Tag Archives: exchanges

Experts weigh in on covering the SCOTUS challenge

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. Follow her on Facebook.

Photo: Seth Borenstein, Associated Press/New York UniversityPhil Galewitz, of Kaiser Health News; Tom Goldstein, an attorney and founder of SCOTUSblog; Christine Eibner, a senior economist at Rand Corp.; and Thomas Miller, a fellow at the American Enterprise Institute (left to right) discussed how to cover Burwell vs. King Supreme Court Case during a chapter event at the NYU Washington, D.C., Center on Feb. 18.

Photo: Seth Borenstein, Associated Press/New York UniversityPhil Galewitz, of Kaiser Health News; Tom Goldstein, an attorney and founder of SCOTUSblog; Christine Eibner, a senior economist at Rand Corp.; and Thomas Miller, a fellow at the American Enterprise Institute (left to right) discussed how to cover King v. Burwell at the NYU Washington, D.C., Center on Feb. 18.

The Washington, D.C., chapter of the Association of Health Care Journalists had a session last week about the upcoming King v. Burwell case that will go before the Supreme Court challenging whether the Affordable Care Act subsidies can flow through the federal exchanges.

More than 30 people attended the event at New York University’s D.C. campus, including some students and faculty, and it was mentioned in Politico Pulse. Seth Borenstein, a science writer for The Associated Press and adjunct professor, helped organize and co-host the session. Kaiser Health News reporter Phil Galewitz, who leads the D.C. chapter, and Margot Sanger-Katz, a health writer with The New York Times, spoke to students after the event about how journalists have covered the Affordable Care Act.

A ruling for King would affect people in 34 states. Three other states – Nevada, New Mexico and Oregon – are using HealthCare.gov technology but are running enough of their own exchange to be a sort of hybrid. Briefs for both sides filed in the case agree that it will affect 34 states, not 37.

We’re assembling a tip sheet with more resources on the case, but here are some highlights from the event. Continue reading

Reviewing patterns in marketplace insurance pools

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. Follow her on Facebook.

Photo by Thomas Hawk via Flickr.com.

Photo by Thomas Hawk via Flickr.com.

Back when states were deciding whether to run their own exchanges or let the feds do it, they also had to make a lot of decisions about how their exchanges would operate.

One question was whether to have a “clearinghouse” and let any health plan that met the legal requirements participate in the marketplace. The other option was to be an “active purchaser,” and to have the state exchange directly negotiate with the health plans over premiums, provider networks etc.

The rationale, for each model: Continue reading

What ACA enrollment numbers tell us – and what they don’t

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. Follow her on Facebook.

insuranceBy now you have heard of “Dentalgate.” The administration, twice, released ACA enrollment numbers this fall that included nearly 400,000 dental plans, alongside the regular health insurance plans. That made it sound like more than 7 million people were covered in the state and federal exchanges.

That’s wrong. Depending on which date you used, there were either about 6.9 million (as of mid-August) or 6.7 million (October).

You know the politics too: The GOP said it was “deception;” the Department of Health and Human Services said, “Oops.” There will be a hearing on the Hill on Dec. 9 when CMS chief Marilyn Tavenner will testify before the House Oversight committee.

But what do we know about where the numbers come from, or what they say about attrition from the 8 million who signed up for coverage by the middle of April? Continue reading

How to understand 2015 exchange plan insurance rate changes

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. Follow her on Facebook.

Image by 401(K) 2012 via Flickr

It’s rate increase season, and as we head into the second ACA enrollment season, it’s hard to understand why some rates are going up, some down – sometimes in the same place.

Also, some of the rates we’re hearing about are proposals. Depending on how much regulatory oomph state insurance officials have, the rates may change.

This post give you some ideas on what to watch for and how to think about rate increases in individual states, and what questions to ask the health plans and the regulators in your state. Remember that even in states using the federal exchange, HealthCare.gov, state insurance officials still have a role.

The Alliance for Health Reform (an invaluable resource on this issue) recently held a briefing on rate changes. The full briefing (webcast, transcript, background materials, source list) can be found online here.  A recent Health Affairs blog post by Christopher Koller and Sabrina Corlette provides another important resource.

Here are some key points outlined in these two resources: Continue reading

Use site’s data on silver plans on state, D.C. exchanges

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. Follow her on Facebook.

Want to know everything about premiums, networks, deductibles, cost-sharing and out-of-pocket limits for all 7,000-plus silver plans on exchanges in every state and Washington, D.C.? Well, now you can have it.

The Robert Wood Johnson Foundation and Breakaway Policy Strategies have created a unique dataset that you can access for free. (It can be viewed in Excel, too.) Breakaway also has done an 8-page report identifying some of the key findings in the data.

The material will let you spot national trends, see how your state is like or unlike other states, or see what variety of plans your state is offering, and what may have to change for next year. It also gives some details about what is or is not counted toward the deductible – which, as we’ve noted before, is not always straightforward.

What we know – and don’t know – about Marketplace enrollment

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. Follow her on Facebook.

ACA-enrollmentWe posted yesterday on what we knew about enrollment as we waited for the updated HHS report – which of course then came out. … So here are a few key points:

Marketplace enrollment: It’s a bit over 8 million, as we knew. There’s no solid data on how many have paid premiums, although the insurance industry is estimating it will be about 85 percent. A small data sample – which HHS said may not be too reliable – suggested that about 87 percent of those who got subsidies were uninsured at the time they applied. But we won’t have a really good grasp on the newly insured numbers for some time, although it’s in the millions (including Medicaid and other enrollment). As we explained earlier, the numbers may fluctuate because of special enrollment (and disenrollment). Continue reading