“State officials offered assurances Wednesday that software fixes to the flawed MNsure health insurance exchange are happening as planned, and that the system should be in good working order by the Nov. 15 start of open enrollment.
Still grappling with consumer fallout and political pressure over last year’s troubled rollout, MNsure officials said changes are being made to the system that will allow more time for testing and that sufficient backup plans are in development if things go wrong.
MNsure is preparing for the “worst case, if that comes about,” interim Chief Operating Officer Wes Kooistra told the agency’s board of directors, but he added that all hands are on deck to ensure an “improved user experience for 2015.”
IBM installed its final software upgrades over the weekend, officials said, a move that should resolve one of several major logjams that have prevented consumers from seamlessly logging onto the MNsure website and enrolling in health insurance coverage.”

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“When Covered California unveiled its initial slate of 13 carriers last year, their low rates got some attention — but so did their mix.
While Covered California couldn’t boast Aetna or UnitedHealthcare, which instead elected to leave the state’s individual market, four major insurers were on board: Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser Permanente.
And the exchange also had drawn in several smaller health plans, like Ventura County Health Plan, which were going to compete for share on the individual market for the first time.
“For me, the story is [these] new participants,” Micah Weinberg of the Bay Area Council told California Healthline last summer. “Who exactly they are, and how they are being offered in these marketplaces, is worth watching.”
But Ventura County quietly pulled out. A second small carrier, Alameda Alliance, was kicked out.

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“Low-income consumers struggling to pay their premiums may soon be able to get help from their local hospital or United Way.
Some hospitals in New York, Florida and Wisconsin are exploring ways to help individuals and families pay their share of the costs of government-subsidized policies purchased though the health law’s marketplaces – at least partly to guarantee the hospitals get paid when the consumers seek care.
But the hospitals’ efforts have set up a conflict with insurers, who worry that premium assistance programs will skew their enrollee pools by expanding the number of sicker people who need more services.
“Entities acting in their [own] financial interest” could drive up costs for everyone and discourage healthier people from buying coverage, insurers wrote recently to the Obama administration.
Insurers are asking the federal government, which regulates the health insurance marketplaces, to restrict the practice.”

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“Backers of the health-care law say they are rushing to make sure tens of thousands of people provide more documents to prove they are in the U.S. legally and therefore entitled to the coverage they obtained through HealthCare.gov.
Immigrant advocates say they felt the Obama administration moved hastily in announcing Tuesday it would cut off health insurance for up to 310,000 people who signed up for plans through online exchanges run by the federal government if they don’t send additional information in the next few weeks showing they are U.S. citizens or legal residents.

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“Small and stand-alone nonprofit hospitals are facing mounting pressure from weak operating margins and lower patient volumes, with more signals of stress on the way, according a report released Wednesday from Standard & Poor’s Rating Services.
The rating agency warned the healthcare sector was at “a tipping point where negative forces have started to outweigh many providers’ ability to implement sufficient countermeasures.” Beginning in 2013 and continuing into this year, credit downgrades outpaced upgrades at an accelerating rate.
In particular, stand-alone providers are under greater pressure from physician departures, rising bad debt, and higher employee benefit costs.”

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“AUSTIN — A legislative committee is examining market-based alternatives to providing low-income Texans with health care since the state has rejected the expansion of Medicaid under the federal Affordable Care Act.
Members of the state Senate Health and Human Services committee plan Thursday to discuss alternatives to the law critics call “Obamacare.”
Some ideas include expanding Medicaid block grants and waivers. Lawmakers are seeking to hold health costs in-check while improving access to care.”

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“California is coming face to face with the reality of one of its biggest Obamacare successes: the explosion in Medi-Cal enrollment.
The numbers — 2.2 million enrollees since January — surprised health care experts and created unforeseen challenges for state officials. Altogether, there are now about 11 million Medi-Cal beneficiaries, constituting nearly 30 percent of the state’s population.
That has pushed the public insurance program into the spotlight, after nearly 50 years as a quiet mainstay of the state’s health care system, and it has raised concerns about California’s ability to meet the increased demand for health care.
Even as sign-ups continue, state health officials are struggling to figure out how to serve a staggering number of Medi-Cal beneficiaries while also improving their health and keeping costs down. Many are chronically ill and have gone without insurance or regular care for years, and some new enrollees have higher expectations than in the past.”

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“The Affordable Care Act is like a patient who is feeling worse when key clinical indicators say he is doing better.
Obamacare recovered from its Web site fiasco last October and went on to exceed enrollment projections in March. Despite predictions of “rate shock,” early indications are that premiums in the new insurance marketplaces are increasing modestly in most states that have made 2015 information public and more slowly than the non-group market has grown in the past. While critics said that the Affordable Care Act was having no impact on the uninsured, the share of the population that is uninsured is down significantly. Adding to the more upbeat news, health costs are rising at historically moderate rates, although the ACA has played only a supporting role in that so far.

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“What happens in November will play a major role in shaping President Obama’s final two years in office.
No, it’s not just the 2014 midterm elections that have the White House on edge, but also the return of open enrollment in Obamacare.
After the disastrous rollout of the president’s signature domestic initiative in 2013, the administration needs to avoid the problems that diminished public confidence in the most significant overhaul to the health care system since the creation of Medicare.
The White House believes the technical problems that crashed healthcare.gov will become a distant memory. However, team Obama must worry about much more than just a website.
Here are the top five potential Obamacare headaches looming in November:”

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