A project of the Galen Institute

Issue: "States"

BREAKING: Judge rules against Obamacare subsidies

Paul Demko, Modern Healthcare
Tue, 2014-09-30
"In a legal setback for the Obama administration, a federal judge in Oklahoma ruled Tuesday that people in states that rely on the federal insurance exchange are not eligible for Obamacare premium subsidies to help them pay for coverage. Judge Ronald White, a George W. Bush appointee, invalidated an Internal Revenue Service rule interpreting the Patient Protection and Affordable Care Act to allow the premium tax credits in states that have not established their own exchange. “The court holds that the IRS Rule is arbitrary, capricious, an abuse of discretion or otherwise not in accordance with law,” White wrote. In his ruling, White rejected the argument that striking down the subsidies would cripple the entire healthcare reform law. “Congress is free to amend the ACA to provide for tax credits in both state and federal exchanges, if that is the legislative will,” he wrote."

Obamacare doctor networks to stay limited in 2015

Chad Terhune, Sandra Poindexter, Doug Smith, LA Times
Tue, 2014-09-30
"Finding a doctor who takes Obamacare coverage could be just as frustrating for Californians in 2015 as the health-law expansion enters its second year.. The state's largest health insurers are sticking with their often-criticized narrow networks of doctors, and in some cases they are cutting the number of physicians even more, according to a Times analysis of company data. And the state's insurance exchange, Covered California, still has no comprehensive directory to help consumers match doctors with health plans."

Jindal under fire in La. on health care

Melinda Deslatte
Associated Press
Tue, 2014-09-30
"Gov. Bobby Jindal has been viewed as a health care policy wonk, and he’s tried to build on that image ahead of a likely 2016 presidential campaign, positioning himself as the candidate with substantive ideas. But his administration’s handling of health care matters at home could undermine his bonafides in the subject area and threaten his efforts to sell himself as a health care expert."

Scrambling To Prove He’s Eligible For Obamacare

Daniela Hernandez
Kaiser Health News
Tue, 2014-09-30
"When Fabrizio Mancinelli applied for health insurance through California’s online marketplace nine months ago, he ran into a frustrating snag. An Italian composer and self-described computer geek, Mancinelli said he was surprised to find there wasn’t a clear way to upload a copy of his O-1 visa. The document, which grants temporary residency status to people with extraordinary talents in the sciences and arts, was part of his proof to the government to that he was eligible for coverage. So, the 35 year-old Sherman Oaks resident wrote in his application that he’d be happy to send along any further documentation. Months went by without word from the state. Then last week he came home from vacation to find a notice telling him he was at risk of losing the Anthem Blue Cross plan he’d purchased."

Blues Plans In Three States To Cancel Non-ACA Individual Plans This Year

Rachana Dixit Pradhan, Inside Health Policy
Tue, 2014-09-30
"Three Blue Cross Blue Shield plans operated by Health Care Service Corporation have decided to discontinue their “transitional” non-ACA compliant plans at the end of this year and cancellation notices will be sent to affected policyholders “shortly,” a company spokesperson tells Inside Health Policy. HCSC says the decision was made to help keep premiums for ACA plans affordable, because moving those enrollees into compliant plans will result in a more balanced mix of individuals. Transitional plans that were on the market this year from Blue Cross Blue Shield of Texas, Blue Cross Blue Shield of New Mexico and Blue Cross Blue Shield of Oklahoma will be discontinued effective Jan. 1. One source tracking state developments said the Blues appear to be discontinuing the plans on its own volition. The Blues participated aggressively in the exchanges in the first year while many other carriers remained cautious about entering the new markets, though that is beginning to change for 2015.

Survey: Employers passing Obamacare costs to employees

Rudolph Bell
Greeneville, S.C., News
Fri, 2014-09-26
"New survey data show that companies are passing on to their employees additional costs they have incurred as a result of the Affordable Care Act, according to a management professor at the University of South Carolina's Moore School of Business. And that means employees who get their health insurance through work are bearing the cost of subsidizing people newly covered under President Obama's healthcare reform law, said Professor Patrick M. Wright."

At Raleigh forum, underwriter anticipates 60-percent increase within two years

Dan Way, Carolina Journal
Fri, 2014-09-26
"RALEIGH — A sizable number of North Carolina residents are learning they are no longer eligible for Obamacare, and some health policy premiums could jump 60 percent within two years, an insurance official says. Rufus Langley, an Apex insurance agent and state leader of the North Carolina Association of Health Underwriters, said Coventry Health Care of the Carolinas CEO Tracy Baker recently told his group that substantially higher consumer costs are anticipated. “He can see in 2016 this thing shooting up anywhere from 30 to 60 percent in costs” as delayed taxes start to kick in this year and next year, and medical care costs still rising, Langley said Monday at a Raleigh panel discussion."

Cover Oregon health exchange discovers new tax credit problem, number affected unknown

Nick Budnick, Oregonian
Thu, 2014-09-25
"Officials at Cover Oregon have realized the number of people affected by tax credit errors is much larger than previously thought -- meaning they may owe money at tax time. Early this month, The Oregonian revealed the existence of the erroneous formula, which had to do with the tax credits used by qualified individuals to reduce their premiums. Cover Oregon first noted the formula was wrong in January, but correcting it took a back seat to fixing the exchange's technological problems, officials said."

Consumer Group Sues 2 More Calif. Plans Over Narrow Networks

Julie Appleby, Kaiser Health News
Thu, 2014-09-25
"Insurers Cigna and Blue Shield of California misled consumers about the size of their networks of doctors and hospitals, leaving enrollees frustrated and owing large bills, according to two lawsuits filed this week in Los Angeles. “As a result, many patients were left without coverage in the course of treatment,” said Laura Antonini, staff attorney for Consumer Watchdog, a Santa Monica-based advocacy group that filed the case. Both cases allege that the insurers offered inadequate networks of doctors and hospitals and that the companies advertised lists of participating providers that were incorrect. Consumers learned their doctors were not, in fact, participating in the plans too late to switch to other insurers, the suits allege, and patients had to spend hours on customer service lines trying to get answers. Both cases seek class action status."

Governors: States Should Consider Easing Physician Assistant Limits

John Wilkerson, Inside Health Policy
Thu, 2014-09-25
"Governors suggest in a new report that states consider easing restrictions on physician assistants to help deal with swelling Medicaid rolls. The National Governors Association says states should consider including PAs in the definition of "provider," loosening so-called scope-of-practice laws to let physicians delegate more tasks to PAs, opening clinical training sites and encouraging PAs to work in primary care. "To increase the use of the physician assistant workforce, states should review the laws and regulations affecting the profession and consider actions to increase the future supply of PAs," an NGA release states."

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