Recent Articles

Last week, the Department of Health and Human Services (HHS) released the payment amounts that some insurers owe and some insurers will receive through the Affordable Care Act (ACA) risk adjustment program. As the law’s implementation moves forward, it is increasingly clear that the controversial risk adjustment program presents a fundamental trap, a sort of…

Connecticut’s financially “unstable” Obamacare health-insurance co-op was placed under state supervision on Tuesday, as regulators said 40,000 people covered by the company will ultimately have to find new plans for the coming year. HealthyCT is the 14th of 23 original Obamacare co-ops to fail since they began selling health plans on government-run Affordable Care Act…

Last year, healthcare leaders had their eyes trained on one big case – King v. Burwell – and they celebrated when the justices voted to uphold a key provision of the Affordable Care Act. This year wasn’t nearly so straightforward for healthcare leaders watching the Supreme Court, which wrapped up its latest term last week.…

This refrain may sound familiar: If you qualify for Medicaid but you like your “Obamacare” plan, you can keep it … unless you can’t. That’s the confusing and mixed message residents are getting from the state and insurance companies now that Louisiana has become the 31st state to expand Medicaid coverage under the Affordable Care…

Last week, the GOP kept a promise to the American people by delivering a replacement plan for Obamacare. The plan — part of the party’s “A Better Way” campaign — was unveiled by House Speaker Paul Ryan, R-Wisc. “What we are laying out today is a first-time-in-six-years consensus by the Republicans in the House on…

Graduate students have long relied on health insurance subsidies awarded as part of financial-aid packages as they try to earn a living and a degree. But the future of that benefit could be jeopardized by the Internal Revenue Service’s interpretation of a provision of the Affordable Care Act that casts the subsidies as an attempt…

A while back, I explained how the ACA’s Medicare Shared Savings Program (MSSP) uses Accountable Care Organizations (ACOs) to encourage healthcare providers to deny healthcare to seniors and disabled Medicare beneficiaries. To summarize: ACOs are paid bonuses if they “reduce costs” in the fee-for-service system, which they can do only by providing fewer services. The system…

Friday, the U.S. Court of Appeals for the D.C. Circuit released two opinions in Patient Protection and Affordable Care Act (PPACA) cases.  In one case, the federal government prevailed. In the other, it did not. In the first case, West Virginia v. Department of Health and Human Services, a unanimous panel concluded that the state of West…

Out-of-pocket spending is a controversial topic in healthcare. On the one hand, the purpose of insurance is to reduce the financial impact of adverse events, like illness and injury, so higher out-of-pocket costs mean insurance is providing less protection. On the other hand, with little or no exposure to costs, a patient might over-consume healthcare,…

When he was chairman of the Ways and Means Committee, Paul Ryan was frustrated when decisions about tax and other legislation under his committee’s jurisdiction emanated from the House leadership offices rather than from his committee.  When he was elected Speaker last fall, he promised to change that, and, in the “Better Way” package of…