Category: Investigations

“RALEIGH — A sizable number of North Carolina residents are learning they are no longer eligible for Obamacare, and some health policy premiums could jump 60 percent within two years, an insurance official says.
Rufus Langley, an Apex insurance agent and state leader of the North Carolina Association of Health Underwriters, said Coventry Health Care of the Carolinas CEO Tracy Baker recently told his group that substantially higher consumer costs are anticipated.
“He can see in 2016 this thing shooting up anywhere from 30 to 60 percent in costs” as delayed taxes start to kick in this year and next year, and medical care costs still rising, Langley said Monday at a Raleigh panel discussion.”

“The Obama administration, which is scrambling to prepare a new push to enroll Americans in health coverage under the federal health law, is reassessing how many more people will sign up, Health and Human Services Secretary Sylvia Mathews Burwell said Wednesday..
About 7.3 million people are enrolled in health plans being sold through marketplaces created this year by the Affordable Care Act, according to federal figures.”

“Health and Human Services Secretary Sylvia Mathews Burwell told reporters Wednesday that officials are “continuing, step by step” in their effort to get HealthCare.gov ready to open for its second year of business in 50 days’ time but steered clear of specific commitments that have haunted officials who preceded her.
In her first on-the-record question session with reporters since taking the top job at HHS, Ms. Burwell got several inquiries about whether the department’s preparations to fix and revamp the site were on schedule, and answered all of them without making the kinds of comments that people could hold against her later.
“Right now, what we are doing is prioritizing,” she said. “Every day we are continuing, step by step.””

“Insurers Cigna and Blue Shield of California misled consumers about the size of their networks of doctors and hospitals, leaving enrollees frustrated and owing large bills, according to two lawsuits filed this week in Los Angeles.
“As a result, many patients were left without coverage in the course of treatment,” said Laura Antonini, staff attorney for Consumer Watchdog, a Santa Monica-based advocacy group that filed the case.
Both cases allege that the insurers offered inadequate networks of doctors and hospitals and that the companies advertised lists of participating providers that were incorrect. Consumers learned their doctors were not, in fact, participating in the plans too late to switch to other insurers, the suits allege, and patients had to spend hours on customer service lines trying to get answers. Both cases seek class action status.”

“Governors suggest in a new report that states consider easing restrictions on physician assistants to help deal with swelling Medicaid rolls. The National Governors Association says states should consider including PAs in the definition of “provider,” loosening so-called scope-of-practice laws to let physicians delegate more tasks to PAs, opening clinical training sites and encouraging PAs to work in primary care.
“To increase the use of the physician assistant workforce, states should review the laws and regulations affecting the profession and consider actions to increase the future supply of PAs,” an NGA release states.”

“This week’s double-barreled release of government statistics on health insurance coverage leaves us with only one question: How many Americans are insured because of Obamacare? Remarkably, the two highly-regarded government surveys released this week do not even agree whether the number of uninsured increased or decreased. The survey that received a great deal of attention said there were 3.8 million fewer uninsured. The other, which was hardly noticed, found that there were 1.3 million more uninsured.
The Centers for Disease Control (CDC) reported preliminary results on the expansion of health insurance coverage. Its National Health Interview Survey (NHIS) interviewed 27,000 people in the first three months of this year. The survey estimates that the number of uninsured dropped by 3.8 million since 2013. That represents a 1.3 percentage point decline in the uninsured rate, from 14.4 percent last year to 13.1 percent early this year.”

“In 2009, President Obama repeatedly told the American people, “If you like the plan your health care plan, you’ll be able to keep your health care plan, period.” However, implementation of the Affordable Care Act, popularly known as Obamacare, quickly led to the debunking of the president’s claim.
But why exactly did millions of Americans receive cancellation notices from their health insurance companies? Robert Graboyes, senior research fellow at George Mason University’s Mercatus Center, dug through the Affordable Care Act’s 1,000 pages and came up with a simple way to explain the specific provisions that prompt insurers to cancel plans.”

“One of Barack Obama’s best-remembered promises was, “If you like your health insurance, you can keep it.” But at the very same time the president was making that promise, lawmakers on Capitol Hill were drafting legislation that would make sure that promise could never be kept.
We call it Obamacare.
Moreover, the problem is not only that millions of people were unable to keep the plan they had in 2010, when the health reform law was passed. They are not likely to be able to keep for long any plan they have selected this year on a health insurance exchange. As we go forward, all health plans will be subjected to restrictions that are likely to change every year. So a plan that meets the Obamacare restriction this year, may not meet the restriction next year or the year after that.”

“Supporters of the Obama administration like to create the impression that there is no viable alternative to the Affordable Care Act — i.e., Obamacare. But that is demonstrably not true. Republican senators Richard Burr, Tom Coburn, and Orrin Hatch introduced a plan earlier this year that would cover just as many people with insurance as Obamacare at a fraction of the cost.
Now we have confirmation, in the form of a new cost estimate, that a similarly constructed but slightly different proposal would also cost less, while covering nearly the same number of people.”

“Everybody is for wellness, including corporate America. As the chart above shows, wellness programs–as varied as gym memberships, lifestyle coaching, flu shots and vaccinations, nutrition counseling and biometric screening, and other weight-loss efforts–are corporate America’s favorite strategy for health cost containment. That’s right, cost containment–despite the fact that evidence of wellness programs’ effectiveness is mixed when it comes to holding down costs and actually improving health.
The appeal of wellness programs has much to do with the popularity of wellness benefits among employees (and a belief that they can reduce absenteeism and improve productivity). The roughly $6 billion wellness industry aggressively sells products–and wellness programs are a far easier cost-containment strategy to sell to employees than higher cost sharing or narrower provider networks.”