Wednesday, October 30, 2013

Why Insurers Cancel Policies, And What You Can Do About It

More From Shots - Health News HealthOnline Advice Can Hurt Teens At Risk For Suicide, Self-HarmHealthNotices Canceling Health Insurance Leave Many On EdgeHealthThe Long List Of Health Apps Features Few Clear WinnersHealthWhy Insurers Cancel Policies, And What You Can Do About It

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Notices Canceling Health Insurance Leave Many On Edge

More From Shots - Health News HealthOnline Advice Can Hurt Teens At Risk For Suicide, Self-HarmHealthNotices Canceling Health Insurance Leave Many On EdgeHealthThe Long List Of Health Apps Features Few Clear WinnersHealthWhy Insurers Cancel Policies, And What You Can Do About It

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Confused About Health Insurance? Take Our Quiz!

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Monday, October 28, 2013

Some Health Screenings May Harm More Than Help

More From Shots - Health News HealthUnlikely Multiple Sclerosis Pill On Track To Become BlockbusterHealth CareMore Technical Issues For Obamacare, But Good News For MedicareResearch NewsEeek, Snake! Your Brain Has A Special Corner Just For ThemHealthSome Health Screenings May Harm More Than Help

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Wednesday, October 23, 2013

White House Turns To 'Rock Star' Manager For Obamacare Fix

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Tuesday, October 22, 2013

Enrollments For Health Care Exchanges Trickle In, Slowly

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Monday, October 21, 2013

If A Tech Company Had Built The Federal Health Care Website

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Thursday, October 17, 2013

If A Tech Company Had Built The Federal Health Care Website

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HealthCare.gov was meant to create a simple, easy way for millions of Americans to shop for subsidized health care.

Instead, in a little two more than weeks, it has become the poster child for the federal government's technical ineptitude.

A dysfunctional contracting system clearly bears some of the blame. But entrepreneurs in Silicon Valley likely would have approached the project differently from the start.

A week after the site launched, NPR spoke to Suzanne Cloud, a jazz musician based in Philadelphia. At that point, Cloud had spent hours on the site, trying to sign up for coverage. "Something went wrong, and it just went to a page with all kinds of html stuff," she said.

This week, Cloud says she gave up on the website and ended up registering by phone. The folks on the phone took all of her information � then asked if she'd like to pick out her plan online or receive information about her health care options via snail mail.

Cloud chose snail mail. "Once I signed up with the telephone, I didn't go back and try the site again," she said.

At 17 days old, HealthCare.gov has become a bit of a joke � even to folks like Cloud, who were eagerly awaiting its rollout.

So how could a roughly $400 million software project that had been in the works for years have so many problems at its launch? One bit of advice from Silicon Valley: Start small.

"It's not as if Facebook says, 'OK, here is our six-year plan for how we're going to make Facebook.com,' " says entrepreneur Ben Balter. "They build one feature at a time, and take a step back, look at how the feature is be used, before they go on to the next feature."

Balter says you build something small, you test it, and when it works for your users, then you take the next step. Right now, Balter works for GitHub.

"GitHub is a social code-sharing service," he says. "Think of it like Facebook for code. So instead of posting pictures of your kids or posting ... on Twitter what you had for lunch, you are showing what projects you're working on."

By sharing the code you are writing, lots of people can critique it, find the bugs, offer ideas and make sure it works. It's called open source, and Balter believes HealthCare.gov should have been written that way from the start.

"Why would you make that code private?" Balter asks.

But often when things don't work in government, the impulse is to duck and cover and clamp down on information.

"I think the key reason is the way projects get funded," says Michael Cockrill, who used to work in startups and is now the chief information officer for Washington state.

He says to get a software project funded in the public sector, typically you have say exactly what it is going to do, spell how much it will cost and when you will finish.

"As a result, you end up creating this culture that is all about doing what you said you were gonna do," Cockrill says.

