The Cuomo administration late Friday announced emergency regulations that would upend the federal government’s risk adjustment program, a move meant to protect some of the state’s smaller players and keep them from bolting the still nascent small-group market created by the Affordable Care Act.
The move comes the same day as the deadline for health insurance companies to contract with New York State of Health, the state-run exchange that sells insurance to individuals and small groups, and follows threats from several insurers that said they would not sell small group plans in 2017 if changes to the program were not made.
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Average premium increases above 25%, roughly one-third of U.S. counties projected to lack any competition in the Affordable Care Act (ACA) exchanges next year, and enrollment less than half of initial expectations provide strong evidence that the law’s exchange program is failing. Moreover, the failure is occurring despite massive government subsidies, including nearly $15 billion of unlawful payments, for participating insurers. As bad news pours in and with a potentially very rough 2017 open enrollment period ahead, the Obama administration signaled on Friday that it may defy Congress and bail out insurers through the risk corridor program. Congress should take all steps at its disposal to prevent the administration from doing so.
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Leading progressive senators are demanding an explanation from the insurance giant Aetna about its abrupt decision to pull out of most ObamaCare exchanges this year, which they said appeared to be politically motivated.
Sens. Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.) announced Thursday they are launching a probe into Aetna, which bailed on ObamaCare just weeks after the Justice Department moved to block its multi-billion merger with another top-five insurer.
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The Obama administration said Tuesday that it is planning to test out further steps to tighten the rules for ObamaCare sign-up periods that have drawn insurer complaints.
The Centers for Medicare and Medicaid Services (CMS) said that it will launch a pilot program in 2017 to test ways to put in place a “pre-enrollment verification system,” meaning a way to check documentation to make sure enrollees are actually eligible to sign up for ObamaCare through an extra sign-up period.
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Floridians who buy their own health insurance in 2017 are likely to see their premiums rise by an average of 19 percent over the current year, according to an analysis released Friday by the state’s Office of Insurance Regulation.
The average increase calculated by the state applies to all health insurance plans sold in Florida next year that comply with the Affordable Care Act’s minimum coverage requirements, whether those plans are sold on the ACA exchange at HealthCare.gov or off of it.
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Under the ACA, health insurance marketplaces, also called health exchanges, were set up to facilitate the purchase of health insurance in each state. Customers are free to choose from a set of standardized healthcare plans from participating insurers, and those policies are eligible for federal subsidies.
But insurers have been fleeing the exchanges, arguing that they are loss makers and the types of people attracted to them make the risks too great for the insurers to provide affordable (and profitable) policies.
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Under intense pressure to curb costs that have led to losses on the Affordable Care Act exchanges, insurers are accelerating their move toward plans that offer limited choices of doctors and hospitals.
A new McKinsey & Co. analysis of regulatory filings for 18 states and the District of Columbia found that 75% of the offerings on their exchanges in 2017 will likely be health-maintenance organizations or a similar plan design known as an exclusive provider organization, or EPO. Both typically require consumers to use an often-narrow network of health-care providers—in some cases, just one large hospital system and its affiliated facilities and doctors.
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In the last few years, even though premiums in the Affordable Care Act’s health insurance marketplaces were rising, most customers could avoid a big price rise by shopping for a cheaper plan.
Next year, according to a preliminary analysis, that is going to be a lot harder.
Even someone who shopped wisely this year and is willing to switch plans to get the best deal next year is looking at an average premium increase of 11 percent, according to an analysis of rate filings in 18 states and the District of Columbia provided by the McKinsey Center for U.S. Health System Reform.
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When is a government program not a government program?
When the insurance industry says it isn’t.
In its effort to keep billions in unlawful ObamaCare corporate subsidies flowing, the industry is trying to persuade Congress that it receives no federal funds through the federal “reinsurance” program. Good luck with that.
The ObamaCare statute established the temporary, three-year (from 2014 to 2016) reinsurance program for two purposes: 1) to provide $5 billion to the Treasury; and 2) to provide $20 billion to issuers of individual ObamaCare policies.
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Now that the ACA is on the books, and the private-insurance options are on shaky ground, there’s no real reason for proponents of the ACA not to fully embrace the public option. It’s what most of them wanted all along, and the turbulence among the private insurers provides the perfect excuse to pursue it.
The fact that introducing a public option at this stage would only add to the instability of the private options offered on the exchanges is not a reason for the public-option advocates to abandon the idea because they never really wanted a functioning private-insurance marketplace anyway. The goal all along has been government-run health care, even if they haven’t always been willing to admit that.
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