Articles on the implementation of ObamaCare.
“Insurers can no longer reject customers with expensive medical conditions thanks to the health care overhaul. But consumer advocates warn that companies are still using wiggle room to discourage the sickest — and costliest — patients from enrolling.
Some insurers are excluding well-known cancer centers from the list of providers they cover under a plan; requiring patients to make large, initial payments for HIV medications; or delaying participation in public insurance exchanges created by the overhaul.
Advocates and industry insiders say these practices may dissuade the neediest from signing up and make it likelier that the customers these insurers do serve will be healthier — and less expensive.
“It’s the same insurance companies that are up to the same strategies: Take in as much premium as possible and pay out as little as possible,” said Jerry Flanagan, an attorney with the advocacy group Consumer Watchdog.”
“Thought HealthCare.gov had problems?
Another federal government-run website created under ObamaCare is suffering the same symptoms as the troubled federal health care exchange — grappling with delays, data problems and other hiccups as the deadline to take it public nears.
At issue is a database known as the Open Payments website. It was created under the Affordable Care Act to shed light on the financial ties between doctors and pharmaceutical companies as well as device manufacturers.
The transparency initiative is supposed to include detailed information about drug payments made by doctors as well as the value of gifts and services given by drug makers. Such items can include everything from meals to swanky retreats.
The database project, though, is dealing with a minefield of technical problems and confusion over the data. The problems led the Centers for Medicare and Medicaid Services to shut down what is currently a private site for 11 days earlier this month.”
“Cover Oregon will hold a special open enrollment period for 1,400 Oregonians who were incorrectly enrolled into the low-income Oregon Health Plan by the state’s troubled health insurance exchange.
Starting Aug. 31, the people affected will have no coverage through the OHP, the state’s version of Medicaid. However, they will have the option to sign up for coverage from private insurers and to qualify for tax credits through Cover Oregon to bring down premiums.
Meanwhile, Cover Oregon is contacting at least 700 people who should have been enrolled in the Oregon Health Plan, but were incorrectly enrolled in a commercial health plan instead.
If they were receiving tax credits for private plans, those will go away immediately, though they can keep their plan.
Cover Oregon is currently negotiating with the federal government over whether those people will have to refund to the IRS all the tax credits they received incorrectly, said Amy Fauver, Cover Oregon communications director. She said the exchange is optimistic that they won’t.”
“Noridian Healthcare Solutions, the company fired by Maryland officials after the disastrous launch of the state’s health insurance exchange, received a request from federal auditors last month to turn over documents related to the troubled project, chief executive Tom McGraw said Tuesday.
McGraw said in a statement that Noridian was “cooperating fully” with the July 30 request by the inspector general’s office for the Department of Health and Human Services, which has been auditing the use of federal funds in creating the Maryland Health Benefit Exchange.
McGraw’s statement came after Rep. Andy Harris (R-Md.), a fierce critic of the exchange and the federal health-care law that led to it, said that federal auditors had issued subpoenas as part of their review.
“The Office of Inspector General has moved this from an audit into a full-blown investigation,” he said in a statement. “Now we know that fraud may have occurred.””
“As federal officials wrestle over whether HealthCare.gov will withstand the weight of millions of new customers and re-enrollees this fall, state brass with Your Health Idaho are looking to detach from the federal health insurance portal.
But they’re going to need help from Idahoans.
The state-run insurance marketplace has begun setting up state-based accounts through its own technology for the 76,000 residents who signed up for health care last year, said spokeswoman Jody Olson.
Idaho used HealthCare.gov’s Web system in its inaugural year, as officials believed accounts could easily be transferred. The federal government, however, continues to “drag its feet, and we still don’t have the data we were told we’d get,” Olson wrote in a release.”
“Responding to ongoing problems at the Washington Healthplanfinder insurance exchange, state Insurance Commissioner Mike Kreidler on Monday instituted a limited special enrollment period for consumers who want to obtain coverage outside the exchange.
