Articles on the implementation of ObamaCare.
The conceit that the five major commercial health insurers will consolidate to three seems to be dissolving, as four of those insurers called off a pair of mega-mergers on Tuesday. After 18 months of courtship among the Big Five starting in 2015, the outgoing Obama Justice Department’s antitrust division sued to block the $34 billion Aetna- Humana tie-up as well as Anthem’s $48 billion acquisition of Cigna. Federal judges blocked both transactions earlier this year. Anthem had planned to appeal but on Tuesday Cigna pulled the plug after Aetna and Humana did the same.
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Healthcare.gov enrollment came in well below what was anticipated last month. After running very slightly ahead of last year’s numbers in December, January brought the news that about 400,000 fewer people had enrolled on the federal exchanges than did so in 2016. Those are scary numbers, not so much for the absolute size of the decline—it’s roughly 4%—but because any backwards movement is very bad news for the exchanges. Trump was only president for a few days’ worth of open enrollment. Could he really have somehow caused 400,000 people to forgo health insurance?
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A major insurer on Wednesday reported a huge drop in the number of Obamacare customers it has.
Humana reported in its latest fourth quarter 2016 earnings Wednesday that total enrollment in the individual market, which includes Obamacare’s exchanges, declined by 69 percent in January 2017 compared to the month before.
The company said on Dec. 31 it had about 450,800 in the individual market, which includes Obamacare’s marketplaces. However, in January 2017 membership dropped by 69 percent to 204,000.
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The Trump administration intends to publish a new regulation soon aimed at stabilizing Obamacare’s marketplaces, just as insurers are weighing whether to participate next year.
The administration hasn’t released the text for the regulations or said whether it could be finalized before insurers face the first deadlines this spring for submitting plans for 2018.
The Office of Management and Budget released a notice on a pending rule received Feb. 1 aimed at stabilizing Obamacare markets.
The rule was received the same day that insurers told Congress that they need to know soon whether cost-sharing reduction payments will be reimbursed in 2018.
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The Affordable Care Act’s insurance exchanges have become too risky for major health insurers, and that’s creating further doubt about coverage options consumers might have next year.
Anthem CEO Joseph Swedish said Wednesday his company is waiting to see whether the government makes some short-term fixes to the shaky exchanges before it decides how much it will participate next year. The Blue Cross-Blue Shield carrier is the nation’s second largest insurer and sells coverage on exchanges in 14 states.
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One of the stated aims of the Affordable Care Act was to increase competition among health insurance companies. That goal has not been realized, and by several different measures the ACA’s exchanges offer less competition and choice in 2017 than ever before. Now in the fourth year of operation, the exchanges continue to be far less competitive than the individual health insurance market was before the ACA’s implementation. Moreover, insurer participation in the law’s government-run exchanges has declined over the past two years and is now at the lowest level yet. This lack of insurer participation leaves exchange customers in 70 percent of U.S. counties with no insurer choice, or a choice between merely two insurers.
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The attempted imposition of the notorious Obama-era “HHS mandate” on religious organizations, especially Catholic institutions, reflected an attitude that has been pervasive during Obama’s presidency, which is one of barely concealed hostility toward persons or organizations holding on to traditional religious beliefs. It should be the first order of business of the incoming Trump administration to rid the federal government of this attitude and the associated policies that flow from it.
The place to begin that process is with the HHS mandate itself. The mandate is a rule, finalized initially in 2013, that requires nearly all employers in the United States to provide all manner of free contraception in their health-plan offerings. The Obama administration went out of its way to impose this requirement even on many Catholic institutions, such as universities and hospitals, knowing full well that the requirement violated fundamental teachings of the church. It then provided only the narrowest of exemptions to the general requirement and fought every legal challenge trying to provide greater latitude to religious organizations or employers with religious sensibilities.
The individual mandate is Obamacare’s least popular feature. It was the subject of the 2012 lawsuit asserting Obamacare was unconstitutional: Never before had the federal government forced any resident to buy a good or service from a private business. The people lost that argument. Nevertheless, Republicans have pledged to eliminate the individual mandate. This commitment remains good politics. However, it is also good economics.
According to last November’s Kaiser Family Foundation Tracking Poll, only 35 percent of respondents have a favorable view of the individual mandate. The proportion drops to just 21 percent among Republicans, and just 16 percent among Trump supporters.
About 6.4 million people have signed up for health insurance next year under the Affordable Care Act, the Obama administration said Wednesday, as people rushed to purchase plans regardless of Republican promises that the law will be repealed within months.
The new sign-ups — an increase of 400,000 over a similar point last year — mean the health care coverage of millions of consumers could be imperiled by one of the first legislative actions of Donald J. Trump’s presidency. Hundreds of thousands of other people who took no action will be automatically re-enrolled by the federal government in the same or similar plans, officials said, and their coverage could be threatened as well. Consumers still have until the end of January to enroll.
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The news is all full of supporters of the Affordable Care Act warning about how the health insurance system will collapse if, as various Republican repeal programs propose, the “individual mandate” is immediately gutted while parts of the ACA briefly solider on. It’s not that the people issuing the warning aren’t correct. Repeal of the individual mandate without some immediate replacement will clearly reduce the stability of whatever markets would otherwise remain as the ACA continues its death march. It’s just that many of them are hypocrites.
It was the Obama administration and supporters of the ACA who essentially gutted the individual mandate.
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