A Medical Loss Ratio (MLR) is a calculation used to loosely gauge the efficiency and profitability of a health insurance plan. The measurement determines what portion of the money consumers pay in premiums is spent on providing health care services or improving the quality of care delivery. A higher MLR is thought to indicate a higher quality insurer because a larger portion of the company’s funds are spent on providing care. However, this is not necessarily the case if an insurer succeeds in keeping a healthier-than-expected risk pool.Details
The public employees responsible for overseeing $600 million in contracts to build healthcare.gov were inadequately trained, kept sloppy records, and failed to identify delays and problems that contributed to millions in cost overruns.
That’s according to a new government audit, published today. It reveals widespread failures by the federal agency charged with managing the private contractors who built healthcare.gov.
Unsurprisingly there are more problems with the Affordable Care Act (Obamacare) that await members of Congress coming back from their August recess.
Topping the list of issues is a provision in Obamacare that changes the definition of “small employer” from “50 or fewer employees” to “100 or fewer employees,” starting January 1, 2016.Details
The healthcare sector is undergoing a secular consolidation as payers and providers assume a historic level of mergers and acquisitions. These trends were underway prior to implementing the Affordable Care Act. But there’s little question that ACA hastened them.Details
President Obama says he will veto any legislation that amends or repeals the Affordable Care Act (ACA), his signature legislative achievement, either in whole or in part. But GOP congressional leaders in both House and Senate promised their colleagues that they would use a special parliamentary procedure called “reconciliation” to bypass a certain filibuster by Senate Democrats to put a full repeal bill on the president’s desk anyway.Details
Between the end of March and the end of June, 29 states plus the District of Columbia lost Obamacare enrollees, based on an Americans for Tax Reform analysis of recently released data from the Centers for Medicare and Medicaid Services (CMS). In total, Obamacare exchanges had a net loss of 238,119 enrollees in the three-month period.Details
Ike Brannon is offering a full-throated defense of the Cadillac tax over at The Weekly Standard. He fully concedes that Obamacare is “replete with bad policies.” But he would have us believe “the so-called Cadillac tax is not one of them.”Details
Section 9001 of the Affordable Care Act (ACA), set to take effect in 2018, imposes what it calls an “Excise Tax on High Cost Employer-Sponsored Health Coverage”, which has come to be known as the “Cadillac Tax.” This is a 40 percent tax on employer-sponsored health benefits that are defined as “excess benefits.” That means anything in excess of $10,200 (employee only) or $27,500 (family) coverage for 2018, with adjustments for subsequent years. The “excess benefit” includes not only benefits provided by the employer, but also the portion of premium paid by the employee, as well as any money the employee chooses to set aside out of salary to pay for health expenses via a Flexible Spending Account (FSA).Details
Iowa’s experience with Obamacare’s Medicaid expansion has been turbulent. In 2014, state officials agreed to expand Medicaid, despite the fact that the Obama administration denied virtually all of their requests for flexibility.
Iowa’s expansion was loosely modeled after Arkansas’ Obamacare expansion. Under Iowa’s “Marketplace Choice” waiver, able-bodied adults above the poverty line would receive Medicaid benefits through Obamacare exchange plans.Details
Congress has less than a month to make a small fix to Obamacare that could have a big impact on small businesses.
A bill that has been introduced would enable a state to decide whether to expand the definition of a small group health insurance market. It may not seem like a big deal, but lawmakers say the slight change could have a big impact on premiums for more than 3 million employees.Details