Starting in January, the Affordable Care Act will require businesses with 50 or more full-time-equivalent employees to offer workers health insurance or face penalties that can exceed $2,000 per employee. The health care law’s employer mandate, a provision that business groups fought against fiercely, is intended to make affordable health insurance available to more people by requiring employers to bear some of the cost of providing it. For some business owners on the edge of the cutoff, the mandate is forcing them to weigh very carefully the price of growing bigger.
The brief’s key findings:
- The 2010 Affordable Care Act (ACA) included roughly 165 provisions to improve Medicare’s finances.
- The Medicare Trustees Report, which reflects the ACA provisions, shows dramatically lower cost projections for Medicare in the future.
- The Medicare actuaries also produce alternative projections assuming that the legislated restraints on growth in payments to health providers are not feasible.
- A review of both sets of projections over the past six years shows that the gap between them is narrowing due to declines in the alternative cost projections.
- However, a significant gap still remains, which underscores the inherent uncertainty involved in long-range projections.
Big news: UnitedHealth Group slashed its earnings outlook today, citing new problems related to Obamacare, and told investors it may exit the program’s exchanges. “In recent weeks, growth expectations for individual exchange participation have tempered industrywide, co-operatives have failed, and market data has signaled higher risks and more difficulties while our own claims experience has deteriorated,” Stephen J. Hemsley, chief executive officer of UnitedHealth Group, explained in a press release.
Many enrolling in health insurance coverage under the Affordable Care Act’s 2016 health policies will face higher premiums, higher out-of-pocket costs, fewer doctors, and skimpier coverage this year. Federal officials are encouraging people to evaluate their options and consider switching plans to try to keep costs in check. However, a review from the Wall Street Journal shows that shopping around may not help, especially for those who don’t qualify for subsidies.
Beginning in December of 2016, restaurants with more than 20 locations will be required to provide calorie information on their menus as part of the multi-stage Obamacare rule roll-out. While big chain restaurants and their large-scale suppliers like Coca-Cola or Budweiser will be able to follow this rule relatively easily, this could effectively ban craft beer from these establishments as smaller breweries struggle to comply.
The Government Accountability Office (GAO) found that the ObamaCare health insurance exchanges are still easily tricked by fake Social Security numbers and immigration details, even more than one year after the weakness was first pointed out. The GAO also found that many have been double-covered by private insurance and Medicaid after enrolling in an exchange plan. “Our undercover testing for the 2015 coverage year found that the health care marketplace eligibility determination and enrollment process remains vulnerable to fraud,” said Seto Bagdoyan of GAO’s Forensic and Investigative Service wrote a testimony before the House Energy and Commerce Committee’s health subcommittee.
Private insurance plans typically require some form of cost sharing, or out-of-pocket costs, such as copayments, coinsurance, and deductibles. This brief shows the cost sharing in plans sold to individuals through Healthcare.gov for 2016, with a focus on the variation in the ways plans may set cost sharing for services, such as physician visits, prescription drugs, and hospital stays.
According to a new Mercer study of 134 large employers (5,000 or more employees), 15% say that their onsite or near-site worker clinics will push them into the bracket where they will be required to pay the Cadillac Tax. But most of the respondents, 46%, either didn’t know how the clinics will affect their Cadillac tax status or didn’t think there would be an effect (28%).
According to HealthPocket.com, Bronze plan deductibles are rising on the Obamacare federal exchanges by an average of 11% to $5,731 and Silver Plan deductibles are rising by 6% to an average of $3,117. A survey by the Commonwealth Fund published last November found that three in five low-income adults and about 50% of adults with moderate incomes believe that deductibles are “difficult or impossible to afford.”
A recent National Bureau of Economic Research (NBER) study reveals that ObamaCare Marketplace plans are a bad deal, even for near-poor enrollees receiving large subsidies from the federal government. The study confirms that net premiums (after subsidies) were still several times what enrollees might have paid out-of-pocket for medical expenses had they remained uninsured.