organizations lauded the final regulations for Section 1557, which expressly prohibit insurers from employing plan benefit designs or marketing practices that discriminate.