Articles on the implementation of ObamaCare.
In the wake of Louisiana governor John Bel Edwards’ announcement last week that his state would expand Medicaid under ObamaCare, the White House rolled out a new scheme to persuade the 19 states that are still holding out to fall into line and expand their programs: throw more money at them.
But these state officials should resist the temptation, for at least three reasons:
- First and most obvious is that expansion states have all experienced the same thing: More people signed up than expected, and it blew a hole in the states’ budgets.
- The second reason is that there’s no such thing as “free” federal dollars. The money comes with conditions, which effectively shifts policymaking from the receiving state’s legislature and governor to a distant federal bureaucracy (in this case, the Centers for Medicare & Medicaid Services), which dictates how states must spend federal Medicaid funds.
- The third reason is less abstract: Medicaid will harm those it’s meant to help. Often lost in the expansion debate is that Medicaid is the worst form of health coverage in the country.
After the passage of the Affordable Care Act, the federal government gave Oregon $300 million to build an online health insurance exchange. The state then hired Oracle, the world’s second-largest software company, with profits of nearly $10 billion last year, to build the website.
The website never worked. In May 2014, then-Gov. John Kitzhaber, who was running for re-election and getting a lot of heat for Cover Oregon’s failure—asked Attorney General Ellen Rosenblum to sue Oracle.
For nearly two years, Oracle has been in a bruising, $5.5 billion legal battle with the state of Oregon over who is at fault for Cover Oregon, the failed $300 million health insurance website.
The U.S. government will limit a process that allowed people to sign up for health insurance under ObamaCare outside of the normal enrollment period. Typically, individuals have from about November to January to purchase insurance under ObamaCare. In some cases, though, they’re allowed to sign up outside that period, such as when they have a child.
The government is also tightening an exception that let people sign-up when they moved, by clarifying that people can’t get coverage based on a short-term or temporary relocation, the Centers for Medicare and Medicaid Services said in a blog post on Tuesday. It also plans to more tightly enforce other limits on enrollment by making sure people are qualified to sign-up in the remaining special circumstances.
In November, UnitedHealth abruptly reversed its previously sunny take on ObamaCare and said that the company would have to pull out of the government-run exchanges if market conditions didn’t improve.
UnitedHealth’s bombshell raised the specter, once thought safely in the grave, of the “adverse selection death spiral,” the phenomenon where sick people are more likely to buy insurance, which raises the average expenditure, which means higher premiums, which makes insurance a worse deal for the healthiest members of your insurance pool, which means they drop out, which means your pool is even sicker and average expenditure goes up even more … and there goes the insurance market.
President Obama is proposing to boost federal funding for states that choose to expand Medicaid under ObamaCare in a new effort to entice states to make the move.
Obama will propose in his 2017 budget to have the federal government pick up the entire cost of expansion for three years, no matter when a state decides to accept the expansion.
Under current law, states only got three years of full federal funding if they accepted the expansion in 2014. If nothing changes, states newly accepting the expansion would not get full federal funding after 2016 and instead would get payments that are somewhat less, eventually dialing back to 90% of costs.
Humana Inc. has added its name to the list of mega-medical insurers to report big problems under ObamaCare.
The Louisville, Ky.- based company does not expect to make enough money this year in premiums from individual plans to cover what it will pay out in claims, according to a regulatory filing made last week with the U.S. Securities and Exchange Commission.
Humana, which is being acquired by Aetna Inc., said it is still trying to figure out how big the gap will be.
Health insurers in the Affordable Care Act exchanges will see changes from the Centers for Medicare & Medicaid Services this year to strengthen the market, including eliminating special enrollment periods and an early look at plans’ risk-adjustment data, the top CMS official, Andy Slavitt, said on Monday.
Andy Slavitt, head of the Centers for Medicare & Medicaid Services, spoke at the J.P. Morgan health conference in San Francisco, using the opportunity to announce new initiatives, including responding to the failure of ObamaCare’s exchanges. Although sugar-coating his diagnosis, Mr. Slavitt clearly knows exchanges are in trouble.
Mr. Slavitt proposes two solutions to force more people into the exchanges. First, he will tighten up the open season for enrollment. More promising, and necessary, is a new look at risk adjustment. Slavitt promises more announcements on managing ObamaCare’s risk pool over the next few weeks.
Better risk adjustment is critical, but administrative adjustments alone will not fix the exchanges.
A new survey from payroll services giant ADP reveals that about 40% of mid-sized and large companies that are offering health coverage to workers aren’t familiar with two new ObamaCare-related forms that must be filed with the Internal Revenue Service starting this tax season.
Last week, the Department of Health and Human Services (HHS) released 2016 exchange enrollment data through the first two months of the three-month open enrollment period. Although nearly one month of open enrollment remains, the new data generally supports my previous findings. Here are seven things you should know about the new data.
1) 2016 enrollment will likely be at least ten million people below expectations when the ACA was passed
2) People with at least middle class income still largely shunning exchanges
3) Enrollees still skewing older
4) Average advance premium tax credit up 12% from last year
5) 90% of enrollees selected silver or bronze plans
6) 27% of enrollees are new sign-ups, 38% of enrollees are active reenrollees, and 33% of enrollees are automatic reenrollees
7) High auto-enrollment in states not using HealthCare.gov may lead to premium shock