Articles on the implementation of ObamaCare.
The Trump administration took another step Wednesday toward deregulating federal insurance exchanges created under the Affordable Care Act.
For coverage in 2018, consumers can buy an ACA-approved plan directly from a broker or an insurer’s website instead of having to go through HealthCare.gov, the CMS announced. The news comes just two days after small businesses were given permission to skip the federal marketplace to sign their employees up for SHOP coverage.
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The Department of Health and Human Services on Tuesday released a checklist for states that choose to seek waivers from certain Obamacare requirements.
Through the waivers, commonly known as “innovation waivers” or 1332 waivers, states can ask the federal government to allow them to set up high-risk pools, reinsurance programs or another proposal that would reduce costs for customers or allow for more people to be covered.
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New York’s health insurers will request double-digit rate increases for ObamaCare policies for 2018 while debate rages in Washington on overhauling the law, analysts told The Post.
The insurers officially submit their rate plans to state regulators on Monday.
Last year, the state Department of Financial Services approved an average 16.6 percent hike for individual policies and an average 8.3 percent for small group policies on the state’s ObamaCare exchange — the highest in four years.
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The Trump administration plans to let small businesses bypass the Affordable Care Act’s online marketplace to get health insurance for their employees.
Obamacare was meant to offer better insurance options for small businesses through the Small Business Health Options Program while rewarding companies with tax credits for offering insurance to their employees. But enrollment in SHOP plans fell drastically below expectations. Just 230,000 Americans were insured in the plans as of January, less than one-tenth of the Congressional Budget Office’s estimate of 4 million covered by this year.
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Health insurance giant Aetna said Wednesday that it will not be participating in any Obamacare exchanges in 2018.
“Our individual commercial products lost nearly $700 million between 2014 and 2016, and are projected to lose more than $200 million in 2017 despite a significant reduction in membership,” T.J. Crawford, Aetna spokesman, said in an email.
The reason for the losses, he said, came from structural issues within the exchanges “that have led to co-op failures and carrier exits, and subsequent risk pool deterioration.”
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The Trump administration won’t penalize insurers for failing to verify the number of severely ill patients they’ve enrolled through the insurance exchanges. The Affordable Care Act mandated that third-party auditors and the Department of Health and Human Services validate that plans receiving risk-adjustment payments do indeed have sicker patients. However, HHS has struggled to get the program off the ground due, in part, to technical woes. Although HHS has been collecting audit data from the plans, it hasn’t held them accountable for discrepancies in their sick patient volumes.
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Aetna Inc. is quitting Virginia’s Obamacare market for 2018, the second state that Chief Executive Officer Mark Bertolini is exiting as he seeks to limit his insurer’s risks from the beleaguered health law.
“We will not offer on- or off-exchange individual plans in Virginia,” Aetna said in an emailed statement, citing $200 million or more in losses the company anticipates this year on individual products. The insurer also cited “growing uncertainty in the marketplace” for the plans.
UnitedHealth Group Inc., which has largely stopped selling ACA health plans, said last month it was pulling out of Virginia. Also in April, Aetna said it wouldn’t sell Obamacare plans on Iowa’s market next year.
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Aetna Inc. will again scale back its presence in the Affordable Care Act exchanges in 2018, saying it expects losses on the business this year.
Individual plans are a small share of Aetna’s overall business, and the insurer had already scaled back its exchange presence to four ACA marketplaces currently, down from 15 last year.
Aetna said it expects 2017 losses on its individual business will amount to roughly half its loss last year, which was $450 million.
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The Trump administration appears to have scrapped one of the key tools the Obama administration used to encourage states to expand Medicaid under the Affordable Care Act.
The shift involves funding that the federal government provides to help hospitals defray the cost of caring for low-income people who are uninsured. Under a deal with Florida, the federal government has tentatively agreed to provide additional money for the state’s “low-income pool,” in a reversal of the previous administration’s policy.
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Even as Anthem, one of the nation’s largest insurers, reported an improved financial picture for the last year, the company warned on Wednesday that it would consider leaving some federal health care marketplaces or raising its rates sharply if the government does not continue subsidies to help low-income people.
Joseph R. Swedish, the company’s chief executive, set a deadline of early June for a decision on the subsidies, saying Anthem would weigh increasing rates by at least 20 percent next year.
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