Articles on the implementation of ObamaCare.
Iowa Insurance Commissioner Nick Gerhart can hardly believe he’s giving some consumers this advice: If you can’t find an affordable, full-fledged health insurance policy, he tells them, maybe you should consider going without one.
The Affordable Care Act started requiring most Americans to have health insurance in 2014. But the law offers an exemption for people who can’t find policies that would cost them less than about 8 percent of their household incomes.
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The Obama administration said Tuesday that it is planning to test out further steps to tighten the rules for ObamaCare sign-up periods that have drawn insurer complaints.
The Centers for Medicare and Medicaid Services (CMS) said that it will launch a pilot program in 2017 to test ways to put in place a “pre-enrollment verification system,” meaning a way to check documentation to make sure enrollees are actually eligible to sign up for ObamaCare through an extra sign-up period.
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Along with “stakeholders” (campaign donors), “investments” (government spending) and “obstruction” (Congress), one of our favorite political euphemisms is “improper payments.” That’s how Washington airbrushes away the taxpayer money that flows each year to someone who is not eligible, or to the right beneficiary in the wrong amount, or that disappears to fraud or federal accounting ineptitude. Now thanks to ObamaCare, improper payments are soaring.
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Under the ACA, health insurance marketplaces, also called health exchanges, were set up to facilitate the purchase of health insurance in each state. Customers are free to choose from a set of standardized healthcare plans from participating insurers, and those policies are eligible for federal subsidies.
But insurers have been fleeing the exchanges, arguing that they are loss makers and the types of people attracted to them make the risks too great for the insurers to provide affordable (and profitable) policies.
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Under intense pressure to curb costs that have led to losses on the Affordable Care Act exchanges, insurers are accelerating their move toward plans that offer limited choices of doctors and hospitals.
A new McKinsey & Co. analysis of regulatory filings for 18 states and the District of Columbia found that 75% of the offerings on their exchanges in 2017 will likely be health-maintenance organizations or a similar plan design known as an exclusive provider organization, or EPO. Both typically require consumers to use an often-narrow network of health-care providers—in some cases, just one large hospital system and its affiliated facilities and doctors.
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Senate Majority Leader Mitch McConnell (R-Ky.) says major changes are coming for ObamaCare next year, no matter who wins the White House.
Pointing to rising costs and shaky insurance markets, McConnell said the next president will have to work with Congress to keep the situation from worsening, though he did not specifically say the healthcare law would be repealed.
“It will be revisited by the next president, whoever that is,” McConnell said at an event Monday with the Kentucky Chamber of Commerce. “No matter who wins the election, no matter who’s in control of Congress.”
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The Centers for Medicare and Medicaid Services on Monday issued a proposed rule to govern how Obamacare exchanges will operate in 2018. The proposal would change Obamacare’s risk adjustment program to account for prescription drug data.
Currently, the government determines which plans have sicker enrollees, and thus should receive assistance, based on claims data.
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On Tuesday, Commissioner Julie Mix McPeak, who runs Tennessee’s Department of Commerce and Insurance, announced that her department was approving massive premium increases for insurers providing individual health insurance policies through the Patient Protection and Affordable Care Act exchange in the state.
The percentage increases are stunning and prompted the commissioner to put them in context. Her context was more stunning than the increases themselves.
“I would characterize the exchange market in Tennessee as very near collapse,” McPeak said.
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Enrollment in the insurance exchanges for President Obama’s signature health-care law is at less than half the initial forecast, pushing several major insurance companies to stop offering health plans in certain markets because of significant financial losses.
As a result, the administration’s promise of a menu of health-plan choices has been replaced by a grim, though preliminary, forecast: Next year, more than 1 in 4 counties are at risk of having a single insurer on its exchange, said Cynthia Cox, who studies health reform for the Kaiser Family Foundation.
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In the wake of Aetna’s recent announcement that it was pulling up stakes in 11 of 15 states where it had been selling insurance on Obamacare exchanges, there are more alarming signs that other major insurers are struggling to remain in the game.
On Tuesday, three of the major players in Tennessee — Cigna Health Insurance, Humana and Blue Cross Blue Shield — were granted huge double-digit premium increases for the 2017 season beginning in January amid a warning from the state’s insurance commissioner that the Obamacare markets were “very near collapse.”
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