Insurers from Oregon to Pennsylvania, including a failed health-care co-operative and two long-established Blues plans have lost billions of dollars selling Obamacare policies. Now they are suing the federal government to recoup their losses. In a testament to industry desperation, insurers are asking federal judges to simply ignore a congressional ban on the payment of these corporate subsidies.
The regulatory atrocity that is Obamacare inspired this race to the courthouse. Despite billions in subsidies — to both low-income individuals and well-capitalized insurance companies — the industry has incurred big losses in the individual market.
In a paper published June 28 by the Mercatus Center, Brian Blase (Mercatus), Ed Haislmaier (Heritage Foundation), Seth Chandler (University of Houston), and Doug Badger (Galen Institute) used data derived from insurance-company regulatory filings to determine the extent and source of those losses. The study examined the performance of 174 insurers that sold qualified health plans (QHPs) in 2014 to both individuals and small groups (generally companies with 50 or fewer workers).
. . .
Minnesota’s largest health insurer, Blue Cross and Blue Shield of Minnesota, has decided to stop selling health plans to individuals and families in Minnesota starting next year.
The insurance carrier’s parent company, which goes by the same name, will continue to sell a much more limited offering on the individual market through its Blue Plus HMO.
The insurer explained extraordinary financial losses drove the decision.
“Based on current medical claim trends, Blue Cross is projecting a total loss of more than $500 million in the individual [health plan] segment over three years,” BCBSM said in a statement.
. . .
ObamaCare officials are partnering with the IRS to help drive down uninsured rates among young people.
For the first time, the federal tax agency is working with the Department of Health and Human Services (HHS) to reach out directly to taxpayers who paid the required fee last year because they lacked coverage.
About 45 percent of people who paid the fee — or claimed an exemption, like financial hardship — were under 35, according to HHS.
The planned mailings will lay out options for coverage and include details about how to qualify for federal subsidies. HHS will also again partner with the ride-hailing service Lyft, which will offer discounts to customers who attend open enrollment sessions.
. . .
Today, after years of hearings and speeches and debates, the Paul Ryan-led House of Representatives has done something it has not done before: it has released a comprehensive, 37-page proposal to reform nearly every federal health care program, including Medicare, Medicaid, and Obamacare. No proposal is perfect—and we’ll get to the Ryan plan’s imperfections—but, all in all, we would have a far better health care system with the Ryan plan than we do today.
The first thing to know about the Ryan-led plan — part of a group of proposals called “A Better Way” — is that it’s not a bill written in legislative language. Nor is it a plan that has been endorsed by every House Republican.
Instead, it’s a 37-page white paper which describes, in a fair amount of detail, a kind of “conversation starter” that House GOP leadership hopes to have with its rank-and-file members, and with the public, in order to consolidate support around a more market-based approach to health reform.
. . .
The Department of Health and Human Services will up their direct outreach to uninsured young adults, who they hope will enroll in the Affordable Care Act exchanges and help stabilize the markets.
HHS on Tuesday announced steps the department will take during the upcoming open enrollment period to enhance their outreach to people between ages 18 and 35 who they hope will purchase insurance policies on the federal exchanges. The announcement is the latest in a string of expected steps the department is announcing this month to strengthen the marketplace.
The department hopes to increase the number of young and healthy adults enrolled on the exchanges to improve the risk pools, which would help lower costs for all marketplace consumers.
. . .
House Speaker Paul Ryan’s policy plan for health care, as expected, leans heavily on market forces, more so than the current system created by Obamacare. The proposal contains a host of previously proposed Republican ideas on health care, many of which are designed to drive people to private insurance markets.
Importantly for conservatives, as part of a full repeal of the Affordable Care Act, the current law’s mandates for individuals and insurers would disappear under the GOP plan. It would overhaul Medicare by transitioning to a premium support system under which beneficiaries would receive a set amount to pay for coverage. The plan also would alter Medicaid by implementing either per capita caps or block grants, based on a state’s preference.
. . .
Democrats should push for universal health coverage ahead of the November election, several health care advocates urged the committee drafting the Democratic National Committee’s platform at a recent session focused on health policy.
Their liberal health care proposals echo a similar theme from an environment-themed session the same day, in which activists criticized DNC members for not pushing harder on climate change.
The hearing was part of a series of regional events held by the Democratic Platform Drafting Committee “designed to engage every voice in the party.”
Too many people are still uninsured six years after the passage of the Affordable Care Act, said many of the advocates who spoke before the committee in Phoenix on Friday. Still more are underinsured, they said, and people are struggling to pay for rising premiums and to afford prescription drugs.
. . .
Ohio’s co-op will become the thirteenth of the 23 co-ops created under the Affordable Care Act to fold.
The Ohio Department of Insurance requested to liquidate the state’s health insurance co-op, InHealth Mutual, the state announced Thursday. Nearly 22,000 Ohio residents will have 60 days to replace their InHealth policy with another company’s on the federal exchange.
“Our examination of the company’s financials made it clear that the company’s losses would prevent it from paying future claims should its operations continue,” Mary Taylor, the Ohio Director of Insurance and the state’s lieutenant governor, said in a statement.
. . .
The uninsurance rate for nonelderly adults increased in the decade before the passage of the Affordable Care Act (ACA), driven by declining rates of employer-based coverage, especially during the recession at the end of the decade. The ACA was intended to decrease the percentage of the population without health insurance and to provide “quality, affordable health care for all.” The purpose of this brief is to consider how uninsurance rates are changing under the ACA.
. . .
Top Republicans on the House Energy and Commerce Committee sent letters this week seeking more information about the financial status of the 11 remaining co-ops created under the Affordable Care Act.
Reps. Fred Upton (R-Mich.), Tim Murphy (R-Pa.) and Joe Pitts (R-Pa.) say they want to better understand the financial challenges the co-ops are facing and ensure the Centers for Medicare and Medicaid Services is taking the “necessary and appropriate steps” to keep the co-ops functioning. The agency has placed eight of the remaining co-ops on corrective action plans, and 12 had closed by the start of 2016.
. . .