A project of the Galen Institute

Issue: "Premiums/Costs"

In South Florida And The Nation, Health Care Costs Often Are Shrouded In Secrecy

Daniel Chang, Miami Herald
Tue, 2014-09-16
"At a hearing to discuss the rising costs of healthcare benefits for Miami-Dade County, Fla., employees this year, a labor union consultant raised his hand to ask what seemed like a basic question. Could the committee charged with reducing Miami-Dade labor’s healthcare expenses look at the spreadsheet showing the rates that the county pays local hospitals and doctors for medical services to employees? “We really need to understand where the money is being spent in order to be insightful about benefit design changes,’’ said Duane Fitch, a healthcare consultant for SEIU Local 1991, which represents physicians and nurses at the county-owned Jackson Health System."

Companies race to adjust health-care benefits as Affordable Care Act takes hold

Aaron Gregg
Washington Post
Tue, 2014-09-16
"Large businesses expect to pay between 4 and 5 percent more for health-care benefits for their employees in 2015 after making adjustments to their plans, according to employer surveys conducted this summer. Few employers plan to stop providing benefits with the advent of federal health insurance mandates, as some once feared, but a third say they are considering cutting or reducing subsidies for employee family members, and the data suggest that employees are paying more each year in out-of-pocket health care expenses."

Health Law Falls Flat With Kentucky Voters, Even Those It Helps

Abby Goodnough
New York Times
Tue, 2014-09-16
"Despite the success of the Affordable Care Act in Kentucky, state Democrats are having a hard time winning over even those Republicans who admit they are benefiting from the law. The Affordable Care Act allowed Robin Evans, an eBay warehouse packer earning $9 an hour, to sign up for Medicaid this year. She is being treated for high blood pressure and Graves’ disease, an autoimmune disorder, after years of going uninsured and rarely seeing doctors. “I’m tickled to death with it,” Ms. Evans, 49, said of her new coverage as she walked around the Kentucky State Fair recently with her daughter, who also qualified for Medicaid under the law. “It’s helped me out a bunch.” But Ms.

Brady Questions HHS Authority To Put Forward Hospital Appeals Settlement

http://insidehealthpolicy.com/brady-questions-hhs-authority-put-forward-hospital-appeals-settlement
Tue, 2014-09-16
"House Ways & Means health subcommittee chair Kevin Brady (R-TX) questions HHS' authority to settle hospitals' appeals of denied inpatient claims and is urging HHS Secretary Sylvia Burwell to retract what he views as an "ill thought" settlement process. Brady wants Burwell to work with lawmakers to come up with a different "fair, transparent and conclusive settlement process." Brady wrote to Burwell Tuesday (Sept. 16) that he is dismayed by HHS' reluctance to work with the committee on an equitable settlement process that is fully legal, adding that the "lack of engagement makes it challenging for the Congress to solve the current appeals problems and prevent similar problems in the future." CMS announced late last month (Aug. 29) that it will pay hospitals 68 percent of denied inpatient status claims in the appeals queue if hospitals take them out of the backlogged appeals process.

ACA open enrollment for 2015 causing anxiety for plans, providers

Paul Demko
Modern Healthcare
Mon, 2014-09-15
"During the 2014 open enrollment for Obamacare coverage, Mary Denson, 21, a student at Columbia (Mo.) College, qualified for a federal premium subsidy that reduced her premium contribution for buying health insurance to less than $20 a month. But she fears that when she renews her coverage for 2015, she won't have enough income from her nanny job to reach the subsidy income threshold of 100% of the federal poverty level and continue qualifying for premium tax credits. She isn't eligible for Medicaid because Missouri hasn't expanded that program for low-income adults. Denson says she's considering looking for another job to reach the $11,670 income threshold but worries she may have to drop classes. Without the subsidy, her coverage would cost nearly $400 a month, far more than she can afford. “I'm just going to have to re-apply and pretty much hope that I make the cut again,” Denson said."

Obamacare Premiums Are Magical Mystery Tour

Megan McArdle
Bloomberg
Mon, 2014-09-15
"Last week, we finally learned the prices for the new benchmark plans for Obamacare. The good news: Prices are falling slightly. The bad news: Contrary to optimistic early reports, that doesn’t mean that everyone’s costs are falling; consumers will have to be attentive to make sure that their costs don’t go up. The worse news: We won’t actually know what effect the Affordable Care Act is having on insurance prices until 2017, when a bunch of temporary subsidies for insurers expire. The important thing to keep in mind is that when the “benchmark rate” goes down, that doesn’t mean that the cost of the old benchmark plan has fallen. It just means that whatever plan is now the second-cheapest "silver" plan on the exchanges is cheaper than whatever was the second-cheapest plan last year."

Growing Burden of Employer-Provider Health Care Has Accelerated Under Obamacare

Chris Conover
Forbes magazine
Mon, 2014-09-15
"There’s been a fierce debate over whether Obamacare has increased health insurance premiums. Progressives have argued Obamacare is working due to modest projected premium increases on the Exchanges for 2015. Conservatives have retorted that “there can be no doubt that health care today is more costly than it would have been without Obamacare.” But this argument has focused on the health Exchanges, where only 7-8 million people bought their coverage in 2014. Readers would do well to remember that more than 20 times that number of people rely on employer-provided health benefits (Table C-1). In the employer-based market, the adverse effects of Obamacare on premiums and affordability are strikingly obvious. The growing burden of employer-provided health care has accelerated under Obamacare. And yet the New York Times would have you believe everything is hunky-dory since “the growth in health insurance premiums was only 3 percent between 2013 and 2014.

Obamacare Can’t Take Credit for Slower Health Spending Growth

Alyene Senger
Daily Signal
Fri, 2014-09-12
"Some of Obamacare’s big supporters say the new law has already contributed to decreases in the rate of growth of health spending. But a new report from the Center for Medicare and Medicaid Services Office of the Actuary says the rate slowed because of a slow economic recovery, increased cost-sharing for those enrolled in private plans and sequestration. Indeed, the report does not even mention Obamacare when assessing the situation. “The recent period is marked by a four-year historically low rate of health spending growth, which is primarily attributable to the sluggish economic recovery and constrained state and local government budgets following the 2007-09 recession,” the report states."

Census Bureau: Health Costs Inch Up As Obamacare Kicks In

Jay Hancock, Kaiser Health News
Fri, 2014-09-12
"Doctors and hospitals treated more patients and collected more payments in the spring as millions gained insurance coverage under the health law, new figures from the government show. But analysts called the second-quarter increases modest and said there is little evidence to suggest that wider coverage and a recovering economy are pushing health spending growth to the painful levels of a decade ago."

Flaw In Federal Software Lets Employers Offer Plans Without Hospital Benefits, Consultants Say

Jay Hancock, Kaiser Health News
Fri, 2014-09-12
"A flaw in the federal calculator for certifying that insurance meets the health law’s toughest standard is leading dozens of large employers to offer plans that lack basic benefits such as hospitalization coverage, according to brokers and consultants. The calculator appears to allow companies enrolling workers for 2015 to offer inexpensive, substandard medical insurance while avoiding the Affordable Care Act’s penalties, consumer advocates say. Insurance pros are also surprised such plans are permitted. Employer insurance without hospital coverage “flies in the face of Obamacare,” said Liz Smith, president of employee benefits for Assurance, an Illinois-based insurance brokerage."

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