Small, regional health insurers and upstart co-op plans again incurred large charges under the Affordable Care Act’s risk-adjustment program, according to new data the CMS released Thursday. Calendar year 2015 marks the second year of risk adjustment, and many smaller insurers have had to pay into the program both years.
The data also show payouts for the ACA’s reinsurance program. For ACA plans sold in 2015, the reinsurance payments total $7.8 billion. The temporary reinsurance program, which expires at the end of this year, protects health insurers against costly claims.
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Insurers helped cheerlead the creation of Obamacare, with plenty of encouragement – and pressure – from Democrats and the Obama administration. As long as the Affordable Care Act included an individual mandate that forced Americans to buy its product, insurers offered political cover for the government takeover of the individual-plan marketplaces. With the prospect of tens of millions of new customers forced into the market for comprehensive health-insurance plans, whether they needed that coverage or not, underwriters saw potential for a massive windfall of profits.
Six years later, those dreams have failed to materialize. Now some insurers want taxpayers to provide them the profits to which they feel entitled — not through superior products and services, but through lawsuits.
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ObamaCare enrollment dropped to about 11.1 million people at the end of March, according to new figures released by the administration.
A dropoff was expected, and has occurred in previous years as well, given that some people who sign up do not pay their premiums.
The CMS said 87 percent of enrollees remained signed up, within the expected range of 80 percent to 90 percent retention.
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The health care law President Obama signed six years ago was supposed to fix the individual insurance market with enlightened rules and regulations. Instead, ObamaCare is destroying this market. Just look at what’s happening to Blue Cross Blue Shield.
If any insurer could cope with ObamaCare, it should have been Blue Cross Blue Shield.
Blue Cross companies came into the ObamaCare exchanges with decades of experience writing individual policies. Most of them are non-profits, which gives them an automatic leg up on the competition. And their plans captured the largest share of the exchange markets across the country.
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Two major health insurers in Arizona are discontinuing Obamacare plans in part of the state next year.
Blue Cross Blue Shield of Arizona and Health Net will stop selling plans on the Affordable Care Act marketplaces in the city of Maricopa and Pinal County, dropping coverage for tens of thousands of enrollees, according to new state filings reported by the Arizona Republic.
Additionally, Health Net is scaling back its Obamacare offerings in Pima County, selling only mid-level silver and gold marketplace plans.
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This year, premiums were up an average of 8 percent. In many states, double-digit premium hikes were the norm.
Nearly 22,000 Ohioans — more than one-third of whom live in the Columbus area — have until Thursday to find a new health insurance plan or face being uninsured for most of July.
The Ohio Department of Insurance took over InHealth Mutual, a subsidiary of Coordinated Health Mutual, in May. The health insurance cooperative based in Westerville was set up in 2014 to be a lower-cost option for Ohioans who shop the federally run health insurance marketplace. The state agency is liquidating the company because it ceased to meet the federal requirements for minimum essential coverage under the Affordable Care Act.
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The Affordable Care Act opened the door for millions of young adults to stay on their parents’ health insurance until they turn 26.
But there’s a downside to remaining on the family plan.
Chances are that Mom or Dad, as policyholder, will get a notice from the insurer every time the grown-up kid gets medical care, a breach of privacy that many young people may find unwelcome.
With this in mind, in recent years a handful of states have adopted laws or regulations that make it easier for dependents to keep medical communications confidential.
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For six years, it has been abundantly clear that Americans want Obamacare to be repealed—but only if a well-conceived conservative alternative is positioned to take its place. That’s why the recent release of the House GOP health care plan is a big deal. The new plan would of course repeal Obamacare. But it would also fix what the federal government had already broken even before the law was passed and made things so much worse.
The proposal pairs an Obamacare alternative with Medicaid reforms and the crucial Medicare reforms (amounting to a kind of “Medicare Advantage Plus”) that Speaker Paul Ryan and House Republicans have long championed. As Ryan put it after the proposal’s release, “The way I see it, if we don’t like the direction the country is going in—and we do not—then we have an obligation to offer an alternative….And that’s what this is.” He called the plan not merely “a difference is policy” but “a difference in philosophy.”
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Sen. Lamar Alexander says he’s more than happy to strike deals with Democrats — even on Obamacare.
“Whoever the president is in January, we’re going to have to take a good, hard look at Obamacare,” the powerful chairman of the Senate HELP committee told POLITICO’s “Pulse Check” podcast. “It can’t continue the way it is.”
Alexander laid out several changes that he’d like to see in health care: Less government “management,” more support of private sector innovation and more flexibility for states on Medicaid. He also credited House Speaker Paul Ryan’s recent white paper that summarized Republican health care proposals as a “helpful” starting point, though he didn’t explicitly endorse the House GOP’s insistence on replacing the whole law.