Health insurer CareSource will offer Affordable Care Act exchange plans in Ohio’s Paulding County, leaving no place in the U.S. currently known to be at risk of lacking marketplace offerings under the law next year.
The decision by CareSource, a nonprofit that focuses largely on Medicaid, caps a triumph for state regulators around the country, who have fought hard to fill potential bare patches in their coverage maps after insurers announced pullbacks over the past several months amid uncertainty about the law’s future.
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Under the ACA, insurance companies must sell polices to people with chronic diseases and charge the same premiums paid by healthy people. But patients with pre-existing conditions in fact are being denied coverage when their insurance plans don’t cover medically-recommended treatments or when they place significant obstacles in the way. Many plans impose “utilization management” rules restricting access to drugs. Dr. Blinderman suggests a “preauthorized trial period” for all medications. Following this trial period, physicians could be asked to justify continuation of the therapy. Doing this would relieve patient suffering due to delays or disruptions in the amelioration of symptoms, reducing health-care costs in the process.
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A fast-approaching deadline for insurers to commit to selling health plans next year under the Affordable Care Act is pressuring Republican lawmakers to decide quickly whether to shore up the law and ease the path for insurers or continue efforts to roll it back.
Lawmakers returning to the Capitol from recess on Sept. 5 will have only 12 legislative days to decide whether to pass a bipartisan bill aimed at bolstering the ACA’s markets before insurers must commit to participating in the law’s exchanges in 2018. At the same time, a plan from Sens. Lindsey Graham (R., S.C.) and Bill Cassidy (R., La.) that would largely topple most of the ACA is gaining traction among Republicans.
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A recent study by Express Scripts Holding found that about a quarter of Medicaid patients were prescribed an opioid in 2015. Wisconsin Sen. Ron Johnson presents intriguing evidence that the Medicaid expansion under ObamaCare may be contributing to the rise in opioid abuse. According to a federal Health and Human Services analysis requested by the Senator, overdose deaths per million residents rose twice as fast in the 29 Medicaid expansion states—those that increased eligibility to 138% from 100% of the poverty line—than in the 21 non-expansion states between 2013 and 2015.
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The oracles at the Congressional Budget Office this week descended from Delphi to predict 20% premium increases if the Trump Administration ends illegal Obama Care subsidies for insurers, and Democrats are happy to agree. Yet a careful reading of the report reveals some surprising results that are far less ominous and for consumers mostly benign.
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The ACA has expanded funding for Medicaid services, but it has also to an even greater degree expanded the pool of people eligible. It used to be that Medicaid did a fair job of providing for the truly disabled and needy. Now it does a lousy job of serving more people. My wife and I have an adult child living at home and will for the rest of our lives. Please join me in supporting the repeal of the ACA and put Medicaid funding back in the pot for the truly needy and disabled in our society. Our daughter will thank you.
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Republicans in Congress haven’t repealed or replaced Obama Care, but the Trump Administration still has an obligation to help Americans facing higher premiums and fewer choices. One incremental improvement would be rescinding regulations on temporary health-insurance plans.
Sen. Ron Johnson (R., Wis.) this summer sent a letter to the Health and Human Services Department about an Obama rule on short-term, limited-duration health insurance plans, which as the name suggests offer coverage for certain periods, often insuring against hospitalizations or other unexpected events. A person could hold such a plan for 364 days, but a rule issued last year limited the duration of the policy to a mere 90 days, effective April 1.
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Congressional Republicans plan to use the next four weeks away from Washington making a public case for a sweeping rewrite of the tax code, an ambitious legislative undertaking they hope will heal divisions that opened when the party’s signature health-care bill collapsed. But at home in their districts, they face pressures that could make it hard to focus on taxes.
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President Trump likes to govern by Twitter threat, which often backfires, to put it mildly. But he’s onto something with his recent suggestion that Members of Congress should have to live under the health-care law they imposed on Americans.
Over the weekend Mr. Trump tweeted that “If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!” He later added: “If ObamaCare is hurting people, & it is, why shouldn’t it hurt the insurance companies & why should Congress not be paying what public pays?”
Mr. Trump is alluding to a dispensation from ObamaCare for Members of Congress and their staff, and the back story is a tutorial in Washington self-dealing. A 2009 amendment from Chuck Grassley (R., Iowa) forced congressional employees to obtain coverage from the Affordable Care Act exchanges. The Senate Finance Committee adopted it unanimously.
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Major health insurers in some states are seeking increases as high as 30% or more for premiums on 2018 Affordable Care Act plans, according to new federal data that provide the broadest view so far of the turmoil across exchanges as companies try to anticipate Trump administration policies.
Big insurers in Idaho, West Virginia, South Carolina, Iowa and Wyoming are seeking to raise premiums by averages close to 30% or more, according to preliminary rate requests published Tuesday by the U.S. Department of Health and Human Services. Major marketplace players in New Mexico, Tennessee, North Dakota and Hawaii indicated they were looking for average increases of 20% or more.
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