Friday, January 31, 2014

Two Obamacare exchanges see more health insurer competition

By David Morgan



WASHINGTON Fri Jan 31, 2014 8:36pm EST





U.S. President Barack Obama takes the stage to deliver remarks on the Affordable Care Act, commonly known as Obamacare, at an Organizing for Action grassroots supporter event in Washington, November 4, 2013.



Credit: Reuters/Jonathan Ernst







<span id="articleText"><span id="midArticle_start"/> WASHINGTON (Reuters) - At least two U.S. states running their own Obamacare health insurance exchanges expect new insurers to enter their marketplaces and bolster competition in 2015, officials said on Friday.



<span id="midArticle_1"/>Kynect, which is Kentucky's marketplace, and the Rhode Island Health Benefits Exchange have had separate talks about 2015 with health insurers that could opt to join the online marketplaces set up under President Barack Obama's healthcare reform law. Kentucky also expects an expansion of physician networks available within current plans.



<span id="midArticle_2"/>Increased competition would increase consumer choices and tend to put downward pressure on health insurance cost trends. It could also help ensure the future of Obama's Affordable Care Act, which depends on the success of new online marketplaces.



<span id="midArticle_3"/>Kentucky and Rhode Island are among states with the most successful Obamacare launches. Obama himself highlighted Kentucky's performance in his State of the Union address on Tuesday.



<span id="midArticle_4"/>Each state also has only a small number of insurers. Kynect currently has three insurers and has enrolled more than 44,000 people in private plans since its October 1 launch. The Rhode Island exchange, with two insurers for individual consumers, has enrolled about 12,000 people.



<span id="midArticle_5"/>It was not clear whether more competition would be in the offing for other states with their own exchanges or the federal government, which runs a marketplace for 36 states that have chosen not to operate their own.



<span id="midArticle_6"/>"We expect our number of carriers to certainly grow and our networks to become more robust," said Audrey Haynes, a one-time aide to former President Bill Clinton who is now secretary of the Kentucky Cabinet for Health and Family Services.



<span id="midArticle_7"/>Christine Ferguson, director of the Rhode Island exchange, predicted an expansion would result from insurer interest in individuals and small-business employees. "We are definitely in conversations with other carriers to come in. And I think we'll be successful with that," she said.



<span id="midArticle_8"/>Both women were speaking to reporters at an event hosted by the nonprofit Robert Wood Johnson Foundation, which tracks healthcare trends.



<span id="midArticle_9"/>Healthcare marketplaces, which began operating in all 50 states and the District of Columbia on January 1, allow consumers who lack coverage to purchase private health insurance, often at federally subsidized rates.



<span id="midArticle_10"/>But a botched autumn launch of the federal marketplace and lagging enrollment among younger adults have raised concerns about the success of the marketplaces, with critics predicting big increases in costs down the road.



<span id="midArticle_11"/>Haynes said officials in Kentucky had spoken to managed care plans owned by larger national insurance companies. "We've heard that they want to come into the market," she said.



<span id="midArticle_12"/>California, which operates the nation's largest state-run healthcare exchange, has 13 insurers and has enrolled more than 625,000 people through private plans since October 1.



<span id="midArticle_13"/>The state has barred new insurers from entering its marketplace in 2015, but officials say they are confident about the current roster of insurers.



<span id="midArticle_14"/>"All of the plans with Covered California are really recognizing that this is a long-term play and are looking at things like benefit design, how do we improve the benefits," Peter Lee, executive director of the California exchange, told the same forum.



<span id="midArticle_15"/>(Reporting by David Morgan; Editing by Tom Brown)



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Goodell talking big ahead of Super Bowl

By Steve Keating



NEW YORK Fri Jan 31, 2014 9:14pm EST





NFL Commissioner Roger Goodell speaks during a news conference ahead of the Super Bowl, in New York January 31, 2014.



