Photo: Peg via Flickr
Decisions by United Healthcare, Humana and now Aetna to shrink their footprint in the ACA exchanges – along with the collapse of the most of the co-ops – are likely to significantly decrease competition in some parts of the country next year.
Among the states likely to be most affected are: Alaska, Arizona, Oklahoma, Alabama, Georgia, the Carolinas, and probably parts of Florida. Continue reading
Photo: Phil Galewitz
About 25 Washington, D.C., area journalists met on Sept. 30 to learn about how the Affordable Care Act was affecting a local brewery and discover how the district’s health insurance exchange was working to help such small employers gain coverage for their employees. Continue reading
We’ve put up a tip sheet and written about the King v. Burwell case, but now that the ruling is imminent, we wanted to bring one more good one-stop-shopping resource to your attention and share a few tips.
The Alliance for Health Reform has issued a very good four-page tool kit – links to background articles, think tank papers, issue briefs and lots of sources. One caveat – it says that 7.5 million are subsidized in the affected states but the most recent government numbers are 6.4 million.
Other things to remember
There are 37 states using HealthCare.gov (with Hawaii, soon 38). But the reason you keep reading that 34 states are affected is that 34 are federal exchanges. Continue reading
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
We 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
Ten days before the (expected) close of open enrollment, The Philadelphia Inquirer reported that the federal exchange’s window-shopping tool – the one that the administration encourages everyone to check before applying for Marketplace insurance – was using the wrong year’s poverty-level guidelines. Neither the Obama administration nor any health-care consultants or policy experts that reporter Don Sapatkin could find had noticed it and the site was corrected within hours after the story was posted.
In theory, almost anyone going on the site got slightly incorrect information for 35 days. Most seriously affected, however, were people just above the poverty line in states that have not expanded Medicaid. When they put their information into the tool, it responded: “Not eligible for help paying for coverage.” Many of them may have given up right there and not submitted the actual applications (which were using the correct poverty stats and were assessed correctly). It’s impossible to tell from the notification letter whether errors were made.
Read about how Sapatkin uncovered the error and what the response was from the Centers for Medicare and Medicaid Services.