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Health Estimates Newswire

Dec. 27, 2018: Despite Obamacare uncertainty, Medicaid expansion likely to proceed

Despite Obamacare uncertainty after ruling, Medicaid expansion likely to proceed
The three red states — Idaho, Nebraska and Utah — that bucked their own Republican legislatures last month and approved Medicaid expansion under the Affordable Care Act are likely to proceed, despite Friday's ruling by a federal judge in Texas that the entire federal health care law is unconstitutional. Even in Montana, where voters last month defeated an extension of the temporary Medicaid expansion approved in 2015, legislative leaders predict that lawmakers will make the expansion permanent, since it is politically unpopular to take coverage away from people once it has been extended.

Nearly 200,000 uninsured Virginians have enrolled in Medicaid under expansion for Jan. 1 start date The Roanoke Times
Kara Murdock camped out on Halloween night so she would be the first person in Prince William County to enroll in Virginia's newly expanded Medicaid program. The 27-year-old, whose right arm was amputated below the elbow as the result of a blood clot when she was 23, has been uninsured since she was dropped from her parents' insurance coverage when she turned 26. But on Jan. 1, Murdock will be one of the more than 180,000 uninsured people to gain Medicaid coverage under the program's new qualification rules.

Utah senator wants Medicaid work requirements back on the menu KUER 90.1, NPR Utah
A familiar health program known as work requirements will be returning in the upcoming legislative session after Utahns' voted to fully expand Medicaid in November. Work requirements are the rules that say if an individual gets low-income health insurance through the state's Medicaid program, they also have to fulfill a requirement like taking classes, doing job training or volunteering. "You either have to be employed or you have to be looking for work, or preparing yourself so that you're qualified to go to work if you are able," said Utah State Senator Allen Christensen, R-Ogden.

Obamacare enrollment dips 3.6 percent in Texas, 4 percent nationally

Austin American-Statesman
Enrollment in health insurance plans for 2019 under the Affordable Care Act has slipped about four percent from the signup period last year, according to federal data, after a late surge prevented the decline from reaching double digits. Nearly 8.5 million people in states that use the federal marketplace signed up for 2019 coverage by the Dec. 15 deadline, the federal Centers for Medicare and Medicaid Services reported, off from about 8.8 million last year. Still, this year's decline had measured 13 percent, compared to last year, after the initial four weeks of open enrollment that began Nov. 1, signaling a pickup in the final stretch.

South Carolina: U.S. breach laws are coming National Law Review
In another change to U.S. state breach notice laws in 2019, South Carolina will have new breach notice requirements for insurance companies. The requirements follow the National Association of Insurance Commissioners' Insurance Data Security Model Law. South Carolina was the first to adopt the model text into law, and it is this law that is going into effect on Jan. 1, 2019. South Carolina joins others states, including Connecticut and New York, to have breach notice requirements for insurance companies.

Providers, insurers call for strong enforcement of drug price transparency Modern Healthcare
Providers and insurers want the CMS to put some real teeth — including financial penalties — into any plan requiring greater price transparency from drugmakers. In comments on a proposed rule to require drugmakers to list a drug's wholesale price in TV ads, several provider and insurers groups told the agency that a stick is needed to ensure pharmaceutical companies follow through. Kaiser Permanente, which said it would prefer to see HHS and Congress curtail direct-to-consumer ads, suggested imposing a fine of one percent of Medicare and Medicaid payments on drugmakers that violate the rule, should it become final.

'Patient as payer' trend is growing Health Leaders Media
A study released recently showed that just 30 percent of self-pay accounts, comprised primarily of patients who are uninsured, have generated 80 percent of self-pay revenue for hospitals. That's certainly a lopsided statistic, one made especially significant by the ballooning uninsured rate. But what should revenue cycle executives do — in a practical sense — with that finding?

State launches website to inform Nebraskans about Medicaid expansion progress
Gov. Pete Ricketts' administration has taken a step forward on expanding Medicaid to some 90,000 low-income Nebraskans. State officials recently unveiled a website aimed at informing citizens about progress in carrying out the Medicaid expansion measure passed by voters in November. The measure, known as Initiative 427, became law last week. It requires the Department of Health and Human Services to file a Medicaid plan amendment with the federal government by April 1.

More people are getting treatment for mental health and substance abuse Washington Post
A new study from independent nonprofit FAIR Health analyzed individual procedures or services covered by private insurance companies from 2007 to 2017. In that decade, use of services for behavioral health, which includes substance abuse and mental-health conditions, went up 320 percent. Treatment related to use and dependence on amphetamines climbed more than 3,000 percent, while use of treatment for anxiety diagnoses spiked more than 240 percent.

Exclusion of doctors from public health insurance up 2007 to 2017 Medical Xpress
Alice Chen, Ph.D., M.B.A., from the University of Southern California in Los Angeles, and colleagues conducted a cross-sectional study to examine the characteristics of physicians excluded from Medicare and state public insurance programs for fraud, health crimes, or unlawful prescribing of controlled substances between 2007 and 2017. The researchers found that 2,222 physicians (0.29 percent) were temporarily or permanently excluded from Medicare and state public insurance programs during 2007 to 2017.

Jeff Sopko