Smaller insurers with experience in Medicaid, such as Centene Corp. and Molina Healthcare, are outperforming the broader insurance industry on the federal health exchanges. Their success is putting a spotlight on their business model as the Obama administration and other insurers seek to stabilize the fledgling individual market.
If Medicaid-like plan features become the norm, consumers and medical providers would be substantially affected. Such plans are often popular in the exchanges for their low premiums, but consumers have criticized limits on their access to medical providers such as doctors. And physicians fault the plans for low reimbursement rates.
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Two GOP lawmakers have introduced a bill that deviates from years of Republican health care orthodoxy by not attempting to repeal the Affordable Care Act.
Sen. Bill Cassidy (R-La.) and Rep. Pete Sessions (R-Texas) on Monday formally announced a bill that they say would cover more people than the Affordable Care Act does now. While the bill does not repeal the 2010 health care law, it would repeal both the individual and employer mandates and limits the “non-essential” products that plans would have to cover.
They aren’t being shy about how great they think their proposal is. They are calling it the “World’s Greatest Healthcare Plan.”
The Obama Administration is unlawfully diverting billions of dollars from taxpayers to insurance companies that sell Obamacare policies.
That is the conclusion reached in a legal opinion letter released today by former Ambassador and White House Counsel Boyden Gray.
Mr. Gray’s letter reinforces the conclusion of legal experts at the nonpartisan Congressional Research Service who found that the administration’s actions “would appear to be in conflict with the plain text” of the Obamacare statute.
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As candidates in both parties focus on the general election campaign, some Republicans wonder if large premium increases related to the Affordable Care Act could be an “October surprise” that helps propel them to victory in November. The causes of the approaching premium increases vary, but some are rooted in a 2013 Obama administration proposal.
In reporting on premium increases by one Iowa insurer, the Des Moines Register noted that individuals who bought new plans that complied with Affordable Care Act regulations could face premium increases of 38% to 43% next year.
For every action, there is an equal and opposite reaction. Political solutions from years past may materialize in the form of rate hikes this fall–and could generate a distinct reaction among voters on Election Day.
Rushing to enact the giant Obamacare bill in March 2010, Congress voted itself out of its own employer-sponsored health insurance coverage—the Federal Employees Health Benefits Program. Section 1312(d)(3)(D) required members of Congress and staff to enroll in the new health insurance exchange system. But in pulling out of the Federal Employees Health Benefits Program, they also cut themselves off from their employer-based insurance contributions.
Obamacare’s insurance subsidies for ordinary Americans are generous, but capped by income. No one with an annual income over $47,080 gets a subsidy. That’s well below typical Capitol Hill salaries. Members of Congress make $174,000 annually, and many on their staff have impressive, upper-middle-class paychecks.
Maybe the lawmakers didn’t understand what they were doing, but The New York Times’ perspicacious Robert Pear certainly did. On April 12, 2010, Pear wryly wrote, “If they did not know exactly what they were doing to themselves, did lawmakers who wrote and passed the bill fully grasp the details of how it would influence the lives of other Americans?”
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Although she promises to tinker with the Affordable Care Act (see below) Clinton is not proposing to fix any of its largest problems.
So what does Hillary Clinton propose to do about Obamacare? Spend more money. She proposes (1) to limit out of pocket costs to 5% of family income by offering a tax credit of up to $5,000 for spending above that amount, (2) to limit premium expenses to 8.5% of income, (3) to fix the family glitch, whereby dependents who are offered unaffordable coverage at work are barred from the exchange and (4) to spend more money to enroll people in Medicaid.
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Health insurers have not had much to cheer about lately, when it comes to Obamacare. They have been losing money on exchanges, and there is little hope that will change. So, a large health plan in Pittsburgh has asked judges to give it Obamacare money the Administration promised, but Congress declined to appropriate.
As reported by Wes Venteicher and Brian Bowling of the Pittsburgh Tribune-Review, Highmark lost $260 million on Obamacare exchanges in 2014, and claims it is owed $223 million by taxpayers. Unfortunately, it received only about $27 million. And things are getting worse. To date, Highmark has lost $773 million on Obamacare exchanges.
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Earlier this week, as was widely reported, Judge Rosemary Collyer of the District of Columbia District Court prohibited the Obama administration from continuing to divert money Congress had appropriated for federal tax refunds to instead pay insurance companies billions of dollars in “cost sharing reductions,” part of the Affordable Care Act.
The decision affects more than just the cost sharing reduction program. Just as a teaser, if upheld on appeal – and expect this case to get to the United States Supreme Court – the decision means that some high level Obama administration officials run a serious risk of criminal charges being brought against them should a subsequent President and Attorney General be motivated to pursue them.
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Oracle has had enough of Oregon. The business technology giant has decided it will no longer take on new business with the state’s government amid an ongoing legal battle, Oracle senior vice president Ken Glueck told Fortune on Wednesday.
The decision follows a protracted legal tussle between the two parties over a disastrous state healthcare enrollment website that never came online. In 2011, Oregon enlisted Oracle to build a healthcare exchange website related to Obamacare after being impressed by the company’s sales pitch, according to a previous legal filing.
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Hillary Clinton’s “Medicare for More” plan certainly would cover more people — but it could also raise health-care costs for some current Obamacare customers if they aren’t careful.
Nearly 13 million Americans age 50 to 64 who lack insurance or buy private health plans would be eligible to buy into an expanded Medicare program that the Democratic presidential contender has proposed, according to an analysis released Thursday.
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