For the sake of competition in Maryland’s Obamacare marketplace — particularly for those who buy insurance as individuals, not through their employers — Evergreen Health needs to survive. CareFirst BlueCross BlueShield had 80 percent of Maryland’s individual insurance market in 2014, according to the Kaiser Family Foundation, up from 74 percent three years before. Evergreen, with nearly 40,000 members and growing fast, is expanding in the state at a time when other carriers are pulling back. Though still relatively small, it provides another option for consumers and puts pressure on the dominant carrier to innovate and contain costs.

. . .

Delawareans are again facing steep price increases for health insurance next year under the Affordable Care Act.

Insurance Commissioner Karen Weldin Stewart has approved an average rate increase of 32.5 percent in the individual market for Highmark Blue Cross Blue Shield of Delaware, which has the vast majority of the individual market share in Delaware. That follows an average premium increase of 22.4 percent for individual Highmark plans this year.

. . .

Republican presidential nominee Donald Trump’s updated health care proposals narrow what the Republican presidential nominee had previously proposed regarding health care, but his campaign still has not offered details about how such reforms would work.

Trump’s health care proposals outlined online, which were recently updated with little fanfare and still linkto his pervious proposals, say he would replace the Affordable Care Act with health savings accounts if elected to the presidency. He’s previously said people should be allowed to use health savings accounts that are tax-free and can accumulate, and that could be passed on to heirs when they die, saying the “flexibility and security provided by HSAs will be of great benefit to all who participate.”

. . .

Republicans have been vowing for six years now to repeal the Affordable Care Act. They have voted to do so dozens of times, despite knowing any measures would be vetoed by President Barack Obama. But if elected, a President Donald Trump wouldn’t have to wait for lawmakers to once again pass repeal legislation to stop the health law from functioning. Indeed, he could do much of it with a stroke of a pen.

Trump “absolutely, through executive action, could have tremendous interference to the point of literally stopping a train on its tracks,” said Sara Rosenbaum, a professor of law and health policy at George Washington University in Washington, D.C.

. . .

A rarely discussed aspect of Obamacare, one that appeared to give states an “exit strategy” to avoid provisions of the health care law, is likely to become more widely known next year.

But while states led by Democrat governors are beginning to see “innovation waivers” as a way to change their health care systems—and move toward proposals such as a public option—states with Republican governors are proceeding with caution.

The waivers come with strings attached by the Obama administration that some policy experts say constrain free market health care reforms as an alternative to government mandates.

. . .

Donald Trump has added to his healthcare plan a “high-risk pool” for sick enrollees — a traditional Republican idea long dismissed by Democrats.
The unannounced change in the Republican presidential nominee’s healthcare plan comes as a bullet point in a new healthcare page on his website.
The new bullet point reads: “Work with states to establish high-risk pools to ensure access to coverage for individuals who have not maintained continuous coverage.”
High-risk pools offer coverage for sick people that otherwise could be denied coverage for having a pre-existing condition if ObamaCare’s protections were repealed, as Trump proposes.
. . .

Six and a half years after the ACA was signed into law, health reform no longer feels like a steady forward march toward progress. It feels more like World War I: dotted with landmines, lined with trenches, and ending inconclusively. In 2010, the Congressional Budget Office predicted that 21 million people would be enrolled in the ACA’s insurance exchanges by 2016; as of now, only 12 million are. That gap between hype and reality is likely to further expand over time.

What happened? It’s a long story, of course. But the simple answer is that the ACA’s exchanges were designed poorly and implemented poorly, by overconfident advocates who dismissed any and all criticism, no matter how well-reasoned.

. . .

Donald Trump and Hillary Clinton sparred over Obamacare during the second presidential debate on Sunday, outlining how they would reform the health insurance system.

“Obamacare is a disaster,” Trump said. “You know it, we all know it.”

The candidates responded to a question on how they would bring down the costs of healthcare which surged after the Affordable Care Act was passed.

Americans are paying more out of pocket for their medical care than ever before, partially because of the rise of high-deductible plans . Also, the percentage of Americans’ income spent on healthcare is increasing.

. . .

Last week, the comptroller general — the government’s chief accountability officer — issued an official statement that the administration has been sending unlawful payments to insurance companies through the ACA’s reinsurance program. These payments have totaled $3 billion thus far and have forced taxpayers to finance a larger part of insurers’ most expensive enrollees’ claims.

The U.S. House of Representatives filed suit against the administration for unlawful payments through another ACA program. These payments are to insurers for them to make plans more attractive by reducing enrollees’ deductibles and cost-sharing amounts. Congress never appropriated funds, yet the administration has paid insurers at least $10 billion through this program thus far.

. . .

The Obama administration is worried that insurers bailing out of the health law’s markets may prompt their customers to drop out, too. So it plans to match affected consumers with remaining insurance companies.

The hope is to keep people covered, but there’s concern that the government’s match-making will create confusion and even some disappointed customers.

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