Articles on the implementation of ObamaCare.

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.
. . .

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.

. . .

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.

. . .

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.

. . .

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.

. . .

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.

. . .

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.

. . .

Health insurers appeared likely to offer Affordable Care Act plans in all U.S. counties next year, despite months of drama and worries among some state officials about last-minute exits, ahead of a late-Wednesday deadline.

Some major insurers that had signaled that they might pull back, including Cigna Corp. , Health Care Service Corp., Molina Healthcare Inc., Highmark Health and Independence Blue Cross, this week said they would stick to the states and regions where they had filed to offer ACA coverage.
. . .

The Trump administration plans to shut down healthcare.gov, a website consumers use to sign up for the Affordable Care Act, for 12 hours on nearly every Sunday of the coming ACA enrollment season.

The outages, which the administration says are for maintenance, will occur from midnight through noon on every Sunday other than Dec. 10. This year’s enrollment season, which the administration has shortened to half the length of previous years, will run from Nov. 1 through Dec. 15 for states that use the federal marketplace.
. . .

The Centers for Medicare and Medicaid Services has a powerful tool for improving quality and reducing costs: the Center for Medicare and Medicaid Innovation. Congress created the Innovation Center in 2010 to test new approaches or “models” to pay for and deliver health care. The complexity of many of the current models might have encouraged consolidation within the health care system, leading to fewer choices for patients. The Trump administration is analyzing all Innovation Center models to determine what is working and should continue, and what isn’t and shouldn’t. Strengthening Medicare and Medicaid will require health care providers to compete for patients in a free and dynamic market, creating incentives to increase quality and reduce costs.

. . .