Michelle Andrews, Kaiser Health News
"Aiming to contain health care costs, a growing number of employers and insurers are adopting a strategy that limits how much they’ll pay for certain medical services such as knee replacements, lab tests and complex imaging. A recent study found that savings from such moves may be modest, however, and some experts question whether “reference pricing,” as it’s called, is good for consumers.
The California Public Employees’ Retirement System (CalPERS), which administers the health insurance benefits for 1.4 million state workers, retirees and their families, has one of the more established reference pricing systems. More than three years ago, the agency began using reference pricing for elective knee and hip replacements, two common procedures for which hospital prices varied widely without discernible differences in quality, says Ann Boynton, CalPERS’ deputy executive officer for Benefit Programs Policy and Planning."
Kaiser Health News
"Health law? What health law?
Almost nine of 10 uninsured Americans – the group most likely to benefit — don’t know that the law’s second open enrollment period begins Nov. 15, according to a poll released Tuesday. Two-thirds of the uninsured say they know “only a little” or “nothing at all” about the law’s online insurance marketplaces where they can buy coverage if they don’t get it through their jobs. Just over half are unaware the law might give them financial help to buy coverage, according to a new poll.
Despite that lack of awareness, nearly 60 percent of those uninsured people say they plan to get coverage in the next few months, including 15 percent who say they’ll get it through an employer, 15 percent who say they’ll purchase it themselves and 8 percent who expect to get it through Medicaid."
Eric Pianin and Brianna Ehley, Financial Times
"With the new Obamacare enrollment period scheduled to begin on November 15, here’s an intriguing question: If you’re one of the rare Americans to have the misfortune of contracting Ebola, can you apply for a new insurance policy on one of the government-run health exchanges without being rejected?
Currently, only four people are being treated for Ebola in the United States, and a few hundred who may have been exposed to it are either being monitored or have been notified – so this is an extremely unusual situation. Still, while no insurance company would relish the prospects of taking on a consumer suffering from one of the worst viruses to occur in today’s modern world, the Affordable Care Act prohibits insurance companies from turning down applicants with pre-existing conditions, such as cancer, heart disease, kidney disease, or even – yes – Ebola."
Michael Dresser, Baltimore Sun
"Republican gubernatorial candidate Larry Hogan criticized the O'Malley administration Monday over its decision to delay a lawsuit against the contractor it has blamed for the failed launch of the state's health exchange web site. .
Hogan, locked in a battle with Democratic Lt. Gov. Anthony G. Brown with two weeks to go before Election Day, accused the administration of putting politics ahead of the taxpayers by delaying court action against Noridian Healthcare Solutions."
Sarah Hurtubise, Daily Caller
"The Obama administration has funded a new study by top consulting firm RAND Health that startlingly finds that if taxpayer subsidies are eliminated, Obamacare exchanges will fall into a “death spiral.”
The study comes in the wake of a number of lawsuits which are challenging the Obama administration’s implementation of Obamacare subsidies. Three lawsuits have made it to U.S. Circuit Courts, just one step from the Supreme Court, arguing that the text of the Affordable Care Act allows premium subsidies for state-run exchanges only. (RELATED: Second Court Strikes Down Obamacare Subsidies In Federal Exchanges)"
Nick Budnick, The Oregonian
"More than 12,000 people who purchased policies through Cover Oregon could owe a combined $1.12 million at tax time because of errors in subsidized premiums issued by the health insurance exchange.
The vast majority of people affected are expected to owe no more than $10 per month that their policy was in effect. That figure is not final, however, because a $10,000 consultant's study intended to settle the question did not succeed. The exchange is planning to commission a second, more in-depth study."
Katie Kerwin McCrimmon, Health News Colorado
"Cost and confusion prevented many uninsured people from signing up for health coverage this year in Colorado, according to two new reports.
A Rand study, Barriers to Enrollment in Health Coverage in Colorado, found that some consumers didn’t want to sign up because they opposed the individual mandate. Others were frustrated that they first had to apply for Medicaid in a cumbersome process. Still others found Colorado’s exchange website confusing. And many people said costs for insurance and co-pays seemed too high."
Andy Miller, Georgia Health News
"A state agency says Georgia consumers’ personal data has not been compromised so far in the wake of a theft of a laptop computer that contained some people’s health information. The computer was stolen from the vehicle of an employee of the Department of Behavioral Health and Developmental Disabilities who was attending a Clayton County conference in August.
The laptop contained health information on 3,397 individuals who receive services from the agency. A majority of these patients get services in the Columbus region, DBHDD said."
Christopher Snowbeck, Minneapolis Star-Tribune
"Sticker shock awaits thousands of people with health coverage through PreferredOne, the top seller on the MNsure exchange during its first year.
The Golden Valley-based insurer said Wednesday that its individual market subscribers will see an average premium increase next year of 63 percent due to high claims costs.
“Given the volatility of the individual marketplace due to the first year of the [federal health law], this increase is a significant step at stabilizing our rates and plans for the years to come,” the company said in a statement."
Rebecca Riffkin, Gallup
"WASHINGTON, D.C. -- Although more provisions of the Affordable Care Act have taken effect over the past year, more Americans still say the law has hurt rather than helped them. Compared with early 2014, fewer Americans say it has had no effect, although this group is still in the majority, at 54%.
Americans overall are both more positive and more negative about the law's effect on themselves and their families. Since the start of this year, the percentage saying the law has helped them has increased from 10% to 16%, while the percentage saying it has hurt them has also gone up, and by a similar amount, from 19% to 27%."