“A key provision of the Affordable Care Act (ACA) is the requirement that private insurance plans cover recommended preventive services without any patient cost-sharing.1 Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they develop into more complicated, debilitating conditions, and that some services are also cost-effective.2 However, costs do prevent some individuals from obtaining preventive services (Figure 1). The coverage requirement aims to remove cost barriers.”Details
“Remember Obama’s now “infamous” line, “If you like your healthcare, you can keep it?” If it only had been true, because many Americans—especially our nation’s young people are suffering as a result of the President’s signature legislation.
President Obama told us that the average American would see their health insurance premiums lowered; yet the opposite is true. A recent study shows that health insurance premiums have drastically skyrocketed among 23-year-olds, especially males who have seen a 78 percent price increase. Women have seen close to a 45 percent increase.”
“Aetna Inc. (AET), the third-largest U.S. health insurer, raised its profit forecast for the year as enrollment increases.
Operating earnings this year will be $6.60 to $6.70 a share, above the previous forecast of $6.45 to $6.60, the Hartford, Connecticut-based company said today in a statement.”
“Spoiler alert! When it comes to covering the uninsured, Obamacare has proven itself to be one giant expansion of Medicaid. A new report released Wednesday reveals the total coverage increase for the first half of 2014. While total coverage increased by 8,538,327 individuals, enrollment in Medicaid accounted for 71 percent of that growth. Check out the infographic below for the full breakdown of the numbers.”Details
“A confession: I am a health economist, and I cannot rationally select a health plan.
I buy health insurance through the Federal Employees Health Benefits Program, or F.E.H.B.P., which is very similar to the Affordable Care Act’s exchanges. Like the exchanges, the federal employee program runs an online marketplace with a choice of plans, which vary by region.”
“NEW YORK — The federal government has sued New York City, saying it ripped off Medicaid for millions of dollars by submitting tens of thousands of false claims.
A civil lawsuit seeking unspecified damages was filed Monday in Manhattan federal court.
The lawsuit says the city and a computer company used computer programs to dodge a requirement that Medicaid be billed only after private insurance coverage is exhausted. The lawsuit says false diagnosis codes were submitted to Medicaid.”
“Now that many people finally have health insurance through the Affordable Care Act exchanges, some are running into a new problem: They can’t find a doctor who will take them as patients.
Because these exchange plans often have lower reimbursement rates, some doctors are limiting how many new patients they take with these policies, physician groups and other experts say.”
“Businesses in five states received early access Monday to select features at ObamaCare’s online health insurance marketplace for small employers.
The soft launch for the SHOP system is an effort by federal health officials to troubleshoot any problems at the exchange before Nov. 15, when it will open to all states that did not elect to build their marketplaces.
Small businesses in New Jersey, Delaware, Illinois, Ohio and Missouri can establish accounts, complete an application, receive a determination of eligibility and upload an employee roster, the Centers for Medicare and Medicaid Services said. In November, employers will also be able to browse plans and pricing.”
“Remember the excitement surrounding Castlight Health’s initial public offering? Last March, the San Francisco startup’s stock price soared when investors bought into the idea that online price transparency would transform the healthcare marketplace.
Castlight’s business plan calls for offering software through insurers and employers that allows people to comparison shop for healthcare services. With employers rapidly moving their workers into high-deductible plans, patients looking to lower their out-of-pocket expenses could use Castlight to find low-cost providers.”
“New language in contracts between the CMS and insurers operating on HealthCare.gov is grabbing attention, with some calling it an admission by the government that it might lose upcoming court battles dealing with insurance subsidies on the health portal and others saying the new wording is just a practical precaution.
The new language appears to allow insurers to stop offering their plans should federal premium subsidies disappear. A number of cases regarding the legality of the subsidies in states without their own exchanges are now working their way through the courts.
The language says, “CMS acknowledges that (the insurer) has developed its products for the (federal exchange) based on the assumption that (advance payments of the premium tax credit) and (cost-sharing reductions) will be available to qualifying enrollees.