The West Virginia Insurance Commission approved rate increases for Highmark West Virginia and CareSource Insurance’s services sold in the “Obamacare” exchange.

MetroNews learned Tuesday premiums for Highmark West Virginia will increase by 25.6 percent, while CareSource Insurance will have a 19.6-percent increase in its rate.

Eight-five percent of the around 25,000 residents who received health care through the exchange last year received a government subsidy, but those who did not saw a 32-percent increase in monthly premiums.

. . .

The plan Iowa has developed to salvage its insurance market — the Iowa Stopgap Measure — suffers three major flaws.

  1. Although the Iowa Stopgap Measure helps upper middle class Iowans afford health insurance, it illegally deprives poorer Iowans of the ability to make use of health insurance.
  2. The Iowa Stopgap Measure creates effective marginal tax rates of more than 100% on many individuals, particularly those over 50, and excessive effective marginal tax on many others.
  3. Unless there’s more to its fuzzy math than it has heretofore presented, the Iowa plan costs the federal government a good deal of money.

Don’t add rejection of the Iowa waiver to the list of acts of sabotage of the ACA by the Trump administration. This is an instance where the President has faithfully executed the law. And if that law is not working or if the waiver criteria are too strict, it is to Congress that complaint should be made.

. . .

In a strongly worded letter to the Trump administration, Oklahoma’s health commissioner recently expressed frustration that a state waiver to lower costs for Obamacare customers had not been approved as quickly as federal officials had promised.

The proposal called for a reinsurance program in which government funding pays for costly medical claims while keeping prices down for other customers. Having run out of time to make a dent in premiums, the state decided to withdraw its waiver. Health commissioner Terry Cline lamented the months that Oklahoma officials spent developing a plan, followed by six weeks of daily calls or emails with federal officials, with no results.

. . .

Paul Melquist of St. Paul, Minn., has a message for the people who wrote the Affordable Care Act: “Quit wrecking my health care.”

Teri Goodrich of Raleigh, N.C., agrees. “We’re getting slammed. We didn’t budget for this,” she says.

Millions of people have gained health insurance because of the federal health law. Millions more have seen their existing coverage improved.

But one slice of the population, which includes Melquist and Goodrich, is unquestionably worse off. They are healthy people who buy their own coverage but earn too much to qualify for help paying their premiums. And the premium hikes that are being announced as enrollment looms for next year — in some states, increases topping 50 percent — will make their situations more miserable.

. . .

Obamacare plan premiums may increase an average of 45 percent in Florida next year due to health care insurers rate hike requests, according to Florida’s Office of Insurance Regulation.

There are six insurers in Florida selling plans on and off the exchanges in 2018 including Blue Cross and Blue Shield, Celtic Insurance Company, Florida Health Care Plan, Health First Commercial Plans, Health Options, and Molina Healthcare of Florida.

Molina Healthcare requested the highest rate increase of 71.2 percent. Individuals with this coverage can expect their monthly premium to increase from $402 to $688.

. . .

Obamacare has not done much to slow the growth of health care costs. Government actuaries project that health spending will grow 5.8% a year over the next decade — substantially faster than growth in the economy. Could Republican proposals to sell health insurance across state lines bend the cost curve and make premiums more affordable?

The idea seems simple enough. Right now, if you are buying your own health insurance, that coverage must be sold by an insurer regulated in your state. Instead of a national market, health insurance is sold in 51 state markets (including D.C.) with differing regulations.
. . .

Congress should enact waiver legislation that clarifies the availability of federal subsidies for the purposes of evaluating waivers’ deficit neutrality, including all potential federal spending that could be offset by a waiver, and evaluates its impact over a long (8-10 year) time period after an initial pilot period. Federal “guardrails” to prevent unintended consequences on patient outcomes and the deficit should focus on collecting data on costs and impact on vulnerable populations, while expanding consumer choices around affordable, high quality plan options.
Congress should also instruct HHS to create a set of standardized, expedited waivers that could be quickly approved, to enhance confidence in the process. Congress should also allow states to form multi-state compacts to share costs and develop the necessary implementation infrastructure.
. . .

Conspicuously absent from most commentary arguing that Kansas should expand Medicaid under the Affordable Care Act is any discussion about the program actually improving the health of recipients. Instead, we are left with terribly materialistic arguments about forgone federal money. Why is it that on the biggest policy questions facing Kansas, such as Medicaid or education, we hear lots about money spent and little about health outcomes or student achievement?
. . .

The idea of turning more power over to the states has long been advocated by conservatives, but there are compelling reasons for liberals to get behind devolving power from the federal government.

When Congress passed the Affordable Care Act in 2010, it left many of the details to the discretion of the Department of Health and Human Services, giving vast powers to the secretary to determine everything from fast-food menu labeling requirements to when individuals could purchase insurance. During the Obama years, the administration used its regulatory discretion — pushing and arguably exceeding the limits of the law — to prop up the president’s signature legislative accomplishment as the program ran into implementation problems.

. . .

It’s worth reading the Graham-Cassidy bill. It would repeal the individual and employer mandates of the Affordable Care Act, impose per capita caps on Medicaid, increase contributions to health-savings accounts, allow states to waive regulations on private insurance providers, and provide those states with block grants so they can design their own health-care systems.

If the bill became law, it would therefore be a genuine federalist triumph. A large portion of the federal money now set to fund the Medicaid expansion and subsidies of the Affordable Care Act would be instead distributed to individual states. Each state would have the freedom and means to develop its own health-care system. Reasonable people disagree over how best to design a health-care system, and under Graham-Cassidy, their ideas could be tested without causing a nationwide catastrophe and the disruption of a vital service.
. . .