Category: Investigations

” Who’s up for the latest batch of bad Obamacare-related news?
(1) Consumers brace for the second full year of Obamacare implementation, as the average individual market premium hike clocks in at eight percent — with some rates spiking by as much as 30 percent.
(2) “Wide swings in prices,” with some experiencing “double digit increases.”(Remember what we were promised):
Insurance executives and managers of the online marketplaces are already girding for the coming open enrollment period, saying they fear it could be even more difficult than the last. One challenge facing consumers will be wide swings in prices. Some insurers are seeking double-digit price increases…”

“The administration finally released the Obamacare enrollment count this week.
Like everything else about their scorekeeping we got a number. Just one number. A number that was conveniently better than we had expected. And, we got no real context for the number or any of the back-up information.
I thought this quote in a Politico article was telling:
The figure is complex to unravel. The number came from the health insurers, who told the Obama administration every month how many people are covered by Affordable Care Act plans. A CMS official said Thursday that in prior monthly reports, the numbers varied widely, but recently stabilized.””

“California’s health insurance exchange is vowing to fix enrollment delays and dropped coverage for about 30,000 consumers before the next sign-up period this fall..
Covered California said it failed to promptly send insurance applications for 20,000 people to health plans recently, causing delays and confusion over their coverage.
Another group of up to 10,000 people have had their insurance coverage canceled prematurely because they were deemed eligible for Medi-Cal based on a check of their income, officials said.”

“The launch of the Affordable Care Act has focused attention on the idea of a health insurance exchange, or marketplace. Separate from the ACA, private exchanges have also started to emerge as an option for employers providing coverage to their workers. This report identifies the different types of private exchanges as well as projects the potential size of the private exchange market, which has the potential to reshape the employer-sponsored health insurance landscape, in the coming years.
Through interviews with representatives of more than fifteen private health insurance enrollment platforms as well as several employers and health plans moving in this direction, this report examines important implications in this quickly-growing landscape, including the potential for cost stability to employers and more choice among health plans for consumers.”

“CMS Administrator Marilyn Tavenner on Thursday (Sept. 18) pledged the agency would conduct full “end-to-end” testing of healthcare.gov prior to the launch of open enrollment in November, likely either by the end of this month or early October. Tavenner also told members of Congress that the site will see continued improvement but will not be perfect in year two.
The comments came during a sometimes fiery House oversight committee hearing that focused on the security of the exchange website, which took place shortly after the Government Accountability Office released a report finding that healthcare.gov continues to be vulnerable to breaches. On Wednesday, Chair Darrell Issa (R-CA) released a scathing report on the run-up to the launch of the site that highlighted staff concerns about security, attempts to cover-up the reasons behind the failed launch, and a disconnect between HHS and CMS staff.”

“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.”

“A major innovation in health insurance plan design over the past several years has been the rapid growth of “narrow network” plans. Such plans either limit enrollee choices of providers, or place providers in differential cost tiers whereby individuals face higher cost in selecting some providers relative to others. This movement harkens back to the restrictions put in place during the U.S. initial infatuation with managed care in the mid-1990s. That episode ended badly for the limited choice model, as the “HMO backlash” induced regulatory restrictions on plans which handicapped choice limitations within the HMO model.
The latest growth of narrow network plans has been hastened by the introduction of health insurance exchanges under the Affordable Care Act (ACA). State exchanges have fostered strong insurer competition through both organizing the marketplace and through tying low income health insurance tax credits to the second-lowest cost plan in the silver tier. Insurers have responded to these competitive incentives in many ways, but perhaps the most notable is the expansion of narrow network insurance products. Such products are widespread on exchanges and appear to be growing rapidly.”

“Republicans have found a new opening against ObamaCare after struggling for months to craft a fresh strategy against a healthcare law that now covers millions of people.
Lifted by a pair of federal audits that found major flaws with the law’s implementation, Republicans see their first chance in months to launch a serious attack against the law.
“The news that we’ve seen over the last week and a half really emphasizes what conservatives and Republicans were trying to do last year, which was preventing a lot of this from happening,” said Dan Holler, a spokesman for the conservative political group Heritage Action for America.
“What I hope happens is that the Republican Party as a whole says, ‘Yes, there is a reason besides politics that we’re fighting ObamaCare: It’s hurting people,’” Holler said.”

“A wave of hospital mergers and acquisitions spreading across the U.S. has the health insurance industry attempting to stand in the way with legalese, Congressional lobbying and in the court of public opinion.
America’s Health Insurance Plans, the powerful lobby and trade group representing the biggest names in commercial insurance appears to be leading the charge battling deals in New York, Chicago and beyond.
“Consolidation promises greater efficiency, but all that ever materializes is greater costs,” Brendan Buck, former press secretary to Speaker of the U.S. House John Boehner, who was tapped this spring to be vice president of communications at America’s Health Insurance Plans (AHIP) told the Chicago Sun-Times following news two of the wealthiest hospital operators in the city would merge.”

“If you bought health insurance at an Affordable Care Act marketplace this year, it really pays to look around before renewing your coverage for next year.
The system is set up to encourage people to renew the policies that they bought last year — and there are clear advantages to doing so, such as being able to keep your current doctors. But an Upshot analysis of data from the McKinsey Center for U.S. Health System Reform shows that in many places premiums are going up by double-digit percentages within many of the most popular plans. But other plans, hoping to attract customers, are increasing their prices substantially less. In some markets, plans are even cutting prices.”