Political uncertainty isn’t the only threat to the Affordable Care Act’s future. Cracks also are spreading through a major pillar supporting the law
Health insurance exchanges created to help millions of people find coverage are turning into money-losing ventures for many insurers.
The nation’s largest, UnitedHealth Group Inc., could lose as much as $475 million on its exchange business this year and may not participate in 2017. Another major insurer, Aetna, has questioned the viability of the exchanges. And a dozen nonprofit insurance cooperatives created by the law have already closed, forcing around 750,000 people to find new plans.
More insurer defections would lead to fewer coverage choices on the exchanges and could eventually undermine the law, provided the next president wants to keep it.
Right now, the New Hampshire House is considering reauthorizing Medicaid expansion under ObamaCare. Doing so would be a big mistake that our state simply cannot afford to make.
In 2014, New Hampshire expanded its Medicaid program under the Affordable Care Act. Previously, to qualify for Medicaid a person needed to be both poor and medically needy (pregnant women, children or disabled). Under Medicaid expansion, a person needs only to be below 138 percent of the federal poverty level. That means that able-bodied adults, even above the poverty line, would have taxpayers buy health insurance for them.
The measure that was passed in 2014 ends on Dec. 31, 2016. That means that if the program is not reauthorized, eligible able-bodied adults would no longer have taxpayer-funded health insurance.
The reauthorization bill currently sits before the House Finance Committee to make sure our Medicaid policy is on a solid financial footing. Given the total size of the program – close to $500 million per year – this seems like a prudent step.
More than 7 in 10 (72 percent) in our national survey said they get good value for what they pay toward the cost of their health care. But a significant 22 percent disagree.
That may be because few see added benefits in the face of cost increases. Only 1 in 6 adults believe their benefits have increased in the past two years, and 12 percent believe they’ve declined.
Transitional Reinsurance is a key part of the Affordable Care Act. It’s a component of a set of provisions designed to lure private health insurers into selling insurance on various Exchanges. Without continued private insurer participation, Obamacare as we know it falls apart. Congress thought it needed lures (1) because health insurers did not have much experience with the medical expenses of the population they would be insuring and (2) because Congress was outlawing health insurers’ favorite technique for staying profitable: pricing policies according to the predicted medical expenses of the insured. Congress set the hook by giving insurers selling on the Exchanges something for free that they otherwise would have to pay for: reinsurance. With “Transitional Reinsurance” The federal government would itself pick up the bill three years for much of the expense of insureds who ended up having high medical expenses.
But, as with lunch, there is really no such thing as free reinsurance.
Donald Trump had a complete meltdown Thursday night when he got locked in this exchange with Marco Rubio over health care. Rubio kept pressing him on what his plan for health care was, and Trump responded by incoherently talking about getting rid of “the lines around the states.” Essentially, Trump wants to increase competition by allowing insurers to sell plans across state lines without regard to the states’s own insurance regulations.
Setting aside the fact that Trump’s understanding of health care policy is woefully inadequate, his one idea on health care isn’t even a good one. Granted, this is an idea a lot of Republicans have floated and, in theory, increased insurance competition is needed and state insurance regulations are often an impediment to this. But in practice, the idea runs into the buzzsaw of federalism.
While health care ranks fourth as an important voting issue, presidential hopefuls have proposed a range of visions for the future of the health care system, from the full repeal of the Affordable Care Act to the adoption of a universal government plan. The survey finds that when given four broad approaches for the future of the health care system that are currently being discussed, Americans opinions are split.
A Centers for Medicare and Medicaid Services official said Thursday she could not say how many of the remaining 11 insurance co-ops created under the Affordable Care Act are profitable.
Eight of the 11 remaining co-ops are on corrective action plans this year that detail operational issues and ways to correct them, Mandy Cohen, CMS’s chief operating officer and chief of staff, said at a House Oversight and Government Reform Health Subcommittee hearing. She also said she could not tell lawmakers at the hearing which of the remaining co-ops are meeting their enrollment projections.
The recent lawsuit filed by the Health Republic Insurance Company of Oregon regarding ObamaCare’s “risk corridor” program raises the question: Does the federal government have a duty to defend the lawsuit? Could they confess that the plaintiffs are right, or, better still, settle the case for the face value? Nicholas Bagley of the University Of Michigan School Of Law does not think the feds will do that while they can still argue that the claims are unripe. But if the case gets past the initial procedural hurdles, they’ll be sorely tempted to cut a deal.
Consumers who try to sign up for insurance after the Obamacare open enrollment period will soon need to submit proof that they are eligible for most special enrollment periods, federal health officials announced Wednesday.
This new confirmation process, which is expected to start in the next few months, will only affect those living in the 38 states that use the federal Healthcare.gov site.
It addresses complaints from insurance companies that the Centers for Medicare and Medicaid Services was allowing too many people to buy insurance after the open enrollment deadline passed. This, insurers said, left them with many consumers who waited until they were sick to sign up and then dropped coverage after they received treatment. And the companies claim that created a sicker-than-expected pool of customers that was contributing to the losses on Affordable Care Act exchange plans.
Six states filed a new lawsuit Wednesday against the Obama administration over the Affordable Care Act.
The complaint that Texas, Wisconsin, Kansas, Louisiana, Indiana and Nebraska filed in the Northern District of Texas takes issue with the Health Insurance Providers Fee assessed to health insurers to cover federal subsidies.
The lawsuit says nothing in the Affordable Care Act’s language provided clear notice that states would also have to pay the fee.
“This notice was not even provided by rule but was ultimately provided by a private entity wielding legislative authority,” the suit says.