The Supreme Court ruling upholding subsidies on the federal health-insurance exchange may prompt state-run exchanges to forge regional networks or use the federal marketplace.
Many of the dozen states operating exchanges under the Affordable Care Act are encountering financial strains, and could join the three dozen states already using the federal marketplace, HealthCare.gov. Some policy experts say it’s possible most of those states will eventually do just that, creating a largely national exchange program.
Health insurance premiums are poised to go up for 220,000 Oregonians who buy their own coverage, according to the state’s proposed rates unveiled Thursday.
In some cases, insurance companies proposed rates that were similar to or better than the current rates, but they were told by the state that they must be raised. The state says the cost of medical care has far outstripped revenue, forcing insurers to dip into reserve funds.
More than 220,000 Oregonians who buy their own health insurance are poised to pay higher premiums next year — some of them a lot higher.
State regulators on Thursday announced rates for people who aren’t covered by their employers or government programs. And the news is not good.
While some insurers proposed rates similar to or better than this year’s, officials are ordering them to be raised — saying they need to close a sizable gap between what insurers have collected and what they spend on claims.
Last week, the White House released a report outlining the economic benefits to states of expanding Medicaid. The report continues a line of argument the Obama administration has used in encouraging states to expand Medicaid under the Affordable Care Act, the president’s health-care law.
The administration faces several obstacles in attempting to sell this argument to reluctant states.
Leading Republicans are charging that the Obama administration is illegally funding yet another part of Obamacare, in addition to the part of the healthcare law over which House Republicans are already suing.
Their latest criticism centers on the Affordable Care Act’s basic health program, an optional program for states that started this year, in which low-income residents can get subsidized, state-contracted health plans instead of buying them through the new online marketplaces.
This week, Hawaii pulled the plug on its state-created Obamacare exchange. Gov. David Ige (D) declared that the Hawaii Health Connector has been “unable to generate sufficient revenues to sustain operations.” The decision to kill the exchange will cost taxpayers $200 million, a relative bargain compared to the political-inspired fiasco that happened with the Oregon version of the Obamacare exchange — Cover Oregon.
Even in Kentucky, which championed the 2010 health care law by expanding Medicaid and running its own insurance marketplace, about half of poor people say they have heard little about the Affordable Care Act, according to a Harvard University study published Monday in Health Affairs.
Awareness of Obamacare was even lower in Arkansas and Texas—two states that have not embraced the law as warmly. The study — which surveyed nearly 3,000 low-income residents in the three states last December– found 55 percent of those Texans and 57 percent of those Arkansans had heard little or nothing about the law’s extension of health coverage. Arkansas expanded Medicaid eligibility to cover more people under the law, but the state legislature prohibited spending public money to promote that or the federal subsidies available to help people buy private Obamacare plans. Texas did not expand Medicaid and restricted private groups wanting to help people enroll in new insurance options.
Such assistance was critical to whether people completed the application for coverage process, the study found. In fact, enrollment assistance led to a nearly 10 percentage point increase in the probability of people getting coverage, the study found.
The Florida House has soundly rejected a Medicaid expansion compromise that even supporters admitted had its flaws and was seemingly doomed to fail almost from the start.
The bill, which tore apart the regular session as the House and Senate bitterly disagreed, was voted down 72-41 Friday after a rousing, nearly seven-hour debate during which nearly 60 lawmakers spoke. It was an attempt by the Senate to draw down $18 billion federal dollars and give it to hundreds of thousands of Floridians to purchase private health insurance instead of putting them in the regular Medicaid program.
But Republicans insisted it would still expand President Barack Obama’s health care overhaul and increase the federal deficit. Even supporters acknowledged the bill would cover far fewer people than the 800,000 who are eligible. Gov. Rick Scott was also strongly opposed.
Hawaii’s health insurance exchange announced on Friday that it will be shutting down, and its nearly 40,000 enrollees will be transitioned to the federal Obamacare marketplace, Healthcare.gov.
The private, nonprofit Hawaii Health Connector, which has been embattled from its inception, has not generated “sufficient revenues to sustain operations,” according to the office of Hawaii Gov. David Ige (D).
The state invested $130 million in the Connector, but the exchange has been plagued by low enrollment numbers and technological issues, making it noncompliant with the federal requirements outlined in the Affordable Care Act.
“It was a failed project,” state Sen. Sam Slom (R) told the Honolulu Star-Advertiser. “It was a boondoggle from the very beginning, and our residents deserve better than that.”
According to Hawaii Health Connector CEO Jeff Kissel, Hawaii’s health exchange will become a state-run exchange that uses HealthCare.gov, which is similar to the setup in Nevada, New Mexico and Oregon.
It may be easier than expected for states to save their ObamaCare subsidies, if the Supreme Court rules against the law this month.
Two states — Pennsylvania and Delaware — said this week they would launch their own exchanges, if needed, to keep millions of healthcare dollars flowing after the decision. Both want to use existing pieces of the federal ObamaCare exchange, like its website and call center — a path that would be far less costly than the way most other states have created their exchanges.
If those plans win approval, many of the other 36 states that stand to lose their subsidies could then pursue a similarly simple strategy.