A few weeks ago, the administration issued new regulations in a last-ditch attempt to save the few remaining CO-OP organizations.
Ohio’s co-op will become the thirteenth of the 23 co-ops created under the Affordable Care Act to fold.
The Ohio Department of Insurance requested to liquidate the state’s health insurance co-op, InHealth Mutual, the state announced Thursday. Nearly 22,000 Ohio residents will have 60 days to replace their InHealth policy with another company’s on the federal exchange.
“Our examination of the company’s financials made it clear that the company’s losses would prevent it from paying future claims should its operations continue,” Mary Taylor, the Ohio Director of Insurance and the state’s lieutenant governor, said in a statement.
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On Jan. 13, 2014, a team of Internal Revenue Service financial managers piled into government vans and headed to the Old Executive Office Building for what would turn out to be a very unusual meeting.
The clandestine nature of the session underscores the intense conflict over Obamacare spending, which is the subject of a federal lawsuit in which House Republicans have so far prevailed, as well as a continuing investigation by the Ways and Means and the Energy and Commerce Committees. It also shows that more than six years after President Obama signed the Affordable Care Act into law, Republican opposition has not waned.
After failing to win congressional approval for the funds, the Obama administration spent the money anyway and has now distributed about $7 billion to insurance companies to offset out-of-pocket costs for eligible consumers. The administration asserts that the health care legislation provided permanent, continuing authority to do so, and that no further appropriation was necessary.
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Blue Cross Blue Shield of Texas, facing massive losses for its ObamaCare plans, has requested a 58% premium hike for 603,000 customers.
The company is pricing in the claims experience of customers that’s been far higher than expected after suffering a $770 million loss on its exchange plans in 2015, equal to 26% of premiums.
Overall, individual market insurers requested a 35% ObamaCare premium hike for about 1.3 million customers, calculated ACASignups.net, based on the full range of insurer filings available.
BCBS of Texas also is seeking an 18% increase for 353,000 members who buy plans via the small group market that caters to businesses with fewer than 50 employees.
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News that a CareFirst BlueCross BlueShield subsidiary will stop selling bronze level plans on the Virginia marketplace next year prompted some speculation that it could signal a developing movement by insurers to drop that level of coverage altogether. The reality may be more complicated and interesting, some experts said, based on an analysis of plan data.
Bronze plans provide the least generous coverage of the four metal tiers offered on the insurance marketplaces, paying 60 percent of benefits on average, compared to 70 percent for silver plans, which are far more popular. During the 2016 open enrollment period, 23 percent of marketplace customers signed up for a bronze plan, compared with 68 percent who chose silver, 6 percent who picked gold and 2 percent who chose a platinum plan.
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The first change would limit the restriction on people with health insurance experience to those who have been “an officer, director, or trustee,” and it limits “pre-existing insurer” to those to who were active in the individual or small-group markets prior to July 16, 2009. This would open up the field of potential CO-OP board members to people who had (a) worked for health insurers active only in the large-group market, or (b) worked for any insurer, but in a lower-level capacity.
The House Oversight Committee released a report Wednesday detailing extreme misconduct surrounding Oregon’s failed $305 million taxpayer funded Obamacare exchange and is calling on the Department of Justice to open a criminal investigation.
“The documents and testimony show Oregon State officials misused $305 million of federal funds and improperly coordinated with former Governor John Kitzhaber’s campaign advisers. Official decisions were made primarily for political purposes. Cover Oregon was established as an independent organization by the legislature, and was not intended to be a wholly controlled subsidiary of the Governor’s political apparatus,” House Oversight Committee Chairman wrote in a letter sent to Attorney General Loretta Lynch and Oregon Attorney General Ellen Rosenblum.
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According to a legal opinion letter by former White House Counsel C. Boyden Gray, the answer is YES.
In this recording of a May 26, 2016 media conference call, experts describe the Obama administration’s decision to pay health insurers generous reinsurance subsidies while stiffing taxpayers, despite a statutory requirement that fixed sums must go to the U.S. Treasury.
Mr. Gray’s letter reinforces the conclusion of experts at the nonpartisan Congressional Research Service, who also found that the administration’s actions “would appear to be in conflict with the plain text” of the ACA regarding the Transitional Reinsurance Program.
Speakers on the call:
- Doug Badger, Senior Fellow, Galen Institute
- Derek Lyons, Counsel, Boyden Gray & Associates
- Tom Miller, Resident Fellow, American Enterprise Institute
For more on this issue, read our column at Forbes. The media call was sponsored by the Galen Institute, which also commissioned the legal opinion letter from Mr. Gray. (The recording starts about two minutes into the call with Doug Badger speaking.)
In state capitols across the country, health care lobbyists and consultants are pushing a relatively unknown provision of the Affordable Care Act: Section 1332. According to some proponents, these waivers will “turbocharge state innovation” and will provide states with an “exit strategy” from the ACA. But is the hype true? Will Section 1332 waivers be as truly transformative to our health care system as suggested?
As policy practitioners who work daily with state policymakers around the country, we have seen proponents be overly dismissive—or perhaps even unaware—of the large practical and political challenges surrounding the implementation of these waivers. A serious, objective examination of the new Section 1332 federal guidance sparks far more questions than answers for policymakers.
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The numbers are staggering — and taxpayers, you’re footing the bill.
A new investigation has turned up more evidence that the Centers for Medicare and Medicaid Service unlawfully diverted $3.5 billion from taxpayers to the Affordable Care Act exchange insurers.
The notion of diverted money came up earlier this year, when the nonpartisan Congressional Research Service issued a memo claiming that distributing the money to insurers instead of the U.S. Treasury violated the ACA. Department of Health and Human Services Secretary Sylvia Mathews Burwell contended that her agency and the CMS had the statutory authority to defer payments to insurers.
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The costs of providing health care to an average American family surpassed $25,000 for the first time in 2016 — even as the rate of health cost increases slowed to a record low, a new analysis revealed Tuesday.
The $25,826 in health-care costs for a typical family of four covered by a employer-sponsored “preferred provider plan” is $1,155 higher than last year, and triple what it cost to provide health care for the same family in 2001, the first year that Milliman Medical Index analysis was done.
And it’s the 11th consecutive year that the total dollar increase in the average family’s health-care costs exceeded $1,110, actuarial services firm Milliman noted as it released the index.
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