The Obama administration on Sunday begins what is expected to be the toughest enrollment period yet for ObamaCare. The administration has sought to lower expectations, trimming back its overall enrollment projection while warning that the people who remain uninsured will be the hardest to reach.
A low-cost health insurance co-op that covers about one in three Arizonans that have an Affordable Care Act marketplace plan won’t be allowed to sell health plans Sunday — the opening day consumers can purchase insurance — after the state of Arizona and the federal government took action against the entity. The Arizona Department of Insurance said Friday afternoon that Meritus Health Partners/Meritus Mutual Health Partners has been placed into “supervision” and only can continue to serve existing clients until the end of the year. The federal government also suspended Meritus from the Affordable Care Act’s federal marketplace, which means the company won’t be able to sell health plans via healthcare.gov when the health-care law’s three-month enrollment period begins Sunday.
New analysis from Avalere Health examines the 2016 Federal Exchange Premium File. According to HHS, more than 8 in 10 (86 percent) of current enrollees can find a lower premium plan in the same metal level by returning to the exchange and shopping for 2016. As a result, tables and figures below examine the lowest cost options in two metal levels.
Last week I reported on a fascinating new Wharton School study of non-poor uninsured people . Another revealing finding from that same study highlights a dilemma facing any would-be health reformer: even before Obamacare, less than one quarter of health costs for uninsured persons were paid for out of pocket, regardless of family income . Think about that. Third parties already covered more than three quarters of health spending for the average uninsured family–even those with incomes above 400% of poverty. In the jargon of Obamacare, uninsured people essentially already had coverage equivalent to an actuarial value (AV) of 75%! In contrast, a Bronze plan under Obamacare has an AV of 60%, while Silver plans have an AV of only 70%.
Shopping for health insurance on healthcare.gov starting Sunday will find fewer plans offered by about the same number of insurers, the Obama administration announced Friday. A snapshot of the plans being sold on the Obamacare online marketplaces this year shows that the average consumer will have 50 plans to choose from in their county, down from an average of 58 plans last year.
When the open enrollment period for the New Mexico Health Insurance Exchange kicks off Sunday, one carrier with thousands of patients won’t be ready to offer plans through the state’s online portal. New Mexico Health Connections has announced that its insurance offerings on the exchange will be delayed by one or two weeks as some technical glitches are resolved. Dr. Martin Hickey, chief executive of the nonprofit insurance cooperative, said the plans should be available by Nov. 15. Hickey said the problem occurred as the co-op was uploading templates to the federal healthcare.gov website, where New Mexicans seeking individual coverage must go to enroll in a policy.
The Affordable Care Act (ACA) called for the establishment of non-profit “Consumer Operated and Oriented Plans” (CO-OP) to offer health insurance at lower prices and with patient, rather than corporate, interests at heart. Almost half the CO-OPs have failed in the first two years, with five failures announced just in the last month. Understanding the reasons why the CO-OPs were set up and why they failed can help us learn important lessons about the potential of government and private enterprise not just in the health care sector, but in all areas of the economy.
Insurance regulators said Friday the financial condition of Health Republic of New York, the largest of 23 health insurance co-ops established by a $2.4 billion Obamacare program, is “substantially worse than the company previously reported in its filings.” It is unclear if the co-op deliberately misled state regulators in its original filings, or if regulators found evidence of financial wrongdoing while they tried to close down the defunct non-profit. The co-op’s insolvency was announced September 25.
About 29 million people are still without health insurance, government estimates show — down more than a third since 2013. About half are eligible for subsidized coverage through the marketplaces or can enroll in Medicaid. Signing them up won’t be easy, Obamacare navigators and advocates say. Many don’t see the need for coverage, they believe it’s too expensive or they are unaware of financial assistance to lower the costs for insurance, surveys and interviews have found.
During the health reform debate in 2009 and 2010 that preceded the adoption of the Affordable Care Act (ACA), one of the prominent arguments used by advocates for national control of the health insurance market was that the existence of private market in health insurance led to “waste” in the form of advertising and marketing – costs of private health insurance that, it was claimed, raised premiums without benefiting consumers.