Articles on the implementation of ObamaCare.

Louisiana’s health insurance market for individuals has been plagued in recent years by insurers fleeing the market and double-digit rate increases — prompting a proposed fix that would tack a fee on policies across the state to create a safety net against insurers’ losses and hold the line on runaway premiums.

The state Department of Insurance is pushing a bill through the Legislature that it says would lower premiums in the individual market by an average of 15 percent next year. The bill would put a roughly $1.25-a-month fee on every health-insured life in the state. That money, which one critic labeled a tax on business disguised as a fee, would go into what is called a reinsurance pool designed to protect insurers against high-cost patients.

. . .

Arizona has asked the CMS to allow it to end retroactive coverage for Medicaid beneficiaries.

If granted, the waiver request now under review at the CMS, would nix providers’ ability to bill for services provided in the three months before a beneficiary applies for Medicaid coverage, assuming the patient was eligible during that time.

Providers in the state had urged the state not to submit the waiver to the CMS because it could put hospitals in a difficult financial situation and limit access to care.

. . .

Medicaid expansion is back on the ballot.

Organizers in Utah submitted signatures on Monday to put an initiative expanding Medicaid on the state’s ballot in November. They got 165,000 signatures, or about 50,000 more than they needed.

State legislators are actually pushing a limited form of Medicaid expansion, but, as we covered before, the Trump administration seems unlikely to greenlight that proposal. The ballot initiative being submitted today would be a clean version of expansion

. . .

President Donald Trump signed a broad executive order urging a revamp of federal government aid programs Tuesday, invigorating a contentious debate from which Republicans hope to gain momentum before the November elections.

The executive order lays out broad principles for overhauling government aid programs to require that more participants prove they are working or trying to find jobs, senior administration officials said. It also instructs federal agencies to propose changes to the programs they oversee and craft new regulations if necessary. The order is primarily aimed at programs such as food stamps, which covers about 43 million Americans, Medicaid, which covers 74 million people, and housing programs, an official said.

. . .

The federal health insurance exchange allows people to enroll for insurance coverage outside of the annual open enrollment period under certain circumstances, such as losing coverage from an employer. Insurers are concerned that some people are misusing this flexibility by reenrolling after their coverage was terminated for nonpayment of premiums. Not only is this against the rules, but it undermines the stability of the exchange. CMS doesn’t collect complete data that would allow it to gauge the extent of the problem. GAO recommends gathering data on coverage terminations for nonpayment of premiums.

. . .

The White House on Friday cleared the CMS to scale back efforts to evaluate Indiana’s conservative approach to Medicaid expansion. The move could prevent the agency from gathering adequate data to determine if the state’s method of expansion harmed access to care.

Some feel that even with a scaled-back study, the CMS could still glean pertinent information from Indiana about the impact its expansion approach has had on Medicaid beneficiaries.

“Surveys were just one element, and getting rid of them is not enough to make or break an evaluation” said Doug Badger, a senior fellow at the Galen Institute, a conservative think tank.

. . .

A couple of years ago, the health insurance exchange in Minnesota – MNsure – was in deep trouble. Health insurance premiums for individual policies had shot up by as much as 67 percent, among the steepest increases in the country.  Insurers were abandoning the market, leaving 116,000 Minnesotans with scant choices.

The Minnesota Legislature offered a solution: a $271 million, publicly funded reinsurance pool that would help health insurance companies pay the most expensive medical claims, thereby lowering overall insurance premiums. The hope was that backstopping the insurers would stabilize the market and halt the rocket-like rise in premiums.

. . .

Congress in 2017 failed to “repeal and replace” the Affordable Care Act. But the health law has been changed in many other ways over the past year and a half. Some changes were made by Congress, some by President Donald Trump and his administration and some by state officials. Here is a timeline of the most consequential events that have shaped the health law:

On his first day in office, Trump issues an executive order to “minimize the unwarranted economic and regulatory burdens” of the health law. It includes instructions to agencies to “exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden.”

The same day, officials at the Department of Health and Human Services begin removing information on how to sign up for coverage from the healthcare.gov website, even though enrollment for 2017 policies lasts until the end of the month.

Maryland lawmakers on Wednesday finalized a bipartisan measure to collect $380 million in taxes from health insurers next year to help curtail surging premiums for 150,000 Marylanders and prevent the state’s Obamacare marketplace from a potential collapse.

The legislation was a quiet, one-year compromise between the Democratic-controlled General Assembly and Republican Gov. Larry Hogan, who is expected to sign the measures.

. . .

 

The Trump administration said on Tuesday that 11.8 million people had signed up for health insurance through the Affordable Care Act marketplaces for 2018 — roughly 400,000 fewer than last year. Virtually the entire decrease came in the 39 states that use the marketplace run by the federal government, HealthCare.gov. In the 11 states that sell coverage for the ACA through their own marketplaces, enrollment remained the same as last year.