Articles on the implementation of ObamaCare.
Political discussion aside, The Affordable Care Act will fail for business reasons. The fundamental reason the ACA will fail is because it mandates a minimum Medical Loss Ratio (MLR), or the percentage of premiums paid out to cover health care expenses. The problems associated with mandating MLR are two-fold: 1) incentivizing the insurance industry to become less efficient; 2) contributing to the elimination of new insurers entering the market and increasing the level of competition.
The latest turmoil in health insurance marketplaces created by the Affordable Care Act has emboldened both conservatives who want to shrink the federal role and liberals who want to expand it. UnitedHealth Group announced last week that it may pull out of the marketplaces in 2017 after losing money this year. This followed the collapse of 12 of the 23 nonprofit insurance cooperatives created with federal loans under the health law. In addition, insurance markets in many states are unstable. Premiums are volatile and insurers say their new customers have been sicker than expected.
Michael Cannon of the Cato Institute, Tarren Bragdon of the Foundation for Government Accountability, and Daniel Landon of the Missouri Hospital Association joined former Secretary of the Department of Health & Human Services (HHS) Kathleen Sebelius to discuss Medicaid expansion under the Affordable Care Act.
The sudden collapse of the largest nonprofit insurance cooperative created under the Affordable Care Act is causing headaches in New York, especially for medical providers owed millions of dollars for treating the failed plan’s patients. Hospitals, doctors, and other clinicians are legally obligated to continue treating Health Republic patients through the end of the month but have been given no assurances they will ever be paid for that care.
Executives with Arizona’s nonprofit health insurance co-op said Tuesday that they have failed to come up with additional financial backing and the insurer plans to shut down all operations December 31, 2015. The announcement by Meritus Health Partners means 59,000 Arizonans it now covers need to find a new insurer by December 15 if they want coverage on January 1, 2016.
“Taxpayers should not be forced to throw good money after bad,” Grace-Marie Turner said in an interview with LifeZette. Turner is president of the Galen Institute, a not-for-profit health and tax policy research organization. “Congress would be well advised to exercise its oversight function to ensure no additional federal dollars are wasted on the program, as well as investigate how the taxpayer loans have been spent and who will pay it back,” she said.
The Centers for Medicare & Medicaid Services has proposed mandating minimum network standards for health plans sold on the federal marketplace in 2017 as part of an effort to handle the broad shift toward narrow provider networks. The Affordable Care Act requires that all medical policies on the exchanges have enough in-network hospitals and doctors for members so that “all services will be accessible without unreasonable delay.” However, the 381-page proposed rule (PDF) released Friday goes a step further, asking states to establish a quantitative measure to ensure ACA policyholders have sufficient access to healthcare providers.
The new individual marketplace created under ObamaCare was intended to rival that of the employer sponsored insurance marketplace in stability and predictability, while premiums were to rise at rates much lower than the historical average. This study from the American Action Forum evaluates the degree to which these promises have been fulfilled. AAF found that the cost of both the benchmark Silver plan and the lowest cost Bronze plan will increase by 10% in 2016.
There are 499 markets for Obamacare plans in the United States. In 89 of them, the insurance company that offered this year’s best deal in the “silver” category will not be returning for 2016. The New York Times has created an interactive map showing in what areas of the United States this is the case.
When the Patient Protection a
nd Affordable Care Act (ACA) was signed into law in 2010, many groups projected how many people would enroll in health insurance plans satisfying the law’s new rules and requirements (ACA plans). Nearly six years later, enrollment in health insurance exchange plans is far short of initial projections, particularly for people who earn too much to qualify for subsidies to reduce high ACA plan deductibles. The dearth of exchange enrollees with at least a middle-class income indicates that the individual mandate is not motivating as many people, particularly younger, healthier, and wealthier people, to purchase coverage as was originally expected. Large insurer losses on ACA plans show that the overall risk pool is sicker and much more costly than originally projected, and are an indication that the law may require significant revision in order to avoid causing an adverse-selection spiral.