“Several unions want the Labor Department to broadly authorize employer-sponsored “wraparound” coverage for workers to supplement their exchange plan benefits and subsidies, according to comments on a rule that is currently being reviewed by the White House.
Under a little-noticed proposed rule the Labor Department issued on Dec. 24, the Obama administration proposed to treat as “excepted benefits” certain limited coverage provided by employers that would wrap around an individual market policy. If the wraparound coverage meets a number of requirements, it’s considered an excepted benefit and would not disqualify the employee from getting subsidized coverage on the exchanges. While unions generally supported the concept, many complained that the parameters the administration proposed would prevent lower wage employees from having access to the coverage and they are the ones that would benefit most.”

“Voters continue to give lackluster reviews to the U.S. health care system despite positive opinions of their own insurance coverage and care. Half still think the system will get worse under the new health care law.
A new Rasmussen Reports national telephone survey finds that only 32% of Likely U.S. Voters rate the nation’s health care system as good or excellent. Just as many (32%) give it poor marks, up from 29% in August but still below the 35% who felt that way in June.”

“Employer groups are ramping up their efforts to revise the ACA’s 30-hour full-time employee definition in hopes of getting it changed before the employer mandate kicks in for some large employers next year. The initiative, titled “More Time for Full-Time,” was announced Friday (Sept. 19) and is the latest tactic by employers to change the standard so that it defines a full-time employee as one who works 40 hours per week.
Groups involved in the initiative include the National Restaurant Association, the National Retail Federation, the U.S. Chamber of Commerce, the National Grocers Association and the International Franchise Association.
“As all Americans have known for decades, 40 hours represents the widely-accepted definition of a full-time work week. Unless there is a statutory change to the definition of a full-time employee in the ACA, there will be fewer full-time jobs, more part-time workers and fewer overall hours available for Americans to work,” International Franchise Association President and CEO Steve Caldeira said in a statement.”

“Costs to buy coverage through Connecticut’s health insurance exchange won’t, on average, rise much next year. For some plans, the prices are dropping.
But some customers who get financial aid to buy their insurance could see price increases beyond the rise in sticker price if they stick with their current plans, according to an analysis by consultants for the exchange, Access Health CT.
As a result, some people might find lower prices by considering different plans, even if they bought the cheapest plan available this year, according to the analysis by Wakely Consulting Group.”

“Who’s up for the latest batch of bad Obamacare-related news?
(1) Consumers brace for the second full year of Obamacare implementation, as the average individual market premium hike clocks in at eight percent — with some rates spiking by as much as 30 percent.
(2) “Wide swings in prices,” with some experiencing “double digit increases.”(Remember what we were promised):
Insurance executives and managers of the online marketplaces are already girding for the coming open enrollment period, saying they fear it could be even more difficult than the last. One challenge facing consumers will be wide swings in prices. Some insurers are seeking double-digit price increases.”

“We did not see big changes in employer-based coverage in the Kaiser-HRET annual Employer Health Benefit Survey released last week. Mostly this is good news, particularly on the cost side where premiums increased just 3%.
But one long-term trend that is not so good is how this market works for firms with relatively large shares of lower-wage workers (which we define as firms where at least 35% of employees earn less than $23,000). These low-wage firms often do not offer health benefits at all. And, as the chart below shows, when they do offer coverage, it has lower premiums on average (likely meaning skimpier coverage) and requires workers to pay more for it. Workers in low-wage firms pay an average of $6,472 for family coverage, compared with $4,693 for workers in higher wage firms.”

“BOSTON — When it comes to the president’s health care law, there’s very little that Republicans and Democrats agree on—but one idea that seems to unite analysts, experts and lawmakers across the political spectrum is that Obamacare has done very little to actually improve health care.
“The U.S. healthcare system was always dysfunctional. The Affordable Care Act has just provided more access to that dysfunctional system,” iVantage chief Donald Bialek said during an ACA debate at The Economist’s health care forum in Boston on Wednesday. Bialek, for his part, was on the side defending the health care law.”

“If you are looking for information on how Americans are engaging with the Affordable Care Act, the Census Bureau’s recently released latest annual estimates of health insurance coverage is probably not the place to look—at least for now.
The Census Bureau, which derives its information on healthcare from the Annual Social and Economic Supplement—the same survey where it asks how many toilets, computers, microwaves, etc., people have in their homes—does provide some useful insights.
It catalogues the demographic characteristics of the population based on participation in different types of health insurance coverage—government health care programs, private employer and individual plans, and the uninsured. It tells us young adults make up a disproportionate share of the uninsured and provides useful information on the relative availability of employer-sponsored coverage by industry and firm size.
But its hard numbers on enrollment and enrollment trends are not reliable for drawing “big picture” conclusions, especially regarding the ACA. Indeed, that unreliability is why this year the Census Bureau started using a new set of health coverage questions in the ASEC.”

“Since the Affordable Care Act’s (ACA) passage, a number of lawsuits have been filed challenging various provisions of the law. The Supreme Court has decided cases about the constitutionality of the ACA’s individual mandate and Medicaid expansion as well as the applicability of the contraceptive coverage requirement to closely held for-profit corporations with religious objections. In addition, several cases challenging the availability of premium subsidies in the Federally-Facilitated Marketplace (FFM) are currently progressing through the federal courts. All of this litigation has altered, or has the potential to alter, the way in which the ACA is implemented and consequently could affect the achievement of the law’s policy goals. This issue brief examines the federal courts’ role to date in interpreting and affecting implementation of the ACA, with a focus on the provisions that seek to expand access to affordable coverage.
Court decisions about how to interpret the ACA will continue to affect the number of people who ultimately obtain affordable coverage. At present, access to Medicaid up to 138% FPL is dependent upon where people live because the Supreme Court held that implementation of the ACA’s Medicaid expansion is effectively a state option. This has resulted in a coverage gap for just over 4.5 million people with incomes too high to qualify for Medicaid but too low to qualify for Marketplace subsidies in the states that have not implemented the ACA’s Medicaid expansion to date.”

“At a hearing to discuss the rising costs of healthcare benefits for Miami-Dade County, Fla., employees this year, a labor union consultant raised his hand to ask what seemed like a basic question.
Could the committee charged with reducing Miami-Dade labor’s healthcare expenses look at the spreadsheet showing the rates that the county pays local hospitals and doctors for medical services to employees?
“We really need to understand where the money is being spent in order to be insightful about benefit design changes,’’ said Duane Fitch, a healthcare consultant for SEIU Local 1991, which represents physicians and nurses at the county-owned Jackson Health System.”