“The last round of oral argument in the most serious legal challenge to Obamacare’s insurance coverage subsidies ended over three months ago. Now the courthouse watch for a final ruling in the U.S. Circuit Court of Appeals for the D.C. Circuit has neared a fever pitch.
Diehard defenders of the Affordable Care Act (ACA) are worried that a three-judge panel is about to overturn an Internal Revenue Service rule issued in May 2012 that authorized distribution of insurance premium assistance tax credits in health exchanges administered by the federal government. By the end of a March 25 hearing on motions for summary judgment in Halbig v. Burwell, it appeared that two of the judges (a majority) were leaning toward agreeing with a group of private individuals and employers (who were appealing a federal district court ruling against them) that only an exchange “established by a state” is eligible for federal tax credits under the ACA.”

“After being without health insurance for two years, Miranda Childe of Hallandale Beach found a plan she could afford with financial aid from the government using the Affordable Care Act’s exchange.
Childe, 60, bought an HMO plan from Humana, one of the nation’s largest health insurance companies, and received a membership card in time for her coverage to kick in on May 1st.
But instead of being able to pick a primary care physician to coordinate her healthcare, Childe says she repeatedly ran into closed doors from South Florida doctors who are listed in her plan’s provider network but refused to see patients who bought their coverage on the ACA exchange.
“I just felt that I wasn’t being treated like a first-class citizen,’’ said Childe, who eventually found a doctor with the help of a Humana counselor. “Nobody, I don’t care what kind of degrees they have, should ever be treated that way.’’
Nearly one million Floridians enrolled in a private health plan through the ACA exchange but some, like Childe, are finding that some physicians refuse to honor their coverage — even when the doctors are included in the plan’s provider network.”

“A new software system for the state’s health insurance website passed its first key test this week, and a final decision on whether Massachusetts will run its own site or join the federal exchange will be made in early August, a top state official said.
Maydad Cohen, special adviser to the governor, told the Massachusetts Health Connector board Thursday morning that the new software from hCentive performed every task required by federal officials, and then some, in a Washington, D.C., demonstration Monday.
This success, he said in an interview afterward, leaves him increasingly but cautiously optimistic that the state will be able to employ the hCentive software when open enrollment starts Nov. 15.
In the spring, the Health Connector abandoned its original, dysfunctional software, made by CGI, and adopted a “dual track” approach: working on a new system while simultaneously preparing to join the federal exchange, healthcare.gov.”

“Alabama, buckle up. You’ll soon learn how much your health insurance premiums will go up for next year. The percentage increase will probably be in the double digits.
But that’s nothing compared to what you’ll face in 2017. In May, I released a comprehensive study showing how the Affordable Care Act — otherwise known as Obamacare — will likely play out. The diagnosis isn’t good.
In two years, the ACA will cause substantial premium increases. This will likely cause Alabamians to leave the insurance market in droves — they won’t be able to afford health insurance, even with federal subsidies. Within a decade, this could swell the ranks of the uninsured by nearly 11 percent.
I reached this conclusion by using a peer-reviewed economic model published in several health journals. It was funded by both private and government sources, including the Department of Health and Human Services.

“Tired of waiting for states to reduce their backlogs of Medicaid applications, the Obama administration has given six states until Monday to submit plans to resolve issues that have prevented more than 1 million low-income or disabled people from getting health coverage.
The targeted states are Alaska, California, Kansas, Michigan, Missouri and Tennessee.
“CMS is asking several state Medicaid agencies to provide updated mitigation plans to address gaps that exist in their eligibility and enrollment systems to ensure timely processing of applications and access to coverage for eligible people,” said Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services. He said the agency will monitor states’ progress in solving the problems getting people enrolled in the state-federal insurance program for the poor.”

“When the District launched its federally mandated health insurance exchange last fall, officials went to great lengths to woo professional insurance brokers — launching a special broker web portal, establishing a “concierge” hotline just for brokers and holding broker-only training classes.
Despite those efforts, many brokers have yet to be paid for the policies they’ve sold through the exchange, known as D.C. Health Link — generating frustration among professionals who say their patience in navigating the changes wrought by the Affordable Care Act has not been rewarded.
“I’ve been very supportive, I put a lot of work into it, and I’ve gotten nothing,” said Steve Nearman, a Virginia-based broker who says he has helped nearly 100 city residents find and buy insurance through the exchange and is owed thousands of dollars in commissions.”

“President Obama’s healthcare law could be dealt a severe blow this week if a U.S. appeals court rules that some low- and middle-income residents no longer qualify to receive promised government subsidies to pay for their health insurance.
The case revolves around a legal glitch in the wording of the Affordable Care Act, which as written says that such subsidies may be paid only if the insurance is purchased through an “exchange established by the state.”
That would seem to leave out the 36 states in which the exchanges are operated by the federal government.
A ruling could come as early as Tuesday.
The administration has argued that Congress intended to offer the subsidies nationwide to low-and middle-income people who bought insurance through an exchange, without making a distinction.”

“At least three health insurers plan to offer insurance statewide in Georgia’s exchange for 2015. This year, only one health plan – Blue Cross and Blue Shield of Georgia – went statewide in the exchange. And the proposed Blue Cross rates for next year’s exchange will decrease by an average of 7 percent. Those were among the immediate highlights of data on proposed premiums, released by Georgia’s department of insurance, from the health plans seeking to participate in the state’s exchange next year. A total of nine insurers are seeking to offer exchange plans in 2015. That’s up from five insurers for the current year.”

“Sicker patients have prompted Denver Health to ask for a 17.5 percent hike next year in health insurance rates while the biggest carrier in western Colorado, Rocky Mountain Health Plans, is working to keep rates flat in high-cost resort counties.
When Colorado’s insurance regulators unveiled proposed 2015 rates for health insurance last week, the numbers were all over the map. (Click here to read Consumers demand lower rates, universal care.)
Denver Health provides care to patients of all ages. Some who have signed up through Colorado’s Health exchange are sicker and Denver Health is therefore proposing a rate increase. (Photo courtesy of Denver Health.)
Denver Health provides care to patients of all ages. Some who have signed up through Colorado’s Health exchange are sicker and Denver Health is therefore proposing a rate increase. (Photo courtesy of Denver Health.)
Denver Health proposed the biggest increase among carriers in Colorado, while other insurance companies proposed modest increases. New Health Ventures, which markets plans called Access Health Colorado, proposed a 22 percent cut in rates while the Colorado HealthOP wants to cut rates by about 10 percent overall.”

“Some New Yorkers are in sticker shock after receiving notices from their insurance companies saying that they have asked for significant rate increases through the state’s health exchange next year.
The exchange, which has prided itself on being affordable, is now facing requests for increases as high as 28 percent for some customers of MetroPlus, a new entry to the individual insurance market and one of the least costly — and most popular — plans on the exchange this year.”