“Nearly one company in six in a new survey from a major employer group plans to offer health coverage that doesn’t meet the Affordable Care Act’s requirements for value and affordability.
Many thought such low-benefit “skinny plans” would be history once the health law was fully implemented this year. Instead, 16 percent of large employers in a survey released Wednesday by the National Business Group on Health said they will offer in 2015 lower-benefit coverage along with at least one health plan that does qualify under ACA standards.
The results weren’t unexpected by benefits pros, who realized last year that ACA regulations would allow skinny plans and even make them attractive for some employers. But the new survey gives one of the first looks at how many companies will follow through and offer them.”
“When benefits enrollment season arrives this fall, employees around the country can expect to see the impact of corporate cost-cutting on their finances.
Benefits costs will rise only 5 percent for employers that take certain cost-reduction measures, instead of 6.5 percent for companies that do not, according to a June survey of employers representing 7.5 million workers by the National Business Group on Health.
Although costs are not rising as quickly, employees are still being squeezed.
The main way companies are keeping healthcare costs in line is by shifting workers into high-deductible health plans, defined by the Internal Revenue Service as having deductibles above $1,250 for an individual. (here)
For 2015, 81 percent of employers will offer a high-deductible plan as an option, up from 72 percent last year; while 32 percent will offer such plans as the only option, up from 22 percent last year.
The challenge employers face is: “How do you keep costs from spiraling out of control but not shift all of it to the employee?” said Karen Marlo, a vice president at NGBH who authored the report.”
“When Covered California unveiled its initial slate of 13 carriers last year, their low rates got some attention — but so did their mix.
While Covered California couldn’t boast Aetna or UnitedHealthcare, which instead elected to leave the state’s individual market, four major insurers were on board: Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser Permanente.
And the exchange also had drawn in several smaller health plans, like Ventura County Health Plan, which were going to compete for share on the individual market for the first time.
“For me, the story is [these] new participants,” Micah Weinberg of the Bay Area Council told California Healthline last summer. “Who exactly they are, and how they are being offered in these marketplaces, is worth watching.”
But Ventura County quietly pulled out. A second small carrier, Alameda Alliance, was kicked out. And earlier this summer, a third carrier — Contra Costa Health Plan — was forced to drop out, citing state rules around offering on- and off-exchange plans.
That’s left Covered California with 10 plans — which would be a bounty for nearly any other state. Not so across California’s vast, 164,000-square-mile expanse, where many regions are essentially dependent on a lone insurer.
As “Road to Reform” tracked throughout last year’s enrollment period, the seven small insurers ended up splitting just a fraction of Covered California’s customers, while the “big four” insurers were responsible for almost 95% of all sign-ups across the state.
“It’s not just an issue of market concentration,” California Insurance Commissioner Dave Jones (D) told California Healthline. “It’s the absence of choice that exists for some consumers in some parts of California.””
“Low-income consumers struggling to pay their premiums may soon be able to get help from their local hospital or United Way.
Some hospitals in New York, Florida and Wisconsin are exploring ways to help individuals and families pay their share of the costs of government-subsidized policies purchased though the health law’s marketplaces – at least partly to guarantee the hospitals get paid when the consumers seek care.
But the hospitals’ efforts have set up a conflict with insurers, who worry that premium assistance programs will skew their enrollee pools by expanding the number of sicker people who need more services.
“Entities acting in their [own] financial interest” could drive up costs for everyone and discourage healthier people from buying coverage, insurers wrote recently to the Obama administration.
Insurers are asking the federal government, which regulates the health insurance marketplaces, to restrict the practice.”
“Backers of the health-care law say they are rushing to make sure tens of thousands of people provide more documents to prove they are in the U.S. legally and therefore entitled to the coverage they obtained through HealthCare.gov.
Immigrant advocates say they felt the Obama administration moved hastily in announcing Tuesday it would cut off health insurance for up to 310,000 people who signed up for plans through online exchanges run by the federal government if they don’t send additional information in the next few weeks showing they are U.S. citizens or legal residents.
The federal government is taking the steps to comply with a requirement in the health law that bars unauthorized immigrants from using the online exchanges to shop for coverage, as well as from receiving federal tax credits to offset the cost of premiums.”
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The law’s supporters inserted the provision to try to tamp down controversy over the prospect that it could help people who aren’t legally in the U.S.
“AUSTIN — A legislative committee is examining market-based alternatives to providing low-income Texans with health care since the state has rejected the expansion of Medicaid under the federal Affordable Care Act.
