Insurers from Oregon to Pennsylvania, including a failed health-care co-operative and two long-established Blues plans have lost billions of dollars selling Obamacare policies. Now they are suing the federal government to recoup their losses. In a testament to industry desperation, insurers are asking federal judges to simply ignore a congressional ban on the payment of these corporate subsidies.
The regulatory atrocity that is Obamacare inspired this race to the courthouse. Despite billions in subsidies — to both low-income individuals and well-capitalized insurance companies — the industry has incurred big losses in the individual market.
In a paper published June 28 by the Mercatus Center, Brian Blase (Mercatus), Ed Haislmaier (Heritage Foundation), Seth Chandler (University of Houston), and Doug Badger (Galen Institute) used data derived from insurance-company regulatory filings to determine the extent and source of those losses. The study examined the performance of 174 insurers that sold qualified health plans (QHPs) in 2014 to both individuals and small groups (generally companies with 50 or fewer workers).
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Rather than stabilizing in 2016 as many experts predicted, the Affordable Care Act (ACA) is leading to large premium hikes and less choice and competition in the individual insurance market as plans prove unattractive to relatively young, healthy, and middle-class people. In order to achieve a better understanding of the ACA’s impact, a new Mercatus Center working paper compared insurers’ performance selling individual Qualified Health Plans (QHPs) with three other markets: the individual non-QHP market, the small group QHP market, and the small group non-QHP market.
My co-authors, Doug Badger of the Galen Institute, Ed Haislmaier of the Heritage Foundation, Seth Chandler of the University of Houston, and I make two key empirical findings. First, individual market QHP enrollees had average medical claims nearly double the average claims for individual non-QHP market enrollees in 2014. Second, individual market QHP enrollees were about 25% more expensive than enrollees in small group QHPs.
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Blue Cross and Blue Shield of Minnesota is cutting back its participation in the state’s Affordable Care Act insurance exchange next year after losing nearly $300 million in the individual market in 2015.
However, the large Blues insurer is not completely exiting the state-based marketplace. Fully withdrawing has its consequences: Federal law bars insurers from re-entering the marketplaces for five years, assuming they discontinue all types of individual policies.
Instead, Blue Cross and Blue Shield of Minnesota is dropping health plans with the broadest networks sold on and off the exchange and will push people toward its narrower HMO option called Blue Plus, according to the Star Tribune.
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The billboards went up quickly. The customers came in droves.
Then, in October, Arches collapsed as suddenly as it went up.
Now eight months after it was announced that the state’s only nonprofit insurance co-op would be dissolved, Utah hospitals are still waiting on about $33 million in outstanding claims that the Utah Department of Insurance says it likely cannot pay until 2017.
Officials with the insurance department say they are doing the best they can to create a “soft landing” for Arches after the federal government reneged on what was supposed to be a $11 million payment this summer.
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The results of a recent poll conducted by the University of Southern California (USC) and the LA Times make it clear there is far from a consensus on the quality and affordability of healthcare in the Golden State. Less than half of those surveyed (44%) felt that healthcare in California was good or excellent, while a plurality (48%) felt that healthcare in the state was fair or poor.
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The GOP House blueprint for health reform repeals these taxes. Specifically, the report cites:
- the 3.8 percent bracket in the Medicare payroll and self-employment tax
- the 3.8 percent “net investment income tax” (NIIT) on savings and investment
- the additional 10 percentage point surtax for non-qualified health savings account (HSA) withdrawals
- the “medicine cabinet tax” which denies the use of pre-tax HSA, health reimbursement arrangement (HRA), and flexible spending account (FSA) dollars for the purchase of non-prescription, over-the-counter medicines
- the $2500 cap on medical FSA deferrals
- the “Cadillac plan” tax of 40 percent on high cost health insurance plans
- the “health insurance tax” (HIT)
- the tax penalties associated with the individual and employer mandates
- the medical device excise tax
- the industry tax on pharmaceutical companies
- the “high medical bills tax” which disallows an itemized deduction for medical expenses for millions of middle class families
- a tax on employers helping their retired employees purchase Medicare Part D plans
The Republican House is methodically laying out a comprehensive agenda to spread prosperity, protect the nation, uphold the Constitution, reform health care, and—with its presentation Friday of a comprehensive tax-reform plan—create jobs, grow paychecks and boost the economy.
This agenda, dubbed “A Better Way: Our Vision for a Confident America,” is Speaker Paul Ryan’s brainchild, but the work of the entire Republican conference.
Mr. Ryan rolled out its first plank June 7 with an audacious reimagining of policies to help Americans rise out of poverty. The initiative would require those on welfare to seek work while providing them better access to job training and assistance. It would reform poverty-fighting programs to help people move from dependency on government to lives of independence and personal responsibility.
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A struggling Illinois health insurance co-op is suing the federal government, claiming it is being shortchanged $72.8 million in promised payments under the Affordable Care Act.
Chicago-based Land of Lincoln Health filed the lawsuit Thursday in the U.S. Court of Federal Claims in Washington, D.C. At least four other insurers have filed similar claims over the so-called risk corridor payments, a temporary provision of the health care law meant to help unprofitable insurers and stabilize consumer prices during the first three years of the law’s new insurance exchanges.
Land of Lincoln’s balance sheet has been deteriorating rapidly. The 3-year-old startup lost $90 million in 2015 and $7 million in the first quarter of 2016.
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The House GOP today released the final of their six major policy blueprints that they will be running on in 2016 and passing in 2017.
Today’s iteration is in many ways the touchstone of the whole effort: tax reform. The plan is, as the report boldly proclaims, “Built for Growth.” But it wisely does so in a way that doesn’t forget middle class working families struggling to get by, and in a way that passes a basic test of common sense and practicality.
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A new poll of voters in battleground states finds a rare opportunity for bipartisan agreement on healthcare, with Americans strongly favoring action on public policies that support medical discovery into new treatments and cures. The poll was jointly commissioned by the Galen Institute and Center Forward, center-right and center-left think tanks.
Purple Insights interviewed 800 registered voters earlier this month and found that nearly all those surveyed believe it is important for the United States to continue to develop new treatments and cures for diseases and believe these new discoveries are an opportunity to help the United States maintain its competitive edge.
A strong 78% say that fostering policies that support medical innovation should be a top priority for members of Congress and candidates for Congress.
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