Proposal Would Require Insurers To Report Health Law Taxes


English: , member of the United States Senate....

English: , member of the United States Senate. Español: John Cornyn, un senador del Senado de los Estados Unidos (Photo credit: Wikipedia)

The measure’s sponsor, Sen. John Cornyn, R-Texas, bills it as a
way to educate consumers about how the health law’s benefits are funded.

The Hill: Insurers Would Report ObamaCare Taxes Under GOP Bill

A new bill from Sen. John Cornyn (R-Texas) would require health insurers
to disclose taxes they pay under ObamaCare to policyholders. In a
statement Monday, Cornyn touted the measure as a way to educate
consumers about how the Affordable Care Act’s benefits are funded
(4/22).

Also in the news, health law opponents are pressing for repeal of the
health law’s medical device tax, among other provisions, in
comprehensive tax reform legislation –

Roll Call: Health Law Tax Foes Find Hope In Overhaul Effort

Proponents of doing away with provisions such as the medical-device tax
and the annual fee on health insurance companies say they already have
bipartisan support for their repeal legislation. But the efforts still
will face health care politics and the need for significant offsets,
making their inclusion far from certain as lawmakers work toward
comprehensive tax legislation that can pass in both chambers (Attias,
4/22).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Next Stage Of Health Law Triggers Concern, Confusion


Obamacare Protest at Supreme Court

Obamacare Protest at Supreme Court (Photo credit: southerntabitha)

News outlets report on the confusion that continues to surround
the health law, especially as key provisions are about to take effect.
Meanwhile, officials and activists strategize about how to educate
consumers about their options.

Georgia Health News: Concern, Confusion Over The Next Stage Of Reform

In six months, Jimmy Rowalt will no longer have health insurance. For
the past two and a half years, the 25-year-old Athens resident has
worked at Highwire Lounge without worrying about the job’s lack of
health benefits. Now he’s a manager there, working 45 to 55 hours a
week. A rule allowing young adults to remain on their parents’ health
insurance policies until age 26 was one of the first provisions of the
Affordable Care Act to go into effect, in September 2010. … Rowalt’s
options will be meager after his October birthday, when he will be
dropped by his parents’ insurance company (Murphy, 4/22).

CT Mirror: Strategizing On Helping The Uninsured With Health Care Reform

As the country gears up to launch the Affordable Health Act, one of the
most difficult tasks will be to sell it to uninsured people who may have
never heard of the word “co-pay” or know what a primary care physician
is. That was the message of Alta Lash, a Connecticut community organizer
who was one of several speakers from across the nation at a daylong
roundtable discussion Monday on how to promote health equity through
“Obamacare.” The event attracted about 200 policymakers, social workers,
physicians and researchers to the Mark Twain House in Hartford for a
discussion of how to eliminate health disparities through the expanded
coverage that will take effect in January (Merritt, 4/22).

CNN Money: Millions Eligible For Obamacare Subsidies, But Most Don’t Know It

Nearly 26 million Americans could be eligible for health insurance
subsidies next year, but most don’t know it. That’s because relatively
few people are familiar with provisions in the Affordable Care Act, aka
“Obamacare,” that will provide tax credits to low- and middle-income
consumers to help them purchase health coverage through state-run
insurance exchanges (Luhby, 4/23).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Insurer Centene: We Can Do Arkansas-Style Medicaid


English: House Bill and Senate Bill subsidies ...

English: House Bill and Senate Bill subsidies for health insurance premiums. (Photo credit: Wikipedia)

By Jay Hancock

April 23rd, 2013, 3:33 PM

Arkansas
is the latest and perhaps best hope for those who want states resistant
to the Affordable Care Act’s Medicaid expansion to reconsider.

Illustration by Darwinek via Wikimedia Commons

Last week the Arkansas legislature approved
a plan to give Medicaid beneficiaries money to buy individual policies
from private insurers on the state’s health insurance exchange — the
subsidized, online markeplaces due to be in business next year. The
governor signed the bill Tuesday — making it law.

