“One message came through loud and clear at today’s meeting of the Washington Health Benefit Exchange’s Operations Committee: It may not be time to panic about the health exchange’s problem-riddled invoicing and payments system, but it is time to sound the alarm and get all hands on deck.
“We are really out of rope on this one,” Chief of Staff Pam MacEwan told the committee. “We need this to be fixed a while ago. We don’t have the patience of the public or the carriers on this anymore.”
Software problems have prevented payments for up to 6,000 consumer accounts from posting properly and being reported to insurers, resulting in some consumers being told they don’t have coverage.
Beth Walter, operations director, noted the exchange had received a commitment from Deloitte, the exchange’s primary contractor, to “engage additional resources on their side.”
“What does that mean?” asked a committee member.
“More people,” Walter replied.”

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“MILWAUKEE (AP) — A federal judge on Monday dismissed a U.S. senator’s lawsuit challenging a requirement that congressional members and their staffs to obtain government-subsidized health insurance through small business exchanges, saying the senator had no grounds to sue.
Sen. Ron Johnson, a Wisconsin Republican, filed the lawsuit in January after the Office of Personnel Management decided months earlier that lawmakers and their staffs should continue to receive health care benefits covering about 75 percent of their premium costs after leaving the health insurance program for federal workers.
Johnson said the decision would make him decide which staff members must buy insurance through an exchange, potentially creating conflict in his office. He also said it forced him to participate in a program that he believed was illegal and that it could make voters view him negatively because his staff received health insurance subsidies the general public did not.
But U.S.

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“Anger over limited choice of doctors and hospitals in Obamacare plans is prompting some states to require broader networks — and boiling up as yet another election year headache for the health law.
Americans for Prosperity is hitting on these “narrow networks” against Democrats such as Sen. Jeanne Shaheen of New Hampshire, whose GOP opponent Scott Brown has made the health law a centerpiece of his campaign to unseat her. And Republicans have highlighted access challenges as another broken promise from a president who assured Americans they could keep their doctor.
It’s not just a political problem. It’s a policy conundrum. Narrow networks help contain health care costs. If state or federal regulators — or politicians — force insurers to expand the range of providers, premiums could spike. And that could create a whole new wave of political and affordability problems that can shape perceptions of Obamacare.”

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“A federal appeals court panel in the District struck down a major part of the 2010 health-care law Tuesday, ruling that the tax subsidies that are central to the program may not be provided in at least half of the states.
The ruling, if upheld, could potentially be more damaging to the law than last month’s Supreme Court decision on contraceptives. The three-judge panel of the D.C. Circuit Court of Appeals sided with plaintiffs who argued that the language of the law barred the government from giving subsidies to people in states that chose not to set up their own insurance marketplaces. Twenty-seven states, most with Republican leaders who oppose the law, decided against setting up marketplaces, and another nine states partially opted out.
The government could request an “en banc” hearing, putting the case before the entire appeals court, and the question ultimately may end up at the Supreme Court.

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“The Affordable Care Act’s success meeting its initial enrollment goals and the repair of HealthCare.gov seem to have calmed the political waters for Obamacare. But the job of enrolling the uninsured gets harder, not easier, because the remaining uninsured will generally be tougher to reach.
Recent surveys show, roughly in line with expectations, that 8 million to 9.5 million fewer adults are uninsured compared with last year before the Affordable Care Act went into effect. Specific data are not yet available for uninsured children who probably got covered as well, and an earlier provision of the health-care law that allowed people to stay on their parents’ insurance up to age 26 is thought to have lowered the number of uninsured young adults by as many as 3 million.
But tens of millions of Americans are not yet covered.
Those who enrolled last year during the first open-enrollment season were more likely to want coverage and were best able to navigate the process to get it.

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“The nation’s largest health insurer expects to play a much bigger role in the health care overhaul next year, as the federal law shifts from raising giant questions for the sector to offering growth opportunities.
UnitedHealth Group said Thursday that it will participate in as many as 24 of the law’s individual health insurance exchanges in 2015, up from only four this year.
These state-based exchanges debuted last fall as a way for customers to buy individual health insurance, many with help from income-based tax credits. They played a key role in helping roughly 8 million people gain coverage for 2014.
But UnitedHealth and other insurers approached them cautiously, in part because they had little information about the health of the people who would sign up.

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“The White House needs to make a decision soon on whether ObamaCare’s controversial employer mandate will take effect in 2015.
With the mandate set to take effect in January, businesses are awaiting final word from the administration on whether they will be required to track and report how many of their employees are receiving coverage.
Federal officials are late in delivering the final forms and technical guidance necessary for firms to comply, raising suspicions the mandate could once again be delayed.
The mandate has been pushed back twice before, the first time in late summer.
The delays to the mandate have angered House Republicans, who are now taking President Obama to court for what they say is his refusal to follow the letter of the law.”

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“UnitedHealthcare, the insurance giant that largely sat out the health law’s online marketplaces’ first year, said Thursday it may sell policies through the exchanges in nearly half the states next year.
“We plan to grow next year as we expand our offering to as many as two dozen state exchanges,” Stephen Hemsley, CEO of UnitedHealth Group, the insurance company’s parent, told investment analysts on a conference call. He was referring to coverage sold to individuals.
The move represents a major acceleration for the company and a bet that government-subsidized insurance, sold online without regard for pre-existing illness, is here to stay. UnitedHealthcare sells individual policies through government exchanges in only four states now.
Even analysts who follow the company closely seemed surprised.
“You’re making a really big move,” Kevin Fischbeck, an analyst for Bank of America, told the company’s executives. “You’re going to do a couple dozen states. You’ve really moved in.

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“Medicare spending growth will be slow again in 2014 relative to historical standards, and some of the usual suspects are now crediting the Affordable Care Act — Obamacare — for the good news. For instance, a recent post at Vox suggests that the slowdown in Medicare spending can be attributed, in part, to the ACA’s provision penalizing hospitals for excessive readmissions of previously treated patients.
This is nonsense.
At the time of the ACA’s enactment in March 2010, the Congressional Budget Office estimated that the readmission provision would reduce Medicare spending by $0.3 billion in 2014, and only $7.1 billion over a decade. That’s about one tenth of 1 percent of total Medicare spending over that time period. There has been no information from any source since 2010 suggesting that the savings from the readmission provision has escalated into a major cost-cutting reform.

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“The White House has begun its search for the next stewards of HealthCare.gov.
A contract solicitation posted online Wednesday enumerates the qualifications and requirements of the next Obamacare website contractor, charged with keeping the online federal health insurance exchange portal up and running.
The 60-page job posting says the next caretaker of the Obamacare site will need to be able to work “under aggressive time constraints” to work with the Federally Facilitated Marketplace in testing and upgrading a variety of hardware, software, and security features. It also states that the contractor will need to be able to perform tests that can demonstrate that the site can function when a large number of users are online.
Accenture currently holds a one-year contract to run HealthCare.gov, which was awarded after a no-bid process back in January.

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