Credit: Reuters/Carlo Allegri







<span id="articleText"><span id="midArticle_start"/> NEW YORK (Reuters) - With gridiron's biggest game being staged on America's biggest stage, National Football League commissioner Roger Goodell used the spotlight on Friday to ponder some big plans.



<span id="midArticle_1"/>From the possibility of more games around the world to expanding the number of playoff teams and adding franchises, to courting more women and Hispanic fans, a relaxed Goodell laid out his blueprint for NFL's expansion during his annual pre-Super Bowl state of the league address.



<span id="midArticle_2"/>The Denver Broncos will take on the Seattle Seahawks in the first cold weather Super Bowl on Sunday at MetLife Stadium and Goodell joked that even the NFL could not control the weather as fluffy fake snow fell on the stage.



<span id="midArticle_3"/>But if nothing else, Mother Nature appears to be a Super Bowl fan with fears of a winter blizzard disrupting the NFL's showcase giving way to a promising forecast of chilly but clear conditions.



<span id="midArticle_4"/>"We are doing something innovative and unprecedented," said Goodell. "Something consistent with the essence of football and the Super Bowl.



<span id="midArticle_5"/>"This is the number one market and a great stage for this Super Bowl matchup, and the world will be watching."



<span id="midArticle_6"/>The world is watching with increasing interest.



<span id="midArticle_7"/>Next year the NFL will play three regular season games in London and according to NFL figures, Sunday's Super Bowl broadcast will be available in 198 countries and territories in 25 languages.



<span id="midArticle_8"/>Mexico is eager to have the NFL back and Goddell did not rule out the possibility of going to South America for a game in Brazil at one of the new stadiums being built for the soccer World Cup and 2016 Olympics.



<span id="midArticle_9"/>"We have not heard directly from any officials in that area," said Goodell when asked about talk of taking the NFL to Brazil. "We're always interested in expanding our game.



<span id="midArticle_10"/>"We see the opportunity for us to continue to expand our game, come into new markets, and we find that valuable to the league."



<span id="midArticle_11"/>BRITISH EXPANSION



<span id="midArticle_12"/>While Goodell downplayed talk of London getting an expansion franchise, the commissioner made it clear that developing the British market was the focus of it global strategy. All three games scheduled for London next season are already sold out.



<span id="midArticle_13"/>"Our focus, as you know, has been in the United Kingdom," said Goodell. "I'm happy to report that all three games are sold out.



<span id="midArticle_14"/>"We're seeing that kind of passion and that kind of excitement about NFL football on a global basis.



<span id="midArticle_15"/>"Our games, when we play them, just as in the United Kingdom, are done with a strategy.



<span id="midArticle_0"/>"They're done with media coverage, with licensing partners and trying to build the fan base from the ground up."



<span id="midArticle_1"/>Growing the fan base at home is also part of the plan.



<span id="midArticle_2"/>Recent studies have found that women represent approximately 45 percent of the NFL fan base and is a market the league believes it can continue to develop.



<span id="midArticle_3"/>To cater to its growing Hispanic base, the Super Bowl this year for the first time will be broadcast in Spanish in the United States.



<span id="midArticle_4"/>"One of our fastest growing audience segments is our Hispanic fans, both here in the States and throughout the world, and we're proud of that, and that's intentional," said Goodell



<span id="midArticle_5"/>"We're working harder to reach those fans, introduce them to the game.



<span id="midArticle_6"/>"Or, if they already are great fans, we want to give them more of the game.



<span id="midArticle_7"/>"Women are really embracing the game. We're not doing anything special other than inviting them into the game.



<span id="midArticle_8"/>"If they feel comfortable being fans, they will. They're great fans."



<span id="midArticle_9"/>One sure way to bring in new fans at home and aboard is to up the excitement and entertainment value of a product and Goodell said more is on the way with talks progressing about adding two teams to the playoffs.



<span id="midArticle_10"/>The playoffs currently involve 12 teams but that number is expected to rise to 14.