The Department of Health and Human Services, which has said it “will consider approving a limited number” of such arrangements, still needs to negotiate details and sign off.

One insurer is already expressing interest.

“We
are very capable of doing an Arkansas-type model,” Centene Corp. CEO
Michael Neidorff said Tuesday. “That’s something that would be a sweet
spot for us.”

Centene sees opportunity in participating in the
health law’s coverage expansions, whether Arkansas-style or not. It
already runs Medicaid managed care plans for those with very low incomes
in several states, although not in Arkansas. Now it wants to offer
plans to individuals with slightly higher incomes through the exchanges.

“We
believe we can achieve increased profitability in 2014 upon the
commencement of the ACA,” Neidorff told stock analysts Tuesday. “The
exchange market represents the largest growth opportunity for Centene
over the next several years, estimated at $52 billion in our existing
markets.”

Policy analysts expect considerable “churn”
from members moving between the ACA’s expanded Medicaid program and
commercial policies sold on the exchanges as their incomes fluctuate.
Centene wants to be on both sides of the line, selling “a product that
offers people a comfortable transition,” said K. Rone Baldwin, chief of
the company’s insurance group.

Whether managed by Centene or some
other carrier, private, individual insurance in the Arkansas mode could
help Medicaid members keep the same doctor and otherwise minimize
disruptions when they graduate to a non-Medicaid exchange plan, some
have suggested.

The Arkansas model faces large questions. Not least are those about cost.
Commercial insurance of the type Arkansas sees covering Medicaid
members typically pays doctors and hospitals more than traditional
Medicaid or Medicaid managed care plans like Centene runs.

But the plan is being praised as a “conservative alternative” to Obamacare classic and is reportedly being eyed by Pennsylvania, Ohio and other states resisting the Medicaid expansion.

Centene
executives spoke to investment analysts on a conference call about the
company’s quarterly profits. Like other insurers, they were coy about
saying where they plan to offer exchange plans and on what terms.

“We
do expect to be on the exchanges in a subset of the places where we
have health plans today, and we’re entering into contracts with
hospitals,” said Baldwin. How well will Centene be paying those
hospitals to care for its exchange members? “It’s certainly not exactly
at [lower] Medicaid rates but I wouldn’t say it’s exactly at [higher]
commercial rates either,” he added.

The company earned $23 million for the quarter on revenue of $2.5 billion.

No Rate Shock Seen In Proposed 2014 Premiums In Vermont


English: Barack Obama speech "Fighting fo...

English: Barack Obama speech “Fighting for Health Insurance Reform” delivered 8 March 2010 (Photo credit: Wikipedia)

By Phil Galewitz

April 1st, 2013, 12:55 PM

After years of anticipation, Vermont became the first state Monday to publish proposed 2014 individual health insurance rates under the federal health law. Despite Republican and insurers’ predictions, there was no “rate shock” in the new premiums, according to the Vermont governor’s office and insurance representatives.

Blue Cross and Blue Shield of Vermont and MVP Health Care submitted plans with monthly premiums that range from an average of $265 for catastrophic coverage for young adults to $609 for platinum coverage, which has the lowest cost-sharing among four categories of plans.

“We think this is a positive development for folks who were worried about what rates would look like in 2014,” said Kevin Goddard, spokesman for Blue Cross and Blue Shield of Vermont, which is the state’s dominant commercial carrier, controlling about two-thirds of the market. He confirmed rates are similar to what the company now offers.

“These rates are comparable to what’s on the market today and that’s good news,” said Robin Lunge, director of health reform in the Vermont governor’s office. She said it’s difficult to do an apples-to-apples comparison because of the many benefit changes required under President Barack Obama’s health overhaul.  These changes, which take effect Jan. 1, include an end to annual lifetime limits in policies and a prohibition on denying coverage to people with medical problems.