It's a culture that is risk-adverse and terrified of public failure. You can't learn from little failures or adjust course midstream. And instead of taking big jobs, breaking them down into small tasks and testing for success at each step, a project like HealthCare.gov becomes a giant all-or-nothing gamble.

Cockrill says too often it's a gamble taxpayers loose.

"You've made all these commitments about what you are going to build. What is it going to look like upfront," Cockrill says. "And even if the market changes underneath you, and even if your customers need something different � which you know always happens � you made a commitment a big public commitment, and they've written it into budgets and law."

Cockrill and many others around the country are trying to help governments become more flexible and agile as they embark on software development projects.

"It's really hard to convince people to kind of trust you," he says. "Especially when you are saying, 'Look I don't know exactly what is going to look like � but we are going to do what matters most first.' "

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Friday, October 11, 2013

California Trains Helpers To Meet Demand For Health Insurance

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FAQ: What Retirees And Seniors Need To Know About The Affordable Care Act

This is one of several explainers to help consumers navigate their health insurance choices under the Affordable Care Act, or as some call it, Obamacare. Click here for answers to other common questions. Have a question we missed? Send it to health@npr.org. We may use it in a future on-air or online segment.

I am on Medicare. Do I need to use one of the new health insurance exchanges?

No. Medicare is not part of the health insurance exchanges. The exchanges won't be selling so-called "Medigap" policies that supplement the coverage seniors get through Medicare.

Seniors will still get health coverage through Medicare's traditional fee-for-service program or Medicare Advantage plans, private health insurance plans that are approved by Medicare. Those who are enrolled in Medicare Part A, which covers hospital care, or the Advantage plans will meet the health law's mandate for individuals to have insurance.

Does the health care law offer any new benefits for Medicare beneficiaries?

Beneficiaries receive more preventive care services � including a yearly "wellness" visit, mammograms, colorectal screening, and more savings on prescription drug coverage. By 2020, the law will close the Medicare gap in prescription drug coverage, known as the "doughnut hole." Seniors will still be responsible for 25 percent of their prescription drug costs.

Does the health law require higher-income Medicare beneficiaries to pay more for their Medicare prescription drug coverage?

It does. Currently, Medicare beneficiaries who earn more than $85,000 ($170,000 for a couple) pay more for their Medicare Part B premiums, which cover physician and outpatient services. The health law brought that same sliding-scale approach to beneficiaries' prescription drug coverage in Medicare Part D for those with incomes of more than $85,000 ($170,000 for a couple). Those income thresholds will be frozen through 2019.

If I'm retired and my former employer offers me insurance, can I shop on the exchange to get a better deal?

Even if your former employer offers coverage, you can opt to buy a plan on the exchange. However, you may not be eligible for a subsidy.

See other Frequently Asked Questions on the Affordable Care Act:

Understanding The Health Insurance Mandate And Penalties For Going Uninsured All About Health Insurance Exchanges And How To Shop At Them A Young Adult's Guide to New Health Insurance Choices How Obamacare Affects Employers And How They're Responding Where Medicaid's Reach Has Expanded � And Where it Hasn't

Additional coverage from NPR Member Stations:

California (KQED, San Francisco) California (KPCC) California (KXJZ Capital Public Radio, Sacramento) Colorado (Colorado Public Radio) Massachusetts (WBUR, Boston) Minnesota (Minnesota Public Radio) Georgia (WABE, Atlanta) New York (WNYC) Oregon (Oregon Public Broadcasting) Pennsylvania (WHYY newsworks.org) Texas (KUHF) Texas (KUT, San Antonio)

This FAQ was produced through a collaboration between NPR and Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonpartisan health-care policy research organization. The Kaiser Family Foundation is not affiliated with Kaiser Permanente.

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Thursday, October 10, 2013

Employers Trim Health Costs By Cutting Coverage For Spouses

More From Shots - Health News HealthWhy Scientists Held Back Details On A Unique Botulinum Toxin HealthEven Mild Strokes Take A Toll On Quality Of LifeHealthActivists Sue U.N. Over Cholera That Killed Thousands In HaitiHealthNobel Goes To Scientists Who Took Chemistry Into Cyberspace

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Wednesday, October 9, 2013

Is Obamacare Enough?

