ObamaCare’s impact on health costs.
“Aetna Inc. (AET), the third-largest U.S. health insurer, raised its profit forecast for the year as enrollment increases.
Operating earnings this year will be $6.60 to $6.70 a share, above the previous forecast of $6.45 to $6.60, the Hartford, Connecticut-based company said today in a statement.”
“Spoiler alert! When it comes to covering the uninsured, Obamacare has proven itself to be one giant expansion of Medicaid. A new report released Wednesday reveals the total coverage increase for the first half of 2014. While total coverage increased by 8,538,327 individuals, enrollment in Medicaid accounted for 71 percent of that growth. Check out the infographic below for the full breakdown of the numbers.”
“A confession: I am a health economist, and I cannot rationally select a health plan.
I buy health insurance through the Federal Employees Health Benefits Program, or F.E.H.B.P., which is very similar to the Affordable Care Act’s exchanges. Like the exchanges, the federal employee program runs an online marketplace with a choice of plans, which vary by region.”
“NEW YORK — The federal government has sued New York City, saying it ripped off Medicaid for millions of dollars by submitting tens of thousands of false claims.
A civil lawsuit seeking unspecified damages was filed Monday in Manhattan federal court.
The lawsuit says the city and a computer company used computer programs to dodge a requirement that Medicaid be billed only after private insurance coverage is exhausted. The lawsuit says false diagnosis codes were submitted to Medicaid.”
“Now that many people finally have health insurance through the Affordable Care Act exchanges, some are running into a new problem: They can’t find a doctor who will take them as patients.
Because these exchange plans often have lower reimbursement rates, some doctors are limiting how many new patients they take with these policies, physician groups and other experts say.”
“Remember the excitement surrounding Castlight Health’s initial public offering? Last March, the San Francisco startup’s stock price soared when investors bought into the idea that online price transparency would transform the healthcare marketplace.
Castlight’s business plan calls for offering software through insurers and employers that allows people to comparison shop for healthcare services. With employers rapidly moving their workers into high-deductible plans, patients looking to lower their out-of-pocket expenses could use Castlight to find low-cost providers.”
“New language in contracts between the CMS and insurers operating on HealthCare.gov is grabbing attention, with some calling it an admission by the government that it might lose upcoming court battles dealing with insurance subsidies on the health portal and others saying the new wording is just a practical precaution.
The new language appears to allow insurers to stop offering their plans should federal premium subsidies disappear. A number of cases regarding the legality of the subsidies in states without their own exchanges are now working their way through the courts.
The language says, “CMS acknowledges that (the insurer) has developed its products for the (federal exchange) based on the assumption that (advance payments of the premium tax credit) and (cost-sharing reductions) will be available to qualifying enrollees. In the event that this assumption ceases to be valid during the term of this agreement, CMS acknowledges that issuer could have cause to terminate this agreement subject to applicable state and federal law.””
“The millions of health insurance cancellations caused by Obamacare don’t mean people are “losing insurance,” according to a top Health and Human Services official — they just mean people are being invited to join an Obamacare exchange.
HHS regional director Joanne Grossie spoke to the Virginia legislature about widespread cancellations. At least 250,000 Virginians will be losing their health insurance Jan. 1 because they don’t meet Obamacare regulations.
Republican state Sen. Jeff McWaters asked Grossie whether HHS knows how many people are going to lose coverage, but Grossie took issue with the idea that customers are even losing insurance.”
“Leo Boudreau of Massachusetts was thrilled to find a psychologist in his insurance network to treat his teenage daughter for emotional stress related to a medical condition. The therapist worked out of a local hospital.
But he was surprised when the bill for each visit contained two charges: the approximately $100 he expected to see for the therapist — and a similar fee for the room, which was not covered.
“How could it be that the doctor was in network and the hospital was in network, but I had to pay separately for the room?” Mr. Boudreau said.”
“If you bought health insurance on HealthCare.gov for this year, you could be in for a few surprises when open enrollment begins next month.
It’s possible, for example, that you could end up being billed for two different plans. The reason, insurers say, is because the federal government hasn’t addressed a key communications issue with the website.
And if you haven’t updated your financial information on the online insurance marketplace, you could face higher premiums and get less of a subsidy than you deserve.”