The Supreme Court unanimously remanded a case challenging the ACA’s contraceptive mandate back to the United States Courts of Appeals for the Third, Fifth, Tenth and D.C. Circuits. The decision will give the parties an opportunity to reach a compromise that “accommodates petitioners’ religious exercise” while ensuring women covered by the petitioner’s health plans receive coverage that includes contraception. The Beckett Fund for Religious Liberty, which brought the lawsuit one behalf of the Little Sisters of the Poor, called the ruling a win for the petitioners.
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The third open enrollment period (OEP) for the public exchanges concluded in January. Many carriers—both early-OEP entrants and “wait-and-see” latecomers—believed this new market would achieve stability and sustainable margins in its third year. However, recent events— including carrier turnover (both entrances and exits), plan terminations, and pricing volatility—suggest the market is still in flux.
One reason for the flux is the variability of individual market financial performance many carriers have disclosed publicly. For some carriers, significant losses are causing marked changes in enterprise-level capital, cost structures, and strategy. Early indications of 2015 performance suggest aggregate negative margins may have doubled; to date, however, only 86% of carriers have released preliminary data publicly. We anticipate that our estimates will evolve as more information is released, such as final 3R results and rebates, as well as 2015 claim run-out and adjustments. Whether carriers’ performance in the individual market will improve in 2016 remains unclear.
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District Court Judge Rosemary Collyer has ruled for Congress in House v. Burwell, a case challenging the authority of the executive branch to pay Obamacare subsidies for which no money has been appropriated.
These are not the highest-profile subsidies; they’re something called the cost-sharing reduction, which lowers the deductibles and out-of-pocket expenses for families buying silver plans who make less than 250 percent of the poverty line. The federal government has paid the insurers a lot of money that wasn’t appropriated, and the House has sued to stop that.
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Most big employers provide wellness programs now, and the Affordable Care Act gave the idea a boost in 2010 by letting companies offer employees financial incentives— such as lower health insurance premiums, gift cards or prizes—worth up to 30 percent of the cost of their health insurance.
But as the wellness industry has grown, questions have started to arise about just how effective these programs really are—and how fair. It’s not clear the programs financially benefit employers, and evidence is also mixed on whether they make employees healthier. And now, some employees have begun to bristle at the omnipresence of wellness in corporate culture and see the requirement to share personal health data with their employer as an intrusion on their privacy.
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The legal war over ObamaCare is back.
A federal judge gave House Republicans a significant victory on Thursday when she ruled that the administration is illegally making certain ObamaCare payments without a congressional appropriation.
Still, the case is far from over. Democrats are turning their attention to the appeal of the ruling, and experts say the case does not pose the same mortal threat to the healthcare law that previous challenges did.
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Rising rates are not solely the result of the uninsured who bought health plans on the exchanges having a tremendous pent-up demand for healthcare services. Many insurers also underpriced their plans to gain a larger share of the new market. The Congressional Budget Office found premiums in 2014 were 15% lower than expected.
The most significant factor behind next year’s sharply rising prices, experts say, is that millions of “young invincibles,” who represent a large segment of the uninsured pool, have so far not signed up for Obamacare.
“We saw very little of the young and healthy,” said Sherri Huff, a consultant and former chief financial officer of Common Ground Healthcare Cooperative in Wisconsin, one of the insurance co-ops funded by ACA loans.
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Health insurance customers in a growing number of mostly rural regions will have just one insurer’s plans to choose from on the ObamaCare exchanges next year as some companies pull out of unprofitable markets. The entire states of Alaska and Alabama are expected to have only one insurer on the health law’s signature online marketplaces next year, according to state regulators. The same is expected to be true in parts of several other states, including Kentucky, Tennessee, Mississippi, Arizona and Oklahoma, state regulators said.
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Insurers and hospitals can’t discriminate against patients because of their gender identity under the Affordable Care Act, federal officials said Friday, but patient groups complained the rule doesn’t go far enough.
The Department of Health and Human Servicesfinalized a rule that prohibited discrimination in health care based on a long list of characteristics ranging from race to pregnancy, gender identity and “sex stereotyping.”
It doesn’t mean insurers have to cover all treatments associated with gender transitioning but they just can’t outright deny them either. But the rule doesn’t go far enough in clarifying what is discrimination, some say.
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