“Congress is returning to Washington with just two months left before ObamaCare’s second enrollment period.
For most of the lawmakers’ August recess, news on the Affordable Care Act and other healthcare debates was fairly quiet.
But that ended for Republicans with the Sept. 4 announcement that a hacker had breached part of HealthCare.gov in July.
Though the exchange was not specifically targeted and no personal data was stolen, the GOP sees an opening to hammer the administration over the site’s security.
House Oversight Committee Chairman Darrell Issa (R-Calif.) has already called Marilyn Tavenner, Centers for Medicare and Medicaid Services administrator, to testify on the matter later this month.
The topic is also likely to dominate Republican remarks at a hearing Wednesday on the Affordable Care Act’s implementation, hosted by the Ways and Means Subcommittee on Health.
The House Republican Conference also plans to zing the healthcare law in at least one set of votes this week.
Majority Leader Kevin McCarthy (R-Calif.) said the chamber will consider a measure to allow insurers to continue offering certain small-group health plans that might not comply with ObamaCare’s rules.
The legislation is a Republican response to President Obama’s much-criticized remark that people could keep their plans under the reform.”
Rep. Bill Cassidy (R-La.), the measure’s sponsor, is challenging Sen. Mary Landrieu (D-La.) in November; the issue will undoubtedly play a role in that campaign.”
“When Congress returns this week, action in both chambers will mostly be a show for the voters back home ahead of the midterm election. In the House, that will include a vote on a bill to allow insurance companies to continue offering any plan that was sold in the group market in 2013.
Noticeably absent from congressional politicking in the next few weeks is the Affordable Care Act’s risk corridor program, which was, as recently as a few months ago, a major Republican criticism of the law. But that doesn’t mean the “insurer bailout” fight is dead. Republicans in both chambers are quietly working to challenge the legality and projected cost of the program. And that could tee up the issue to become a bargaining chip in the budget fights to come at the end of this year, regardless of who wins the Senate.
The Affordable Care Act’s risk corridor program runs from 2014 through 2016, and was established to encourage insurers to take a chance on covering an unknown population — the Americans who would be purchasing insurance on state and federal exchanges. The program collects funds from qualified health plans that bring in more money than they paid for medical claims, and then pays that money to plans with claims that cost more than they brought it from consumers.
But what happens if there isn’t enough money from well-performing insurers to pay all of the insurers that missed the mark? The federal government is on the hook, but where they find the money to pay those insurers is a question being debated throughout Washington. That’s because the law did not give the federal government a clear appropriation to spend money to make up for losses. And Republicans are, of course, very unlikely to give them one.”
“MADISON, Wis. — Nearly 26,000 adults who lost Medicaid coverage through Wisconsin’s BadgerCare Plus program after being kicked off earlier this year will have more time to sign up for private subsidized insurance, the federal government announced Thursday.
The U.S. Centers for Medicare and Medicaid Services said it was establishing a special enrollment period through Nov. 2 for those people to sign up under the federal exchange created under the health overhaul law.
The Wisconsin Department of Health Services estimates that about 25,800 out of 63,000 adults who lost that coverage had yet to sign up for subsidized insurance plans under the federal law.
They lost coverage after Gov. Scott Walker and the Republican-controlled Legislature tightened income eligibility for the state’s Medicaid coverage from 200 percent of poverty to 100 percent. That made the income cutoff for coverage $11,670 for an individual and $23,850 for a family of four.”
“According to figures released today by the Washington Health Benefit Exchange, 24,072 people have been dropped from coverage through the Healthplanfinder insurance exchange since those plans took effect in January 2014. Of that number, 8,310 were disenrolled because of non-payment of premiums, 7,735 voluntarily ended their coverage, and 8,027 were determined to no longer be eligible for a qualified health plan. Most of those determined to be no longer eligible were qualified instead for Medicaid.
The exchange also said 11,497 individuals have gained coverage through the exchange since the open enrollment period ended on March 31. These additions largely involved provisions allowing enrollment after a qualifying life event, such as a moving to a new state or changes in family size.”