Without Single-Payer, Patchwork U.S. Healthcare Leaves Millions Uninsured

From Democracy Now –

Despite helping expanding affordable insurance, “Obamacare” maintains the patchwork U.S. healthcare system that will still mean high costs, weak plans and, in many cases, no insurance for millions of Americans. We host a debate on whether the Affordable Care Act goes far enough to address the nation�s health crisis with two guests: Dr. Steffie Woolhandler, a primary care physician and co-founder of Physicians for a National Health Program; and John McDonough, a professor at the Harvard School of Public Health and former senior adviser on national health reform to the U.S. Senate Committee on Health, Education, Labor, and Pensions. Between 2003 and 2008, McDonough served as executive director of Health Care for All in Massachusetts, playing a key role in the passage of the 2006 Massachusetts health reform law, known as “Romneycare,” regarded by many as the model for the current federal healthcare law.

Tuesday, October 8, 2013

First Step In Health Exchange Enrollment: Train The Helpers

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Questions Rise As Health Care Exchange Draws Near

Enrollment in the Affordable Care Act health exchanges is set to begin Oct. 1. But many eligible Americans still have questions.

Tell Me More reached out to listeners via Facebook and Twitter in an attempt to help answer their questions about the law. Host Michel Martin spoke with Mary Agnes Carey, a senior correspondent at Kaiser Health News � a news service not affiliated with Kaiser Permanente.

On searching for other affordable care options

Listener Caitlin Stevenson: "When the Affordable Care Act goes into effect, if I'm already covered by an employer's health plan, am I still eligible to shop for more affordable care? The plan that my job offers costs more than $350 a month for my husband and me � that's more than a car payment! Will we � healthy adults, 26 and 31— be able to find a plan that costs less than this?"

Carey answers: "Anyone can shop on the exchange. The question here is whether or not they can qualify for a subsidy of purchased coverage. ... In order to qualify for a subsidy, two things have to happen. No. 1: The ... health insurance offered by her husband's employer has to cost more than 9.5 percent of their household income or the plan, if it covers at least 60 percent of the covered medical expenses. [What] I mean is that if it pays for 60 percent of the medical expenses, they could not get into the exchange. So it either costs more than 9.5 percent of the income or it doesn't pay for 60 percent of the covered services. If one of those things happen, they might be able to qualify for a subsidy."

On options for graduating students

Graduate student Lorrie Guess: "I obviously don't know yet if I'm going to have a job that offers me coverage and I don't want to pay a fine if I don't buy the coverage in case I get a job that offers me health insurance. On the other hand, I don't want to buy coverage only to get a job that ends up covering me and then find out that I'm paying for no reason."

Carey answers: "Well here's a couple of ideas. No. 1, is there any way to extend her student health insurance for a period of time after graduation as she decides where she's going to go and what job she has and whether or not she has coverage? That's one thing. Secondly, while the enrollment period for the first year of the Affordable Care Act ends at the end of March, there are things called qualifying life events � you lose your insurance at work, you get married, you have a child. I think graduating from college would be one of these. ... [And she] could get coverage on her parents' health insurance plan for a period of time. As we know, the Affordable Care Act allows that up to age 26."

On mental health options

Carey says, "As part of the Affordable Care Act ... there will be more coverage of mental health services. ... And also there has to be parity between what a plan offers on health services and what they offer on mental health services. But this is an area where I would urge caution, for people to look at and see how parity is defined, how it's implemented in a particular policy. Because this has been a concern � the mental health parity law passed a few years ago, [and while] some of the regulations have come through with it others have not. But it's definitely an area worth watching for people that are enrolling in the exchange coverage."

