“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.”
“The uninsured rate for kids under age 18 hasn’t budged under the health law, according to a new study, even though they’re subject to the law’s requirement to have insurance just as their parents and older siblings are. Many of those children are likely eligible for coverage under Medicaid or the Children’s Health Insurance Program.
The Urban Institute’s health reform monitoring survey analyzed data on approximately 2,500 children, comparing the uninsured rate in June 2014 with the previous year, before the health insurance marketplaces opened and the individual mandate took effect. It found that rates remained statistically unchanged at just over 7 percent for both time periods.”
“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.”
“A report out today puts numbers behind what hit many workers when they signed up for health insurance during open enrollment last year: deductible shock.
Premiums for employer-paid insurance are up 3% this year, but deductibles are up nearly 50% since 2009, the report by the Kaiser Family Foundation shows.
The average deductible this year is $1,217, up from $826 five years ago. Nearly 20% of workers overall have to pay at least $2,000 before their insurance kicks in, while workers at firms with 199 or fewer employees are feeling the pain of out-of-pocket costs even more: A third of these employees at small companies pay at least $2,000 deductibles.”
“An NBC affiliate in Virginia reports that nearly 250,000 people in that state will lose their health care plans due to Obamacare:
“Nearly a quarter million Virginians will have their current insurance plans cut this fall,” said the local anchor. “That is because many of them did not–are not following new Affordable Care Act rules, so a chunk of the companies that offer those individuals their policies will make the individuals choose new policies.”
Says the reporter, “This goes back to that now heavily-criticized line we heared before Obamacare was put in place: ‘If you like your plan, you can keep it.’ Ultimately, that turned out not to be true for thousands of Virginians and companies in the commonwealth. … Wednesday Virginia lawmakers on the health insurance reform commission met for the first time this year. Turns out, a staggering number of Virginians will need new plans this fall.””
“Some of Obamacare’s big supporters say the new law has already contributed to decreases in the rate of growth of health spending.
But a new report from the Center for Medicare and Medicaid Services Office of the Actuary says the rate slowed because of a slow economic recovery, increased cost-sharing for those enrolled in private plans and sequestration.
Indeed, the report does not mention Obamacare when assessing the situation. “The recent period is marked by a four-year historically low rate of health spending growth, which is primarily attributable to the sluggish economic recovery and constrained state and local government budgets following the 2007-09 recession,” the report states.”
“TOPEKA — The three private insurance companies that administer the Kansas Medicaid program under KanCare lost $72.6 million in the first half of 2014, after losing $110 million in 2013.
Rep. Jim Ward, a member of a KanCare oversight committee who requested the fiscal information from the Kansas Department of Health and Environment, questioned Tuesday how long the three companies can sustain such losses.
“These companies can’t keep subsidizing Medicaid to the tune of $100 or $150 million per year, and that’s what’s happening,” said Ward, D-Wichita.
KanCare is the initiative launched by Gov. Sam Brownback on Jan. 1, 2013. It moved virtually all the state’s Medicaid enrollees into health plans run by Amerigroup, UnitedHealthcare Community Plan and Sunflower Health Plan, a subsidiary of Centene.
The three managed care organizations, in information to be filed with the National Association of Insurance Commissioners, reported a total of about $96 million in underwriting losses in the first half of this year. The claims they paid outstripped the $394 million to $483 million each received from the state based on how many Medicaid clients they have.”
“Testifying before a House subcommittee, a key Obama administration official lays out the updates that HHS is making to the online marketplaces before enrollment begins in November. Mary Agnes Carey and Politico Pro’s Jennifer Haberkorn discuss.
MARY AGNES CAREY: Welcome to Health on the Hill, I’m Mary Agnes Carey. With the health law’s open enrollment season just months away, a key Obama administration official was on Capitol Hill today to discuss ongoing efforts to fix problems with healthcare.gov. Politico Pro’s Jennifer Haberkorn was at that hearing and joins us now. Thanks for being with us.
JENNIFER HABERKORN: Thanks for having me.”
“The key findings from the survey, conducted from January through May 2014, include a modest increase in the average premiums for family coverage (3%). Single coverage premiums are 2% higher than in 2013, but the difference is not statistically significant. Covered workers generally face similar premium contributions and cost-sharing requirements in 2014 as they did in 2013. The percentage of firms (55%) which offer health benefits to at least some of their employees and the percentage of workers covered at those firms (62%) are statistically unchanged from 2013. The percentage of covered workers enrolled in grandfathered health plans – those plans exempt from many provisions of the Affordable Care Act (ACA) – declined to 26% of covered workers from 36% in 2013. Perhaps in response to new provisions of the ACA, the average length of the waiting period decreased for those with a waiting period and the percentage with an out-of-pocket limit increased. Although employers continue to offer coverage to spouses, dependents and domestic partners, some employers are instituting incentives to influence workers’ enrollment decisions, including nine percent of employers who attach restrictions for spouses’ eligibility if they are offered coverage at another source, or nine percent of firms who provide additional compensation if employees do not enroll in health benefits.”
“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.”