People who bought policies from Centene, a large for-profit health insurance company, filed a federal lawsuit on Thursday claiming the company does not provide adequate access to doctors in 15 states. “Members have difficulty finding–and in many cases cannot find–medical providers,” who will accept patients covered under policies sold by Centene, according to the lawsuit filed in federal court in Washington State.
“People signed up for insurance and they ‘discovered there were no doctors,”’said Seth Lesser, a partner at the law firm of Klafter Olsen & Lesser who is representing some of the policyholders.
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Idaho has a maverick plan to let insurers sell plans that don’t meet Obamacare coverage rules and patient protections to give more health insurance options to citizens who can’t afford the expensive Obamacare policies. Gov. Butch Otter issued an executive order to authorize a state-level version of the “Cruz amendment,” which Senator Ted Cruz (R-TX) offered to the Better Care Reconciliation Act during efforts to repeal the ACA last year. The amendment would have allowed insurers to offer non-ACA-compliant plans in the individual market so long as they also offered plans through the marketplace. Other conservative states are keeping a close eye on the option. HHS Secretary Alex Azar said he would closely scrutinize Idaho’s plan, but he said it was too early to know what action he might take.
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Two weeks into his new post, HHS Secretary Alex Azar on Wednesday took another step in the Trump administration’s move toward relaxing the Affordable Care Act’s moratorium on new physician-owned hospitals.
In the HHS budget hearing before the House Ways and Means Committee, Rep. Sam Johnson (R-Texas) asked for Azar to commit the administration to help repeal the ACA’s “ban” on physician-owned hospitals.
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Businesses are pushing back on the Internal Revenue Service’s decision to begin enforcing the Affordable Care Act’s employer insurance mandate, challenging penalties that run into the millions and asserting the agency is wrong to impose the fines.
The ACA imposes a penalty on employers with more than 50 workers who don’t provide qualifying coverage to employees, but the fines weren’t initially enforced. In November, the IRS said it would begin assessing penalties, starting with companies that failed to comply in 2015, when parts of the employer mandate first kicked in.
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Galen Institute Senior Fellow Doug Badger has written a paper, published by the Taxpayers’ Budget Office of the National Taxpayers Union Foundation, in which he analyzes CBO’s expectation that the Center for Medicare and Medicaid Innovation (CMMI) would reduce Medicare spending by $45 billion over ten years. The forecast is flawed, Badger concludes, as CBO “ascribes unobserved and unobservable savings to projects that CMMI has not yet undertaken (and may never undertake).” He says the CBO’s judgements “are in some cases questionable, in others mistaken and in still others rendered obsolete.”
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Nevada is taking steps toward leaving the federal healthcare.gov and setting up a separate exchange operated by the state.
The Nevada Appeal reports that the Legislative Interim Finance Committee on Friday authorized state officials to spend $1 million to prepare a request for proposals and find a private provider.
Heather Korbulic, executive director of the state system, says changes are needed because healthcare.gov is steadily raising the rates it charges states that link their front-end systems to the federal exchange.
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Amazon is looking to turn its medical-supplies business into a major supplier to U.S. hospitals and outpatient clinics. The online retailer is pushing hard to expand its foothold in medical supplies, creating a marketplace where hospitals could shop to stock emergency rooms, operating suites and outpatient facilities.
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Gov. Holcomb (R-IN) joined U.S. Health and Human Services Secretary Alex Azar at Eskenazi Hospital on Friday to announce Indiana gained federal approval to continue its Healthy Indiana Plan (HIP).
The plan, which the state calls a successful alternative to traditional Medicaid, has been approved through Dec. 2020.
This will allow the state to continue health coverage for more than 400,000 low-income adult Hoosiers.
The Healthy Indiana Plan was created in 2007 under Gov. Mitch Daniels. The program was expanded in 2015 by then Gov. Mike Pence with a federal waiver to implement HIP as an alternative to traditional Medicaid expansion.
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The budget deal in Congress is billed as a measure to grant stability to a government funding process that has lurched from crisis to crisis — but it is also stuffed with provisions that will broadly affect the nation’s health care system, like repealing an advisory board to curb Medicare spending and funding community health centers. Among the more significant provisions is one that would eliminate a powerful 15-member panel, known as the Independent Payment Advisory Board, created by the ACA to control the rising costs of Medicare. The board was to recommend specific savings if Medicare spending per beneficiary was projected to grow faster than certain benchmarks. Congress could have stepped in to block the recommendations, but they did not need congressional approval to take effect. The power of the board gave pause to politicians in both parties, and health care providers and some advocates for Medicare beneficiaries said it could threaten patients’ access to care.
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States that run their own Affordable Care Act insurance marketplaces significantly outperformed the rest of the country in attracting consumers to sign up for health plans for 2018, according to enrollment tallies released Wednesday.
Overall enrollment stayed essentially level from the year before in the 11 states plus the District with state-based marketplaces, while sign-ups in states that rely on the ACA’s federal exchange fell, on average, by more than 5 percent. Five states with hybrid systems did best of all, according to a report compiled by the National Academy for State Health Policy.
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