Articles on the implementation of ObamaCare.
Humana Inc. has added its name to the list of mega-medical insurers to report big problems under ObamaCare.
The Louisville, Ky.- based company does not expect to make enough money this year in premiums from individual plans to cover what it will pay out in claims, according to a regulatory filing made last week with the U.S. Securities and Exchange Commission.
Humana, which is being acquired by Aetna Inc., said it is still trying to figure out how big the gap will be.
Health insurers in the Affordable Care Act exchanges will see changes from the Centers for Medicare & Medicaid Services this year to strengthen the market, including eliminating special enrollment periods and an early look at plans’ risk-adjustment data, the top CMS official, Andy Slavitt, said on Monday.
Andy Slavitt, head of the Centers for Medicare & Medicaid Services, spoke at the J.P. Morgan health conference in San Francisco, using the opportunity to announce new initiatives, including responding to the failure of ObamaCare’s exchanges. Although sugar-coating his diagnosis, Mr. Slavitt clearly knows exchanges are in trouble.
Mr. Slavitt proposes two solutions to force more people into the exchanges. First, he will tighten up the open season for enrollment. More promising, and necessary, is a new look at risk adjustment. Slavitt promises more announcements on managing ObamaCare’s risk pool over the next few weeks.
Better risk adjustment is critical, but administrative adjustments alone will not fix the exchanges.
A new survey from payroll services giant ADP reveals that about 40% of mid-sized and large companies that are offering health coverage to workers aren’t familiar with two new ObamaCare-related forms that must be filed with the Internal Revenue Service starting this tax season.
The forms — the 1094-C and the 1095-C — are designed to track compliance with the ObamaCare rule that mid- to large-sized employers offer affordable health insurance to workers or face a fine.
Last week, the Department of Health and Human Services (HHS) released 2016 exchange enrollment data through the first two months of the three-month open enrollment period. Although nearly one month of open enrollment remains, the new data generally supports my previous findings. Here are seven things you should know about the new data.
1) 2016 enrollment will likely be at least ten million people below expectations when the ACA was passed
2) People with at least middle class income still largely shunning exchanges
3) Enrollees still skewing older
4) Average advance premium tax credit up 12% from last year
5) 90% of enrollees selected silver or bronze plans
6) 27% of enrollees are new sign-ups, 38% of enrollees are active reenrollees, and 33% of enrollees are automatic reenrollees
7) High auto-enrollment in states not using HealthCare.gov may lead to premium shock
The Obama administration is promising to crack down on healthcare customers who buy coverage in between enrollment periods to lower costs. Andy Slavitt, acting head of the Centers for Medicare & Medicaid Services, acknowledged publicly for the first time Monday night that some customers are using loopholes in the enrollment sign-up periods to avoid paying healthcare premiums year-round.
He said more details about the administration’s plans will come next week, after the Jan. 31 deadline for coverage.
The president is sure to laud ObamaCare at his final State of the Union speech on Tuesday. And no doubt he’ll boast about the 11.3 million people enrolled in an ObamaCare exchange by the end of the year. That may look like “unprecedented demand” to Obama administration officials. But in fact, it’s an ominous sign that ObamaCare is losing what little luster it had in the marketplace. 11.3 million is nothing to celebrate when you consider that at the end of open enrollment last year, the administration claimed that 11.7 million had signed up. By the end of the entire year, that number had been whittled down to about 9 million, of which 8.2 million re-enrolled.
A recent about-face by the Obama administration on so-called “state innovation waivers” may be the most important change to ObamaCare that no one is paying attention to. These waivers, which will begin in 2017, allow states to take a block grant of funding and waive nearly every major component of the law. A major change, however, is now set to make these experiments mostly impossible. In recent guidance, stealthily released at the close of business on a Friday last month, the Department of Health and Human Services announced that the rules are changing.
Wyoming Gov. Matt Mead announced last month that he would spend the next few months advocating for ObamaCare’s Medicaid expansion in next year’s budget. But so far, Wyoming legislators have taken a thoughtful approach, carefully reviewing all of the evidence and ultimately rejecting ObamaCare expansion. Just 26 out of 90 lawmakers supported the issue during the last legislative session. With expansion costs exploding in other states and federal funding now on the chopping block, it’s clear that their decision was the right one.
Humana will lose money on its 2016 individual market health plans, and the health insurer expects up to 300,000 will drop their coverage by the end of this year, according to a Securities and Exchange Commission filing released late Friday.
It marks the second investor-owned insurer to publicly disclose the problems it is having with the Affordable Care Act’s insurance markets. UnitedHealth Group has lost millions on the marketplace and said it may exit the exchanges by 2017 if things don’t turn around.