Tag Archives: Affordable Care Act

Looking ahead to the second ACA enrollment period

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Photo by jfcherry via Flickr

Photo by jfcherry via Flickr

We’re closing in on the start of the ACA’s second open enrollment season. Both Kevin Counihan, the new HealthCare.gov “CEO” within the Department of Health and Human Services, and HHS Secretary Sylvia Burwell have been speaking out a bit more about the upcoming season.

But there’s a lot they aren’t saying – or touting. Here are a few things we do – or don’t – know about what to expect by Nov. 15, the start of the three-month enrollment period: Continue reading

D.C.-area journalists get tips on upcoming ACA stories

Margot Sanger-Katz

About Margot Sanger-Katz

Margot Sanger-Katz (@sangerkatz) covers health care for The Upshot at The New York Times. She was a health care correspondent for the National Journal and, as the recipient of an AHCJ Reporting Fellowship on Health Care Performance, she produced a series examining hospital consolidation and its influence on health care costs and the future of health reform.

Photo: Margot Sanger-KatzJournalists at Sept. 18 Washington, D.C., chapter meeting heard from Tom Scully, a former CMS administrator; Stephen Zuckerman, a senior fellow at the Urban Institute; and Marilyn Serafini, a former journalist now with the Alliance for Health Reform.

Photo: Margot Sanger-KatzJournalists at a Sept. 18 Washington, D.C., chapter meeting heard from Tom Scully, a former CMS administrator; Stephen Zuckerman, a senior fellow at the Urban Institute; and Marilyn Werber Serafini, a former journalist now with the Alliance for Health Reform.

Open enrollment is coming again. And with millions of new people signing up for health insurance and renewing their plans come opportunities for new stories about how the Affordable Care Act is working.

Stephen Zuckerman, a senior fellow at the Urban Institute and Tom Scully, a former administrator at the Centers for Medicare and Medicaid Services who now works as a private equity investor, spoke to an AHCJ chapter meeting in Washington, D.C. about the possible stories ahead.

Continue reading

About 115,000 could lose insurance coverage based on residency issues

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Image via USCIS.gov

Image via USCIS.gov

We wrote earlier this month about the Sept. 5 deadline for people who had signed up for ACA coverage through the federal exchange but still had some inconsistencies in the record about their citizenship or legal residency. Here’s an update:

As of early September, the Department of Health and Human Services said 310,000 people still had status questions (down from close to a million “data-matching” cases in late May). Most did get the information in and the questions resolved. But about a third did not, and that means about 115,000 people will lose coverage at the end of this month. Continue reading

No shift to part-time work seen (yet) under ACA

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Photo by Marta P via Flickr

Photo by Marta P via Flickr

Remember all those stories about people being shifted into part-time work so their employers don’t have to provide health insurance?

According to a new Urban Institute report, funded by the Robert Wood Johnson Foundation, it hasn’t happened.

If, and when, the employer mandate fully kicks in (more on that below) things could change. But the anecdotes we’ve heard about employers cutting hours because of the Affordable Care Act are just that – scattered anecdotes. (And when it does occur, it might be a result of other business conditions, not the health law). Under the ACA the definition of “full-time” work is 30 hours; anyone working 30 hours a week or more would have to be covered. The fear was that employers would cut them to, say, 28 or 29 hours, to avoid that obligation. Continue reading

Thousands face Friday deadline to document citizenship, immigration status for federal marketplace

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Image via USCIS.gov

Image via USCIS.gov

Friday is the deadline for some 350,000 people who have yet to document their citizenship/legal residency for their health insurance through the federal exchange to get the information submitted and verified or face losing insurance at the end of this month.

It would be a good time to check with health, enrollment and immigrant advocacy groups in your community to see what kind of obstacles they are facing (technical, language barriers, poor communication, confusion) and what steps they are taking to meet the deadline. The Centers for Medicare & Medicaid Services says it has been trying to reach the affected people by email, mail and telephone. Immigration advocacy groups say that the outreach has left a lot to be desired and people are having trouble getting problems sorted out. Continue reading

ACA rules force health insurers to increase spending on care delivery

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

The percent of premium dollars allocated to administrative costs and profit dropped in all markets since the introduction of the 80/20 rule.

The percent of premium dollars allocated to administrative costs and profit dropped in all markets since the introduction of the 80/20 rule. (Click to enlarge image.)

A new report on how health insurers are complying with the medical loss ratio rules shows insurers spent more on care delivery and less on profit and overhead in 2013 than they did in the previous two years.

