Month: December 2014

by Jim McLean, KHI News Service

Topeka — Consumers in Kansas and Missouri are among those who could be most affected if the U.S. Supreme Court eliminates federal subsidies in states that didn’t set up their own health insurance marketplaces.

The court announced on Monday that it will hear arguments in the case — King v. Burwell — on March 4, 2015.

At issue is whether the Affordable Care Act authorizes federal subsidies only in state-operated marketplaces and not in the federal marketplace being used by consumers in Kansas, Missouri and up to 35 other states.

Opponents of the law point to language that suggests Congress intended to restrict subsidies to only those states that set up their own marketplaces. The law’s supporters maintain the restrictive language is a drafting mistake and that other parts of the law make it clear that Congress intended for all eligible consumers to have access to subsidies.

Nationally, more than 13 million Americans could lose their coverage if the court eliminates subsidies in federal marketplace states. In Kansas, nearly 80 percent of the 57,013 who purchased coverage in the first ACA enrollment period would lose their subsidies as would 85 percent of the 152,335 Missouri consumers who used them to help purchase coverage.

Sheldon Weisgrau, director of a foundation-funded effort to educate Kansas consumers and policymakers about the ACA, said a court decision to allow subsidies in only the states that run their own marketplaces could be “devastating for tens of thousands of residents of Kansas and Missouri” who need financial assistance to purchase health coverage.

“Most will no longer be able to afford health insurance and will once again face the health and financial consequences of being uninsured,” Weisgrau said.

In addition, he said, “The insurance market could be destabilized, endangering the financial health of insurance companies and coverage of those who don’t rely on the federal exchange.”

Kansas Republican Attorney General Derek Schmidt sides with ACA opponents who contend the law restricts subsidies to the 18 states that established their own marketplaces, also known as exchanges. He and other state attorneys general intervened in the King case and in another challenge to Internal Revenue Service rules that allowed subsidies in federal marketplace states.

“Congress might not have expected so many states to decline to establish an exchange under the Affordable Care Act, but that misjudgment cannot justify allowing the IRS to effectively rewrite the statute to satisfy policy and political objectives, ” Schmidt said in a July media release.

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Health officials with the Kansas Department of Health and Environment are working with the Centers for Disease Control and Prevention to investigate a new virus that was linked to the death of a Kansas resident in the summer of 2014.

Although the host of the new virus, called Bourbon virus, is not known at this time, it is thought to be transmitted through the bites of tickets or other insects, health authorities said.

Symptoms of the Kansas resident resembled other tick-borne diseases, including fever and fatigue.

This is the first known case of Bourbon virus, which has been named after Bourbon County, Kan., where the patient had lived, health officials said. Bourbon County is in southeast Kansas near the Ft. Scott area.

Because of the patient’s symptoms and changes in blood counts, it was believed that the resident had a tick-borne illness, such as ehrlichiosis or Heartland virus disease. However, specimens taken from the resident tested negative for known tick-borne diseases and after further investigation it was determined to be a new, never before seen, virus. It is not known if Bourbon virus was the cause of death or how much it contributed to the resident’s death.

CDC, KDHE, and the clinical team are working to learn more about this new virus. The patient’s case history has been reviewed and there are plans to test other residents, with similar symptoms, who have tested negative for Heartland virus in the last year for this novel virus, officials said.

CDC has developed blood tests that can be used to identify and confirm recent Bourbon virus infections. Investigations are ongoing to explore how people are getting infected with the virus, including plans to collect and test ticks and other insects for the new virus,

There is no known specific treatment, vaccine, or drug for Bourbon virus disease, according to officials. Since Bourbon virus disease is thought to be transmitted through tick or insect bites, risk to the public during the winter months is minimal. To reduce the potential risk of tick- or insect-borne illnesses, KDHE and CDC recommend that people:

• Avoid wooded and bushy areas with high grass and leaf litter;
• Use insect repellent containing DEET when outdoors;
• Use products that contain permethrin on clothing;
• Wear clothing with long sleeves and pants;
• Bathe or shower as soon as possible after coming indoors to wash off and more easily find ticks that are crawling on you;
• Conduct a full-body tick check after spending time outdoors; and
• Examine gear and pets, as ticks can “ride” into the home and attach to a person later.