<span id="midArticle_11"/>"There has been a great deal of focus over the last year on if we would make any modifications to our postseason," admitted Goodell. "There's a lot of benefits to doing that. We think we can make the league more competitive.



<span id="midArticle_12"/>"We think we can make the matchups more competitive towards the end of the season.



<span id="midArticle_13"/>"There will be more excitement, more memorable moments for our fans."



<span id="midArticle_14"/>(Editing by Greg Stutchbury)



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Swiss lead, Spain trail, Czechs level in Davis Cup

By Toby Davis



LONDON Fri Jan 31, 2014 8:31pm EST









1 of 8. Switzerland's Roger Federer (C) and Michael Lammer (R) congratulate Stanislas Wawrinka (L) after winning his Davis Cup world group first round tennis match against Serbia's Dusan Lajovic in Novi Sad January 31, 2014.



Credit: Reuters/Novak Djurovic







<span id="articleText"><span id="midArticle_start"/> LONDON (Reuters) - Roger Federer and Stanislas Wawrinka gave Switzerland a 2-0 lead over last year's runners-up Serbia while injury-hit Spain trailed Germany by the same margin as the Davis Cup World Group first-round ties got underway on Friday.



<span id="midArticle_1"/>Serbia fielded a second string team without world number two Novak Djokovic, two months after they lost to the Czech Republic in the final, and were quickly under pressure in Novi Sad.



<span id="midArticle_2"/>Federer beat 268th-ranked Ilija Bozoljac in straight sets while Wawrinka, fresh from winning his maiden grand slam title at the Australian Open, eased past Dusan Lajovic in four.



<span id="midArticle_3"/>Five-times champions Spain, without injured world number one Rafa Nadal and David Ferrer, got off to a poor start against Germany in Frankfurt with Davis Cup rookie Roberto Bautista Agut easily beaten by Philipp Kohlschreiber in straight sets.



<span id="midArticle_4"/>They put up more of a fight in the second rubber but a gutsy effort from Feliciano Lopez was eventually repelled by Florian Mayer after five sets with the fans on the edge of their seats.



<span id="midArticle_5"/>The Czechs, who retained the Davis Cup in November, were level at 1-1 with the Netherlands in Ostrava, with Radek Stepanek going down in five tough sets to Robin Haase before Tomas Berdych thrashed Igor Sijsling in straight sets.



<span id="midArticle_6"/>France got off to a flier against Australia with Jo-Wilfried Tsonga beating veteran Lleyton Hewitt in straight sets after Richard Gasquet outclassed Nick Kyrgios, also in three.



<span id="midArticle_7"/>Britain lead the United States 2-0, Wimbledon champion Andy Murray having beaten John Isner's replacement Donald Young in straight sets before 175th-ranked James Ward upset big-serving American Sam Querrey, ranked 49th, in five sets.



<span id="midArticle_8"/>Ward came from 1-6 7-6 3-6 down to stun a partisan U.S. crowd at Petco Park in San Diego, winning 10 of the last 11 games as he sealed victory in three hours, 11 minutes.



<span id="midArticle_9"/>Canada were level with Japan, Italy and Argentina were also all square and Kazakhstan were leading 2-0 at home to Belgium.



<span id="midArticle_10"/>COMMANDING LEAD



<span id="midArticle_11"/>Switzerland go into Saturday's doubles with a commanding lead after Federer beat Bozoljac 6-4 7-5 6-2 in the opening singles before Wawrinka overcame Lajovic 6-4 4-6 6-1 7-6(7).



<span id="midArticle_12"/>Federer recovered from 5-2 down in the second and having weathered the storm against hard-hitting Bozoljac, the former world number one raced through the third set to fire the Swiss ahead.



<span id="midArticle_13"/>"The most important thing is that I won the match in straight sets after I struggled to read his serve early on and fought back in the second set," Federer told a news conference.



<span id="midArticle_14"/>Wawrinka, who showed signs of fatigue after a long-haul flight from Melbourne following his win over world number one Nadal in the Australian Open final on Sunday, had to dig deep to fend off a spirited challenge from 23-year old Lajovic.



