Recent Articles

The third open enrollment period (OEP) for the public exchanges concluded in January. Many carriers—both early-OEP entrants and “wait-and-see” latecomers—believed this new market would achieve stability and sustainable margins in its third year. However, recent events— including carrier turnover (both entrances and exits), plan terminations, and pricing volatility—suggest the market is still in flux. One…

District Court Judge Rosemary Collyer has ruled for Congress in House v. Burwell, a case challenging the authority of the executive branch to pay Obamacare subsidies for which no money has been appropriated. These are not the highest-profile subsidies; they’re something called the cost-sharing reduction, which lowers the deductibles and out-of-pocket expenses for families buying…

Most big employers provide wellness programs now, and the Affordable Care Act gave the idea a boost in 2010 by letting companies offer employees financial incentives— such as lower health insurance premiums, gift cards or prizes—worth up to 30 percent of the cost of their health insurance. But as the wellness industry has grown, questions…

The legal war over ObamaCare is back. A federal judge gave House Republicans a significant victory on Thursday when she ruled that the administration is illegally making certain ObamaCare payments without a congressional appropriation. Still, the case is far from over. Democrats are turning their attention to the appeal of the ruling, and experts say…

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…

  Health insurance customers in a growing number of mostly rural regions will have just one insurer’s plans to choose from on the ObamaCare exchanges next year as some companies pull out of unprofitable markets. The entire states of Alaska and Alabama are expected to have only one insurer on the health law’s signature online…

Insurers and hospitals can’t discriminate against patients because of their gender identity under the Affordable Care Act, federal officials said Friday, but patient groups complained the rule doesn’t go far enough. The Department of Health and Human Servicesfinalized a rule that prohibited discrimination in health care based on a long list of characteristics ranging from race to…

Research shows an array of questions shared by in-person assisters, local navigators and certified application counselors to the Assister Help Resource Center (AHRC) from November 2015–January 2016. AHRC fielded nearly 1,400 calls during this period pertaining to complex health insurance application filings; eligibility determinations; and enrollment scenarios.The topics of the calls AHRC fielded were: 40%…

The Obama administration’s continuing efforts to rewrite and re-interpret the legal requirements of the Affordable Care Act (ACA) hit a new roadblock in federal district court yesterday. Judge Rosemary M. Collyer ruled that advance payments to insurers of cost-sharing reduction (CSR) subsidies for certain lower-income enrollees in Obamacare’s health insurance exchanges were never appropriated by…

The Department of Justice will appeal a federal judge’s ruling in a lawsuit from House Republicans against the Obama administration. A spokesperson did not respond to an inquiry asking when the department would file an appeal. A district judge for the District of Columbia ruled yesterday that the administration was improperly funding cost-sharing subsidies under the Affordable Care Act. . .…