States are beginning to turn to hospitals to cover the cost of Medicaid expansion once the federal match begins to drop next year. The Affordable Care Act provides 100% federal financing for those made newly eligible for Medicaid under the law. The federal match rate falls to 95% in 2017, 94% in 2018, 93% in 2019, and then 90% in 2020 and beyond. Starting next year, eight of the 32 states that have expanded Medicaid planned to use provider taxes or fees to fund all or part of the states’ share of costs, the report said. These states have chosen to implement a new or modify an existing provider assessment specifically for the purpose of covering the costs of expansion.

. . .

In the last moments of the final presidential debate Wednesday, the candidates used a question about entitlements to restate their positions on Obamacare. Donald Trump again vowed to “repeal and replace” the law and said that he was glad premiums had gone up, presumably to make his point that President Obama’s signature health care reform law was “destroying our country.” Hillary Clinton said repealing Obamacare would make maintaining the solvency of Medicare more difficult.

. . .

Vermont has received tentative approval from the Obama administration to establish an all-payer reimbursement system for healthcare providers in the state starting in January.

Maryland long has had an all-payer system, but it covers only hospitals. Vermont plans to use an accountable care organization-type structure that would cover all providers. All-payer systems require all insurers, whether private, Medicare or Medicaid, to pay similar rates for services.

. . .

A majority of physicians look negatively at their profession and are increasingly burdened by new reimbursement models, according to a new survey.

The Physicians Foundation, a not-for-profit organization that supports research on the impact of the Affordable Care Act on physician groups, surveyed 17,236 physicians across the U.S. (PDF) on a variety of issues related to their field.

The report highlighted low morale among a majority of physicians. Fifty-four percent of physicians rated their morale as somewhat negative or very negative and only 37% were positive about the future of their profession. This is a decrease, however, from 2012 when 68% of physicians described low morale when surveyed by the organization.

. . .

The CMS says some Medicare beneficiaries are receiving tax credits to purchase insurance through the Affordable Care Act marketplace. The agency is warning them to cancel their exchange coverage immediately and pay back the credit they’ve received.

. . .

Steve Banke employs 40 people at 3-Points, a small IT outsourcing company he founded almost 15 years ago. And he wants those workers and their families to have strong health insurance options.

Employees at the firm, based in Oak Brook, Ill., can choose between two types of Blue Cross and Blue Shield of Illinois plans: a PPO with a broader network of hospitals and doctors or a cheaper HMO network. Banke’s company covers a percentage of the premiums, and those costs have risen rapidly over the past several years, often more than 12% annually, he said.

. . .

When Aetna decided last week to drop 70% of its health plans in the Affordable Care Act markets, CEO Mark Bertolini publicly blamed the exits on the poor risk pool, as well as “the current inadequate risk-adjustment mechanism.”

The federal government’s decision to block Aetna’s acquisition of Humana also factored heavily into Aetna’s exchange exodus, as Bertolini warned in a July letter that was obtained by the Huffington Post.

 

. . .

Republican-led states are pushing back on a federal proposal to limit the use of short-term health plans. The Obama administration aims to move more healthy people into the Affordable Care Act marketplace by limiting cheaper but less-robust coverage options.

Under a proposal co-drafted by the IRS, HHS and Department of Labor, short-term policies may be offered for only less than three months and coverage cannot be renewed at the end of the three-month period. As things are now, consumers can stay in such plans for 12 months.

. . .

Hospital system Catholic Health Initiatives’ experiment with health insurance has hit the end of the road after a couple years of heavy losses. CHI is “exploring options to sell” its health plan subsidiary, executives said in new financial documents.

The documents, released this week to bondholders, explain that top CHI executives “decided to exit the health insurance business” in May after undergoing a strategic review in March. CHI’s consolidated insurance division, QualChoice Health, formerly known as Prominence Health, has hemorrhaged money since its inception. QualChoice sells Medicare Advantage plans and commercial plans to employers in six states.

. . .

Healthcare policy got remarkably little discussion during the Democratic National Convention in Philadelphia, despite repeated nods to the issue from Hillary Clinton, Barack Obama, and Bernie Sanders. Here’s why.

No one wanted to talk about the costs, regulations, and other tough tradeoffs that would be involved in further expanding insurance coverage under the Affordable Care Act, improving affordability for consumers, curbing medical spending growth, and reducing prescription drug costs.

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