California’s health exchange may require its health plans to pay sales commissions to insurance agents to keep insurers from shunning the sickest and costliest patients.
Covered California is working on a proposal that would force the plans to pay commissions effective next year, said Executive Director Peter Lee. The proposed rules could apply to regular and special enrollment periods, and would leave the specific commission amount or percentage up to insurers, he said.
Regulators in other states have warned insurers about altering commissions in a way that discriminates against higher-cost consumers, but Lee said Covered California may be the first exchange to adopt specific rules.
The state’s Kynect health insurance exchange is a financially unsustainable boondoggle that has cost $330 million, Gov. Matt Bevin’s top health officials told lawmakers at the Capitol Tuesday. Additionally, state spending on Medicaid will jump by 20 percent in the next two-year budget, to $3.7 billion, as federal support declines, they said.
“The day of reckoning has come, and we’re going to have to pay the bills,” Health and Family Services Secretary Vickie Yates Brown Glisson told the House budget subcommittee for human services.
The Department of Health and Human Services announced Friday night that it was in the process of shorting the U.S. Treasury $3.5 billion.
Well, they didn’t exactly announce it. You had to read between the lines.
The theft of $3.5 billion will help prop up insurers that have agreed to sell ObamaCare policies in the individual market. Behind all the happy talk from Administration officials about the program’s success lies an unpleasant truth: insurers that participate in ObamaCare exchanges are bleeding money.
Those losses are coming despite billions of dollars in handouts the government is providing the industry. Some of those handouts are entirely lawful; others, not so much.
The so-called “reinsurance” program falls into the latter category.
Earlier this month, Speaker Paul Ryan announced six task forces, each comprised of House Committee Chairmen, to develop a “bold, pro-growth agenda.” What was remarkable was that one of the task forces was on health care reform. Many had thought Congressional Republicans were investing too much time and energy grandstanding ObamaCare repeal, and not enough developing a credible alternative.
That may have changed with the selection of four Committee Chairman to the Health Care Reform Task Force. They are: Budget Committee Chairman Tom Price (R-GA), Education & the Workforce Committee Chairman John Kline (R-MN), Energy & Commerce Committee Chairman Fred Upton (R-MI), and Ways & Means Committee Chairman Kevin Brady (R-TX).
Forty-three percent of Americans expect to pay more for health care this year than they did last year, according to a survey released Tuesday from GOBankingRates.com, a personal finance and consumer banking website.
About one-fourth of respondents (23 percent) said they expect to pay “a little more than the last year,” and 20 percent said they expect to pay “a lot more than the last year.”
Vermont Sen. Bernie Sanders has energized Democratic voters with a proposal for a $1.38 trillion single-payer health care system that he says would provide universal coverage and make medical care more efficient.
By contrast, his opponent in the Democratic primary, Hillary Clinton, is promising to defend the Affordable Care Act and make reforms to help lower deductibles and other out-of-pocket costs.
In other words, Sanders wants revolution; Clinton wants to build on what President Obama started.
If elected, each candidate could potentially have a significant impact on the nation’s health care policies and the choices and costs facing consumers.
The leading candidates for the Republican nomination are all proposing to repeal ObamaCare. The difference between them is what they would replace it with.
Businessman Donald Trump and U.S. Sen. Ted Cruz of Texas both have said they want to increase competition to allow Americans to purchase insurance across state lines, but neither has offered a detailed plan for replacing President Obama’s signature law.
Jeb Bush and U.S. Sen. Marco Rubio of Florida would provide tax credits to help Americans purchase individual health insurance policies and give states more control of their insurance markets.
Meanwhile, Ohio Gov. John Kasich says the focus should be on improving primary care and rewarding providers that generate better health outcomes and help to hold down costs.
Whoever is nominated will have a chance to bring about a fundamental shift in health care policy.
There’s not much more time to speculate about how the Supreme Court will handle health care-related cases without the late Justice Antonin Scalia. A number of them are fast approaching on the court’s calendar, including one scheduled for arguments Tuesday.
Legal experts say they expect the court will go ahead and hear those cases and others despite the conservative justice’s unexpected death late last week.
The case set to be argued Feb. 23 involves the penalties companies face for patent infringement and could have a significant impact on the medical device industry. And in two weeks, the court is scheduled to hear a major case over whether Texas has gone too far in regulating abortions.
Hundreds of thousands of people lose subsidies under the health law, or even their policies, when they get tangled in a web of paperwork problems involving income, citizenship and taxes. Some are dealing with serious illnesses like cancer. Advocates fear the problems, if left unresolved, could undermine the nation’s historic gains in health insurance.
Coverage disruptions due to complex paperwork requirements seem commonplace in the health law’s system of subsidized private insurance, which currently covers about 12.7 million people.
The government says about 470,000 people had coverage terminated through Sept. 30 last year because of unresolved documentation issues involving citizenship and immigration. During the same time, more than 1 million households had their financial assistance “adjusted” because of income discrepancies. Advocates say “adjusted” usually means the subsidies get eliminated.
It is common sense that people take care of their own property better than community property, often times referred to as “commons.” Because community resources are finite (say, grazing land in a pastoral society), overgrazing (and too little maintenance) is bound to occur absent any collaborative agreements. Moreover, one person’s conservation efforts cannot overcome all the other self-interested parties’ perverse incentives. Economists call this the tragedy of the commons. Unfortunately, ObamaCare proponents (and LBJ for that matter) did not understand how the tragedy of the commons would boost health care spending. Medicare, Medicaid and Obamacare plans are all examples of attempts by government to expand the health care commons — rather than encourage individuals to sustainably manage their own health care resources with appropriate incentives.