A project of the Galen Institute

Issue: "Mandates"

How Does Where You Work Affect Your Contraceptive Coverage?

Kaiser Health News
Fri, 2014-09-12
"The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of this provision in 2012, some nonprofit and for profit employers with religious objections to contraceptives have brought legal challenges to this rule. For many women today, their contraceptive coverage depends on their employer or when they purchased their individual insurance plan."

Apparent Retail Glitch Triggers Copays For Birth Control

Shefali Luthra, Kaiser Health News
Fri, 2014-09-12
"CVS Health is investigating a potential glitch in its drug pricing system that appears to have charged women copayments for prescription birth control – though the scope of the error is unclear. The problem came to the attention of Rep. Jackie Speier, D-Calif., after one of her staffers attempted to buy generic prescription birth control in Washington D.C. and was charged a $20 copay. The retailer’s error, highlighted in a letter to the company from Speier, runs counter to a provision of the federal health law that mandates insurance coverage of women’s preventive care – a category including generic prescription birth control – without cost sharing."

In Employer Health Insurance Costs, Stability Is the New Normal

Drew Altman
Wall Street Journal
Fri, 2014-09-12
"Employers have complained for years about their rising health-care costs. But over the past decade, as the chart above shows, premium increases for employer health insurance have moderated sharply and stabilized. Premiums for family policies in the group market grew 72% between 1999 and 2004; 34% between 2004 and 2009; and 26% between 2009 and 2014. Even as premium growth moderated, health insurance costs still outpaced inflation and wage growth. But this year premiums grew 3%, about the same rate as wages and inflation. Despite fears that premiums would rise in the group market because of the Affordable Care Act, they have remained stable. Policy experts do not fully understand why health-care costs have moderated or when and how rapidly they might begin to again rise more quickly.

Employer health plan deductibles see big 5-year jump

Jayne O'Donnell, USA Today
Thu, 2014-09-11
"A report out today puts numbers behind what hit many workers when they signed up for health insurance during open enrollment last year: deductible shock. Premiums for employer-paid insurance are up 3% this year, but deductibles are up nearly 50% since 2009, the report by the Kaiser Family Foundation shows. The average deductible this year is $1,217, up from $826 five years ago. Nearly 20% of workers overall have to pay at least $2,000 before their insurance kicks in, while workers at firms with 199 or fewer employees are feeling the pain of out-of-pocket costs even more: A third of these employees at small companies pay at least $2,000 deductibles."

250K Virginians to Lose Health Care Due to Obamacare

The Weekly Standard
Thu, 2014-09-11
"An NBC affiliate in Virginia reports that nearly 250,000 people in that state will lose their health care plans due to Obamacare: "Nearly a quarter million Virginians will have their current insurance plans cut this fall," said the local anchor. "That is because many of them did not--are not following new Affordable Care Act rules, so a chunk of the companies that offer those individuals their policies will make the individuals choose new policies." Says the reporter, "This goes back to that now heavily-criticized line we heared before Obamacare was put in place: 'If you like your plan, you can keep it.' Ultimately, that turned out not to be true for thousands of Virginians and companies in the commonwealth. ... Wednesday Virginia lawmakers on the health insurance reform commission met for the first time this year. Turns out, a staggering number of Virginians will need new plans this fall.""

The Next Chapter of Obamacare

Bob Laszewski
Health Care Policy and Marketplace Review
Wed, 2014-09-10
"Welcome back from the summer. It's been pretty quiet lately on the Obamacare front. So quiet, that there has been a flurry of articles recently over how Obamacare has dropped to a second or even third tier issue and will hardly matter come election-time. Wishful thinking. Obamacare has largely been out of the news cycle for a couple of months but that is about to change. A few thoughts. The 2015 rate increases have been largely modest. Does that prove Obamacare is sustainable? No. You might recall that on this blog months ago my 2015 rate increase prediction was for increases of 9.9%. You might also recall my reason for predicting such a modest increase. With almost no valid claims data yet and the "3Rs" Obamacare reinsurance program, insurers have little if any useful information yet on which to base 2015 rates and the reinsurance program virtually protects the carrier from losing any money through 2016.

Obama Administration ‘Doubles Down’ on Fight Against Nuns

Kelsey Harkness
The Daily Signal
Wed, 2014-09-10
"The Obama administration has decided to continue its legal battle against Little Sisters of the Poor, a Catholic charity that objects to Obamacare’s mandate that employee health plans cover contraceptives and abortion-inducing drugs. The order of Catholic nuns argues that the rule fashioned by the Department of Health and Human Services requires them to violate their religious beliefs by offering insurance coverage for 20 specific drugs and devices — some of which the nuns believe could destroy what they consider a human life. If the Little Sisters of the Poor choose not to abide by the HHS mandate, they face devastating fines by the Internal Revenue Service that could result in millions of dollars a year being diverted from their mission of caring for elderly women and men."

Young adults may be less likely to use ED when insured

Sabriya Rice, Modern Healthcare
Wed, 2014-09-10
"Having access to health insurance is slowing the rate of young adults who head to the emergency department for care, a new study suggests. Relative use of the ED decreased among 19- to-25-year-olds after the healthcare reform law allowed them to stay on their parents' policies. The authors say the results show insurance can reduce ED overuse by removing the economic barriers to preventive care. “It's possible that when people have healthcare insurance they are less worried about the financial costs of care,” said Tina Hernandez-Boussard, assistant professor of surgery and biomedical informatics at Stanford University and lead author of a study published Monday in the journal Health Affairs. “They might seek appropriate care elsewhere and take care of conditions earlier. This could lead to a reduction in utilization of the emergency department.”"

Obamacare lets young adults stay on their parents’ insurance longer. Has that made them better off?

Jason Millman
Washington Post
Mon, 2014-09-08
"Allowing young adults to stay on their parents' health plans is one of the most popular elements of the president's health-care law, but a pair of new studies out today raises questions about the overall impact of the coverage expansion to an estimated 3 million people. The provision, which allows young adults to stay on their parents' health insurance plans until their 26th birthday, was one of the earliest parts of the law to take effect, in 2010, and researchers are now starting to report on the effects of that expansion. As expected, it increased the rate of health insurance among young adults, who historically had the highest uninsured rates of any age group. But the provision didn't change whether the age group perceived themselves as healthier or whether they thought health care was any more affordable, according to a new study in JAMA Pediatrics."

Consumers To Hear Soon If Plans Are Canceled

Michelle Andrews, Kaiser Health News
Sat, 2014-09-06
"Consumers may soon find a surprise in their mailbox: a notice that their health plan is being canceled. Last year, many consumers who thought their health plans would be canceled because they didn’t meet the standards of the health law got a reprieve. Following stinging criticism for appearing to renege on a promise that people who liked their existing plans could keep them, President Barack Obama backed off plans to require all individual and small group plans that had not been in place before the health law to meet new standards starting in 2014. The administration initially announced a transitional policy that, with state approval, would allow insurers to renew plans that didn’t comply with coverage or cost standards starting in December 2013 and continue doing so until October 2014. Then in March, the administration said it would extend the transitional policy for two more years, meaning that some people will be able to hang onto their non-compliant plans through 2017."

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