Articles on the implementation of ObamaCare.
Weeks ago, President Donald Trump tweeted, “As I have always said, let Obamacare fail and then come together and do a great health care plan. Stay tuned!”
And indeed, the system established by the Affordable Care Act is collapsing on its own. Average premiums are up 105 percent since the health overhaul law took effect, and premiums will soar again next year, based upon early announcements. That will drive more young and healthy people away, further destabilizing the health insurance markets.
People in 40 percent of U.S. counties risk having only one “choice” of plan next year, and some may have none as insurers flee the market because of heavy losses.
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Anthem Inc. said that if it doesn’t quickly get more certainty about the future of the Affordable Care Act exchanges, it will likely further pull back its planned participation for next year, a threat that adds to the pressure on Senate Republicans as they struggle to pass health-care legislation.
The big insurer, speaking during its second-quarter earnings call, strongly emphasized that it needed answers about the future of federal payments that help reduce out-of-pocket costs for low-income ACA exchange-plan enrollees. Chief Executive Joseph R. Swedish said that without greater clarity, particularly around the cost-sharing payments, “we will need to revise our rate filings to further narrow our level of participation.” He added that the insurer may make decisions “in a relatively short period of time” and in September at the latest.
All eyes are on the Senate as it debates what to do about ObamaCare. But the House has a last chance this week to abolish one of the law’s most dangerous creations: a board with sweeping, unchecked power to ration care.
The Independent Payment Advisory Board—what critics call the death panel—would be an unelected, unaccountable body with broad powers to slash Medicare plans spending. But the law contains a living will for IPAB. If the president signs a congressional resolution extinguishing the panel by Aug. 15, it will never come into existence.
The real deadline is closer, since the House plans to recess Friday and not return until Sept. 5. But if the House does act, the Senate will have time to follow, since it plans to remain in session until mid-August.
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Key ObamaCare subsidies to insurers will be paid this month, the White House confirmed to The Hill on Wednesday, one day before the deadline to make July’s cost-sharing reduction (CSR) payments.
The administration has not made a commitment beyond this month.
The payments help low-income people afford the co-pays, deductibles and other out-of-pocket costs associated with health insurance policies.
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Minuteman Health of Massachusetts and New Hampshire announced it is withdrawing from the Affordable Care Act exchanges in 2018, leaving only four co-ops in operation. The co-op will stop writing business on January 1 and organize a new company, Minuteman Insurance Company, instead.
The company cited issues with Obamacare’s risk-adjustment program, which is the program that shifts money away from those with healthier customers to those with sicker enrollees. Minuteman Health said that the negative impact of this program had been “substantial.”
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Highlighting the continued uncertainty around the Affordable Care Act marketplaces, insurers announced major changes to their offerings for next year, including pullbacks that potentially leave more counties without exchange plans.
Anthem Inc. said it will exit the marketplaces in Wisconsin and Indiana next year, while nonprofit MDwise said it too would leave the Indiana exchange. Those moves may leave four Indiana counties at risk of having no exchange insurers in 2018, according to the Kaiser Family Foundation, though its researchers cautioned the outlook remains unclear. An estimated 44 counties in Ohio, Washington and Missouri will likely face a similar situation.
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nsurance startup Oscar Insurance Corp. said it plans to expand its offerings in the Affordable Care Act marketplaces, as insurers face a federal deadline Wednesday for initial filings to participate in the health law’s exchanges next year.
Oscar, which has been under a spotlight partly because of its tie to the Trump administration, said it aims to begin selling ACA plans in Tennessee for the first time in 2018, and re-enter the exchange in New Jersey, where it sat out this year. The insurer also will expand the regions where it sells ACA plans in California and Texas, and will continue selling plans in its home market of New York. Last week, Oscar announced that it will begin selling marketplace plans in Ohio next year, working with the Cleveland Clinic.
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The Trump administration has made critical ObamaCare payments to insurers for the month of June but won’t provide any certainty about whether they’ll continue in the future.
The payments, known as cost sharing reduction subsidies, reimburse insurers for providing discounts to low-income patients.
Insurers have been threatening to raise premiums — or leave the ObamaCare markets — if they don’t receive certainty about the payments from Congress or the White House.
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Obamacare’s second biggest flaw is that even as it upended the half-century long consensus over who should be in Medicaid, the law inexplicably left intact a feature of Medicaid that we have known for decades fuels excess spending: its open-ended matching rate.
So long as states put up a dollar to fund Medicaid, Uncle Sam is obliged to match it with anywhere from $1 to $3 federal dollars depending on that state’s unique matching rate. It has been proven empirically that this formula fuels higher spending. An analysis by Thad Kousser at UC Berkeley showed that all other things being equal, shifting a state from the lowest to highest federal matching rate increases discretionary Medicaid expenditures by 22 percent.
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It’s been just over seven years since President Obama declared: “It is not sufficient for us simply to add more people to Medicare or Medicaid to increase the rolls, to increase coverage in the absence of cost controls and reform. Another way of putting it is we can’t simply put more people into a broken system that doesn’t work” [emphasis added].
Regrettably, the law he signed less than 10 months later fell far short of the president’s own benchmark as it relates to Medicaid. Not only did the ACA fail to impose any cost controls on Medicaid, it likewise contained no reforms to reverse or even corral the perverse incentives that for decades had simultaneously led to indefensible levels of Medicaid overspending even while creating enormous problems of access to the very people the program aimed to help. Instead, it amplified those incentives, making an already-bad situation even worse.
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