The pharmaceutical industry, insurers and the Obama administration all want prescription drugs to be included in determinations about whether a certain pools of patients are riskier than others. The determinations are important because insurers who take on riskier sets of patients are eligible to receive compensation under Obamacare. Right now, those determinations are made using…

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Obamacare to date has failed miserably relative to what was originally promised regarding how many people would get covered and the number of these who would obtain their coverage through the Obamacare exchanges. The president’s claim that “America is on a stronger footing because of the Affordable Care Act” is dubious at best. Literally no…

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The Medicare Advantage Value-Based Insurance Design Model kicks off Jan. 1, 2017 and will run for five years. Value-based insurance design, or VBID, refers to health plans that waive or lower out-of-pocket costs for healthcare and prescription drugs that are proven effective for patients with chronic health conditions. The CMS wants feedback on ways to…

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Most of the remaining non-elderly uninsured people in the U.S. likely won’t gain coverage, a new study released this week suggests. The study, from the Urban Institute says that while some higher-income people who are uninsured will surely gain coverage as the penalties for not having insurance increase, the possibility for increased coverage is actually lower among those…

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The Congressional Budget Office projects millions of workers will leave employer-sponsored health plans over the next decade because of ObamaCare. Some will opt to go on Medicaid, but others will be kicked off their company plans by employers who decide not to offer coverage anymore, according to a new CBO report titled,  “Federal Subsidies for Health Insurance…

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The GOP committee chairmen issued subpoenas for Health and Human Services (HHS) documents related the “Basic Health Program,” which they say the administration is unconstitutionally funding despite a lack of appropriation from Congress. Republicans say the Obama administration is paying out these funds for the program even though Congress has not appropriated the money. The…

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The analysis, based on claims from 21 Blue Cross and Blue Shield insurers around the country, highlights a challenge the companies say they face covering the population that signed up for plans issued under the ACA, sold both on the law’s signature marketplaces and outside them. A number of Blue Cross and Blue Shield insurers…

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The justices heard oral arguments in the case just last week. Now they are asking the parties to address how employees would obtain contraceptive coverage through their employer’s insurance companies without any involvement from the employer, including notifying the government, their insurer, or third-party administrator of their objection. The parties have the opportunity to spell…

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According to a Blue Cross Blue Shield Association report, people who enrolled in health insurance through the ACA appear to be sick than expected. People who enrolled in individual health insurance plans after 2014 were less healthy and used more healthcare in 2014 and 2015 than those who were already enrolled in individual plans and…

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The Supreme Court asked for additional information from both sides on “whether and how” employees of religious nonprofits could get contraceptive coverage through other means that would be less objectionable to their employers. The goal, is to address how employees could still get contraceptive coverage “but in a way that does not require any involvement” from…

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