Lisa Schnecker, Modern Health Care
"New language in contracts between the CMS and insurers operating on HealthCare.gov is grabbing attention, with some calling it an admission by the government that it might lose upcoming court battles dealing with insurance subsidies on the health portal and others saying the new wording is just a practical precaution.
The new language appears to allow insurers to stop offering their plans should federal premium subsidies disappear. A number of cases regarding the legality of the subsidies in states without their own exchanges are now working their way through the courts.
The language says, “CMS acknowledges that (the insurer) has developed its products for the (federal exchange) based on the assumption that (advance payments of the premium tax credit) and (cost-sharing reductions) will be available to qualifying enrollees.
Merrill Goozner, Modern Healthcare
"Remember the excitement surrounding Castlight Health's initial public offering? Last March, the San Francisco startup's stock price soared when investors bought into the idea that online price transparency would transform the healthcare marketplace.
Castlight's business plan calls for offering software through insurers and employers that allows people to comparison shop for healthcare services. With employers rapidly moving their workers into high-deductible plans, patients looking to lower their out-of-pocket expenses could use Castlight to find low-cost providers."
Elise Viebeck, The Hill
"Businesses in five states received early access Monday to select features at ObamaCare's online health insurance marketplace for small employers.
The soft launch for the SHOP system is an effort by federal health officials to troubleshoot any problems at the exchange before Nov. 15, when it will open to all states that did not elect to build their marketplaces.
Small businesses in New Jersey, Delaware, Illinois, Ohio and Missouri can establish accounts, complete an application, receive a determination of eligibility and upload an employee roster, the Centers for Medicare and Medicaid Services said. In November, employers will also be able to browse plans and pricing."
The Associated Press
"NEW YORK — The federal government has sued New York City, saying it ripped off Medicaid for millions of dollars by submitting tens of thousands of false claims.
A civil lawsuit seeking unspecified damages was filed Monday in Manhattan federal court.
The lawsuit says the city and a computer company used computer programs to dodge a requirement that Medicaid be billed only after private insurance coverage is exhausted. The lawsuit says false diagnosis codes were submitted to Medicaid."
Caroline Chen, Bloomberg
"Aetna Inc. (AET), the third-largest U.S. health insurer, raised its profit forecast for the year as enrollment increases.
Operating earnings this year will be $6.60 to $6.70 a share, above the previous forecast of $6.45 to $6.60, the Hartford, Connecticut-based company said today in a statement."
Kaiser Family Foundation
"A key provision of the Affordable Care Act (ACA) is the requirement that private insurance plans cover recommended preventive services without any patient cost-sharing.1 Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they develop into more complicated, debilitating conditions, and that some services are also cost-effective.2 However, costs do prevent some individuals from obtaining preventive services (Figure 1). The coverage requirement aims to remove cost barriers."
Melinda Deslatte, Associated Press
"BATON ROUGE, La. — U.S. Sen. Mary Landrieu has doubled down on her support for the federal health care law even as polls show the revamp remains unpopular in Louisiana and a new Republican attack ad launched Tuesday hits the Democratic incumbent again for her vote.
The 30-second TV commercial by national conservative group Crossroads GPS, co-founded by GOP operative Karl Rove, says Landrieu's vote for President Barack Obama's signature initiative was a betrayal of Louisiana."
Jordan Shapiro, St. Louis Post-Dispatch
"If you bought health insurance on HealthCare.gov for this year, you could be in for a few surprises when open enrollment begins next month.
It’s possible, for example, that you could end up being billed for two different plans. The reason, insurers say, is because the federal government hasn’t addressed a key communications issue with the website.
And if you haven’t updated your financial information on the online insurance marketplace, you could face higher premiums and get less of a subsidy than you deserve."
Kristina Wong, The Hill
"Sen. David Vitter (R-La.) said on Sunday that the No. 1 priority for Republicans, if they take control of the Senate, is to repeal ObamaCare.
"Now that would be vetoed by President Obama, but I think it's very important to move forward with that, the House and Senate together.
"And then also look at specific reforms after that veto that can make a difference in the next two years before the next presidential election," he said on Fox News."
By Nicholas Fouriezos, Atlanta Journal-Constitution
"As Georgia’s insurance commissioner, Republican Ralph Hudgens rarely hesitated to voice his criticism of the health care law known as Obamacare. The incumbent continued that mantra Sunday even while caught in a political crossfire from his two lesser-known opponents.
“I’ve said it’s going to limit choices, limit the number of doctors, and that premiums are going to increase,” Hudgens said Sunday at an Atlanta Press Club debate. “Those statements have been well legitimized by what has happened.”
But some of his other statements put a bulls-eye on Hudgens."