Vermont may not be the best barometer of the impact of the heath overhaul on premiums, however,  because the state already prohibits insurers from using health status to determine an individual’s premiums. It is one of only seven states in the country which have so-called community rating regulations.

Vermont also requires prices to be the same regardless of person’s age. Two of the health law’s biggest changes include prohibiting insurers from using health status to determine premiums and prohibiting insurers from charging older people more than three times the rates of younger people.

Insurance industry predictions of rate shock are more likely in the majority of states that currently allow insurers to set premiums based on an individual’s health status, Goddard said.

Starting Oct. 1, individual and small group coverage in the state will be sold on a new online health insurance marketplace as required under the Affordable Care Act. Health insurers nationwide have just begun submitting their pricing and benefit information to states and the federal government for policies which will be sold in the marketplaces, or exchanges. Most people who buy on the new marketplaces are expected to be eligible for government subsidies.

Vermont insurance regulators still must approve the insurers’ proposed rates. In January 2013, the state approved about a 10 percent rate increase on the individual market after carriers asked for about a 13 percent increase, Lunge said.

All the health plans in the new marketplaces are standardized into platinum, gold, silver and bronze categories depending on their actuarial value so consumers have an easier time comparing.

The Vermont 2014 annual premiums for bronze plans range from $4,200 to $4,440, compared to a Congressional Budget Office estimate of $4,500 for an individual, according to Carolyn Pearson of consulting firm Avalere Health.

Mary Eversole, executive director of the Vermont Insurance Agents Association, said she was surprised the rate increases were not higher. At first blush, she said the 2014 proposed rates appear to be about 10 percent higher than this year. Premiums for the gold and platinum  policies appear lower than similar products, but silver and bronze policies are higher.

Officials from MVP were not available for immediate comment.

Adding Muscle To Plans’ Push For Value-Based Health Care


Dow Chemical corporate headquarters in Midland...

Dow Chemical corporate headquarters in Midland, Michigan (Photo credit: Wikipedia)

The July 24, 2006 issue of Fortune, featuring ...

The July 24, 2006 issue of Fortune, featuring its Fortune 500 list (Photo credit: Wikipedia)

Topics: Health Costs, Insurance, Marketplace

Mar 27, 2013

A survey from Catalyst for Payment Reform, a nonprofit lobbying group comprising highly profitable Fortune 500 giants, found that many of  its members do not feel like they are getting the value for which they are paying.

Medscape: Corporations Demand More Bang For Their Healthcare Buck
A coalition comprising some of the largest and most powerful healthcare buyers in the United States claims its members are not getting the value they are paying for. Only 10.9% of commercial in-network payments to doctors and hospitals goes toward “value-oriented” care, defined as payments that are either tied to performance or designed to cut waste, according to Catalyst for Payment Reform (CPR), a nonprofit lobbying group comprising highly profitable Fortune 500 giants, including 3M, Boeing, Dow Chemical, Verizon, and Walmart, among others (Osterweil, 3/26).

Modern Healthcare: Value-Based Insurance Plans Gain Momentum
The movement among employers to push insurers to adopt health plan benefit designs that improve medical outcomes without raising costs is slowly gathering steam, according to an employer coalition pushing payment reform. While only 11% of payments that commercial insurers made to in-network providers in 2012 were “value-oriented,” according to a survey from Catalyst for Payment Reform, that’s more than halfway to its goal of 20%, which the group hopes to attain by 2020. The numbers suggest there is reason to believe the insurance industry and providers can achieve the coalition’s goal, said Suzanne Delbanco, executive director of the not-for-profit coalition of employer groups, which issued its first-ever National Scorecard on Payment Reform (Block, 3/26).

Related KHN Coverage: Slow Progress On Efforts To Pay Docs, Hospitals For ‘Value,’ Not Volume (Mitchell, 3/26)

Sebelius: Some Insurance Costs Could Increase When Law Is Implemented


Portrait of United States Health and Human Ser...

