Articles on the implementation of ObamaCare.

As Open Enrollment for 2018 coverage gets underway, consumers who have health coverage through the Affordable Care Act (ACA) Marketplace are again receiving renewal notices from their health insurers.  Though the insurer renewal notices are based on the same model notice required in the past, this year for many consumers, it may be causing significant – and misleading – sticker shock.

That is because renewal notices sent by insurers are required to inform consumers what their 2018 monthly premium will be, assuming they receive the same amount of advanced premium tax credit (APTC) next year that they did in 2017.  Insurer renewal notices have been required to present information this way since 2014.

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More than 600,000 people signed up last week for health insurance under the Affordable Care Act, significantly beating the pace of prior years as consumers defied President Trump’s assertion that the marketplace was collapsing.

In a report on the first four days of open enrollment, the Trump administration said Thursday, 601,462 people selected health plans in the federal marketplace, HealthCare.gov. Of that number, 137,322 consumers, or 23 percent, were new to the marketplace and did not have coverage this year through the federal insurance exchange.

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Uncertainty over the future of the Affordable Care Act was a challenge for insurers and state regulators as they prepared for the 2018 plan year. Various insurers exited or reduced service areas in the health insurance marketplaces, while others threatened exits or delayed participation decisions. In several states, some or all counties seemed likely to have no insurance plan available for residents seeking marketplace coverage. But as of the start of open enrollment, no states had counties without an insurer for plan year 2018

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The Trump administration will encourage states to pursue work requirements for certain Medicaid beneficiaries, a top official said Tuesday.

The remarks by Centers for Medicare and Medicaid Services (CMS) administrator Seema Verma would signal a significant departure from the Obama administration’s approach to such requests.

Several states have already proposed work requirements, and Verma’s comments indicate a willingness to fast-track those approvals.

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Voters in Maine approved a ballot measure on Tuesday to allow many more low-income residents to qualify for Medicaid coverage under the Affordable Care Act, The Associated Press said. The vote was a rebuke of Gov. Paul LePage, a Republican who has repeatedly vetoed legislation to expand Medicaid.

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The Trump administration is moving ahead with Obama-era requirements to post calorie counts in restaurants, supermarkets, convenience stores and pizza delivery chains nationwide next year.

Despite years of opposition by some food sellers, the Food and Drug Administration is offering only minor compromises to industry complaints about the difficulties of displaying calories at takeout chains, self-service buffets and other non-restaurant food locations.

The FDA posted a preliminary guidance online Tuesday to help businesses comply with the law.

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The CMS has finalized a proposed rule to exempt more small providers from complying with MACRA. It also reversed course on plans to give providers a pass on gauging whether they are cutting costs under the Merit-based Incentive Payment System, or MIPS.

Physician practices with less than $90,000 in Medicare revenue or fewer than 200 unique Medicare patients per year would be exempted under the rule finalized Tuesday.

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Democrats are accusing the Trump Administration of “sabotaging” Obama Care by discontinuing illegal subsidies to insurers, but last week even an Obama-appointed judge in California said otherwise. The ruling deserves more public attention.

Federal Judge Vince Chhabria rejected and ridiculed a petition by 18 states to enjoin the White House from stopping cost-sharing reduction payments (CSRs) that subsidize lower copays and deductibles for consumers on the exchanges who earn less than 250% of the poverty line. “It appears initially that the Trump Administration has the stronger legal argument,” the judge noted, adding that “the emergency relief sought by the states would be counterproductive.”
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The House and the Trump administration are asking to keep a pause on a years-long court battle over the legality of crucial ObamaCare payments to insurers, while Democratic attorneys general are seeking for the case to proceed.

In 2014, the House sued the Obama administration, arguing it was funding key payments to insurers illegally, alleging that there wasn’t a direct appropriation from Congress. The House won, and the Obama administration appealed the ruling.
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Federal health officials are proposing changes to rules for coverage sold through the ACA’s insurance marketplaces that, starting in 2019, would let states alter the benefits that health plans must provide and limit enrollment help for consumers. In envisioning a larger role for states in setting benefits, the draft rule would still require ACA plans to cover 10 categories of medical services. But for the first time, any state could adopt benefits standards already in use by another state—or rewrite its own standards.

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