“Large businesses expect to pay between 4 and 5 percent more for health-care benefits for their employees in 2015 after making adjustments to their plans, according to employer surveys conducted this summer.
Few employers plan to stop providing benefits with the advent of federal health insurance mandates, as some once feared, but a third say they are considering cutting or reducing subsidies for employee family members, and the data suggest that employees are paying more each year in out-of-pocket health care expenses.”
“The Obama administration bragged about its enrollment numbers in the compulsory ObamaCare system, but the lack of eligibility-confirmation systems in the exchanges may take a big bite out of those numbers shortly. Just how big a bite is anyone’s guess, however, with warnings to multiple groups that either their coverage or their subsidies may stop at any time. Last night, HHS warned that 115,000 people currently covered by ObamaCare might lose their insurance thanks to immigration issues:”
“House Ways & Means health subcommittee chair Kevin Brady (R-TX) questions HHS’ authority to settle hospitals’ appeals of denied inpatient claims and is urging HHS Secretary Sylvia Burwell to retract what he views as an “ill thought” settlement process. Brady wants Burwell to work with lawmakers to come up with a different “fair, transparent and conclusive settlement process.”
Brady wrote to Burwell Tuesday (Sept. 16) that he is dismayed by HHS’ reluctance to work with the committee on an equitable settlement process that is fully legal, adding that the “lack of engagement makes it challenging for the Congress to solve the current appeals problems and prevent similar problems in the future.”
CMS announced late last month (Aug. 29) that it will pay hospitals 68 percent of denied inpatient status claims in the appeals queue if hospitals take them out of the backlogged appeals process. The agency has been encouraging hospitals to take advantage of the settlement to “alleviate the burden of Medicare appeals on both the hospital and Medicare systems,” according to the CMS website.
Hospitals should decide whether to participate by the end of October, and CMS in a Frequently Asked Questions document released Sept. 9 says that four hospitals have already stepped forward to take the settlement offer. The document also states that this is a one-time offer from CMS.”
“Last year I wrote that Obamacare could leave doctors holding the bag for claims for patients who don’t pay their insurance premiums. That’s because the law includes a three-month grace period during which health insurers must continue to cover patients who sign up, but don’t pay the price of their insurance. If the patients eventually make good, there’s no problem. But if patients don’t pay the owed premiums, the insurance company has to cover the cost of claims filed during the first month. Providers are stuck with the tab for any claims filed during months two and three.
The piece I wrote last July was theoretical. The notification letter I’m holding in my hand, addressed to my wife’s pediatric practice, is reality. And reality costs, in this case, over $600. That’s the outstanding balance owed the practice by a patient insured by BlueCross BlueShield of Arizona. It’s a balance that my wife might have to eat, or else try to collect herself.”
“During the 2014 open enrollment for Obamacare coverage, Mary Denson, 21, a student at Columbia (Mo.) College, qualified for a federal premium subsidy that reduced her premium contribution for buying health insurance to less than $20 a month.
But she fears that when she renews her coverage for 2015, she won’t have enough income from her nanny job to reach the subsidy income threshold of 100% of the federal poverty level and continue qualifying for premium tax credits. She isn’t eligible for Medicaid because Missouri hasn’t expanded that program for low-income adults. Denson says she’s considering looking for another job to reach the $11,670 income threshold but worries she may have to drop classes. Without the subsidy, her coverage would cost nearly $400 a month, far more than she can afford.
“I’m just going to have to re-apply and pretty much hope that I make the cut again,” Denson said.”
“There’s been a fierce debate over whether Obamacare has increased health insurance premiums. Progressives have argued Obamacare is working due to modest projected premium increases on the Exchanges for 2015. Conservatives have retorted that “there can be no doubt that health care today is more costly than it would have been without Obamacare.”
But this argument has focused on the health Exchanges, where only 7-8 million people bought their coverage in 2014. Readers would do well to remember that more than 20 times that number of people rely on employer-provided health benefits (Table C-1).
In the employer-based market, the adverse effects of Obamacare on premiums and affordability are strikingly obvious. The growing burden of employer-provided health care has accelerated under Obamacare. And yet the New York Times would have you believe everything is hunky-dory since “the growth in health insurance premiums was only 3 percent between 2013 and 2014. That’s tied for the lowest rate of increase since Kaiser started measuring (this is the 16th year of the survey).” This view is dead wrong: here’s why.”
“The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of this provision in 2012, some nonprofit and for profit employers with religious objections to contraceptives have brought legal challenges to this rule. For many women today, their contraceptive coverage depends on their employer or when they purchased their individual insurance plan.”
“Doctors and hospitals treated more patients and collected more payments in the spring as millions gained insurance coverage under the health law, new figures from the government show.
But analysts called the second-quarter increases modest and said there is little evidence to suggest that wider coverage and a recovering economy are pushing health spending growth to the painful levels of a decade ago.”
“A flaw in the federal calculator for certifying that insurance meets the health law’s toughest standard is leading dozens of large employers to offer plans that lack basic benefits such as hospitalization coverage, according to brokers and consultants.
The calculator appears to allow companies enrolling workers for 2015 to offer inexpensive, substandard medical insurance while avoiding the Affordable Care Act’s penalties, consumer advocates say.
Insurance pros are also surprised such plans are permitted.
Employer insurance without hospital coverage “flies in the face of Obamacare,” said Liz Smith, president of employee benefits for Assurance, an Illinois-based insurance brokerage.”
“Employers have complained for years about their rising health-care costs. But over the past decade, as the chart above shows, premium increases for employer health insurance have moderated sharply and stabilized. Premiums for family policies in the group market grew 72% between 1999 and 2004; 34% between 2004 and 2009; and 26% between 2009 and 2014. Even as premium growth moderated, health insurance costs still outpaced inflation and wage growth. But this year premiums grew 3%, about the same rate as wages and inflation. Despite fears that premiums would rise in the group market because of the Affordable Care Act, they have remained stable.
Policy experts do not fully understand why health-care costs have moderated or when and how rapidly they might begin to again rise more quickly. And coverage is still very expensive: The average family policy costs $16,834 a year, with employers paying, on average, 71% of the expense and employees 29%.
Corporate benefits managers will continue to do what they can to tamp down annual premium increases, and companies will continue to raise deductibles and other forms of cost sharing to help constrain premium increases. But as long as these more modest increases in their health insurance premiums continue, corporate CEOs will see their health costs more like a chronic illness to be managed than an acute problem or crisis, and they will no doubt focus their energies on other problems.”