Leading the News
Insurer To Offer ACA Coverage In Last “Bare County” In The US.
The Washington Post (8/24, Bump) reports that as of Thursday morning, the 334 people in Paulding County, Ohio, who were facing the prospect of not having any Affordable Care Act plans in 2018, will be able to enroll in ACA coverage. The article says every county in the US now has at least one insurer offering ACA plans next year. The Post adds, “As the debate over repealing the Affordable Care Act raged on Capitol Hill earlier this year, the withdrawal of insurers from Obamacare exchanges nationally was a frequent talking point among those advocating for replacing the law.” Indeed, President Trump used this issue “as a talking point in speeches and on Twitter.”
In a separate article, the Washington Post (8/24, Goldstein) reports that advocates of the ACA consider this “a milestone signaling that the exchanges that are a core aspect of the ACA are withstanding the political feuding over the law’s future.” The article says, however, that this milestone did nothing to change the Trump Administration’s stance. Matt Lloyd, a senior HHS spokesman, said, “[P]remiums continue to surge, insurers continue to abandon wide swaths of the country, and choices continue to vanish.” He added, “Nearly half of counties across the nation only have one health insurance option which, by definition, is not a choice. Under Obamacare, Americans were promised access to a wide variety of high-quality, affordable coverage options.”
The Wall Street Journal (8/24, Mathews, Subscription Publication) reports that the nonprofit CareSource said it will offer ACA coverage in Paulding County in 2018. The article adds that the insurer’s decision is a victory for state regulators throughout the US who have worked hard to ensure that every county has access to ACA plans next year.
The AP (8/24, Smyth, Murphy) reports that only a few months ago, more than “40 mostly rural counties faced the prospect of having no options for their exchanges, but insurers have gradually come forward to fill the gaps.” The article adds that insurers have not considered rural counties attractive “because they usually have a smaller, older customer base and a care provider like a hospital system with a dominant market position,” which “can make it difficult to negotiate payment rates.”
Bloomberg News (8/24, Tracer, Recht) reports that the announcement by Ohio officials nullifies “predictions that some Americans wouldn’t have access to coverage under the law in 2018.” The state’s insurance regulators “have found insurers to cover about 20 counties that could have been left without Obamacare coverage.” If not for their actions, about 11,000 Ohioans would have been without ACA coverage next year, they said. Commenting on the agreement, CareSource CEO Pamela Morris stated, “Our decision to offer coverage in the bare counties speaks to our mission and commitment to the marketplace and serving those who are in need of health care coverage.”
Legislation and Policy
Fewer Taxpayers Paid ACA Individual Mandate Penalty Last Year, IRS Reports.
CNN Money (8/24, Luhby) reports that about 4 million households paid the ACA penalty for not having health insurance last year, down from 5.6 million in 2015, according to IRS data. The average penalty was $708, and there were about 10.7 million households requested exemptions from the individual mandate, a drop from 11 million in 2015, according to the report filed by the IRS’ Taxpayer Advocate Service. The article says that President Trump, Health Secretary Tom Price and others “have frequently pointed to the number of people paying the penalty or asking for hardship exemptions as proof that Obamacare has made insurance unaffordable and should be repealed.”
Bipartisan Group Of Lawmakers Attempting To Stabilize ACA Marketplaces Disagrees About How To Proceed.
The Washington Examiner (8/24, Leonard) reports, “A bipartisan Senate health panel is set to meet on Obamacare in September, but lawmakers disagree on funding for insurer payments that would otherwise lead to more exits from health insurance companies and higher premiums for people who don’t receive subsidies.” Lawmakers on the Senate Health, Education, Labor, and Pensions Committee will hold hearings next month about how to stabilize ACA marketplaces, especially if the federal government decides to stop sending subsidy payments to insurers. The article says points “of political disagreement between Democrats and Republicans became apparent at a Thursday breakfast with congressional aides hosted by the Alliance for Health Care Policy, including on whether and how long the insurer payments, called cost-sharing reduction payments, will be appropriated through Congress.”
Graham-Cassidy ACA Replacement Plan Would Cost States, Limit Access, Report Says.
