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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- 40% eligibility for financial assistance,
- 15% how to project income,
- 11% account creation issues, and
- 6% changes in circumstances.
The researchers say that the questions paint a picture of complex eligibility and enrollment processes, and could lend valuable insight in preparation for the fall open enrollment period, beginning November 1.
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The Obama administration’s continuing efforts to rewrite and re-interpret the legal requirements of the Affordable Care Act (ACA) hit a new roadblock in federal district court yesterday. Judge Rosemary M. Collyer ruled that advance payments to insurers of cost-sharing reduction (CSR) subsidies for certain lower-income enrollees in Obamacare’s health insurance exchanges were never appropriated by Congress. Oops. She therefore enjoined any further reimbursements until a valid appropriation is in place, but the judge also issued a stay of that injunction pending any appeal by the parties.
The decision in United States House of Representatives v. Sylvia Matthews Burwell, et al. is a big win for House Republicans, other Obamacare opponents, and the rule of law. It also signals at least the outer limits of the Obama administration’s repeated efforts to stretch implementation of the 2010 law far beyond legal norms and the plain meaning of the ACA’s statutory text.
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The Department of Justice will appeal a federal judge’s ruling in a lawsuit from House Republicans against the Obama administration.
A spokesperson did not respond to an inquiry asking when the department would file an appeal. A district judge for the District of Columbia ruled yesterday that the administration was improperly funding cost-sharing subsidies under the Affordable Care Act.
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John Boehner isn’t popular with conservatives these days, but the former House Speaker deserves an apology from those who derided his lawsuit challenging President Obama’s usurpation of legislative power. Mr. Boehner went ahead despite skeptics from the left and right, and on Thursday the House won a landmark victory on behalf of Congress’s power of the purse.
Federal Judge Rosemary Collyer handed down summary judgment for the House, ruling that the executive branch had unlawfully spent money on ObamaCare without congressional assent. Judge Collyer noted that Congress had expressly not appropriated money to reimburse health insurers under Section 1402 of the Affordable Care Act. The Administration spent money on those reimbursements anyway.
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Tens of thousands of Iowans who buy their own health insurance are about to receive a shock in the mail.
Wellmark Blue Cross & Blue Shield is sending letters this week telling about 30,000 customers it plans to raise their premiums by 38 percent to 43 percent next year.
Wellmark sells about three-quarters of individual policies in Iowa’s health-insurance market. The steep increases will affect people who bought relatively new plans that comply with rules of the Affordable Care Act.
Another 90,000 Wellmark customers who hold older individual insurance plans are expected to face smaller increases, which will be announced in June. The increases being proposed this week also don’t affect the hundreds of thousands of Wellmark customers who obtain coverage via their employers. Their premiums are expected to rise less, because they are in larger, more stable pools of customers.
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A federal judge’s decision Thursday that the Obama administration unconstitutionally spent money to pay for part of the Affordable Care Act may not disrupt health plans or beneficiaries right away. But the fresh uncertainty immediately delivered a blow to the share prices of hospitals and health insurers.
House Republicans alleged in a lawsuit that the administration illegally spent money that Congress never appropriated for the ACA’s cost-sharing provisions. Those provisions include reduced deductibles, copayments and coinsurance many Americans receive, depending on income, for plans purchased through the ACA’s insurance exchanges.
U.S. District Court Judge Rosemary Collyer agreed with House Republicans on Thursday, writing that appropriating the money without congressional approval violates the U.S. Constitution.
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California’s health insurance exchange estimates that its Obamacare premiums may rise 8 percent on average next year, which would end two consecutive years of more modest 4 percent increases.
The projected rate increase in California, included in the exchange’s proposed annual budget, comes amid growing nationwide concern about insurers seeking double-digit premium hikes in the health law’s insurance marketplaces.
Any increases in California, a closely watched state in the health law rollout, are sure to draw intense scrutiny during a presidential election. Republicans are quick to seize on rate hikes as further proof that President Barack Obama’s signature law isn’t doing enough to hold down health care costs for the average consumer.
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