Articles on the implementation of ObamaCare.

Aetna Inc. will again scale back its presence in the Affordable Care Act exchanges in 2018, saying it expects losses on the business this year.

Individual plans are a small share of Aetna’s overall business, and the insurer had already scaled back its exchange presence to four ACA marketplaces currently, down from 15 last year.

Aetna said it expects 2017 losses on its individual business will amount to roughly half its loss last year, which was $450 million.

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The Trump administration appears to have scrapped one of the key tools the Obama administration used to encourage states to expand Medicaid under the Affordable Care Act.

The shift involves funding that the federal government provides to help hospitals defray the cost of caring for low-income people who are uninsured. Under a deal with Florida, the federal government has tentatively agreed to provide additional money for the state’s “low-income pool,” in a reversal of the previous administration’s policy.

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Even as Anthem, one of the nation’s largest insurers, reported an improved financial picture for the last year, the company warned on Wednesday that it would consider leaving some federal health care marketplaces or raising its rates sharply if the government does not continue subsidies to help low-income people.

Joseph R. Swedish, the company’s chief executive, set a deadline of early June for a decision on the subsidies, saying Anthem would weigh increasing rates by at least 20 percent next year.

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Insurance executives, as well as the head of the trade group America’s Health Insurance Plans, met with Seema Verma, administrator of the Centers for Medicare and Medicaid Services, on Tuesday. Insurers have been pressuring administration officials and lawmakers to fund the ACA’s cost-sharing reduction payments. Insurers have struggled to adjust to the individual marketplaces since the ACA created the exchanges, and the ACA’s uncertain political future has only added to the questions they face as they approach the June 21 deadline for filing their 2018 premium rate requests. That will be the first indication of how the individual exchanges fare next year.

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With time running out to set insurance prices and uncertainty surrounding whether the Trump administration will continue funding cost-sharing subsidies on the ACA exchanges, several states are giving health insurers a little more wiggle room to file 2018 rates. State insurance regulators hope an extra few weeks to price plans will be enough to ease the insurance industry’s jitters created by efforts to repeal and replace the ACA and keep insurers from bailing on the exchanges. Colorado, New Hampshire, Oregon and Kentucky have extended deadlines for insurers to submit rates for 2018 ACA health plans.

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The Trump administration on Thursday released a final rule that slashes the open enrollment period for Affordable Care Act coverage in 2018 in half, among other changes, in its first major regulatory change affecting Obamacare.

The regulation, which aims to stabilize the ACA exchanges, could have a significant impact on the marketplace, but it leaves unanswered insurers’ biggest question: whether the government would continue funding the ACA’s cost-sharing subsidies, which help lower-income consumers afford out-of-pocket health costs.

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A second major health-insurer has decided to quit selling individual policies in Iowa, raising fears that tens of thousands of Iowans will have no options for coverage next year.

Aetna informed Iowa regulators Thursday that it had decided to stop selling such policies, which cover people who lack access to employer-provided coverage or government plans. The move would affect 36,205 customers, the company told regulators.

Aetna’s move takes effect in January. It came three days after Iowa’s dominant health-insurer, Wellmark Blue Cross & Blue Shield, announced that it would no longer sell individual health-insurance policies in Iowa.

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More insurance companies around the country are refusing to pay brokers commissions on higher-tier exchange plans or special enrollment sales as the companies face financial losses on the federal marketplace. “It’s the Wild West out here, and companies are doing what they can to survive,” says Ronnell Nolan, CEO of Health Agents for America, which represents independent insurance brokers. “They’re not paying commissions on platinum plans, and they are not paying them for special enrollment plans which cover some of the sickest patients.” An exodus of brokers from the federal marketplace could undermine enrollment efforts since brokers historically sign up at least 50% of exchange enrollees.

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How many different ways are there to make a Domino’s pizza? The answer might interest you. It might also interest the Food and Drug Administration — at least, it should.

The nation’s franchise restaurants are about one month away from the imposition of new nutritional-labeling rules dreamed up by the Obama administration, another gift of the grievously misnamed Affordable Care Act. For outlets of brands with 20 or more locations, that means posting signs in the shop with calorie counts for every item on the menu and for every variation on that item.
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Senior House Republicans said Thursday that they expected the federal government to continue paying billions of dollars in subsidies to health insurance companies to keep low-income people covered under the Affordable Care Act for the rest of this year — and perhaps for 2018 as well. “While the lawsuit is being litigated, then the administration funds these benefits,” the House speaker, Paul D. Ryan, said Thursday. “That’s how they’ve been doing it, and I don’t see any change in that.”

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