The Connecticut Mirror (8/24, Radelat) reports a bill being written by Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA) that “aims to give states full authority to craft their own health care systems” with federal block grants “would increase the number of uninsured nationwide, restructure Medicaid and have an especially harmful impact on Connecticut,” according to an analysis released Thursday by the Center on Budget and Policy Priorities. The think tank “estimated Connecticut could lose almost $2.5 billion a year in federal health care funds by 2026 under the Graham-Cassidy plan.”
The New Haven (CT) Register (8/24, O’Leary) also reports.
California To Hold Hearings On Universal Healthcare.
The Sacramento (CA) Bee (8/24, Hart) reports California Assembly Speaker Anthony Rendon said Thursday the state Legislature should have a “serious discussion” on creating a universal healthcare system for the state. Rendon “has been under fire” for refusing to bring Senate Bill 562 to the Assembly floor earlier this year. The bill sought to reorganize California’s healthcare financing under a government-run single-system. Rendon said, “I don’t think we’ve at all had anything close to approaching an honest discussion about single payer,” adding that he will organize a committee this fall to examine “several different approaches being proposed, including Medicare for all, single payer, hybrid systems and [Affordable Care Act] expansion.”
Public Health and Private Healthcare Systems
Northwell To Shutter CareConnect Over ACA Uncertainty, Costs.
Newsday (NY) (8/24, Reich-Hale, Polsky) reports that CareConnect said Thursday it would shut down, exiting the insurance market in 2018 “because of the uncertainty of the Affordable Care Act’s future” and costs. About 126,000 CareConnect policyholders “would remain covered while they transfer to new health providers.” CareConnect parent Northwell Health highlighted a $112 million payment into the ACA’s risk-adjustment pool this year, which represented 44 percent of CareConnect’s 2016 revenue from its small group health plan. CareConnect faced another such payment and “said it never received $150 million from the federal government in risk-corridor payments.”
The New York Times (8/24, Nir, Subscription Publication) quotes Northwell CEO Michael Dowling saying in an interview that the politics are “so poisonous at the moment that nobody wants to sit down collectively and, in my view, do their duty to fix the things that need to get fixed.”
Maine Governor Plans Legal Challenge To Medicaid Expansion Referendum.
The AP (8/24) reports that Maine Gov. Paul LePage (R) vowed to challenge the November 7 ballot question on Medicaid expansion because the language of the referendum describes Medicaid as “insurance,” but he says it is “free health care paid for by the taxpayers.”
Connecticut Asks Insurers For Supplemental Filings Assuming Loss Of CSR Payments.
The Hartford (CT) Courant (8/24, Singer) reports that the Connecticut Department “has asked Anthem and ConnectiCare Benefits Inc. to submit a supplemental filing that considers the absence of the cost sharing reduction subsidy for 2018.” The supplemental filing “‘would apply only on Silver exchange plans.” Commissioner Katharine Wade said in a statement that the supplemental filing will give the Insurance Department “maximum flexibility in making final determinations for health insurance rates on the exchange” within tight time limits and a looming November open enrollment.
The New Haven (CT) Register (8/24, Stuart) notes that “Anthem Health requested an average 33.8 percent increase for individual health insurance plans both on and off the exchange” while ConnectiCare Benefits requested a 15.2 percent average rate hike.
CT News Junkie (8/24, Stuart) also reports.
Arkansas Enrollment in Medicaid Expansion Falls For Sixth Straight Month.
The Arkansas Democrat Gazette (8/24, Davis) reports that the state Department of Health Services published figures Wednesday showing that enrollment in Medicaid expansion fell slightly in July, the sixth straight month of declines. The department attributed much of the dip to its efforts to identify Medicaid recipients who are no longer eligible, and removing them from the rolls.
Utah Officials Say CMS Gave “Positive Signs” To Medicaid Waiver Request; Activists Wary Of Plan.
The Deseret (UT) News (8/24, Lockhart) reports that the Utah Department of Health told lawmakers on Thursday that federal officials at CMS gave “positive signs about approving an amended Medicaid expansion waiver” aimed at expanding Medicaid to 6,500 Utahans who are chronically homelessness, need treatment for drug addiction or mental health, or who have criminal records. The article adds that the Obama Administration had “discouraged” some of the provisions such as a five-year limit on benefits and work requirements. Critics took issue with the five-year limit, pointing out that mental illness and substance abuse do “not end in five years,” and that recidivism is likely.
