The central feature of the latest plan in Nebraska is to deliver Medicaid expansion benefits through health plans sold on the Obamacare exchange, instead of through the state’s managed care system. But, at the end of the day, this is really just a more expensive way to expand Medicaid under Obamacare.
Nebraska’s own actuaries estimate that using these plans to expand Medicaid would increase per-person costs by 94% next fiscal year. By 2021, the cost difference is expected to reach 150%. Overall, this plan would cost taxpayers billions of dollars more (as if regular Medicaid expansion wasn’t expensive enough) and leave even fewer dollars for the truly needy.
The Affordable Care Act’s health insurance co-ops absorbed deep financial losses last year, and 2016 is shaping up to be a make-or-break year for these nonprofit alternatives to traditional insurers.
Officially called Consumer Operated and Oriented Plans, these still-fledgling insurers were devised during the ACA’s creation to inject competition into insurance markets. But they have struggled from the start to build a customer base from scratch and deal with higher-than-expected expenses, among other problems.
Christopher E. Press nails our experience (“$lammed by ObamaCare,” op-ed, March 8). My wife and I are self-employed and were content with our modest, cost-effective health insurance. By “self-insuring,” we knew we risked a little higher deductible if something were to happen.
When the president talked up his health-care plan, we weren’t really concerned since he promised, “If you like your health-care plan, you can keep [it],” and “keep your doctor,” too. Then he slammed our carefully chosen policy as having “inadequate” coverage. When ObamaCare was rammed through Congress, not only did we scramble to keep the doctors who had cared for us for years, but we paid double for the bronze plan that was most similar to our previous (now canceled) coverage. And, of course, our deductibles went up.
What does the president consider “adequate” coverage for two people past age 55 with no kids? Maternity benefits and teen dental coverage? How helpful. What is the point of ObamaCare? Better health care? Hardly. It’s called “redistribution.”
Last year’s final enrollment numbers under President Barack Obama’s health care law fell just short of a target the administration had set, the government reported Friday.
The numbers are important because the insurance markets created by the president’s 2010 health care law face challenges building and maintaining enrollment. The marketplaces offer subsidized private insurance to people who don’t have access to job-based coverage.
The report from the Health and Human Services Department said about 8.8 million consumers were still signed up and paying premiums at the end of last year.
HHS Secretary Sylvia M. Burwell had set a goal of having 9.1 million customers by then.
The average monthly ObamaCare premium grew by about 5 percent over last year once financial assistance is factored in, according to government data released Friday.
The average monthly premium on the ObamaCare marketplace is $106 this year, compared to $101 last year, according to a new Department of Health and Human Services (HHS) report.
Those figures factor in the financial assistance under the healthcare law that substantially lowers the premiums consumers have to pay. Eighty-five percent of enrollees qualified for financial assistance.
Ask the price of anything and the answer is always the same: What insurance do you have? Patients are blocked from shopping for fair value. The part of the Affordable Care Act which was supposed to control insurance costs, perversely, incentivizes insurers to pay higher, not lower costs. Under the Affordable Care Act, premiums and profits are legally permitted to rise only as health costs rise. In short, when it comes to pricing, nobody is watching the store and citizens cannot shop to protect themselves from medical price gouging.
This former hospital president says that because billing rates are not set, the health industry is able to prey on patients at their most vulnerable. And if you are out of network or uninsured, you pay the highest rates.
When agencies release information on a Friday afternoon, it is generally because of unfavorable news they hope will lose potency over the weekend. On Friday, the Department of Health and Human Services (HHS) released 2015 end-of-the-year exchange enrollment data. After reviewing the numbers, it is understandable why HHS would want this release to attract as little attention as possible.
Most news stories reporting the numbers have focused on the large overall decline in exchange enrollment throughout 2015—down 25% from the number of people who selected a plan at the end of open enrollment—or how the end-of-the-year number failed to meet even HHS’ downgraded target. The most striking number from the data, however, is the large drop in exchange enrollment—equal to about 1.13 million people—during the last six months of the year. As I explain below, this large net decline is problematic for the future of the Affordable Care Act (ACA) as it likely exacerbates other adverse selection problems induced by the law.
Republican leaders of the House Energy and Commerce Committee have asked America’s Health Insurance Plans and several major insurance companies to brief staffers by next week on reinsurance payments to insurers by the Centers for Medicare and Medicaid Services.
Reps. Fred Upton (R-Mich.), Tim Murphy (R-Pa.) and Joe Pitts (R-Pa.) wrote to Marilyn Tavenner, president and CEO of AHIP, as well as Aetna, Anthem, Blue Cross Blue Shield, Cigna, Humana and UnitedHealth Group asking for briefings by March 15. The request follows an announcement made last month by CMS that it would use funds from the Department of the Treasury to make reinsurance payments to insurers, and that violates federal law, they write.
The failures of a dozen nonprofit health insurance plans created by the Affordable Care Act could cost the government up to $1.2 billion, according to a harsh new congressional report that concludes federal officials ignored early warnings about the plans’ fragility and moved in too late as problems arose.
The report, released Thursday by a Senate investigations panel, says that the bulk of those loans are unlikely to be recovered, with some plans unable to pay “a substantial amount of money” they still owe doctors and hospitals for members’ care.
In its release of wonk beach reading late last month, the 539-page HHS Notice of Benefit and Payment Parameters for 2017 and the 87-page 2017 Letter to Issuers in the Federally-facilitated Marketplace, the federal government displayed its latest efforts to apply science to the issue of network adequacy. Beginning in 2018, for policies sold on healthcare.gov, the federal government will rate and display plans as “Basic,” “Standard” or “Broad.”
This network rating will be in addition to the federal government’s current efforts to ensure that networks established by an insurer are not so sparse as to be useless to the consumer. It does not appear as if states running their own exchanges will be required to do more than assess insurer networks for adequacy; state websites will not have to grade the quality of insurer networks for policies sold on their exchanges.