Articles on the implementation of ObamaCare.

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.

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Anthem announced Friday that it would fill Virginia’s 63 counties that were slated to have no ObamaCare insurers on the exchange next year.

Anthem initially announced it wouldn’t sell plans in Virginia in 2018, but backtracked Friday to cover the so-called bare counties.

“Since learning that 63 counties and cities in Virginia would not have access to Individual health plans, Anthem has been engaged in further evaluation and discussion with regulators to ensure that no bare counties or cities exist in the state,” Anthem said in a statement Friday.

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New Mexico Health Connections, a not-for-profit insurance co-op funded through the Affordable Care Act, is a month overdue in filing its second-quarter financial paperwork. And the co-op’s most recent documents, as well as federal ACA documents, show potentially large financial problems that could force New Mexico to shut the company down. This could be another potential black eye for the ACA’s co-op program, in which 19 of 23 companies have already gone under.

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Navigator groups that help educate and enroll consumers in the Affordable Care Act insurance exchanges are shutting down because the federal government isn’t paying them.

Several navigator organizations, including the University of South Florida, which received the country’s largest federal grant for navigation services in 2016, are suspending education and outreach activities ahead of the 2018 open enrollment period that is slated to begin Nov. 1.

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Half of Virginia’s counties now are on track to have no health insurers offering Obamacare plans in 2018 after an insurer reversed a decision to sell individual health coverage in much of the state.

The pullback by Optima Health in Virginia ends a brief, two-week period in which every county in the United States was projected to have at least one Obamacare insurer next year.

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The Kaiser Family Foundation’s Larry Levitt says, “States actually have a lot flexibility in theory under current waivers, but the guardrails are very hard to meet, which limits the amount of flexibility in practice.” During the repeal-and-replace effort, Republicans wanted to remove some of those “guardrails”—allowing states to chip away more substantively at some of the law’s benefit mandates and coverage guarantees. Sen. Lamar Alexander, though, is trying to keep his proposal more tailored. He’s focusing more on changes to the process of seeking a waiver than on the substance of what can be waived.

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California and several other states will exempt themselves this year from a new Trump administration rule that cuts in half the amount of time consumers have to buy individual health insurance under the Affordable Care Act.

In California, lawmakers are contemplating legislation that would circumvent the rule in future years, too.

The Trump administration’s rule gives people shopping for 2018 coverage on the federal exchange 45 days to sign up, from Nov. 1 through Dec. 15.

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Major healthcare insurer Anthem will only offer Obamacare exchange plans in roughly half of Kentucky’s 120 counties due to mounting policy uncertainty from Washington and a deteriorating market.

Anthem had earlier planned to offer individual market plans in every county in Kentucky. However, the insurer said that lingering problems with the market and massive federal uncertainty has forced its hand.

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Virginia became the latest state at risk of having regions that will lack Affordable Care Act exchange plans next year, after a small insurer announced it will scale back the area where it expects to offer marketplace insurance.

The Virginia area that currently has no 2018 exchange insurer includes 48 counties and parts of six more, as well as 15 cities that are independent of counties, according to a Virginia state regulator. In total, the state has 95 counties and 38 independent cities.

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HHS plans to save taxpayer dollars by curtailing waste and requiring better performance in the ACA Navigator program which pays organizations to enroll people in ObamaCare coverage. The HHS analysis showed that in 2016 “One [Navigator] grantee received $200,000 and enrolled ONE person in Obamacare.” The top 10 most costly Navigators spent a total of $2.77 million to enroll 314 people in Obamacare—costing an average of $8,800 to enroll each person (on top of tax credits and other subsidies). In the upcoming enrollment period, CMS plans to spend $10 million on promotional activities—consistent with similar spending on Medicare Advantage and Medicare Part D.

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