<span id="midArticle_15"/>The young Serb squandered two set points in the fourth set tiebreak, after coming back from 3-0 down in the set and the breaker, but choked under pressure and blasted a relatively easy smash beyond the baseline as Wawrinka sealed the match.



<span id="midArticle_0"/>"I always knew this was going to be a difficult match because I didn't really have time to prepare for it but I was determined to fight until the end in order to win the second point for my team," said Wawrinka.



<span id="midArticle_1"/>"We are in a good position now but we have to stay focused and hopefully we will finish the job in Saturday's doubles."



<span id="midArticle_2"/>HIGH DRAMA



<span id="midArticle_3"/>Spain surrendered the first rubber as Bautista Agut lost 6-2 6-4 6-2 to Kohlschreiber but there was far more drama in the second singles with local favorite Mayer racing into a two-set lead before Lopez battled back to win the third 6-1.



<span id="midArticle_4"/>The left-handed Spaniard then saved two match points in the fourth set before breaking the German to force a deciding set in front of a noisy 5,000 crowd at the Fraport Arena.



<span id="midArticle_5"/>Mayer, ranked 29th, three places behind Lopez, squandered two more match points in the fifth before a thundering serve on the line put the hosts 2-0 up after almost four hours.



<span id="midArticle_6"/>"I always wanted to win a singles rubber in the World Group," said Mayer in a courtside interview.



<span id="midArticle_7"/>"I had match points, then injured my shoulder but in that fifth set with that kind of support it worked out."



<span id="midArticle_8"/>Germany's highest-ranked player Tommy Haas, the world number 12, was ruled out for the singles on Friday due to a shoulder injury but was named along with Daniel Brands to face Fernando Verdasco and Marrero in the doubles on Saturday.



<span id="midArticle_9"/>CZECH RECOVERY



<span id="midArticle_10"/>The Czech Republic fought back in the defense of their title to move level at 1-1 against Netherlands after Tomas Berdych beat Sijsling 6-3 6-3 6-0 in one hour 42 minutes having earned six breaks while never allowing his opponent to come close.



<span id="midArticle_11"/>The Dutch had enjoyed a fine start versus the twice defending champions when Haase fought back to beat Radek Stepanek 3-6 6-4 6-7(4) 6-2 6-1 in a titanic battle.



<span id="midArticle_12"/>After an evenly-balanced affair in the opening two sets the pair exchanged breaks early in the third and Haase then had to save three set points to force the tiebreak but a determined Stepanek sealed it on his fifth to send the home fans wild.



<span id="midArticle_13"/>However, Haase regrouped to move 2-0 in front at the start of the fourth and, with Stepanek visibly tiring, wrapped up the match with a winning forehand to the back of the court.



<span id="midArticle_14"/>France's world number nine Gasquet was made to work hard for an hour by the gifted Kyrgios but the 18-year-old Australian lacked the strength to challenge his experienced opponent on the indoor clay court in Mouilleron-le-Captif, Western France.



<span id="midArticle_15"/>"I was the favorite but I think (Kyrgios) has a great future ahead of him. He's going to be a top 10 player," Gasquet told reporters after his 7-6(3) 6-2 6-2 victory.



<span id="midArticle_0"/>Tsonga expected a longer fight against five-set specialist Hewitt but the world number 10 was too solid for the 32-year-old whose record on clay does not match his hard court pedigree.



<span id="midArticle_1"/>Tsonga held serve throughout the match, surviving a rare scare in the fourth game of the third set by saving two break points before eventually prevailing 6-3 6-2 7-6(2).



<span id="midArticle_2"/>France, who last won the trophy in 2001, have won 98 percent of their Davis Cup encounters after taking a 2-0 lead.