From Aug. 27 to Nov. 14, those who have had problems with enrolling or making payments through Healthplanfinder can enroll in coverage outside the exchange either by selecting a different plan with the same carrier or by changing carriers.
“This is a problem that has been around since the end of December,” Kreidler said in an interview. “I am cautiously optimistic that the exchange is doing a much better job right now to resolve the problems, but there is no guarantee that they’re going to be gone as we go into open enrollment.””
“Those who favor women being guaranteed no-cost birth control coverage under their health insurance say the new rules for nonprofit religious organizations issued by the Obama administration simply put into force what the Supreme Court suggested last month.
A demonstrator holding up a sign outside the Supreme Court in Washington in June 2014. The Obama administration announced new measures last week to allow religious nonprofits and some companies to opt out of paying for birth control for female employees while still ensuring those employees have access to contraception. (Photo by Pablo Martinez Mosivais/AP)
“We interpret what [the administration] did to be putting into effect that order,” said Judy Waxman, vice president for health and reproductive rights at the National Women’s Law Center. She’s referring to the controversial Supreme Court order in a lower court case involving Wheaton College, a Christian school in Illinois.
The unsigned order agreed to by six of the nine justices said Wheaton College need not fill out and send to its insurance company a form opting out of offering the coverage. Instead, it could merely inform the government of its objections.
The new rules unveiled Friday require those with religious objections to providing some or all FDA-approved contraceptives to do exactly that – notify the government rather than their insurance carriers that they cannot provide the coverage. Many religious organizations had complained that filing the form to their insurance companies, which would then provide the coverage using other funds, would make them “complicit” in providing the benefit. Under the new regulations, the government would subsequently be responsible for notifying insurers, which would then arrange contraceptive coverage.”
“From Halbig to Sovaldi, this summer was a busy one for health policy and politics. We’ve made it easy to catch up, collecting all of the top stories you clicked on over the past few months. Together, they tell a story about the state of healthcare in the U.S., and offer clues as to where things may be headed when Congress returns in the fall.
Among them: The political battle over Obmacare has become more complicated for Republicans since the government cleaned up the Healthcare.gov mess, and with midterm elections around the corner, the focus will be on how much either party continues to attack or ignore the law. There are policy, legal and business matters to be settled as well – the employer mandate is under attack from the left and the right, the courts have been a wildcard for the health law to this point and could continue to be so, and employers and employees are finding themselves wading through the on-the-ground impacts of the law. That doesn’t even get to our top three storylines of the summer, so be sure to click through to find out what tops the list.”
“The state of Oregon filed a lawsuit Friday against Oracle America Inc. and several of its executives over the technology company’s role in creating the troubled website for the state’s online health insurance exchange.
The lawsuit, filed in Marion County Circuit Court in Salem, alleges that Oracle officials lied, breached contracts and engaged in “a pattern of racketeering activity.”
Oracle was the largest technology contractor working on Oregon’s health insurance enrollment website, known as Cover Oregon. The public website was never launched, forcing the state to hire hundreds of workers to process paper applications by hand. The website’s failure became a political problem to Democratic Gov. John Kitzhaber, who is running for re-election.
A related project to modernize functions for social services also was scrapped. The state paid Oracle $240 million for both projects.”
“Supporters of President Obama’s health care law have been touting proposed insurance rates for 2015 — arguing that they aren’t as high as some of the dire warnings of the law’s critics.
But it’s worth considering some additional context.
Data compiled by the Health Research Institute of PricewaterhouseCoopers from about 29 states plus the District of Columbia show that the average premium increase for insurance starting next year is currently 8.2 percent. But within that average, there’s a wide range.
In Arizona, for instance, the average premium increase submitted was 11.2 percent, but rates ranged from a decrease of 23 percent to a spike of 27 percent. In Arkansas, where the average increase was 11.2 percent, some consumers could see their premiums soar by 50 percent.
Defenders of Obamacare argue that rates typically went up annually before the law went into effect.
However, it’s important to keep in mind that it was Obama himself who repeatedly promised that premiums would go down by an average of $2,500 per family.”