In state capitols across the country, health care lobbyists and consultants are pushing a relatively unknown provision of the Affordable Care Act: Section 1332. According to some proponents, these waivers will “turbocharge state innovation” and will provide states with an “exit strategy” from the ACA. But is the hype true? Will Section 1332 waivers be as truly transformative to our health care system as suggested?
As policy practitioners who work daily with state policymakers around the country, we have seen proponents be overly dismissive—or perhaps even unaware—of the large practical and political challenges surrounding the implementation of these waivers. A serious, objective examination of the new Section 1332 federal guidance sparks far more questions than answers for policymakers.
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The numbers are staggering — and taxpayers, you’re footing the bill.
A new investigation has turned up more evidence that the Centers for Medicare and Medicaid Service unlawfully diverted $3.5 billion from taxpayers to the Affordable Care Act exchange insurers.
The notion of diverted money came up earlier this year, when the nonpartisan Congressional Research Service issued a memo claiming that distributing the money to insurers instead of the U.S. Treasury violated the ACA. Department of Health and Human Services Secretary Sylvia Mathews Burwell contended that her agency and the CMS had the statutory authority to defer payments to insurers.
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The costs of providing health care to an average American family surpassed $25,000 for the first time in 2016 — even as the rate of health cost increases slowed to a record low, a new analysis revealed Tuesday.
The $25,826 in health-care costs for a typical family of four covered by a employer-sponsored “preferred provider plan” is $1,155 higher than last year, and triple what it cost to provide health care for the same family in 2001, the first year that Milliman Medical Index analysis was done.
And it’s the 11th consecutive year that the total dollar increase in the average family’s health-care costs exceeded $1,110, actuarial services firm Milliman noted as it released the index.
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ObamaCare is bringing out corporate America’s worst crony-capitalist impulses. The health-insurance lobby has teamed up with trial lawyers to sue the federal government—through individual lawsuits and a $5 billion class action—for not following through on a bailout deal buried in the law. This provision, the risk corridor program, would have required taxpayers to bail out insurers for losing money on the health-care exchanges. In late 2013, Sen. Marco Rubio introduced legislation to repeal the provision entirely and later another bill to make the program budget neutral. When it came time to pass a spending bill at the end of 2014, Congress succeeded in making it the law of the land that the bailout program could not cost taxpayers a single cent—which ended up saving taxpayers $2.5 billion. In December of last year, they repeated the feat. Now, Rubio is urging leaders in both the House and Senate to make this a priority and stop the bailout a third time.
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ObamaCare premium increases will be higher than last year, according to a new analysis of early data.
The analysis from the consulting firm Avalere Health finds that proposed ObamaCare premiums for silver-level plans are increasing an average of 16 percent in nine states that so far have complete data.The proposed increases for silver plans, the most popular, vary widely, from a 44 percent average increase in Vermont to a 5 percent increase in Washington state.
The increases appear to be higher than last year on average. An Avalere analysis at a similar point in the process last year found an average increase of about 6 percent.
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The Oklahoma Health Care Authority (OHCA) has proposed a plan to “rebalance” Medicaid eligibility in the Sooner State. Although OHCA’s “plan” so far consists of only a single page of bullet points, what little that is already known makes clear that the plan would gut the existing Insure Oklahoma program and replace it with Obamacare’s Medicaid expansion by another name. Oklahoma policymakers should quickly reject OHCA’s latest proposal to expand Obamacare and refocus their efforts on improving the program for the most vulnerable.
Thousands of kids and adults with intellectual and developmental disabilities in Oklahoma are already sitting on Medicaid waiting lists to get the home and community-based services that they desperately need.
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Obamacare is entering a new stage. The recent announcement by United Health Care that it will stop selling insurance to individuals and families through most health insurance exchanges marks the transition. In the next stage, federal and state policy makers must decide how to use broad regulatory powers they have under the Affordable Care Act to stabilize, expand, and diversify risk pools, improve local market competition, encourage insurers to compete on product quality rather than premium alone, and promote effective risk management. In addition, insurance companies must master rate setting, plan design, and network management and effectively manage the health risk of their enrollees in order to stay profitable, and consumers must learn how to choose and use the best plan for their circumstances.
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The uninsurance rate for nonelderly adults increased in the decade before the passage of the Affordable Care Act (ACA), driven by declining rates of employer-based coverage, especially during the recession at the end of the decade. The ACA was intended to decrease the percentage of the population without health insurance and to provide “quality, affordable health care for all.” The purpose of this brief is to consider how uninsurance rates are changing under the ACA.
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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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