Members of the state Senate Health and Human Services committee plan Thursday to discuss alternatives to the law critics call “Obamacare.”
Some ideas include expanding Medicaid block grants and waivers. Lawmakers are seeking to hold health costs in-check while improving access to care.”
“California is coming face to face with the reality of one of its biggest Obamacare successes: the explosion in Medi-Cal enrollment.
The numbers — 2.2 million enrollees since January — surprised health care experts and created unforeseen challenges for state officials. Altogether, there are now about 11 million Medi-Cal beneficiaries, constituting nearly 30 percent of the state’s population.
That has pushed the public insurance program into the spotlight, after nearly 50 years as a quiet mainstay of the state’s health care system, and it has raised concerns about California’s ability to meet the increased demand for health care.
Even as sign-ups continue, state health officials are struggling to figure out how to serve a staggering number of Medi-Cal beneficiaries while also improving their health and keeping costs down. Many are chronically ill and have gone without insurance or regular care for years, and some new enrollees have higher expectations than in the past.”
“The Affordable Care Act is like a patient who is feeling worse when key clinical indicators say he is doing better.
Obamacare recovered from its Web site fiasco last October and went on to exceed enrollment projections in March. Despite predictions of “rate shock,” early indications are that premiums in the new insurance marketplaces are increasing modestly in most states that have made 2015 information public and more slowly than the non-group market has grown in the past. While critics said that the Affordable Care Act was having no impact on the uninsured, the share of the population that is uninsured is down significantly. Adding to the more upbeat news, health costs are rising at historically moderate rates, although the ACA has played only a supporting role in that so far. Still, opinion about the ACA has not moved significantly in any direction since 2010, when the law passed, and remains decidedly more negative than positive.
The best explanation can be seen in the chart below, which shows partisan views of the Affordable Care Act since 2010: Republicans have intensely disliked the health-care law from the start; Democrats have favored it; and independents are in the middle.”
“What happens in November will play a major role in shaping President Obama’s final two years in office.
No, it’s not just the 2014 midterm elections that have the White House on edge, but also the return of open enrollment in Obamacare.
After the disastrous rollout of the president’s signature domestic initiative in 2013, the administration needs to avoid the problems that diminished public confidence in the most significant overhaul to the health care system since the creation of Medicare.
The White House believes the technical problems that crashed healthcare.gov will become a distant memory. However, team Obama must worry about much more than just a website.
Here are the top five potential Obamacare headaches looming in November:”
“The latest somersaults and contortions over Obamacare last month spread from courtrooms to the blogosphere, with another round of regulatory “adjustments” not far away. The common principle followed by the health law’s most energetic advocates appears to be the whatever-it-takes motto of the late Oakland Raiders owner Al Davis, “Just win, baby!”
A pair of federal appellate court decisions on July 21 (Halbig v. Burwell and King v Burwell) sent Obamacare backers cycling through at least the first three stages of grief (anger, denial, and bargaining) over the potential loss of tax credit subsidies for states with federal-run health exchanges, along with the likelihood of further unraveling of the health law’s interrelated scheme of coverage mandates and tighter insurance regulation. A 2-1 majority ruling in Halbig delivered the latest blow to the Affordable Care Act, by deciding to vacate a 2012 Internal Revenue Service rule that attempted to authorize such subsidies.
The loudest voices among the flock of pro-ACA court watchers had previously declared such a judicial decision all but “inconceivable.” For example, Henry Aaron of the Brookings Institution termed these legal challenges to Obamacare as absurd, crazy, and wacky in an April 1, 2014 New England Journal of Medicine article. Jonathan Gruber of MIT and a key architect of both Massachusetts-based Romneycare and its cloned twin Obamacare called the tax credit theory behind the cases “screwy,” “nutty,” “stupid,” “unprecedented,” and “desperate” (but that depends on which version of Gruber one chooses to sample).
Tim Jost of the Washington and Lee University School of Law and a frequent blogger on this issue at Health Affairs, continues to be often wrong, but never in doubt—at least until later events require some modest repositioning. In July 2012, he flatly asserted that “these claims are simply false” regarding contentions that final IRS rules to enable premium tax credits through federal exchanges are unauthorized by law. Jost further opined that the only viable challengers with legal standing to contest the IRS rule would be employers failing to offer their employees insurance (or at least affordable or adequate coverage), but that any such challenges would be barred by the Tax Anti-Injunction Act until probably sometime in 2015.”