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One Key Thing No One Knows About Obamacare

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Commander In Chief, Explainer In Chief Tout Health Care Law

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President Obama joins former President Clinton to talk about the health care law, during the annual Clinton Global Initiative meeting Tuesday in New York.

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President Obama joins former President Clinton to talk about the health care law, during the annual Clinton Global Initiative meeting Tuesday in New York.

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President Obama's health care law has so far survived challenges in Congress and the courts. But its biggest test could begin next week. That's when the online marketplaces offering health care coverage to the uninsured are set to start signing people up. The question is, will they come?

Of the uninsured surveyed by NBC and the Wall Street Journal this month, only about 1 in 3 said they're likely to use the exchanges. Obama is trying to make the argument that signing up is a good deal: "In many states across the country, if you're, say, a 27-year-old young woman, don't have health insurance, you get on that exchange, you're going to be able to purchase high-quality health insurance for less than the cost of your cellphone bill."

The White House is enlisting nurses, ministers, celebrities, even radio DJs to help spread that message. On Tuesday, Obama got some help from former President Bill Clinton. The two leaders sat side by side in a pair of overstuffed armchairs at the Clinton Global Initiative for a televised � if somewhat wonky � conversation about health care economics.

It's the nature of insurance, Obama said, for healthy people to subsidize those who need more care. Clinton says that's why it's important to get healthy young people enrolled in the insurance exchanges.

"This only works, for example, if young people show up," said Clinton. "We've got to have them in the pools. Because otherwise all these projected low costs cannot be held if older people with pre-existing conditions are disproportionately represented in any given state."

Clinton understands those economics, having launched his own, unsuccessful push for universal coverage 20 years ago this week. Obama got further, pushing his bill through Congress, but he notes the battle to implement the law is far from over: "Let's face it: It's been a little political, this whole Obamacare thing."

The administration is now using social media and other tactics honed during the president's re-election campaign to promote enrollment in the health care exchanges. Obama acknowledges they're battling a multimillion-dollar advertising blitz mounted by the president's critics.

"Those who have opposed the idea of universal health care in the first place and have fought this thing tooth and nail through Congress and through the courts and so forth, have been trying to scare and discourage people from getting a good deal," said Obama.

Congressional Republicans also continue to challenge the law, which was passed over their unanimous opposition in 2010. Despite the battle being waged within the Republican ranks right now over tactics like the filibuster and a threatened government shutdown, Senate GOP leader Mitch McConnell says his party is united in its opposition to the health care overhaul.

"Obamacare hasn't even been fully implemented yet but we can already see the train wreck headed our way," said McConnell. "Major companies have been dropping the health care plans their employees have and like. And every week it seems there are new reports about glitches that will hurt families, compromise personal information, or expose the American people to fraud."

The administration has been forced to delay some elements of the law, including a requirement that large employers provide health care coverage or pay a penalty.

On the plus side, Clinton noted Tuesday the growth in health care costs has slowed dramatically in recent years, though analysts are unsure what's behind the change. Obama says if U.S. health care costs could be brought in line with other countries, it would largely fix the federal deficit and make U.S. employers more competitive.

"This has everything to do with the economy, in addition to what I consider to be the moral imperative that a mom should not have to go bankrupt if her son or daughter gets sick," said Obama.

Obama plans to deliver another health care speech Thursday, as the countdown to enrollment continues.

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Would A Federal Shutdown Delay Health Care Exchanges?

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Tech Problems Plague First Day Of Health Exchange Rollout

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Monday, October 7, 2013

Medicaid Looks Good To A Former Young Invincible

More From Shots - Health News HealthDelaying Aging May Have A Bigger Payoff Than Fighting DiseaseHealthNobel Winners Decoded How Neurons And Cells Talk To Each OtherHealthFor Boys With Eating Disorders, Finding Treatment Can Be HardHealthIt's Time To Rediscover The IUD, Women's Health Advocates Say

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A Medicaid Expansion In Pennsylvania May Take Time

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Would A Federal Shutdown Delay Health Care Exchanges?

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