More than 2 million existing customers with insurance under the Affordable Care Act have had coverage renewed automatically for 2016 by HealthCare.gov, after they ignored government warnings to shop around to avoid surprise spikes in prices of health plans. According to data released Tuesday, 8.2 million people already have chosen — or have been automatically assigned to — health coverage next year through the federal insurance exchange.
A group of state insurance commissioners is developing a proposal to limit the amount that health insurers might have to pay out under the Affordable Care Act’s risk adjustment program, New Mexico Insurance Superintendent John Franchini told SNL.
The plan would install a so-called circuit breaker to prevent companies from paying more than 2% of their premium revenue into the program each year. That boundary would make insurers’ financial obligations more predictable and avoid the kinds of surprise payouts that contributed to the destabilization of several health plans in 2015.
Using data from 49 states and Washington, D.C., the Commonwealth Fund analyzed changes in cost-sharing under health plans offered to individuals and families through state and federal exchanges from 2014 to 2015. They examined eight vehicles for cost-sharing, including deductibles, copayments, coinsurance, and out-of-pocket limits, and compared findings with cost-sharing under employer-based insurance.
For people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average,
Despite advice to shop around before selecting a plan, consumers may find that getting answers about drug coverage can be an exercise in frustration, despite a federal health law requirement that insurers provide lists of the prescription medications included in their plans.
That’s because many treatments — particularly intravenous treatments like those used in cancer, hemophilia or multiple sclerosis — are covered under a separate part of an insurance plan, not the pharmacy benefit.
Two years ago, the Obama administration called the near-total, initial meltdown of the ObamaCare federal exchange a technical “glitch.” The term was widely ridiculed at the time, especially since it took weeks to fix the exchange’s website, healthcare.gov.
At Saturday night’s Democratic debate, front-runner Hillary Clinton called soaring health care costs and deductibles “glitches” resulting from the Affordable Care Act.
It has been called into question whether it’s true that Sen. Marco Rubio is responsible for the provision (inserted into last year’s annual spending bill and now again into this year’s) that requires the risk-corridor program in ObamaCare to be budget neutral. Like this year’s giant spending law, last year’s omnibus bill was the result of a leadership-driven process that drew on substantive expertise from the relevant committee staffs but did not much involve most members of either house. But Rubio was without question the first and most significant congressional voice on this subject, and if he hadn’t done the work he did, the risk-corridor neutralization provision would not have been in last year’s (or this year’s) budget bill.
Consumers buying health insurance through federal and state exchanges will see their monthly premiums for the popular silver-level plans jump by an average of more than 11%, while also likely facing higher deductibles, a new analysis of exchange data by the Robert Wood Johnson Foundation shows.
These increases will hike the cost of health insurance especially for customers who don’t receive federal subsidies to buy insurance, which may also limit the number of people insured under ObamaCare.
There has been some interesting coverage lately about Florida Sen. Marco Rubio’s successful effort to ensure that taxpayers were not on the hook for excess losses incurred by insurers participating in Obamacare’s exchanges. Today, however, two Associated Press reporters alleged that this victory against the law was one that Rubio “didn’t deliver.” But the facts show that Rubio is right, and the AP is wrong.
HealthSpan, the insurance arm of Catholic health system Mercy Health, is getting rid of its medical group and halting sales of ObamaCare policies just two years after acquiring Kaiser Permanente’s Ohio subsidiary. Spokesman Chuck Heald said HealthSpan will stop selling individual and small-group health plans on the ObamaCare exchanges to focus more on Medicare and employer plans. HealthSpan jacked up premium rates for 2016 individual and small-group plans anywhere from 9% to 32% to account for the sicker-than-expected exchange population.
The Obama administration created a “risk corridor” program to help prop up insurers who lost money in the first three years of ObamaCare where profitable insurers would pay some of those profits into a pool to help insurers who lost money. If the amount insurers lost exceeded what the companies paid in, the government would step in and make up the difference. Calling this “a taxpayer-funded bailout for insurance companies,” Rubio last year quietly inserted language into the omnibus government spending bill that barred the Department of Health and Human Services from dipping into general funds to pay failing insurers. “While the Obama administration can still administer the risk-corridor program, for one year at least, they won’t be able to use taxpayer funds to bail out insurance companies,” Rubio said.