Californians better get comfortable. The wait time to see a doctor in the Golden State may be about to skyrocket.

Last week, California Assembly Speaker Anthony Rendon and a select committee of representatives held two days of hearings in Sacramento on Senate Bill 562 — the Healthy California Act — which promises to enroll all Californians in a government-run, single-payer healthcare system.

The controversial bill passed the state Senate on June 1. But Speaker Rendon “parked” it because he said it did not give enough details on cost and coverage. The California Nurses Association is pushing hard for the Assembly to pass the bill early next year. It is unclear whether Governor Brown would sign it.

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Federal health officials are proposing changes to rules for coverage sold through the ACA’s insurance marketplaces that, starting in 2019, would let states alter the benefits that health plans must provide and limit enrollment help for consumers. In envisioning a larger role for states in setting benefits, the draft rule would still require ACA plans to cover 10 categories of medical services. But for the first time, any state could adopt benefits standards already in use by another state—or rewrite its own standards.

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As California health care officials brace themselves for changes to the Affordable Care Act by President Donald Trump and the Republican-controlled Congress, state lawmakers today and Tuesday will hold a hearing examining the gaps in coverage and financing of California’s current system.

Among the topics expected to be front and center is single-payer health care and Senate Bill 562, introduced earlier this year by Senators Ricardo Lara, D-Bell Gardens, and Toni Atkins, D-San Diego. That controversial proposal would replace California’s private health insurance market with a single, government-run plan with no premiums or deductibles for nearly 40 million Californians.
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Iowa is abandoning its quest to shed major elements of the Affordable Care Act, after federal health officials failed to approve the plan in time for the insurance-buying season that begins in just over a week. The state’s withdrawal comes two months after President Trump telephoned a top federal health official with instructions to reject Iowa’s proposal.

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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.

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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.

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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.

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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.

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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.

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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 health plans 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.
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