When Oregon Attorney General Ellen Rosenblum filed suit against Oracle last year, she claimed the contractor “repeatedly lied and defrauded the state” during the course of its work on the failed Cover Oregon health exchange. The defunct health exchange website cost $300 million in federal grants, which could mean that even if Oregon prevails in court and wins a judgment for the billions it is seeking, the state might not be able to keep any of it.
States increased their spending in fiscal year 2015 by the biggest margin in more than 20 years, but most of the increase was thanks to huge leaps in Medicaid spending under the first full year of the Affordable Care Act. Spending increased last fiscal year, which ended on June 30 for most states, by 7.8 percent, according to new estimates from the National Association of State Budget Officers (NASBO).
Land of Lincoln Health, an insurance co-op created under ObamaCare, is no longer taking new small-business customers. The health insurer announced in October that it would severely cap enrollment on the exchange, HealthCare.gov, and limited new small-business clients in particular to help the co-op survive long term. More than half of the co-ops nationwide have failed.
Over the last few years, Kentucky captured the nation’s attention by wholly embracing the health care law and expanding Medicaid under the Affordable Care Act. Now, with Governor-elect Matt Bevin promising to “repeal the expansion as it currently exists,” Kentucky may become a laboratory for the kind of rollback that the law’s opponents have so far only dreamed of.
When consumer advocates tried to call the obstetrician-gynecologists in the online directory of insurers’ in-network providers on the Maryland state exchange, they found that only about 22% of the 1,493 practitioners were accepting new patients, performed well-patient visits and had appointments available within four weeks. More than a third weren’t available at all because they had left the networks, retired or were dead.
Advocates in Washington of the Affordable Care Act have been fighting tooth and nail to preserve the president’s signature health-care law—and they’re fighting even harder to expand it in the states. Conservative lawmakers in our home states of Utah and Florida recently defeated a combined three proposals to expand Medicaid under ObamaCare. They were absolutely right to do so, as the fiscal messes in states that did expand Medicaid demonstrate.
A major jump in health insurance premiums next year for hundreds of thousands of Minnesotans has put state officials and lawmakers in brainstorm mode, figuring out the best way to get a handle on costs in an individual market that is smaller and more expensive to cover than both regulators and health insurance companies expected.
Much to the dismay of people who buy health insurance on their own, premiums for thousands in Minnesota’s individual market are going way up.
The state Commerce Department said Thursday that rates will increase an average of nearly 50 percent at Blue Cross and Blue Shield of Minnesota — the largest insurer in the market — and anywhere from 14 percent to 39 percent on average at four other insurers in the state that sell the policies.
The goal of all insurance plans is to provide the right services to the right patient population. Insurance eligibility is a big factor, and companies spend a lot of time and effort determining if their patients qualify for coverage. The question of eligibility is also critical to the operation of the Affordable Care Act’s insurance marketplaces, and a recent OIG report found problems within the New York state marketplace that potentially led to ineligible enrollees.
Lackluster enrollment numbers, technology issues, and high maintenance costs are among the challenges plaguing ObamaCare state exchanges that were reviewed by the House Energy and Commerce Oversight Subcommittee at a hearing Tuesday.
“CMS has seemed more focused on doling out taxpayer dollars rather than overseeing how those dollars are spent,” Chairman Tim Murphy (R-PA) said of the lack of oversight.
Executives from six state exchanges—Oregon, Massachusetts, Hawaii, California, Minnesota, and Connecticut—provided testimony. So far, Oregon and Hawaii’s exchanges have both proven to be unsustainable, closing down and migrating consumers to HealthCare.gov’s federal marketplace with others likely to follow.
Chairman Murphy emphasized in his opening statement the sufficient amount of taxpayer money that was poured into creating these now-failing exchanges: “The Centers for Medicaid and Medicare Services has awarded $5.51 billion dollars to the States to help them establish their exchanges. Let me repeat that. The States received $5.51 billion in federal taxpayer dollars to set up their own exchanges. Yet, the ACA had no specific definition of what a state exchange was supposed to do, or more importantly, what it was not supposed to do.”
Grant money used to fund the exchanges was cut off in 2015 when states were expected to start bringing in enough money to continue operation on their own. Of the 17 states that chose to establish their own exchanges, nearly half face financial difficulties.
The committee hopes to find out why exchanges have struggled to become self-sustaining and whether or not any grant money will be recouped from states where exchanges have been shut down. For instance, Oregon spent $305 million of taxpayer dollars to establish its failed exchange, while Hawaii spent $205 million.
As Americans for Tax Reform points out, Tuesday’s hearing is a vital first step to addressing the urgent problems within the state exchanges—before they spread to all 17.