“A caucus of seven nervous Democratic senators, led by Mark Begich of Alaska, has been pushing a plan to “reform” the Affordable Care Act by allowing insurers to offer an even skimpier insurance plan than the skimpiest permitted now. .
The idea of their “Expanded Consumer Choice Act” is to create a new “copper” tier of health plan permitted in the individual and small-business markets under the ACA. The copper tier would undercut the current tiers of health plans by covering only 50% of expected health costs. Under the current law, the stingiest “bronze” tier covers 60% of costs.”
“A key provision of the Affordable Care Act (ACA) is the requirement that private insurance plans cover recommended preventive services without any patient cost-sharing.1 Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they develop into more complicated, debilitating conditions, and that some services are also cost-effective.2 However, costs do prevent some individuals from obtaining preventive services (Figure 1). The coverage requirement aims to remove cost barriers.”
“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.”
“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.”
“Businesses in five states received early access Monday to select features at ObamaCare’s online health insurance marketplace for small employers.
The soft launch for the SHOP system is an effort by federal health officials to troubleshoot any problems at the exchange before Nov. 15, when it will open to all states that did not elect to build their marketplaces.
Small businesses in New Jersey, Delaware, Illinois, Ohio and Missouri can establish accounts, complete an application, receive a determination of eligibility and upload an employee roster, the Centers for Medicare and Medicaid Services said. In November, employers will also be able to browse plans and pricing.”
“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.”
“WASHINGTON — With health insurance marketplaces about to open for 2015 enrollment, the Obama administration has told insurance companies that it will delay requirements for them to disclose data on the number of people enrolled, the number of claims denied and the costs to consumers for specific services.
For months, insurers have been asking the administration if they had to comply with two sections of the Affordable Care Act that require “transparency in coverage.””
“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.”