An investigation by House Republicans argues that the Obama administration is illegally making certain payments under ObamaCare and that officials initially recognized they did not have authority to do so before reversing course.
House Republicans argue that the administration is unconstitutionally making ObamaCare’s “cost sharing reduction” payments to insurers — which help lower out-of-pocket healthcare costs for low-income ObamaCare enrollees — without a congressional appropriation.
. . .
Obamacare enrollment has a smoking problem.
A new study from the Yale School of Public Health finds that an anti-smoking provision in the health law is discouraging people from signing up for insurance while simultaneously failing to get them to kick the habit.
Under the Affordable Care Act, individual health insurance plans sold on statewide marketplaces can only set how high their premiums are based on three factors: a customer’s geographic region, age, and smoking status. This is meant to let health insurers adjust their prices for how much medical care an enrollee may wind up using.
. . .
House Republicans on Thursday released an investigative report and held the first of two hearings questioning the legality of Obamacare’s cost-sharing reduction program. That program is also the subject of a House lawsuit against the administration.
At issue is whether the cost-sharing program is legally funded. House Republicans, through an investigation conducted by the Ways and Means and Energy and Commerce committees, concluded that the health care law does not provide funding for the cost-sharing program.
. . .
It’s policymaking 101: When a policy delivers benefits to people, support for the policy grows. Political scientists call situations like these “policy feedback loops,” and they are a big part of the story of how Social Security and Medicare became so entrenched in American life. But what happens if hyper-partisanship stops the loop? Consider the Affordable Care Act (ACA). Over the past four years, some 20 million people have gained health coverage and the already-insured have received new protections. But public opinion of the ACA has remained mixed.
The numbers are stark. Monthly tracking polls show that 49 percent hold unfavorable views of the ACA versus just 38 percent holding favorable views.
. . .
Republicans and Democrats continued to talk at each other Friday about Obamacare’s cost-sharing reduction program in an Energy and Commerce oversight subcommittee hearing.
The hearing was the second in two days following the release of a GOP report claiming that payments to the administration’s program were made illegally.
Republicans suggested that the way the payments have been handled sets a dangerous precedent for the future and nullifies Congress’s power of the purse. Democrats chalked the investigation up as yet another GOP attempt to sabotage the Affordable Care Act. They also said since there is already a court case on the matter, Congress doesn’t need to do its own investigation.
. . .
Employees contribute far below the maximum amount allowed to an individual-coverage or family-coverage health savings account (HSA), a sign consumers aren’t taking full advantage of the account’s tax benefits, according to a new analysis of consumer records.
Managing health costs, particularly for consumers in or approaching retirement, is considered a growth area for insurance agents and advisors doing comprehensive financial planning. HSAs are primed to play a key role.
More than 20 million Americans have access to health plans with HSAs, according to the trade association America’s Health Insurance Plans (AHIP). Congress recently passed bipartisan legislation expanding the use and contribution limits for HSAs.
. . .
During the first year of Obamacare’s implementation, the individual insurance market became less healthy while the uninsured and Medicaid populations became healthier, according to a new analysis.
A Health Affairs data analysis released Wednesday underscores the often stated observation that the Affordable Care Act has brought sicker, more expensive enrollees into the individual marketplace while healthier people have tended to resist enrollment.
The analysis uses information in the National Health Interview Survey, conducted by the National Center for Health Statistics. It was conducted by officials from the Agency for Healthcare Research and Quality, the Congressional Budget Office, and Social and Scientific Systems.
. . .
Evergreen Health Cooperative must pay $24.2 million to its biggest competitor because of an Affordable Care Act program that aims to level the playing field for insurers taking on riskier customers from state health insurance exchanges.
Evergreen, an innovative insurer established under the new law by former Baltimore Health Commissioner Peter Beilenson, is not alone in having to pay for its healthier clients. Kaiser Permanente of the Mid-Atlantic States owes $14.7 million and Aetna will shell out $11.8 million.
An organization representing state health insurance co-ops criticized the Affordable Care Act’s risk adjustment formula as a failure causing difficulties for the nonprofit insurers created under the law.
The announcement from the National Alliance of State Health Co-Ops came a day after HealthyCT, the Connecticut co-op, was put under an order of suspension, signaling the co-op would start taking steps to shut down. Kelly Crowe, the group’s CEO, said the case was not a “one-off example.”
. . .
The Obama administration suffered a setback in its efforts to strengthen the individual insurance market when a federal appeals court last week struck down an HHS rule barring the sale of certain limited-benefit plans as stand-alone products.
In Central United Life v. Burwell, the U.S. Court of Appeals for the District of Columbia Circuit overturned a 2014 HHS rule restricting the sale of fixed-indemnity insurance plans that pay policyholders fixed dollar amounts to cover medical services regardless of how much the provider bills. These plans, which are cheaper to buy than comprehensive plans but exclude pre-existing conditions, do not comply with Affordable Care Act provisions on minimum essential benefits or guaranteed issue.
. . .