“The Obama administration has already debuted its new, improved version of HealthCare.gov, but still won’t release premium rates on the website until after the Nov. 4 elections.
The Department of Health and Human Services unveiled the updated federal Obamacare exchange on Wednesday. The website is, by all accounts, in much better condition than last year.
HHS secretary Sylvia Burwell has said that the administration has put the new version of HealthCare.gov through its paces. And the administration has allowed insurers to test the site out themselves — although they made clear that insurance companies are not allowed to share their results with the media.”
“CMS says that states should reimburse Medicaid managed care plans for the Affordable Care Act’s health insurance provider fee, and says that the fee itself should be incorporated into plans’ capitation rates, however, as the firm JP Morgan notes, the agency leaves some “wiggle room” on whether states should also factor in other potential effects of the fee, such as its non-deductibility status. Medicaid Health Plans of America President Jeff Myers said CMS’ recently released frequently asked questions document provides certainty for plans, particularly in states that hadn’t yet agreed to cover those fees.
Myers said the plans are gratified CMS decided to move forward with the FAQ, and the release of the FAQ and the 2015 Managed Care Rate Setting Consultation guide suggest that CMS would like to play a more involved role in rate setting for managed care. Since plans have been asking for more transparency around rate setting, CMS’ involvement could be a net positive, Myers said.
“Healthcare information-sharing is largely stuck in neutral, according to the Office of the National Coordinator for Health Information Technology’s annual report on electronic health-record adoption, released Thursday.
While standards and services have been established to support information-sharing, “practice patterns have not changed to the point that healthcare providers share health information electronically across organization, vendor and geographic boundaries,” the report argued.
Information-sharing is seen as a key component in the move from a fee-for-service approach in U.S. healthcare to a quality of care approach, so signs that the sharing isn’t happening could spell trouble for progress toward that shift.”
“Faced with the rising costs of generic prescription drugs, health insurers increasingly are turning to tiers and preferred lists on their formularies to keep costs down. Those strategies previously were used only for brand-name and specialty drugs. Experts say those approaches will increase out-of-pocket costs for patients and could make them less likely to adhere to drug regimens.
For years, insurers have encouraged patients to choose generic drugs because they were less expensive than their brand-name counterparts, and most prescription drugs currently used are generics.
But over the past year the cost of generic drugs has skyrocketed, including for products that have been on the market for many years. A study by Pembroke Consulting comparing CMS data for average generic drug acquisition costs between July 2013 and July 2014 found that half of the generic drugs listed rose in cost, with the median increase nearly 12%. Some drug prices saw extreme increases.
“Health Reform: Wal-Mart says it’s cutting health benefits to part-timers and boosting worker premiums. If a retail empire built on low prices can’t find a way around ObamaCare’s added costs, we are all doomed.
The world’s biggest retailer announced this week that its health costs will be about 48% higher for the current fiscal year than it had expected in February. As a result, it’s cutting 30,000 part-timers from its health benefit plan, raising worker-paid premiums by 19% and trimming its co-payment for health costs above the deductible.
“We had to make some tough decisions,” benefits director Sally Wellborn told the Associated Press. But to hear President Obama tell it, Wal-Mart just didn’t shop around.
That, at least, was what he said when the general manager of the Indiana-based Millennium Steel asked Obama last week about the company’s double-digit premium hikes.
Obama’s response: “The question is whether you guys are shopping effectively enough.””
“If the Congressional Budget Office is close to the mark, in the second open-enrollment season we will see about a doubling of the 7 million people enrolled in the Affordable Care Act insurance marketplaces. Open enrollment, which begins Nov. 15, is three months this year, or half as long as last year, and the remaining eligible uninsured are a more difficult-to-reach population. Here are the biggest challenges this time around:
First, the overwhelming reason the remaining uninsured cite as to why they have not already gotten coverage is that they believe they could not afford it. The message that most needs to reach the uninsured is that there are tax credits available to help make coverage more affordable. For a 30-year-old making $25,000 per year, the ACA tax credit would reduce the average cost of the most commonly selected “silver plan” from $2,877 per year to $1,729.
“Consumers keep price top of mind when they purchase prescription drugs and they’re unafraid to buy against the big labels, a new Morning Consult poll found.
Nearly three quarters of respondents said if given the choice between a brand name drug and a generic version, they’d be more willing to choose the generic version. What’s more, 65 percent of respondents disagreed that brand name drugs were more effective than generic drugs.”
“There are obvious benefits to getting health insurance at work. For one, employer-sponsored insurance is not taxed, meaning that every dollar of compensation provided as medical coverage stretches further. Individual market plans, meanwhile, are purchased with post-tax dollars. The only way to get in on the tax exemption is to buy coverage at work.
But for low-wage workers, Obamacare has introduced a new and big drawback to the employer insurance. Namely, anybody who gets access to affordable coverage at work is barred from getting subsidies through the new exchanges. This is even true for people who don’t buy insurance at work; just the act of getting offered employer coverage blocks individuals from using getting financial help.”
“Some health insurers are having trouble finding doctors and hospitals to accept low rates under Gov. Tom Corbett’s Medicaid expansion plan, leading one company to quit the program and another to reduce participation.
Highmark Inc., the state’s largest health insurer, said it won’t participate in Corbett’s Healthy PA program because it couldn’t sign enough doctors to its network. Healthy PA is an alternative to Medicaid expansion under the Affordable Care Act, proposed by Corbett and approved by the federal government in August, in which private insurers provide coverage to Medicaid recipients.”
“JACKSON, Miss. Groups supporting low-income Mississippi residents said Tuesday that elected officials are ignoring 300,000 people and refusing billions of federal dollars by choosing not to expand Medicaid in one of the poorest states in the nation.
If the state were to extend Medicaid, as allowed under the health overhaul that President Barack Obama signed into law, many low-wage workers could receive coverage that would enable them to afford doctors’ visits, prescriptions and medical supplies, said Roy Mitchell of the Mississippi Health Advocacy Program. He said bus drivers, cashiers, day care workers and many others are in jobs that provide modest paychecks but no health insurance coverage.”