Category: Implementation

Graduate students have long relied on health insurance subsidies awarded as part of financial-aid packages as they try to earn a living and a degree.

But the future of that benefit could be jeopardized by the Internal Revenue Service’s interpretation of a provision of the Affordable Care Act that casts the subsidies as an attempt to elude ACA’s employer mandate.

Seventeen U.S. senators, including Virginia Sens. Mark R. Warner and Timothy M. Kaine, both Democrats, wrote a letter last month urging the Obama administration to clarify the IRS language and warning that it runs counter to ACA’s primary goal to expand insurance coverage.

. . .

Friday, the U.S. Court of Appeals for the D.C. Circuit released two opinions in Patient Protection and Affordable Care Act (PPACA) cases.  In one case, the federal government prevailed. In the other, it did not.

In the first case, West Virginia v. Department of Health and Human Services, a unanimous panel concluded that the state of West Virginia lacks Article III standing to challenge the Obama administration’s decision to waive some of the PPACA’s requirements governing minimum coverage requirements. This litigation responds to the Obama administration’s response to outrage over insurance plan cancellations — cancellations that were politically problematic because they revealed that the president’s promise that “if you like your health insurance plan, you can keep it” was a lie. (Indeed, it was Politifact’s “Lie of the Year” for 2013.)

In a second case decided Friday, the administration did not fare so well.  In Central United Life Insurance, Co. v. Burwell, another unanimous panel invalidated an HHS regulation for exceeding the scope of its delegated powers under the Public Health Service Act (PHSA), as amended by the PPACA. Specifically, HHS had adopted regulations seeking to prevent consumers from obtaining fixed indemnity policies that fail to satisfy the PPACA’s minimum essential coverage requirements, despite the PHSA’s exemption of such plans from such requirements.

. . .

ObamaCare enrollment dropped to about 11.1 million people at the end of March, according to new figures released by the administration.

The health care law President Obama signed six years ago was supposed to fix the individual insurance market with enlightened rules and regulations. Instead, ObamaCare is destroying this market. Just look at what’s happening to Blue Cross Blue Shield.

If any insurer could cope with ObamaCare, it should have been Blue Cross Blue Shield.

Blue Cross companies came into the ObamaCare exchanges with decades of experience writing individual policies. Most of them are non-profits, which gives them an automatic leg up on the competition. And their plans captured the largest share of the exchange markets across the country.

. . .

Two major health insurers in Arizona are discontinuing Obamacare plans in part of the state next year.

Blue Cross Blue Shield of Arizona and Health Net will stop selling plans on the Affordable Care Act marketplaces in the city of Maricopa and Pinal County, dropping coverage for tens of thousands of enrollees, according to new state filings reported by the Arizona Republic.

Additionally, Health Net is scaling back its Obamacare offerings in Pima County, selling only mid-level silver and gold marketplace plans.

. . .

Nearly 22,000 Ohioans — more than one-third of whom live in the Columbus area — have until Thursday to find a new health insurance plan or face being uninsured for most of July.

The Ohio Department of Insurance took over InHealth Mutual, a subsidiary of Coordinated Health Mutual, in May. The health insurance cooperative based in Westerville was set up in 2014 to be a lower-cost option for Ohioans who shop the federally run health insurance marketplace. The state agency is liquidating the company because it ceased to meet the federal requirements for minimum essential coverage under the Affordable Care Act.

. . .

The Affordable Care Act opened the door for millions of young adults to stay on their parents’ health insurance until they turn 26.

But there’s a downside to remaining on the family plan.

Chances are that Mom or Dad, as policyholder, will get a notice from the insurer every time the grown-up kid gets medical care, a breach of privacy that many young people may find unwelcome.

With this in mind, in recent years a handful of states have adopted laws or regulations that make it easier for dependents to keep medical communications confidential.

. . .

The Affordable Care Act (ACA) placed numerous requirements on insurance offered in both the individual and small group markets. This study presents data from the 174 insurers that offered qualified health plans (QHPs)—plans that satisfy the ACA requirements and are certified to be sold on exchanges—in both the individual and small group markets in 2014. QHPs in both markets are essentially the same and are governed by nearly identical regulations, making possible a better-controlled analysis of the performance of insurers participating in the two markets. Average medical claims for individual QHP enrollees were 24 percent higher than average medical claims for group QHP enrollees. Moreover, average medical claims for individual QHP enrollees were 93 percent higher than average medical claims for individual non-QHP enrollees. As a result, insurers made large losses on individual QHPs despite receiving premium income that was 45 percent higher for individual QHP enrollees than for individual non-QHP enrollees. These higher medical claims resulted in loss ratios for individual QHPs nearly 30 percentage points higher than loss ratios in other markets. Given that insurer performance selling individual QHPs worsened in 2015, these findings suggest that the ACA rules and regulations governing QHPs may be incompatible with a well-functioning insurance market even with subsidies to insurers and incentives for individuals to enroll in QHPs.

. . .

Rather than stabilizing in 2016 as many experts predicted, the Affordable Care Act (ACA) is leading to large premium hikes and less choice and competition in the individual insurance market as plans prove unattractive to relatively young, healthy, and middle-class people. In order to achieve a better understanding of the ACA’s impact, a new Mercatus Center working paper compared insurers’ performance selling individual Qualified Health Plans (QHPs) with three other markets: the individual non-QHP market, the small group QHP market, and the small group non-QHP market.

My co-authors, Doug Badger of the Galen Institute, Ed Haislmaier of the Heritage Foundation, Seth Chandler of the University of Houston, and I make two key empirical findings. First, individual market QHP enrollees had average medical claims nearly double the average claims for individual non-QHP market enrollees in 2014. Second, individual market QHP enrollees were about 25% more expensive than enrollees in small group QHPs.

. . .

The results of a recent poll conducted by the University of Southern California (USC) and the LA Times make it clear there is far from a consensus on the quality and affordability of healthcare in the Golden State. Less than half of those surveyed (44%) felt that healthcare in California was good or excellent, while a plurality (48%) felt that healthcare in the state was fair or poor.

. . .