“Washington is full of ideas to overhaul Medicare. Some would increase the program’s eligibility age, others would charge higher-income beneficiaries more for their coverage. There’s movement to link payment to the quality — rather than the quantity — of care delivered.
Marge Ginsburg decided to ask ordinary Americans how they would change the federal entitlement program.”

“President Obama’s claim last spring that 8 million people had enrolled in ObamaCare recently got a significant downgrade from the head of the agency overseeing the plan.
Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, told a congressional committee that “as of August 15, this year, we have 7.3 million Americans enrolled in Health Insurance Marketplace coverage and these are individuals who paid their premiums.””

“The launch of the Affordable Care Act has focused attention on the idea of a health insurance exchange, or marketplace. Separate from the ACA, private exchanges have also started to emerge as an option for employers providing coverage to their workers. This report identifies the different types of private exchanges as well as projects the potential size of the private exchange market, which has the potential to reshape the employer-sponsored health insurance landscape, in the coming years.
Through interviews with representatives of more than fifteen private health insurance enrollment platforms as well as several employers and health plans moving in this direction, this report examines important implications in this quickly-growing landscape, including the potential for cost stability to employers and more choice among health plans for consumers.”

“CMS Administrator Marilyn Tavenner on Thursday (Sept. 18) pledged the agency would conduct full “end-to-end” testing of healthcare.gov prior to the launch of open enrollment in November, likely either by the end of this month or early October. Tavenner also told members of Congress that the site will see continued improvement but will not be perfect in year two.
The comments came during a sometimes fiery House oversight committee hearing that focused on the security of the exchange website, which took place shortly after the Government Accountability Office released a report finding that healthcare.gov continues to be vulnerable to breaches. On Wednesday, Chair Darrell Issa (R-CA) released a scathing report on the run-up to the launch of the site that highlighted staff concerns about security, attempts to cover-up the reasons behind the failed launch, and a disconnect between HHS and CMS staff.”

“Several unions want the Labor Department to broadly authorize employer-sponsored “wraparound” coverage for workers to supplement their exchange plan benefits and subsidies, according to comments on a rule that is currently being reviewed by the White House.
Under a little-noticed proposed rule the Labor Department issued on Dec. 24, the Obama administration proposed to treat as “excepted benefits” certain limited coverage provided by employers that would wrap around an individual market policy. If the wraparound coverage meets a number of requirements, it’s considered an excepted benefit and would not disqualify the employee from getting subsidized coverage on the exchanges. While unions generally supported the concept, many complained that the parameters the administration proposed would prevent lower wage employees from having access to the coverage and they are the ones that would benefit most.”

“Employer groups are ramping up their efforts to revise the ACA’s 30-hour full-time employee definition in hopes of getting it changed before the employer mandate kicks in for some large employers next year. The initiative, titled “More Time for Full-Time,” was announced Friday (Sept. 19) and is the latest tactic by employers to change the standard so that it defines a full-time employee as one who works 40 hours per week.
Groups involved in the initiative include the National Restaurant Association, the National Retail Federation, the U.S. Chamber of Commerce, the National Grocers Association and the International Franchise Association.
“As all Americans have known for decades, 40 hours represents the widely-accepted definition of a full-time work week. Unless there is a statutory change to the definition of a full-time employee in the ACA, there will be fewer full-time jobs, more part-time workers and fewer overall hours available for Americans to work,” International Franchise Association President and CEO Steve Caldeira said in a statement.”

“A major innovation in health insurance plan design over the past several years has been the rapid growth of “narrow network” plans. Such plans either limit enrollee choices of providers, or place providers in differential cost tiers whereby individuals face higher cost in selecting some providers relative to others. This movement harkens back to the restrictions put in place during the U.S. initial infatuation with managed care in the mid-1990s. That episode ended badly for the limited choice model, as the “HMO backlash” induced regulatory restrictions on plans which handicapped choice limitations within the HMO model.
The latest growth of narrow network plans has been hastened by the introduction of health insurance exchanges under the Affordable Care Act (ACA). State exchanges have fostered strong insurer competition through both organizing the marketplace and through tying low income health insurance tax credits to the second-lowest cost plan in the silver tier. Insurers have responded to these competitive incentives in many ways, but perhaps the most notable is the expansion of narrow network insurance products. Such products are widespread on exchanges and appear to be growing rapidly.”

“Republicans have found a new opening against ObamaCare after struggling for months to craft a fresh strategy against a healthcare law that now covers millions of people.
Lifted by a pair of federal audits that found major flaws with the law’s implementation, Republicans see their first chance in months to launch a serious attack against the law.
“The news that we’ve seen over the last week and a half really emphasizes what conservatives and Republicans were trying to do last year, which was preventing a lot of this from happening,” said Dan Holler, a spokesman for the conservative political group Heritage Action for America.
“What I hope happens is that the Republican Party as a whole says, ‘Yes, there is a reason besides politics that we’re fighting ObamaCare: It’s hurting people,’” Holler said.”

“Costs to buy coverage through Connecticut’s health insurance exchange won’t, on average, rise much next year. For some plans, the prices are dropping.
But some customers who get financial aid to buy their insurance could see price increases beyond the rise in sticker price if they stick with their current plans, according to an analysis by consultants for the exchange, Access Health CT.
As a result, some people might find lower prices by considering different plans, even if they bought the cheapest plan available this year, according to the analysis by Wakely Consulting Group.”

“The federal health insurance website is trying to resolve glitches and security questions raised by the Government Accountability Office, so people can safely and successfully sign up for insurance at open enrollment Nov. 15.
Much of the Obama administration’s success in enrolling 8.1 million people in health insurance over the past year was overshadowed by the momentous problems with HealthCare.gov and several state exchanges. As administration officials prepare to test the site with insurers Oct. 7, they’re trying to manage expectations while portraying some confidence.
Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner told a House panel Thursday that there will be “visible improvement, but not perfection” on HealthCare.gov.”: