Consumers who purchase their insurance through the public exchanges will likely see prices rise again next year, according to a new analysis of proposed premiums for next year.
The Avalere Health analysis of 14 states where data is available finds that premium increases for average silver plans would go up by 11 percent. Lower-cost silver plans would increase a bit less, by 8 percent.
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The word is right there in the name of the law: “Affordable.” The ACA promised to bring health insurance down to earth, letting uninsured people buy policies that didn’t break the bank, and bringing the astonishing cost of medical care into reach for all Americans.
What’s becoming clear, three years in, is that “affordable” depends where you look. Twenty million more people are covered and tens of millions of others have broader benefits because of Obamacare. But many insurers, faced with new coverage requirements and competition on premiums, have shifted costs onto consumers.
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Health spending in the U.S. grew to $3.2 trillion in 2015, fueled partly by the expansion of health insurance to millions of people under the Affordable Care Act, according to a new estimate published in the journal Health Affairs.
The study also looks forward, projecting that through the next decade, national health spending will climb at 5.8 percent per year, on average, to encompass a fifth of the economy by 2025.
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A top Centers for Medicare and Medicaid Services official defended the health insurance co-ops created under the Affordable Care Act Wednesday, after four more of the nonprofit insurers announced they would take steps to wind down in recent weeks.
Kevin Counihan, the CEO of HealthCare.Gov, told a subcommittee of the House Committee on Oversight and Government Reforms that the co-ops have spurred innovation within the health insurance marketplace and given consumers more opportunities. But Republicans on the panel railed against the program, as about two-thirds of the co-ops have now announced steps to close down.
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Opt-out payments offered by employers may be used to determine affordability under the Affordable Care Act, depending on whether they are conditional or unconditional, according to IRS proposed rules.
Under the proposed rules, opt-out payments, cash payments given to employees who opt-out of their employer-sponsored health insurance, will be treated as a salary reduction for the purposes of determining health insurance affordability if they are considered unconditional.
An unconditional opt-out payment refers to an arrangement where the employee declines employer-sponsored health insurance without satisfying any other requirements.
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New failures are piling up among the member-run health insurance co-ops carrying out one of the Affordable Care Act’s most idealistic goals, leaving just seven remaining when the health law’s fourth enrollment season starts in the fall.
There were 23 in 2014.
For the rest — which all posted annual losses in 2015, according to the National Alliance of State Health Co-Ops — survival is job No. 1. Some are diversifying to serve larger employers, no longer limiting themselves to their ACA mandate to offer health plans to individuals and small businesses. A Maryland co-op has sued the federal government to avoid paying millions of dollars to other insurers under the ACA’s complex formula to keep premiums stable by balancing risks among insurers and helping ailing ones. Other co-ops are trying to renegotiate contracts with hospitals and other providers.
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The Illinois Insurance Department moved Tuesday to shut down Land of Lincoln because of its unstable financial health, leaving about 49,000 policyholders in a lurch. They will lose coverage in the coming months, but neither regulators nor the company have said exactly when.
Policyholders will be able to buy insurance from a different carrier to cover them for the rest of 2016, according to the state Insurance Department. But switching plans is going to cost them.
The co-pays and deductibles enrollees have been paying since January will not transfer to new plans. A new plan will reset deductibles and out-of-pocket maximums paid by consumers.
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President Obama reflected upon the Affordable Care Act in an article published this week in the Journal of the American Medical Association. He acknowledged the law’s shortcomings and outlined what he believes to be the next steps in health care reform.
The President concluded, “Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs.”
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Lawyers well versed in federal health policy are skeptical that a handful of insurers will triumph in their lawsuits against the Obama administration over two separate but similar payment provisions of the Affordable Care Act (ACA).
Six insurers, including several of the ACA-created Consumer Operated and Oriented Plans, or CO-OPs, are suing the administration over money, while a number of others are 23 Comments lawsuits.
The insurers are suing over the ACA’s risk corridor and risk adjustment programs, which make up two of the “three Rs” built into the law to compensate insurers for losses stemming from market volatility in the first few years of ACA implementation.
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Centrist Democrats appear reluctant to join their party’s embrace of a public option for ObamaCare.
The idea of adding a government-run insurance option to compete with private insurers is making a comeback in the Democratic Party, with President Obama endorsing the idea Monday, two days after presumptive Democratic presidential nominee Hillary Clinton emphasized a public option as part of an effort to win over Bernie Sanders and his supporters after a contentious primary.
But among more centrist members of the Senate, where the “public option” was stopped in 2009, there is little enthusiasm for the idea.
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