Major healthcare insurer Anthem will only offer Obamacare exchange plans in roughly half of Kentucky’s 120 counties due to mounting policy uncertainty from Washington and a deteriorating market.

Anthem had earlier planned to offer individual market plans in every county in Kentucky. However, the insurer said that lingering problems with the market and massive federal uncertainty has forced its hand.

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Virginia became the latest state at risk of having regions that will lack Affordable Care Act exchange plans next year, after a small insurer announced it will scale back the area where it expects to offer marketplace insurance.

The Virginia area that currently has no 2018 exchange insurer includes 48 counties and parts of six more, as well as 15 cities that are independent of counties, according to a Virginia state regulator. In total, the state has 95 counties and 38 independent cities.

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The Cassidy-Graham bill would repeal the ACA’s tax credits for middle-income Americans, the cost-sharing reduction subsides for low-income Americans, and the Medicaid expansion in 2020. It replaces all those programs with a market-based health care grant program, which would send states a lump sum of money to put toward health care–related purposes. Under Cassidy-Graham, this money could be spent on funding high-risk pools, sending payments to insurers to “stabilize premiums and promote State health insurance market participation, or making payments directly to health care providers, like doctors and hospitals.

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A bipartisan group of senators has palpable momentum but little time to make good on a bid to shore up Obamacare insurance markets, even as conservative Republicans press a parallel attempt to make good on their promise to repeal the health care law.

The stabilization effort, led by Republican Lamar Alexander (Tenn.) and Democrat Patty Murray (Wash.), could yield the first bipartisan Obamacare bill since the law was passed seven years ago. It could also provide some measure of certainty for insurance companies that have until Sept. 27 to make final decisions about whether to participate in Obamacare markets next year.

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The Trump administration and Republican leaders in Congress are pledging to turn their attention toward tax reform after their failure to pass a repeal and replacement of the Affordable Care Act. But Republicans can still improve health care and lower costs if they change the treatment of employer-sponsored health insurance plans in tax reform.

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HHS plans to save taxpayer dollars by curtailing waste and requiring better performance in the ACA Navigator program which pays organizations to enroll people in ObamaCare coverage. The HHS analysis showed that in 2016 “One [Navigator] grantee received $200,000 and enrolled ONE person in Obamacare.” The top 10 most costly Navigators spent a total of $2.77 million to enroll 314 people in Obamacare—costing an average of $8,800 to enroll each person (on top of tax credits and other subsidies). In the upcoming enrollment period, CMS plans to spend $10 million on promotional activities—consistent with similar spending on Medicare Advantage and Medicare Part D.

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Health and Human Services announced that the agency will alter the funding structure for ObamaCare “navigators.” These are the community outfits the Obama Administration paid to steer folks through the Affordable Care Act’s subsidies and penalties. Last year the Obama Administration handed out $62.5 million in grants for open enrollment for 2017, and the period arrives again in November.

One grantee took in $200,000 to enroll a grand total of one person. The top 10 most expensive navigators collected $2.77 million to sign up 314 people, and it would have been much cheaper to offer to pay all of their premiums for a year. All told, the navigators last year enrolled about 81,000 people, less than 1% of the total.

The Trump Administration will tie grants to performance.

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Major bipartisan accomplishments in federal policy feel like a rarity these days. But it was just over 20 years ago that the parties came together to pass significant, positive reforms to our nation’s cash assistance program for families in poverty. The 1996 welfare-reform law, passed by a Republican Congress and signed by President Bill Clinton, significantly strengthened work requirements in a new program, now known as Temporary Assistance for Needy Families (TANF). In the years following the law’s enactment, child-poverty rates dropped significantly and employment among poor mothers increased, while teen pregnancy and abortion rates continued to fall. Policies that encouraged work succeeded in achieving the intended, positive result: fewer Americans in poverty and more Americans providing for themselves.
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Despite the setbacks of the past eight months, including the inability of Republicans to agree on a single alternative to the ACA, it is still not too late for this Congress to pass health care reform legislation.

At this point in the Obama administration’s first term, the ACA hadn’t been passed – not even out of committee – and Democrats weren’t the least bit united either. That had, and that point in time, three separate bills – quite different from each other – going through different House committees, and three additional very different bills going through three different Senate committees. In addition, there were numerous other proposals introduced by various Democrats, which had been sidelined by their own leadership.

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The Department of Health and Human Services announced today it’s slashing the advertising and promotional budget for the Affordable Care Act for next year. It’s planning to spend $10 million to promote the law in the open enrollment period that starts in November — compared to the $100 million the Obama administration spent last year.

On a conference call with reporters, HHS officials argued that last year’s promotional spending — which was doubled from the year before — was ineffective because signups for new customers actually went down.

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