The report, “Consumers Benefited From 80/20 Rule in 2013,” from the federal Department of Health and Human Services (HHS) shows that the percentage of consumers insured by companies that met or exceeded the requirements under the MLR rules has risen each year since the rules became effective in 2011. Tables accompanying the report offer some great story ideas for journalists who want to dig deeper into why insurers in their states would pay rebates to consumers rather than put those funds into care delivery.

Also called the 80/20 rules, the MLR regulations in the Affordable Care Act require insurers to spend a minimum of 80 percent of premium income on delivering care (and not on profit and overhead) in the small group and individual markets and at least 85 percent of premium income on care delivery in the large group market.

Under the MLR rules, if insurers fail to spend at least at these levels, they have to rebate the difference to consumers. Those rebates are due by Aug. 1.

“In the first three years of the MLR program, individual and employer plan enrollees received or will receive over $1.9 billion in refunds,” the HHS report said. Continue reading

Breaking down court rulings on Affordable Care Act subsidies

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

supreme-courtEven for those of us who cover the Affordable Care Act (ACA) more or less full time, July 22 was a pretty zany day. Here’s a recap and some resources to help you going forward.

First an appeals court in Washington, D.C., ruled, 2-1 that people can’t continue to get subsidies in the federal exchanges – just on the state exchanges. Only it didn’t move to enforce that ruling – which would cut off millions receiving subsidies – because the three judges on that panel knew they didn’t necessarily have the last word. There are more legal fights to come in the case, known as Halbig v. Burwell. (It was v. Sebelius but the name was updated.)

Then, less than three hours later, another appeals court – also a panel of three judges – in Richmond, Va., issued the exact opposite ruling. They said, 3-0, that the subsidies in the federal exchange were fine. Well, maybe not fine – they thought the law was ambiguous. But even with the ambiguity, they said that the IRS had the right to interpret the law to allow the subsidies in the federal exchange. That case is known as King v. Burwell. (The IRS set the rules for the subsidies, which take the form of premium tax credits.)

The question in very simple terms is this: Did the ACA allow the subsidies through the federal exchanges? The plaintiffs argue no – and cite a specific section of the law that refers to subsidies for people enrolled “through an Exchange established by the State.” They say it’s clear as day – the subsidies are tied to state exchanges. The administration and its supporters say that’s far too narrow and literal an interpretation. The whole law is designed to expand coverage and the federal exchanges are meant to stand in when the states don’t stand up exchanges.

Now what? Continue reading

Documents yield true cost of Illinois’ PR campaign for insurance coverage

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Carla K. Johnson

Carla K. Johnson

When Illinois awarded a $33 million contract to a high-priced PR firm to promote insurance coverage under the Affordable Care Act, Carla Johnson began filing open records requests under the state’s Freedom of Information law.

Eventually Johnson, a medical writer for The Associated Press, filed 10 FOIA requests while reporting on how public money was spent to promote the health law.

She says the “88-page contract, obtained through a records request, contained clues about other existing documents, such as monthly detailed explanations of invoices and a ‘work plan’ required by the contract.” She continued filing requests until she had enough documentation to detect some trends.

Read more about how Johnson reported the story, what she learned and tips for other reporters.

Using data to report on health reform

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

We posted some data tools from the Robert Wood Johnson Foundation for the health reform beat and AHCJ’s New York chapter recently got to hear about them in more detail with some help from RWJF. If you’ve done stories using this data, we’d love to see them and learn about how you used the data. Send them to joanne@healthjournalism.org.

Charles Ornstein Storyfied the meeting and we have this guide for you from RWJF. Continue reading

Mo. journalist shows how undocumented immigrants struggle for care under ACA

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Tammy Worth

Tammy Worth

When the Affordable Care Act passed in 2010, Tammy Worth, an award-winning freelance health and business writer in Kansas City, Mo., was interested in how undocumented immigrants would fare under the new law.

She recognized that undocumented immigrants were ineligible for both of the main provisions of the law meant to extend coverage to 32 million Americans: the Medicaid expansion and the state insurance exchanges.

To fund her work, she applied in 2011 to the Association of Health Care Journalists for an AHCJ Reporting Fellowship on Health Performance, supported by the Commonwealth Fund. At the time, the fellowship program was in its second year of supporting journalists in their work reporting on the performance of local health care systems and the U.S. health system as a whole. In December 2011, she was named one of three fellows for 2012. (Note: Applications for the 2015 program are being accepted until Oct. 1.)

In 2012 and 2013, she focused her reporting on three areas: the economics of immigration, the effect of the law on providers and the health care community, and immigrant health stories.

The result was a three-part reporting project that was produced earlier this year for the Hale Center for Journalism at KCPT, a Kansas City public television station. Read more about how she did the reporting and her advice for other journalists.