The man selected by presumptive Democratic presidential nominee Hillary Clinton as her vice presidential running mate is a strong ally of Clinton’s in her push for improving the Affordable Care Act and expanding Medicaid to more states.
Virginia Sen. Tim Kaine, whom Clinton named Friday as her running mate, has sponsored several bills to fix gaps and glitches in the ACA and to encourage more states to extend Medicaid to low-income adults. None have won Republican support and passed. He also has strongly backed Virginia Gov. Terry McAuliffe’s unsuccessful efforts up to now to expand Medicaid in his own state.
As governor in 2009, Kaine signed a letter with 21 other governors to congressional leaders urging them to enact federal healthcare reform legislation.
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The Obama administration cannot force a Missouri lawmaker and his family to carry health insurance that includes contraception coverage despite the Affordable Care Act’s requirement that insurers cover birth control, a federal judge ruled Thursday.
U.S. District Judge Jean C. Hamilton said Thursday that HHS may not compel Republican state lawmaker Paul Joseph Wieland, his wife Teresa Jane Wieland or their insurer to include contraception coverage in their health plan. The ACA’s contraception mandate otherwise requires group health plans and insurers to cover contraceptives and sterilization procedures.
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The Obama administration suffered a setback in its efforts to strengthen the individual insurance market when a federal appeals court last week struck down an HHS rule barring the sale of certain limited-benefit plans as stand-alone products.
In Central United Life v. Burwell, the U.S. Court of Appeals for the District of Columbia Circuit overturned a 2014 HHS rule restricting the sale of fixed-indemnity insurance plans that pay policyholders fixed dollar amounts to cover medical services regardless of how much the provider bills. These plans, which are cheaper to buy than comprehensive plans but exclude pre-existing conditions, do not comply with Affordable Care Act provisions on minimum essential benefits or guaranteed issue.
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Small, regional health insurers and upstart co-op plans again incurred large charges under the Affordable Care Act’s risk-adjustment program, according to new data the CMS released Thursday. Calendar year 2015 marks the second year of risk adjustment, and many smaller insurers have had to pay into the program both years.
The data also show payouts for the ACA’s reinsurance program. For ACA plans sold in 2015, the reinsurance payments total $7.8 billion. The temporary reinsurance program, which expires at the end of this year, protects health insurers against costly claims.
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Blue Cross and Blue Shield of Minnesota is cutting back its participation in the state’s Affordable Care Act insurance exchange next year after losing nearly $300 million in the individual market in 2015.
However, the large Blues insurer is not completely exiting the state-based marketplace. Fully withdrawing has its consequences: Federal law bars insurers from re-entering the marketplaces for five years, assuming they discontinue all types of individual policies.
Instead, Blue Cross and Blue Shield of Minnesota is dropping health plans with the broadest networks sold on and off the exchange and will push people toward its narrower HMO option called Blue Plus, according to the Star Tribune.
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Policymakers are keeping their eyes on the 2016 Social Security and Medicare trustees’ report to see if the White House will stand by its projection that Medicare will be solvent until 2030. The Congressional Budget Office estimates funds (PDF) for the program will dry up in 2026.
Also of interest is whether the trustees will call for the creation of an Independent Payment Advisory Board called for in the Affordable Care Act to reign in Medicare costs if they grew faster than a set rate. But the board, called the death panel by ACA opponents, has not yet been created. There hasn’t been the need, and some say, the willingness to expend the political capital.
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More than two-thirds of state benchmark plans violate federal requirements to cover treatment for addiction disorders.
The National Center on Addiction and Substance Abuse surveyed addiction treatment benefits offered among 2017 Essential Health Benefits benchmark plans and found none offered a comprehensive array of addiction treatment benefits.
The report cites benchmark plans, which determine the minimum level of benefits available to those covered in state exchange plans, frequently “excluded or not explicitly covered benefits” related to residential treatment and the use of methadone as therapy.
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California is moving to become the first state to allow unauthorized immigrants to purchase insurance through the state exchange. The state Assembly voted Tuesday to open up Covered California to immigrants living in the U.S. illegally who want to purchase a health plan with their own funds.
SB 10, sponsored by Democratic state Sen. Ricardo Lara from southeast Los Angeles County, would authorize the state to apply for a federal waiver to make the change. The state Senate voted to pass the measure last June and an April staff report from Covered California also expressed support for the move.
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Rising rates are not solely the result of the uninsured who bought health plans on the exchanges having a tremendous pent-up demand for healthcare services. Many insurers also underpriced their plans to gain a larger share of the new market. The Congressional Budget Office found premiums in 2014 were 15% lower than expected.
The most significant factor behind next year’s sharply rising prices, experts say, is that millions of “young invincibles,” who represent a large segment of the uninsured pool, have so far not signed up for Obamacare.
“We saw very little of the young and healthy,” said Sherri Huff, a consultant and former chief financial officer of Common Ground Healthcare Cooperative in Wisconsin, one of the insurance co-ops funded by ACA loans.
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A federal judge’s decision Thursday that the Obama administration unconstitutionally spent money to pay for part of the Affordable Care Act may not disrupt health plans or beneficiaries right away. But the fresh uncertainty immediately delivered a blow to the share prices of hospitals and health insurers.
House Republicans alleged in a lawsuit that the administration illegally spent money that Congress never appropriated for the ACA’s cost-sharing provisions. Those provisions include reduced deductibles, copayments and coinsurance many Americans receive, depending on income, for plans purchased through the ACA’s insurance exchanges.
U.S. District Court Judge Rosemary Collyer agreed with House Republicans on Thursday, writing that appropriating the money without congressional approval violates the U.S. Constitution.
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