Elisabeth Rosenthal, NY Times
"Leo Boudreau of Massachusetts was thrilled to find a psychologist in his insurance network to treat his teenage daughter for emotional stress related to a medical condition. The therapist worked out of a local hospital.
But he was surprised when the bill for each visit contained two charges: the approximately $100 he expected to see for the therapist — and a similar fee for the room, which was not covered.
“How could it be that the doctor was in network and the hospital was in network, but I had to pay separately for the room?” Mr. Boudreau said."
Ricardo Lopez, Minneapolis Star-Tribune
"Almost immediately after the state’s insurance regulator earlier this month announced that rates for plans sold through MNsure would rise 4.5 percent on average, Republicans, health policy experts and other critics decried the figure as bogus and misleading.
The state Commerce Department has steadfastly defended the figure — a straight average of rate changes reported by the four returning carriers to MNsure — acknowledging that some consumers will see higher or lower rate changes. State agency officials said consumers can shop around once open enrollment begins Nov. 15 “to find the best option that fits their individual health and financial needs.”
But other states, like California, Colorado and Washington, report their increases in premiums for their respective exchange plans as weighted averages.
Calculated that way, Minnesota’s figure for next year is not 4.5 percent, but 11.8 percent."
John Graham, National Center for Policy Analysis
"Australia’s federal government is about to raise almost $5 billion by privatizing its largest health insurer: Australia hopes to raise up to Aus$5.51 billion (US$4.82 billion) through the sale of the country’s largest health insurer in an initial public offering, Finance Minister Mathias Cormann said Monday. Cormann said the sale would remove the current conflict where the government is both the regulator of the private health insurance market and owner of the largest market participant. Medibank provides cover to 3.8 million people. The government has previously said Medibank is one of 34 competing funds in the private health insurance market in Australia and that a scoping study had found no evidence that premiums would rise as a result of the sale."
Dan Mangan, CNBC
"These insurers will sell you some Obamacare—at least as long as the government is footing the bill for most of their customers.
Insurers doing business on HealthCare.gov will be allowed to terminate their health plans if there's a halt on federal tax credits that help most Obamacare customers buy the coverage, according to new language for 2015 contracts.
The language giving insurers the new opt-out does make clear, however, that individual state laws still may force insurers to continue the coverage."
Guy Benson, Townhall
"It's been a tough week for North Carolina Senator Kay Hagan, who's clinging to a razor-thin lead in her re-election fight. She chose not to attend a 'debate' this week, ceding an hour of statewide airtime to her surging Republican opponent, Thom Tillis. Her chair sat empty throughout the forum. What didn't she want to discuss? Perhaps it was her decision to skip a key classified briefing on ISIS in favor of a New York City fundraiser. Or maybe it was the explosion of reports that her immediate family benefited directly from the "stimulus" law she voted for. It could have been President Obama's endorsement of candidates like Hagan as strong supporters of his agenda in Washington; the extent of Hagan's fealty was underscored again in yesterday's CQ analysis of 2014 voting records:"
Liz Hamel, Jamie Firth, Bianca DiJulio and Mollyann Brodie, Kaiser Health News
"In the final Kaiser Health Tracking Poll before the 2014 midterm elections in November, the Affordable Care Act (ACA) continues to be just one of several issues on voters’ minds. Less than 1 in 10 registered voters (8 percent) identify the ACA as the most important issue to their vote, ranking 5th behind the economy (16 percent), dissatisfaction with government (12 percent), education (10 percent) and the situation in Iraq and Syria (9 percent). The ACA ranks 4th for Democrats, Republicans, and independents alike. Just over half of voters say they’re tired of hearing Congressional candidates talk about the ACA and wish they would move on to other issues, while 44 percent say they want candidates to continue the discussion. Meanwhile, as campaigns make their final appeal to voters, 6 in 10 report seeing political advertising related to the ACA, with more saying they have seen mostly negative advertising about the ACA rather than mostly positive."
"Last spring, John* purchased health insurance through the Washington State healthcare exchange. He was surprised when, last month, he received an email from the exchange at the address he’d provided when he signed up. The email was entitled, “Voter Registration Information.”
It read, in part:
“ARE YOU REGISTERED TO VOTE? If you would like to register to vote or
update your information, visit the Washington Secretary of State
website at https://weiapplets.sos.wa.gov/myvote?Org=confidHBE&language=en”
“I did think it was an effort to [register voters] for the Democrat party,” says John, a union member for the better part of four decades.
He wasn’t the only healthcare exchange customer to get the voter registration email."
Nick Budnick, The Oregonian
"State officials have given up on trying to salvage a portion of the troubled Cover Oregon technology project, essentially abandoning all hope of getting any lasting benefit from the $240 million paid Oracle America on the health insurance exchange and related work.
Instead, Oregon will look to use successful technology built by another state, and is trying to determine which one."
J.D. Harrison, Washington Post
"One year in, the new small-business insurance marketplaces born out of the new federal health-care law have fallen short of their promise in nearly every state, both in terms of functionality and enrollment. However, many are scheduled to see some important updates heading into year two — ones that health officials say should make them much more useful and appealing to small employers and their workers.
In the nation’s capital, for example, officials are preparing to roll out the third major update to the District of Columbia’s health-care marketplace, which already houses one of the country’s most robust small-business exchanges, often called SHOP (Small Business Health Options Program) exchanges. District small businesses have already been able to shop for and select plans online — an option that was delayed by at least a year in most states."
Michelle Andrews, Kaiser Health News
"Aiming to contain health care costs, a growing number of employers and insurers are adopting a strategy that limits how much they’ll pay for certain medical services such as knee replacements, lab tests and complex imaging. A recent study found that savings from such moves may be modest, however, and some experts question whether “reference pricing,” as it’s called, is good for consumers.
The California Public Employees’ Retirement System (CalPERS), which administers the health insurance benefits for 1.4 million state workers, retirees and their families, has one of the more established reference pricing systems. More than three years ago, the agency began using reference pricing for elective knee and hip replacements, two common procedures for which hospital prices varied widely without discernible differences in quality, says Ann Boynton, CalPERS’ deputy executive officer for Benefit Programs Policy and Planning."