Category: Investigations

“If the Congressional Budget Office is close to the mark, in the second open-enrollment season we will see about a doubling of the 7 million people enrolled in the Affordable Care Act insurance marketplaces. Open enrollment, which begins Nov. 15, is three months this year, or half as long as last year, and the remaining eligible uninsured are a more difficult-to-reach population. Here are the biggest challenges this time around:
First, the overwhelming reason the remaining uninsured cite as to why they have not already gotten coverage is that they believe they could not afford it. The message that most needs to reach the uninsured is that there are tax credits available to help make coverage more affordable. For a 30-year-old making $25,000 per year, the ACA tax credit would reduce the average cost of the most commonly selected “silver plan” from $2,877 per year to $1,729. Eighty-five percent of those who got coverage in the new insurance exchanges qualified for credits this year, but in our Kaiser Family Foundation survey of the uninsured in California, 73% of those eligible for assistance did not know they could get help.”

“Consumers keep price top of mind when they purchase prescription drugs and they’re unafraid to buy against the big labels, a new Morning Consult poll found.
Nearly three quarters of respondents said if given the choice between a brand name drug and a generic version, they’d be more willing to choose the generic version. What’s more, 65 percent of respondents disagreed that brand name drugs were more effective than generic drugs.”

“There are obvious benefits to getting health insurance at work. For one, employer-sponsored insurance is not taxed, meaning that every dollar of compensation provided as medical coverage stretches further. Individual market plans, meanwhile, are purchased with post-tax dollars. The only way to get in on the tax exemption is to buy coverage at work.
But for low-wage workers, Obamacare  has introduced a new and big drawback to the employer insurance. Namely, anybody who gets access to affordable coverage at work is barred from getting subsidies through the new exchanges. This is even true for people who don’t buy insurance at work; just the act of getting offered employer coverage blocks individuals from using getting financial help.”

“Some health insurers are having trouble finding doctors and hospitals to accept low rates under Gov. Tom Corbett’s Medicaid expansion plan, leading one company to quit the program and another to reduce participation.
Highmark Inc., the state’s largest health insurer, said it won’t participate in Corbett’s Healthy PA program because it couldn’t sign enough doctors to its network. Healthy PA is an alternative to Medicaid expansion under the Affordable Care Act, proposed by Corbett and approved by the federal government in August, in which private insurers provide coverage to Medicaid recipients.”

“If Washington is ever going to tackle entitlement reform and get federal spending under control, it must start with Medicare.
The former director of the Congressional Budget Office, Doug Holtz-Eakin, details Medicare’s fiscal plight:
Between 2001 and 2010, Medicare’s cumulative cash flow deficits totaled more than $1.5 trillion – or 28% of the total federal debt over the past decade.
But it gets worse: By 2020, as Baby Boomers continue to age into Medicare at the rate of more than 10,000 a day, Medicare’s cumulative $6.2 trillion in cash flow deficits will constitute 35% of the nation’s total debt accumulation.”

“SEATTLE — As Washington’s health care exchange prepares for its second open enrollment period, officials were still trying to resolve billing and computer problems involving about 1,300 accounts from the previous round of sign-ups.
Exchange officials began with about 24,000 problem accounts that were detected as people started to use their insurance earlier this year.”

“A majority of the state’s voters support extending current health insurance programs to all low-income Californians, including undocumented immigrants, according to a new statewide poll released today.
The poll was commissioned by The California Endowment, a foundation that has been actively working to expand health insurance access to all people, regardless of immigration status. The Affordable Care Act expressly bars undocumented immigrants from receiving any of its benefits, including subsidies to purchase health insurance. (Note: The California Endowment funds some of KHN’s coverage.)”

“Meal, drink, tip … insurance?
Some Los Angeles restaurants are adding a 3 percent surcharge to diners’ tabs in order to cover employees’ health insurance.
The owners of the restaurants deny that the additional charge is a “political statement” about the Affordable Care Act, saying it’s merely a way to provide for their employees.
“We want our staff to have health care,” Josh Loeb, a co-owner of the restaurant Milo & Olive told the Los Angeles Times. “It’s not because we support Obama or don’t support Obama, or are Democrats or are not Democrats.””

“This time last year there seemed to be a new catastrophe or scandal every day related to the roll-out of the Affordable Care Act, a.k.a. ObamaCare: many predicted the federal website would never be up and running by the looming deadline, the cost kept escalating, private contractors publically blamed bumbling bureaucrats and vice versa. Meanwhile, individuals who attempted to sign up ran into technical problems, and there were horror stories about people being told they would be dropped by their current insurance provider despite the fact the president had assured them this would not happen. Confusion was everywhere. Ultimately, key players got fired or resigned in disgrace.
So, where do we stand today, one year later?
That’s what the non-profit Transamerica Center for Health Studies (TCHS) wanted to know.”

“CMS on Tuesday (Oct. 7) reopened the period to request hardship exemptions from so-called meaningful use requirements for electronic health records, giving some doctors and hospitals another opportunity to avoid penalties in 2015. The move follows stakeholders’ calls earlier this year for more time to submit hardship requests and lawmakers’ requests that some providers attesting to meaningful use for the first time in 2014 be allowed to avoid penalties in 2015.
CMS told Inside Health Policy that there are still some issues surrounding availability and implementation of the 2014 certified EHRs, and the agency wanted to make sure that providers aren’t penalized because of those problems.”