Articles on the implementation of ObamaCare.

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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The Trump administration on Friday proposed new health insurance regulations that could affect basic benefits required by the Affordable Care Act, but not for a couple of years.

Loosening “Obamacare” benefit requirements was a major sticking point for congressional Republicans in thus-far fruitless efforts to repeal the law.

The complex new plan from the administration would give states a potential path to easing some requirements.
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Data released this week from data.healthcare.gov show that choice in the types of plans available on the Exchanges continued to diminish between 2017 and 2018. There has been diminished choice in the number of insurers and level of competition. In 2017,142 of the 420 rating areas on which data.healthcare.gov maintains information had just one issuer. For 2018, 179 of the rating areas will have just one issuer.

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Insurers selling Affordable Care Act plans have a compelling new pitch: free health insurance.

When sales of plans on the law’s exchanges begin Nov. 1, a growing number of consumers around the country will be able to get coverage for 2018 without paying any monthly premium, according to health insurers and an analysis of newly available federal data.

In nearly all of the 2,722 counties included in the data, some consumers will be able to obtain free health insurance because they qualify for larger federal premium subsidies that cover the full cost of a plan, according to the new analysis.
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Anthem’s membership in the Affordable Care Act marketplaces will decline by 70% in 2018, executives told investors Wednesday on the insurer’s third-quarter earnings call. About 1.4 million people had ACA-compliant plans with Anthem as of Sept. 30, 900,000 of whom bought coverage on the exchanges.

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The plan Iowa has developed to salvage its insurance market — the Iowa Stopgap Measure — suffers three major flaws.

  1. Although the Iowa Stopgap Measure helps upper middle class Iowans afford health insurance, it illegally deprives poorer Iowans of the ability to make use of health insurance.
  2. The Iowa Stopgap Measure creates effective marginal tax rates of more than 100% on many individuals, particularly those over 50, and excessive effective marginal tax on many others.
  3. Unless there’s more to its fuzzy math than it has heretofore presented, the Iowa plan costs the federal government a good deal of money.

Don’t add rejection of the Iowa waiver to the list of acts of sabotage of the ACA by the Trump administration. This is an instance where the President has faithfully executed the law. And if that law is not working or if the waiver criteria are too strict, it is to Congress that complaint should be made.

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In a strongly worded letter to the Trump administration, Oklahoma’s health commissioner recently expressed frustration that a state waiver to lower costs for Obamacare customers had not been approved as quickly as federal officials had promised.

The proposal called for a reinsurance program in which government funding pays for costly medical claims while keeping prices down for other customers. Having run out of time to make a dent in premiums, the state decided to withdraw its waiver. Health commissioner Terry Cline lamented the months that Oklahoma officials spent developing a plan, followed by six weeks of daily calls or emails with federal officials, with no results.

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Republicans and Democrats are engaging in warfare over a traditionally bipartisan program to insure children.

The House Energy and Commerce Committee is marking up legislation to extend the Children’s Health Insurance Program by five years. However, Democrats have objected to the legislation because of measures to pay for the program.

“Here we are with a partisan bill that asks us to pay for coverage of children on the backs of seniors and the most vulnerable among us,” said Rep. Diana DeGette, D-Colo.

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People will be able to enroll in Obamacare plans directly through web brokers and health insurers for 2018, which will reduce the need for federal outreach funds.

That feature will likely be included in an upcoming Department of Health and Human Services proposed rule under review at the Office of Management and Budget, Joel White, president of the Council for Affordable Health Coverage (CAHC), told Bloomberg BNA Sept. 22. Congress isn’t likely to provide more funding for Affordable Care Act outreach activities, so “HHS is going to have to figure out ways to expand options for consumers to get enrolled,” White said HHS officials have told his group. The CAHC is a broad-based group of health-care industries.

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Republicans are willing to provide insurers with two years of ObamaCare subsidies under a bipartisan market stabilization bill, according to the Senate Health Committee chairman.

Sen. Lamar Alexander (R-Tenn.) said continuing cost-sharing reduction subsidies for two years is a key part of the stabilization package he is trying to negotiate with Sen. Patty Murray (D-Wash.).

Alexander and Murray are continuing to try to rally Republicans and Democrats around a short-term plan to lower ObamaCare premiums in 2018 and 2019.

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