“The Trump administration’s action today is cruel,” said Democratic Congressman Frank Pallone Jr. of New Jersey. The new policy is “the latest salvo of the Trump administration’s war on health care,” according to a health-care advocacy group. “The pain is the point” of the policy, wrote columnist and economist Paul Krugman.

They were attacking the Trump administration’s decision last week to allow states to impose work requirements on Medicaid beneficiaries. But far from being a “cruel” action designed to inflict “pain” on the vulnerable, the administration’s decision is completely reasonable.

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The Trump administration is estimating there are now only 700 issuers in the individual and small group markets, which is down from 2,400 in an earlier estimate.

The CMS cited the updated figure in an information collection notice posted Jan. 8. The agency is seeking permission from the White House’s Office of Management and Budget to continue collecting data annually from exchange plans about their enrollees’ risk profiles.

In an earlier version of the request submitted to the executive branch last month, the agency estimated there were 2,400 issuers in the individual and small group markets.

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Anthem’s membership in the Affordable Care Act marketplaces will decline by 70% in 2018, executives told investors Wednesday on the insurer’s third-quarter earnings call. About 1.4 million people had ACA-compliant plans with Anthem as of Sept. 30, 900,000 of whom bought coverage on the exchanges.

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Anthem announced Friday that it would fill Virginia’s 63 counties that were slated to have no ObamaCare insurers on the exchange next year.

Anthem initially announced it wouldn’t sell plans in Virginia in 2018, but backtracked Friday to cover the so-called bare counties.

“Since learning that 63 counties and cities in Virginia would not have access to Individual health plans, Anthem has been engaged in further evaluation and discussion with regulators to ensure that no bare counties or cities exist in the state,” Anthem said in a statement Friday.

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New Mexico Health Connections, a not-for-profit insurance co-op funded through the Affordable Care Act, is a month overdue in filing its second-quarter financial paperwork. And the co-op’s most recent documents, as well as federal ACA documents, show potentially large financial problems that could force New Mexico to shut the company down. This could be another potential black eye for the ACA’s co-op program, in which 19 of 23 companies have already gone under.

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This brief describes alternative forms of subsidized reinsurance and the mechanisms by which they spread risk and reduce premiums. For a given amount of funding, a particular program’s efficacy will depend on how it affects insurers’ risk and the risk margins built into premiums, incentives for selecting or avoiding risks, incentives for coordinating and managing care, and the costs and complexity of administration. These effects warrant careful consideration by policymakers as they consider measures to achieve stability in the individual market in the long term.

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Half of Virginia’s counties now are on track to have no health insurers offering Obamacare plans in 2018 after an insurer reversed a decision to sell individual health coverage in much of the state.

The pullback by Optima Health in Virginia ends a brief, two-week period in which every county in the United States was projected to have at least one Obamacare insurer next year.

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The government says about 500,000 fewer Americans had no health insurance the first three months of this year, but that slight dip was not statistically significant from the same period in 2016.

Progress reducing the number of uninsured appears to have stalled in the last couple of years, and a separate private survey that measured through the first half of 2017 even registered an uptick.

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Under the ACA, insurance companies must sell polices to people with chronic diseases and charge the same premiums paid by healthy people. But patients with pre-existing conditions in fact are being denied coverage when their insurance plans don’t cover medically-recommended treatments or when they place significant obstacles in the way. Many plans impose “utilization management” rules restricting access to drugs. Dr. Blinderman suggests a “preauthorized trial period” for all medications. Following this trial period, physicians could be asked to justify continuation of the therapy. Doing this would relieve patient suffering due to delays or disruptions in the amelioration of symptoms, reducing health-care costs in the process.

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The second-lowest silver plan is one of the most popular plan choices on the marketplace and is also the benchmark that is used to determine the amount of financial assistance individuals and families receive. Based on preliminary 2018 rate filings, the second-lowest silver premium for a 40-year-old non-smoker will range from $244 in Detroit, MI to $631 in Wilmington, DE, before accounting for the tax credit that most enrollees in this market receive.

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