Gwen Hurd got the letter just before her shift at the outlet mall. Her health insurance company informed her that coverage for her family of three, purchased through the Affordable Care Act marketplace, would cost almost 60 percent more this year — $1,200 a month.
She and her husband, a contractor, found a less expensive plan, but at $928 a month, it meant giving up date nights and saving for their future. Worse, the new policy required them to spend more than $6,000 per person before it covered much of anything.
“It seems to me that people who earn nothing and contribute nothing get everything for free,” said Ms. Hurd, 30. “And the people who work hard and struggle for every penny barely end up surviving.”
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Insurer participation and competition in Obamacare declined again in 2018 at both the state and county levels. In 2017, nearly one-third of counties (32.8 percent) had only one insurer offering exchange coverage. In 2018, more than half (51.3 percent) of all counties face that situation. Many insurers have exited the exchanges; ones that remain offer higher premiums and narrow network plans. The emerging norm appears to be one in which major metropolitan areas have two or three insurers offering exchange coverage, while less-populous areas have only one. A health insurance monopoly offering overly expensive coverage that pays for only a very limited set of providers is deeply unattractive, especially to customers who previously enjoyed choice in both their insurance and medical care. Not surprisingly, consumers are looking to Congress and the President for help in escaping the soaring costs and shrinking choices that characterize the ACA exchanges.
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New analysis from Avalere finds that plans with more restrictive networks, including health maintenance organizations (HMOs) and exclusive provider organizations (EPOs), continue to dominate the exchange market, with 73% of the 2018 market comprised of restrictive network plans, up from 68% in 2017 and 54% in 2015. Avalere analysis also found that deductibles for the most popular type of plan on the exchange—silver plans—will climb in 2018, to an average of $3,937, up from $3,703 in 2015, and each following year they will increase.
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People who bought policies from Centene, a large for-profit health insurance company, filed a federal lawsuit on Thursday claiming the company does not provide adequate access to doctors in 15 states. “Members have difficulty finding–and in many cases cannot find–medical providers,” who will accept patients covered under policies sold by Centene, according to the lawsuit filed in federal court in Washington State.
“People signed up for insurance and they ‘discovered there were no doctors,”’said Seth Lesser, a partner at the law firm of Klafter Olsen & Lesser who is representing some of the policyholders.
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Nevada is taking steps toward leaving the federal healthcare.gov and setting up a separate exchange operated by the state.
The Nevada Appeal reports that the Legislative Interim Finance Committee on Friday authorized state officials to spend $1 million to prepare a request for proposals and find a private provider.
Heather Korbulic, executive director of the state system, says changes are needed because healthcare.gov is steadily raising the rates it charges states that link their front-end systems to the federal exchange.
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States that run their own Affordable Care Act insurance marketplaces significantly outperformed the rest of the country in attracting consumers to sign up for health plans for 2018, according to enrollment tallies released Wednesday.
Overall enrollment stayed essentially level from the year before in the 11 states plus the District with state-based marketplaces, while sign-ups in states that rely on the ACA’s federal exchange fell, on average, by more than 5 percent. Five states with hybrid systems did best of all, according to a report compiled by the National Academy for State Health Policy.
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Key House Republicans are warming to a proposal aimed at bringing down ObamaCare premiums, raising the chances of legislative action this year to stabilize the health-care law.
House GOP aides and lobbyists say that top House Republicans are interested in funding what is known as reinsurance. The money could be included in a coming bipartisan government funding deal or in another legislative vehicle.
Any action from Republicans to stabilize ObamaCare would be a major departure from the party’s long crusade against the law, but after having failed to repeal the Affordable Care Act last year, the discussion is shifting.
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Oregon voters recently upheld a myriad of new taxes that were passed as part of a major health-care law last summer. The state government is planning to use the estimated $320 million in revenue to cover hundreds of thousands of residents who have enrolled through the Affordable Care Act. The outcome of this vote has serious implications anyone enrolled in a health-care plan in Oregon.
The referendum was on sections of House Bill 2391, which imposes a 0.7 percent tax on small hospitals as well as a 1.5 percent on individual and family health-care premiums. These revenue raisers are intended to generate more tax dollars for the state. But they also allow Oregon to receive $630 million to $960 million in federal Medicaid matching funds.
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Using 2017 data: Out of 9,201,805 healthcare.gov enrollees, here’s how many would win and lose if the insurer subsidies were now funded:
- Winners: 682,712 unsubsidized exchange enrollees enrolled in middle-of the-road “silver” plans
- Losers: 1,621,325 enrollees who receive premium subsidies and don’t have silver plans
- Likely losers: 1,706,780 enrollees with silver plans and incomes between 200%-400% of the federal poverty level.
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Health care dominated the news cycle in 2017. Yet, for all the legislative wrangling and rhetoric, little changed this past year.
It is my job to listen to health-care consumers. They entered 2017 worried about the cost of coverage. They find themselves at the start of this year in the same place they ended the last. People want to know: What happened to the “affordable” part of the Affordable Care Act?
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