Category: Impact

“The federal government will wait until January to roll out its five-star rating system meant to help consumers compare quality at dialysis centers across the country.
Use of the system on the CMS’ dialysis centers compare website had been scheduled for October, but was met with angst by dialysis providers who questioned the methodology and said the program was likely to be more confusing than helpful.
In response, the federal agency announced Wednesday that it has moved the date by about three months.
The CMS began using the rating program on nursing homes in December 2008 and earlier this year applied a similar rubric to physician groups. In July, the agency announced plans to extend the program to dialysis facilities starting Oct. 9.”

“Welcome back from the summer.
It’s been pretty quiet lately on the Obamacare front.
So quiet, that there has been a flurry of articles recently over how Obamacare has dropped to a second or even third tier issue and will hardly matter come election-time.
Wishful thinking.
Obamacare has largely been out of the news cycle for a couple of months but that is about to change.
A few thoughts.
The 2015 rate increases have been largely modest. Does that prove Obamacare is sustainable? No. You might recall that on this blog months ago my 2015 rate increase prediction was for increases of 9.9%.
You might also recall my reason for predicting such a modest increase. With almost no valid claims data yet and the “3Rs” Obamacare reinsurance program, insurers have little if any useful information yet on which to base 2015 rates and the reinsurance program virtually protects the carrier from losing any money through 2016. I’ve actually had reports of actuarial consultants going around to the plans that failed to gain substantial market share suggesting they lower their rates in order to grab market share because they have nothing to lose with the now unlimited (the administration took the lid on payments off this summer) Obamacare reinsurance program covering their losses.”

“Obamacare’s defenders are busy declaring victory again. Ezra Klein is touting a new survey of Obamacare benchmark premiums in some regions of the country as evidence that the law is defying the predictions of critics and working to cut costs rather than increase them.
But, as Bob Laszewski notes, the truth about Obamacare implementation is far less rosy than the latest round of cheerleading would indicate.
For starters, the federal and state websites remain largely a dysfunctional mess, although the media isn’t really covering the story anymore. The supposed “fix” that allowed millions of consumers to sign up with plans on the exchanges from December through April really wasn’t much of a fix after all. It was a workaround, allowing consumers to access large federal subsidies with minimal verification.”

“DETROIT– A lawsuit has been filed on behalf of potentially thousands of immigrants who have been rejected for full Medicaid coverage in Michigan because of computer problems.
The lawsuit in Detroit federal court says the state has known about the problem for weeks but is moving too slowly to fix it. Attorneys are asking a judge to issue an injunction to get things moving.
The Center for Civil Justice in Flint says many immigrants are approved only for emergency services. The group says federal law typically grants full health coverage under Medicaid to low-income refugees and poor lawful permanent residents.”

“Robert Laszewski, health policy wonk, blogger, and president of Health Policy and Strategy Associates, tells Inside Health Insurance Exchanges:
The Obama administration has no idea how many people are currently enrolled [in exchanges] but they keep cutting checks for hundreds of millions of dollars a month for insurance subsidies for people who may or may not have paid their premium, continued their insurance, or are even legal residents.
And if you think they’re doing those “enrollees” a favor, remember that if it turns out a recipient wasn’t eligible for the subsidy, he or she has to pay the money back.
Surprised? Don’t be. This is part of a deliberate, consistent strategy by the Obama administration to throw money at individual voters and key health care industry groups—lawfully or not—to buy support for this consistently unpopular law.”

“The Obama administration has decided to continue its legal battle against Little Sisters of the Poor, a Catholic charity that objects to Obamacare’s mandate that employee health plans cover contraceptives and abortion-inducing drugs.
The order of Catholic nuns argues that the rule fashioned by the Department of Health and Human Services requires them to violate their religious beliefs by offering insurance coverage for 20 specific drugs and devices — some of which the nuns believe could destroy what they consider a human life.
If the Little Sisters of the Poor choose not to abide by the HHS mandate, they face devastating fines by the Internal Revenue Service that could result in millions of dollars a year being diverted from their mission of caring for elderly women and men.”

“Having access to health insurance is slowing the rate of young adults who head to the emergency department for care, a new study suggests. Relative use of the ED decreased among 19- to-25-year-olds after the healthcare reform law allowed them to stay on their parents’ policies. The authors say the results show insurance can reduce ED overuse by removing the economic barriers to preventive care.
“It’s possible that when people have healthcare insurance they are less worried about the financial costs of care,” said Tina Hernandez-Boussard, assistant professor of surgery and biomedical informatics at Stanford University and lead author of a study published Monday in the journal Health Affairs. “They might seek appropriate care elsewhere and take care of conditions earlier. This could lead to a reduction in utilization of the emergency department.””

“RICHMOND — Gov. Terry McAuliffe (D), who vowed in June to defy the Republican-controlled legislature and expand healthcare to 400,000 uninsured Virginians, unveiled a much more modest plan Monday after being thwarted by federal rules and a last-minute change to state budget language.
McAuliffe outlined measures to provide health insurance to as many as 25,000 Virginians, just a fraction of those he had hoped to cover by expanding Medicaid under the Affordable Care Act.
The biggest change, covering 20,000 people with severe mental illness, will need funding approval from the General Assembly to continue past the current fiscal year. McAuliffe also offered proposals to improve care for people already in Medicaid and boost outreach efforts to those who qualify but are not enrolled.”

“New Health and Human Services Secretary Sylvia Mathews Burwell tried to hit the reset button on perceptions of the health-care rollout in her first public speech since taking the job at the embattled department overseeing it.
“What I’ve told my team at HHS is that we’re not here to fight last year’s battles, we’re here to fight for affordability, access and quality,” said Ms. Burwell to an audience of George Washington University students and faculty on Monday. “Let’s move beyond the back and forth, let’s move forward together.”
Ms. Burwell is stepping into the spotlight after around 100 days on the job and as the agency tries to reorient itself in time for the new enrollment season when millions more Americans are supposed to come to HealthCare.gov to buy coverage in just a few weeks.
She has brought on board several new faces since taking over as secretary from Kathleen Sebelius. They include the head of Connecticut’s health insurance exchange Kevin Counihan to serve as CEO for the site, former clean-up contractor Andy Slavitt as an operations administrator at the Centers for Medicare and Medicaid Services, and her former Walmart colleague Leslie Dach as her senior counselor.”

“Two Planned Parenthood chapters, two United Way organizations, a food bank association and a Catholic hospital system are among 90 nonprofit groups that will receive a total of $60 million to help people sign up for health insurance, the Department of Health and Human Services announced today.
The money will help people in 34 states that rely on the federal government fully or in part for their Affordable Care Act insurance exchanges, where individuals can buy Obamacare policies. States with their own exchanges have separate funding to help consumers get assistance.”