Blue Cross Blue Shield North Carolina To End Grandfathered Health Plans In 2018.
Healthcare Finance News (8/24, Morse) reports Blue Cross Blue Shield North Carolina will cease offering its grandfathered health plan as an alternative to ACA coverage starting in 2018. BCBS North Carolina had offered the grandfathered plan since 2010 because an ACA provision allowed customers to keep their current coverage. The article says that about only 50,000 customers will be affected because many customers dropped the coverage over the past seven years. BCBS North Carolina said, “We’d need to raise rates for these customers a significant amount to keep offering these plans in 2018,” adding that some of customers transitioning from the plan may “qualify for subsidies to offset the cost increase.”
Illinois Consumer Advocates Seek Multiple Insurance Rate Proposals.
The Chicago Tribune (8/24, Schencker) reports that lawmakers and consumer advocates in Illinois have requested that the insurance regulators in the state take a similar action. Earlier this month, several consumer groups “wrote a letter to the head of the Illinois Department of Insurance earlier this month” expressing their concerns over possible double-digit rates hikes for ACA coverage. US Senators Dick Durbin and Tammy Duckworth did the same. The letters “ask the department to follow the lead of other states and require insurers to submit two sets of proposed rates for next years” — one assuming that cost-sharing reduction payments remain intact and the second assuming they are eliminated.
HealthNow New York Sues Federal Government For $38 Million In Unpaid Risk-Corridor Payments.
The Buffalo (NY) News (8/24) reports that HealthNow New York, filed a lawsuit August 11 in the US Court of Federal Claims seeking $38 million “it claims it is owed under a program that was part of the Affordable Care Act.” The lawsuit by HealthNow, which operates as BlueCross BlueShield of Western New York, centers risk-corridor payments not paid by the US Department of Health and Human Services. Attorney Stephen McBrady said in a statement. “HealthNow followed the law and helped expand the markets in terms of individual coverage through the exchanges. It is important for the government to follow through on its payment obligations.”
Medicaid Funding Cuts Would “Devastate” Massachusetts Addiction Treatment Centers, Report Suggests.
The Springfield (MA) Republican (8/24, Young) reports that “waiting times, referral services and behavior health coverage parity” remain challenges for Massachusetts addiction treatment centers, according to a study released Thursday by Sen. Elizabeth Warren’s office. The study, however, also found that the state’s high rate of insurance coverage “helped the vast majority of facilities surveyed” deliver “high-quality care.” The study concluded that the Trump Administration’s proposed Medicaid and other budget cuts “would devastate the ability of Massachusetts treatment facilities to carry out their work.” Over “60 percent of organizations that responded to the survey reported receiving federal Department of Health and Human Services, Department of Housing and Urban Development and Justice Department grant funding in 2016,” the article adds.
Maryland Seeks To Expand Hospital Cost-Control Program To Save $330 Million In Medicare Costs.
The Baltimore Sun (8/24, Gantz) reports that Maryland is seeking CMS approval to expand a five-year pilot program for hospitals to include physicians, rehabilitation facilities, skilled nursing centers, and others who treat Medicare patients. The pilot program “aimed to control rising hospital costs by flipping hospitals’ incentive from boosting the number of patients they see to ensuring patient health.” The ten-year expanded program might save $330 million in Medicare costs. The state released the plan on Thursday for public review and comment and any final plan must be approved by CMS – which could also seek changes to the plan.
Also in the News
Aetna Accidentally Reveals HIV Status Of Some Clients Due To Envelope’s Plastic Window.
Bloomberg News (8/24, Tracer) reports Aetna accidentally revealed the HIV status of some of its patients through a letter mailed to about 12,000 people last month; the envelope containing the letter, which pertained to prescription coverage options for Aetna customers with HIV, had a large plastic window which could show the client’s HIV status if the contents shifted. The company faulted an unnamed vendor for the error, and apologized to any affected clients, stating, “This type of mistake is unacceptable. … We sincerely apologize to those affected by a mailing issue that inadvertently exposed the personal health information of some Aetna members.”