Portrait of United States Health and Human Services Secretary . (Photo credit: Wikipedia)

Topics: Health Costs, Insurance, Marketplace, Medicare, Health Reform

Mar 27, 2013

The HHS secretary’s remarks came as insurers are becoming increasingly jittery about how sweeping health law changes will impact the marketplace and on the same day that the Society of Actuaries released a study that predicted increased medical claims costs.

The Wall Street Journal’s Washington Wire: Sebelius: Some Could See Insurance Premiums Rise
Some people purchasing new insurance policies for themselves this fall could see premiums rise because of requirements in the health-care law, Health and Human Services Secretary Kathleen Sebelius told reporters Tuesday. Ms. Sebelius’s remarks come weeks before insurers are expected to begin releasing rates for plans that start on Jan. 1, 2014, when key provisions of the health law kick in (Radnofsky, 3/26).

Reuters: Some Healthcare Costs May Rise When ‘Obamacare’ Implemented: Official
President Barack Obama’s top healthcare adviser acknowledged on Tuesday that costs could rise in the individual health insurance market, particularly for men and younger people, because of the landmark 2010 healthcare restructuring due to take effect next year. U.S. Health and Human Services Secretary Kathleen Sebelius said definitive data on costs will not be available until later this year when private health plans become authorized to sell federally subsidized coverage on new state-based online marketplaces, known as exchanges (Mason and Morgan, 3/26).

She also spoke about Medicare –

USA Today: White House Warns Cutting Medicare Will Shift Costs
If Congress addresses the nation’s budget deficit by cutting Medicare, that will simply shift health care costs to the private sector and not address the underlying issues, Obama administration officials said Tuesday at a White House briefing. “If you only focus on Medicare, you shift the costs,” Health and Human Services Secretary Kathleen Sebelius said, adding that Medicare and Medicaid are not the reason health costs are going up (Kennedy, 3/26).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Long-Term Care: Expense, Emotions Part Of Planning Dilemma


English: Spending on U.S. healthcare as a perc...

English: Spending on U.S. healthcare as a percentage of gross domestic product (GDP). (Photo credit: Wikipedia)

English: House Bill and Senate Bill subsidies ...

English: House Bill and Senate Bill subsidies for health insurance premiums. (Photo credit: Wikipedia)

US residents with employer-based private healt...

US residents with employer-based private health insurance, with self insurance, with Medicare or Medicaid or military health care and uninsured in Million; U.S. Census bureau: Income, Poverty, and Health Insurance Coverage in the United States: 2007 (Photo credit: Wikipedia)

Topics: Delivery of Care, Health Costs, Insurance, Aging

Mar 26, 2013

In other news, NPR explores the nation’s high disability rate.

The New York Times: Expense And Emotions In Preparing For Long-Term Care
The emotional impact of witnessing the decline of a family member or helping to care for one is often the reason people seek coverage for long-term care, people who work in the aging field say (Carrns, 3/25).

The Fiscal Times: The Health Care Dilemma That Could Bankrupt Women
Nancy S. Buck, a 62-year-old divorced woman from Aurora, Colorado, wants to purchase long-term health care insurance because she doesn’t want to be a financial burden on her children. But right now, that’s not possible, since she’s self-employed, earns only $20,000 a year (too much to qualify for Medicaid), and can barely afford the $450-a-month payment for basic health insurance…As difficult as it has been for single women like Buck to afford long-term health care insurance, it’s about to get harder (Halpert, 3/25).

NPR: Unfit for Work: The Startling Rise Of Disability In America (A four-part series)
In the past three decades, the number of Americans who are on disability has skyrocketed. The rise has come even as medical advances have allowed many more people to remain on the job, and new laws have banned workplace discrimination against the disabled. Every month, 14 million people now get a disability check from the government (Joffe-Walt, 3/26).