“A major innovation in health insurance plan design over the past several years has been the rapid growth of “narrow network” plans. Such plans either limit enrollee choices of providers, or place providers in differential cost tiers whereby individuals face higher cost in selecting some providers relative to others. This movement harkens back to the restrictions put in place during the U.S. initial infatuation with managed care in the mid-1990s. That episode ended badly for the limited choice model, as the “HMO backlash” induced regulatory restrictions on plans which handicapped choice limitations within the HMO model.
The latest growth of narrow network plans has been hastened by the introduction of health insurance exchanges under the Affordable Care Act (ACA). State exchanges have fostered strong insurer competition through both organizing the marketplace and through tying low income health insurance tax credits to the second-lowest cost plan in the silver tier.

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“House Republicans on Friday replaced the firm handling their lawsuit against President Obama after the lawyer representing them pulled out over what was said to be political backlash among his colleagues at the firm, Baker Hostetler.
The lawyer, David B. Rivkin Jr., had taken the case on behalf of House Republicans in August, right after they voted to sue the president, accusing him of overstepping the powers of the presidency. Two people with knowledge of the situation said Mr. Rivkin withdrew from the case under pressure after facing criticism that he had taken on an overly partisan lawsuit. Some members of the firm feared the case against Mr. Obama could drive off potential clients and hurt Baker Hostetler’s credibility, according to one of the people with knowledge of the case. Both people said they were prohibited from publicly discussing such a delicate case.”

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“Republicans have found a new opening against ObamaCare after struggling for months to craft a fresh strategy against a healthcare law that now covers millions of people.
Lifted by a pair of federal audits that found major flaws with the law’s implementation, Republicans see their first chance in months to launch a serious attack against the law.
“The news that we’ve seen over the last week and a half really emphasizes what conservatives and Republicans were trying to do last year, which was preventing a lot of this from happening,” said Dan Holler, a spokesman for the conservative political group Heritage Action for America.
“What I hope happens is that the Republican Party as a whole says, ‘Yes, there is a reason besides politics that we’re fighting ObamaCare: It’s hurting people,’” Holler said.”

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“Republicans have found a new opening against ObamaCare after struggling for months to craft a fresh strategy against a healthcare law that now covers millions of people.
Lifted by a pair of federal audits that found major flaws with the law’s implementation, Republicans see their first chance in months to launch a serious attack against the law.
“The news that we’ve seen over the last week and a half really emphasizes what conservatives and Republicans were trying to do last year, which was preventing a lot of this from happening,” said Dan Holler, a spokesman for the conservative political group Heritage Action for America.
“What I hope happens is that the Republican Party as a whole says, ‘Yes, there is a reason besides politics that we’re fighting ObamaCare: It’s hurting people,’” Holler said.”

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“Costs to buy coverage through Connecticut’s health insurance exchange won’t, on average, rise much next year. For some plans, the prices are dropping.
But some customers who get financial aid to buy their insurance could see price increases beyond the rise in sticker price if they stick with their current plans, according to an analysis by consultants for the exchange, Access Health CT.
As a result, some people might find lower prices by considering different plans, even if they bought the cheapest plan available this year, according to the analysis by Wakely Consulting Group.”

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“The federal health insurance website is trying to resolve glitches and security questions raised by the Government Accountability Office, so people can safely and successfully sign up for insurance at open enrollment Nov. 15.
Much of the Obama administration’s success in enrolling 8.1 million people in health insurance over the past year was overshadowed by the momentous problems with HealthCare.gov and several state exchanges. As administration officials prepare to test the site with insurers Oct. 7, they’re trying to manage expectations while portraying some confidence.
Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner told a House panel Thursday that there will be “visible improvement, but not perfection” on HealthCare.gov.”:

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“Here’s a health law pop quiz: Which two states have the least successful Obamacare health insurance exchanges?
You may guess a state in the Deep South where political opposition to the law is fierce. Or maybe Missouri? It passed a state law saying consumer advisors funded by the Affordable Care Act aren’t allowed to advise consumers.
In fact, Iowa and South Dakota are the two states where the ACA insurance marketplaces struggled the most. In both, just 11.1 percent of residents eligible for subsidized insurance signed up for it – the lowest rates in all 50 states and the District of Columbia, according to data from the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)”

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“A wave of hospital mergers and acquisitions spreading across the U.S. has the health insurance industry attempting to stand in the way with legalese, Congressional lobbying and in the court of public opinion.
America’s Health Insurance Plans, the powerful lobby and trade group representing the biggest names in commercial insurance appears to be leading the charge battling deals in New York, Chicago and beyond.
“Consolidation promises greater efficiency, but all that ever materializes is greater costs,” Brendan Buck, former press secretary to Speaker of the U.S. House John Boehner, who was tapped this spring to be vice president of communications at America’s Health Insurance Plans (AHIP) told the Chicago Sun-Times following news two of the wealthiest hospital operators in the city would merge.”

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“The Obama administration has found their line when it comes to setting expectations for the second roll-out of the federal exchange website: “Improvement but not perfection.”
It’s the semi-optimistic catch-phrase officials have used in congressional testimonies over the past few weeks to describe how well Healthcare.gov will work come November. Andy Slavitt, principal deputy administrator at CMS said it during his testimony with the House Ways and Means Committee last week. Marilyn Tavenner, CMS administrator used the line during her testimony Thursday morning for the House Committee on Government Oversight and Reform.
Voters also seem to be preparing for problems and not perfection as they head back to the site. Open enrollment begins November 15.
Morning Consult polling shows more than half of registered voters — 54 percent — are very concerned or somewhat concerned about security breaches on HealthCare.gov and the state exchange sites.

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“Who’s up for the latest batch of bad Obamacare-related news?
(1) Consumers brace for the second full year of Obamacare implementation, as the average individual market premium hike clocks in at eight percent — with some rates spiking by as much as 30 percent.
(2) “Wide swings in prices,” with some experiencing “double digit increases.”(Remember what we were promised):
Insurance executives and managers of the online marketplaces are already girding for the coming open enrollment period, saying they fear it could be even more difficult than the last. One challenge facing consumers will be wide swings in prices. Some insurers are seeking double-digit price increases.”

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