<span id="midArticle_3"/>(Writing by Toby Davis; additional reporting by Zoran Milosavljevic in Novi Sad, Karolos Grohmann in Berlin, Gregory Blachier in Paris and Mark Lamport-Stokes in Los Angeles; Editing by Ken Ferris and Greg Stutchbury)



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California sees high rate of flu deaths in unusually severe season

By Sharon Bernstein



SACRAMENTO, Calif. Fri Jan 31, 2014 9:03pm EST





<span id="articleText"><span id="midArticle_start"/> SACRAMENTO, Calif. Jan 31 (Reuters) - An unusually severe flu season has claimed the lives of at least 147 young and middle-aged people in California - 10 times the number killed by influenza viruses by the same time last year, public health officials said on Friday.



<span id="midArticle_1"/>The California deaths were caused by a strain of the influenza virus that is sending sufferers across the nation to the doctor for flu-like symptoms at rates that are 50 percent higher than normal, said Lyn Finelli, head of the influenza surveillance and outbreak response team at the Centers for Disease Control and Prevention.



<span id="midArticle_2"/>"That's way above the norm for flu," Finelli said. "It tells us we're still in the middle of flu season, and in the Northeast and California it's going up, up, up."



<span id="midArticle_3"/>The flu strain responsible for the California deaths, H1N1, also predominates nationwide this year. It hits people hardest between the ages of 25 and 64, partly because some older people are believed to have more immunity due to similar outbreaks many decades ago.



<span id="midArticle_4"/>In California, 52 people died last week alone, including one child, the state's chief of communicable disease control told reporters on a conference call Friday.



<span id="midArticle_5"/>"This influenza season continues to be a severe one as the increasing number of influenza-related deaths indicates," Ron Chapman, director of the California Department of Public Health, said in a statement, urging Californians to get vaccinated.



<span id="midArticle_6"/>In addition to the 147 confirmed California flu-related fatalities this season among people under age 65, another 44 suspected flu deaths remain under investigation, said Dr. James Watt, chief of the state's Division of Communicable Disease Control. Most of those felled by the disease had other health conditions, but not all, he said.



<span id="midArticle_7"/>Last year at the same time, the state had recorded just 14 flu deaths among Californians under age 65.



<span id="midArticle_8"/><span id="midArticle_9"/>FIRST VACCINATION



<span id="midArticle_10"/>The death of a 47-year-old television advertising executive in the state's capital city prompted a renewed call for residents to become vaccinated against flu. Sacramento County, with 21 deaths so far, leads the state in fatalities.



<span id="midArticle_11"/>"After reading the heartbreaking story of Nancy Pinnella, went to CVS and got my first flu shot ever," California's first lady, Anne Gust Brown, posted on Twitter.



<span id="midArticle_12"/>It is not fully clear whether California is an outlier in the severity of its cases, because states are not required to report flu deaths to the CDC, and data is collected differently from state to state and county to county, said CDC spokesman Jason McDonald.



<span id="midArticle_13"/>The fatality data that the public health agency does collect, on pediatric deaths, is not useful in studying H1N1, because the virus is more likely to attack adults, Finelli said.



<span id="midArticle_14"/>The public health agency does, however collect information on why people go to the doctor, and whether they are hospitalized for flu. Those signs, she said, show that this year's flu is likely to continue to hit hard.



<span id="midArticle_15"/>Although the number of cases nationwide appears to have plateaued, she said, that does not take into account that California and the Northeast are lagging other areas with a late flu season.



<span id="midArticle_0"/>Meanwhile, CDC data does show that far more people under the age of 65 are being hospitalized with flu-like symptoms than last year. As of last week, for example, 76 percent of those hospitalized for flu were under age 65, compared to less than 50 percent last year.



<span id="midArticle_1"/>Nationwide, the data shows that somewhat fewer people have contracted flu so far this year than last year, Finelli said. This year's strain, however, appears to be causing severe illness in a population that is more typically robust, she said. (Reporting by Sharon Bernstein; Editing by Cynthia Johnston and Lisa Shumaker)



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