“The Cover Oregon board on Thursday moved toward keeping the health insurance exchange semi-independent rather than having state agencies take it over.
That position, if confirmed in a vote that could take place later this month, would be a significant rebuff of Gov. John Kitzhaber. In a statement Thursday, Kitzhaber said having state agencies take over the exchange “offers the lowest-risk path.”
Whatever the board’s vote, it could have ramifications for control of the exchange as well as for the November elections, political observers say.
For months the board had been debating what to recommend to the Legislature about its future. In March, Kitzhaber asked the board to examine their governance structure and determine whether changes were called for.”
“In the shrub steppe of Grand Coulee on the banks of the Columbia River, Wash., the town’s two family doctors practice at an unrelenting pace, working on call every other night and every other weekend.
In the coastal town of Port Angeles, the doctor shortage is so acute that a clinic is turning away 250 callers a week seeking a physician.
George and Lynne Rudesill are two of those people. Since learning earlier this summer that their primary-care doctor in Sequim was retiring, the couple have scrambled to find a replacement. Their calls are being met with waiting lists hundreds of people long or advice to call again in a month.
“I’m going to have to drive all the way to Silverdale or Bremerton to see a doctor,” George Rudesill said, citing cities that are about 70 or more miles away from home. “This area is in a medical crisis right now.”
Rural areas have long been strapped for doctors, but now the Affordable Care Act (ACA) is further straining those limited resources. More people with insurance means more people will want to connect with a doctor — just as aging baby boomers require more care and the doctors are retiring.”
“Consumers may soon find a surprise in their mailbox: a notice that their health plan is being canceled.
Last year, many consumers who thought their health plans would be canceled because they didn’t meet the standards of the health law got a reprieve. Following stinging criticism for appearing to renege on a promise that people who liked their existing plans could keep them, President Barack Obama backed off plans to require all individual and small group plans that had not been in place before the health law to meet new standards starting in 2014. The administration initially announced a transitional policy that, with state approval, would allow insurers to renew plans that didn’t comply with coverage or cost standards starting in December 2013 and continue doing so until October 2014. Then in March, the administration said it would extend the transitional policy for two more years, meaning that some people will be able to hang onto their non-compliant plans through 2017.”
“Well, who could have seen this coming? Thankfully, at this point, the reports say there has been no release of personal information. I can’t say I’m terribly heartened:”
“With the second open enrollment period of the health insurance marketplaces approaching, this analysis provides an initial look at premium changes for marketplace plans for individuals in 15 states and the District of Columbia that have publicly released comprehensive data on rates or rate filings for all insurers.
The analysis examines premium changes for the lowest-cost bronze plan and the two lowest-cost silver plans in 16 major cities. The second-lowest cost silver plan in each state is of particular interest as it acts as a benchmark that helps determine how much assistance eligible individuals can receive in the form of federal tax credits. The findings show that in general, individuals will pay slightly less to enroll in the second-lowest cost plan in 2015 than they did in 2014, prior to the application of tax credits.
Although premium changes vary substantially across and within states, premium changes for 2015 in general are modest when looking at the low-cost insurers in the marketplaces, where enrollment is concentrated. While the analysis provides an early look at how competitive dynamics may be influencing health insurance premiums, it is important to bear in mind that the overall picture may change as comprehensive data across all fifty states becomes available.”
“Over the past few weeks, the American Medical Association has complained publicly and privately to the Centers for Medicare and Medicaid Services over its so-called Open Payments database, which will display what drug and device makers pay physicians. The system was created in response to concerns that medical practice and research may be unduly influenced by industry. But the database has been plagued by delays and technical glitches. The AMA is concerned that physicians lack the needed time to ensure correct data is displayed and that the public will understood what they see. The database is expected to go live on Sept. 30, but the AMA wants a six-month postponement to compensate for the problems. So far, CMS says no. We spoke with AMA president Robert Wah about the frustrations. This is an edited version.”