Category: States

Louisiana’s health insurance market for individuals has been plagued in recent years by insurers fleeing the market and double-digit rate increases — prompting a proposed fix that would tack a fee on policies across the state to create a safety net against insurers’ losses and hold the line on runaway premiums.

The state Department of Insurance is pushing a bill through the Legislature that it says would lower premiums in the individual market by an average of 15 percent next year. The bill would put a roughly $1.25-a-month fee on every health-insured life in the state. That money, which one critic labeled a tax on business disguised as a fee, would go into what is called a reinsurance pool designed to protect insurers against high-cost patients.

. . .

As goes Iowa, so goes the nation — or at least that’s the conventional wisdom during presidential elections. Let’s hope the same rule applies to healthcare reform.

Earlier this month, Iowa Gov. Kim Reynolds signed a law that takes advantage of a major loophole in Obamacare. The legislation, based on a similar effort in Tennessee, enables any Iowan to enroll in a “health benefit plan” sponsored by the Iowa Farm Bureau. Due to a legal technicality, the plans aren’t subject to Obamacare’s premium-inflating regulations.

The reform is a laudable attempt to give consumers an affordable alternative to the plans for sale on Obamacare’s exchanges. Until Congress makes good on its promise to repeal and replace the law, other states can liberate their residents from the law’s financial burdens by following Iowa’s lead.

. . .

Medicaid expansion is back on the ballot.

Organizers in Utah submitted signatures on Monday to put an initiative expanding Medicaid on the state’s ballot in November. They got 165,000 signatures, or about 50,000 more than they needed.

State legislators are actually pushing a limited form of Medicaid expansion, but, as we covered before, the Trump administration seems unlikely to greenlight that proposal. The ballot initiative being submitted today would be a clean version of expansion

. . .

Murphycare could look a lot like Obamacare.

Lawmakers Thursday sent to Gov. Phil Murphy a bill that will require nearly all New Jerseyans to have health insurance or pay a penalty in a bid to stabilize premiums for consumers in the Obamacare marketplace.

They approved another bill that would set up a reinsurance plan that would partly be paid for by the federal government and cover some of the most expensive health care claims.

. . .

The state’s antitrust lawsuit against Sutter Health is a welcome move to stop Sutter from inflating health care costs across the Northern California market.

The lawsuit alleges that Sutter has illegally used its market power to compel commercial health plans to contract with all or none of its hospitals, extract exorbitant prices and prohibit use of financial incentives to encourage use of lower-cost providers.

The problem is not just Sutter, however, but insurance-contracted provider networks (preferred provider organizations and health maintenance organizations), where insurers negotiate medical service prices, keep those prices hidden and make other private deals that maximize revenue at purchaser and consumer expense.

. . .

California’s government would set prices for hospital stays, doctor visits and other health care services under legislation introduced Monday, vastly remaking the industry in a bid to lower health care costs.

The proposal, which drew swift opposition from the health care industry, comes amid a fierce debate in California as activists on the left push aggressively for a system that would provide government-funded insurance for everyone in the state.

Across the country, rising health care costs have put the industry, lawmaker and employers and consumers at odds.

. . .

The White House on Friday cleared the CMS to scale back efforts to evaluate Indiana’s conservative approach to Medicaid expansion. The move could prevent the agency from gathering adequate data to determine if the state’s method of expansion harmed access to care.

Some feel that even with a scaled-back study, the CMS could still glean pertinent information from Indiana about the impact its expansion approach has had on Medicaid beneficiaries.

“Surveys were just one element, and getting rid of them is not enough to make or break an evaluation” said Doug Badger, a senior fellow at the Galen Institute, a conservative think tank.

. . .

It’s the pragmatists versus the idealists in California’s latest quest for universal health care. Increasing numbers of lawmakers and advocates are pushing for policy goals that realistically can be accomplished this year. But there’s an unrelenting camp clinging to single-payer-or-bust.

The Golden State, which has been pushing back against the Trump administration on multiple fronts, is leaning toward the more incremental approach. This includes bills and budget items that would cover everything from insuring undocumented adults to preventing Medicaid work requirements and shielding the state from insurance products favored by the GOP, such as short-term plans.

. . .

California is indeed the Golden State where Medicaid is concerned. The HHS Office of Inspector General (OIG) has found that, by exploiting Obamacare’s expansion of the program, California has enrolled hundreds of thousands of ineligible adults in Medicaid. Consequently, the state has bilked the federal government out of more than $1 billion in funding to which the state was not entitled. Indeed, these figures probably understate the amount of money that California officials have fraudulently extracted from the taxpayers. The OIG sampled a mere six-month period, from October 1, 2014 through March 31, 2015, to arrive at its damning assessment.

. . .