A project of the Galen Institute

Issue: "Premiums/Costs"

With New Health Law, Shopping Around Can Be Crucial

Margot Sanger-Katz and Amanda Cox, NY Times
Fri, 2014-09-19
"If you bought health insurance at an Affordable Care Act marketplace this year, it really pays to look around before renewing your coverage for next year. The system is set up to encourage people to renew the policies that they bought last year — and there are clear advantages to doing so, such as being able to keep your current doctors. But an Upshot analysis of data from the McKinsey Center for U.S. Health System Reform shows that in many places premiums are going up by double-digit percentages within many of the most popular plans. But other plans, hoping to attract customers, are increasing their prices substantially less. In some markets, plans are even cutting prices."

Low-Wage Workers Feel the Pinch on Health Insurance

Drew Altman
Wall Street Journal
Fri, 2014-09-19
"We did not see big changes in employer-based coverage in the Kaiser-HRET annual Employer Health Benefit Survey released last week. Mostly this is good news, particularly on the cost side where premiums increased just 3%. But one long-term trend that is not so good is how this market works for firms with relatively large shares of lower-wage workers (which we define as firms where at least 35% of employees earn less than $23,000). These low-wage firms often do not offer health benefits at all. And, as the chart below shows, when they do offer coverage, it has lower premiums on average (likely meaning skimpier coverage) and requires workers to pay more for it. Workers in low-wage firms pay an average of $6,472 for family coverage, compared with $4,693 for workers in higher wage firms."

Obamacare Has a Long Way to Go, ACA Experts Say

Briana Ehley
Financial Times
Fri, 2014-09-19
"BOSTON -- When it comes to the president’s health care law, there’s very little that Republicans and Democrats agree on—but one idea that seems to unite analysts, experts and lawmakers across the political spectrum is that Obamacare has done very little to actually improve health care. “The U.S. healthcare system was always dysfunctional. The Affordable Care Act has just provided more access to that dysfunctional system,” iVantage chief Donald Bialek said during an ACA debate at The Economist’s health care forum in Boston on Wednesday. Bialek, for his part, was on the side defending the health care law."

Va. House of Delegates plans to vote on Medicaid expansion

Laura Vozzella, Washington Post
Fri, 2014-09-19
"RICHMOND — Republican leaders of Virginia’s House of Delegates, who have staunchly opposed Medicaid expansion all year, plan to put the question to a floor vote as early as Thursday in a special legislative session. The GOP-dominated chamber is widely expected to shoot down the proposed $2 billion-a-year expansion, although a few conservative legislators have expressed fears that the measure might defy expectations and pass — just as a then-record tax hike did when Democrat Mark R. Warner was governor a decade ago."

Big Health Insurance: Obamacare's Worst Bad Guys

Ryan Ellis
Forbes magazine
Wed, 2014-09-17
"Very few industries in bed with Obamacare come off smelling like a rose. But if one had to pick a bad actor above all others, it would probably be Big Health Insurance. America’s largest and most influential health insurance companies actively supported passage of Obamacare in Congress, and continue to do so today. That’s not surprising, since the heart of Obamacare is a mandate on Americans to purchase the product the health insurance companies are selling (the individual mandate). The “essential minimum coverage” on “qualified health insurance plans” as dictated by the Department of Health and Human Services tend to emphasize first dollar insurance coverage whenever possible, which increases insurance company profits. Worst of all, insurance companies are the beneficiaries of a giant taxpayer bailout that makes their Obamacare participation a “heads they win, tails taxpayers lose” kind of scenario."

Health Law Shows Little Effect In Lowering Children's Uninsured Rate, Study Finds

Michelle Andrews, Kaiser Health News
Wed, 2014-09-17
"The uninsured rate for kids under age 18 hasn’t budged under the health law, according to a new study, even though they’re subject to the law’s requirement to have insurance just as their parents and older siblings are. Many of those children are likely eligible for coverage under Medicaid or the Children’s Health Insurance Program. The Urban Institute's health reform monitoring survey analyzed data on approximately 2,500 children, comparing the uninsured rate in June 2014 with the previous year, before the health insurance marketplaces opened and the individual mandate took effect. It found that rates remained statistically unchanged at just over 7 percent for both time periods."

In South Florida And The Nation, Health Care Costs Often Are Shrouded In Secrecy

Daniel Chang, Miami Herald
Tue, 2014-09-16
"At a hearing to discuss the rising costs of healthcare benefits for Miami-Dade County, Fla., employees this year, a labor union consultant raised his hand to ask what seemed like a basic question. Could the committee charged with reducing Miami-Dade labor’s healthcare expenses look at the spreadsheet showing the rates that the county pays local hospitals and doctors for medical services to employees? “We really need to understand where the money is being spent in order to be insightful about benefit design changes,’’ said Duane Fitch, a healthcare consultant for SEIU Local 1991, which represents physicians and nurses at the county-owned Jackson Health System."

Companies race to adjust health-care benefits as Affordable Care Act takes hold

Aaron Gregg
Washington Post
Tue, 2014-09-16
"Large businesses expect to pay between 4 and 5 percent more for health-care benefits for their employees in 2015 after making adjustments to their plans, according to employer surveys conducted this summer. Few employers plan to stop providing benefits with the advent of federal health insurance mandates, as some once feared, but a third say they are considering cutting or reducing subsidies for employee family members, and the data suggest that employees are paying more each year in out-of-pocket health care expenses."

Health Law Falls Flat With Kentucky Voters, Even Those It Helps

Abby Goodnough
New York Times
Tue, 2014-09-16
"Despite the success of the Affordable Care Act in Kentucky, state Democrats are having a hard time winning over even those Republicans who admit they are benefiting from the law. The Affordable Care Act allowed Robin Evans, an eBay warehouse packer earning $9 an hour, to sign up for Medicaid this year. She is being treated for high blood pressure and Graves’ disease, an autoimmune disorder, after years of going uninsured and rarely seeing doctors. “I’m tickled to death with it,” Ms. Evans, 49, said of her new coverage as she walked around the Kentucky State Fair recently with her daughter, who also qualified for Medicaid under the law. “It’s helped me out a bunch.” But Ms.

Brady Questions HHS Authority To Put Forward Hospital Appeals Settlement

http://insidehealthpolicy.com/brady-questions-hhs-authority-put-forward-hospital-appeals-settlement
Tue, 2014-09-16
"House Ways & Means health subcommittee chair Kevin Brady (R-TX) questions HHS' authority to settle hospitals' appeals of denied inpatient claims and is urging HHS Secretary Sylvia Burwell to retract what he views as an "ill thought" settlement process. Brady wants Burwell to work with lawmakers to come up with a different "fair, transparent and conclusive settlement process." Brady wrote to Burwell Tuesday (Sept. 16) that he is dismayed by HHS' reluctance to work with the committee on an equitable settlement process that is fully legal, adding that the "lack of engagement makes it challenging for the Congress to solve the current appeals problems and prevent similar problems in the future." CMS announced late last month (Aug. 29) that it will pay hospitals 68 percent of denied inpatient status claims in the appeals queue if hospitals take them out of the backlogged appeals process.

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