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Tag: Affordable Care Act

The Health Insurance Letter You Never Want to Get

I was reading the December 18th issue of Inside Health Insurance Exchanges and came across an article entitled, “New Kids on the Block Come Out Swinging; Co-Ops Lower Rates for Many Health Plans.”

The gist of the article had to do with the success a number of Obamacare insurance co-ops have had in charging lower rates and getting lots of market share by “[underpricing] more established players inside and outside of the public insurance exchanges.”

The article went on to point out that some traditional competitors are beginning to complain that the co-ops have unfair advantages.

This quote from the CEO of CoOpportunity––the market leading Iowa and Nebraska Obamacare funded co-op that enrolled 120,000 people in 2014––stood out:
For Blues plans and other carriers “with deep reserves, booming stock prices and market entrenchment to plead for relief from these nimble, undercapitalized start-ups is ludicrous and insulting,” counters CoOpportunity Health CEO Cliff Gold. He says his company has been successful in attracting customers in two states despite not having the lowest cost products anywhere in Iowa or the most populous part of Nebraska. “At the end of the day, in the long term, success is determined by a company’s ability to create value for customers, he tells HEX. “That critical but elusive combination of price, product features, provider network, and customer service is what separates competitors.”

Read the full article here.

Contact Steven G. Cosby, MHSA with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

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A Misleading Debate on Health-Care Costs

David Leonhardt of the New York Times has offered up a misleading defense of the Affordable Care Act (ACA) — i.e., Obamacare. Like several others, he celebrates the slowdown in health-care-cost escalation and suggests that the ACA is one reason for the deceleration. Specifically, he suggests that key ACA provisions — which he describes as nudging “the health care system away from paying for the quantity of medical care rather than the quality” — have already played a role in making the health system better and more efficient.

It would be an effective argument for the ACA if it were true. Unfortunately, it isn’t.

Leonhardt is responding to the recent government announcement that national health spending rose 3.6 percent in 2013. That’s certainly a low growth rate — well below the long-term trend over the past several decades. But it isn’t a trend that began with passage of the ACA.

In 2001, national health spending rose 8.5 percent. The following year it rose 9.6 percent. But then the annual growth rate began to drop, and by 2008 health spending was rising just 4.8 percent. Put another way, the growth rate of national health spending was cut in half during the time of the Bush presidency. Did the ACA cause this?
In the first two years of the Obama administration, health spending growth remained moderate. In 2009, health spending rose just 3.8 percent, and in 2010 it rose 3.9 percent. The ACA wasn’t enacted until March 2010.

Read the full article here.

Contact Steven G. Cosby, MHSA with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

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Reporting of Offers of Health Insurance Coverage by Employers

Information reporting under section 6056 is voluntary for calendar year 2014.  Reporting is first required in early 2016 with respect to calendar year 2015.  For more information, see question 2.

 

  • Basics of Employer Reporting: Questions 1-4
  • Who is Required to Report: Questions 5-8
  • Methods of Reporting: Questions 9-13
  • What Information Must ALE Members Report: Questions 14-16
  • How and When to Report the Required Information: Questions 17-21.  What are the information reporting requirements for employers relating to offers of health insurance coverage under employer-sponsored plans?The Affordable Care Act added section 6056 to the Internal Revenue Code, which requires applicable large employers to file information returns with the IRS and provide statements to their full-time employees about the health insurance coverage the employer offered.  (For a definition of applicable large employer, see question 5, below.)Under the regulations implementing section 6056, an applicable large employer may be a single entity or may consist of a group of related entities (such as parent and subsidiary or other affiliated entities).  In either case, these reporting requirements apply to each separate entity and each separate entity is referred to as an applicable large employer member (ALE member).  See question 7 for more information about the treatment of related entities.The IRS will use the information provided on the information return to administer the employer shared responsibility provisions of section 4980H.  The IRS and the employees of an ALE member will use the information provided as part of the determination of whether an employee is eligible for the premium tax credit under section 36B.ALE members that sponsor self-insured group health plans also are required to report information under section 6055 about the health coverage they provide (See our section 6055 FAQs). Those ALE members that sponsor self-insured group health plans file with the IRS and furnish to employees the information required under sections 6055 and 6056 on a single form. The IRS and individuals will use the information provided under section 6055 to administer or to show compliance with the individual shared responsibility provisions of section 5000A.

 

Read the full article here.

Contact Steven G. Cosby, MHSA with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

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House Energy and Commerce Subcommittee on Health Hearing

Chairman Pitts, Ranking Member Pallone and members of the Subcommittee, thank you for the opportunity to testify regarding fiscal priorities in the 114th Congress. As a major driver of federal spending, our health care system must be central to this discussion. I would like to make three main points today regarding the fiscal future of the health care system in the 114th Congress.

First, the expansive spending created by the Affordable Care Act (ACA) will continue to generate fiscal issues for years to come. The ACA was left largely untouched by the Budget Control Act, resulting in unrestrained spending in some of health care’s most expensive programs. Next year Congress should rein in this spending and subject the ACA and Medicaid to cost saving reforms.

Second, making reforms within the exchanges and cutting back on ACA spending will create savings; some of which should be utilized to ensure a sustainable Medicare program for seniors well into the future. In order to preserve Medicare for the next generation, big policy changes must occur, and savings generated through scaling back the excesses of health reform can help pay the way.

Finally, decreasing ACA spending and applying some of these savings to Medicare reform is just part of the fiscal priorities conversation. Any change undertaken should lay a foundation for a more efficient health care system, and the 114th Congress should work to towards that ultimate objective by focusing on achievable goals in the present.

Read the full article here.

Contact Steven G. Cosby, MHSA with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

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Court Case & New Congress: What’s Next for Obamacare?

The newest round of open enrollment under the Affordable Care Act has begun, just as the law comes under a new threat with the Supreme Court’s decision that it will hear a new challenge questioning its government subsidies. The case raises the stakes for HealthCare.gov too; the last thing the Obama administration needs is a repeat of last year’s embarrassing technical glitches. On the flip side, the lawsuit could have an important political effect: It could give GOP leaders Mitch McConnell and John Boehner leeway to avoid dealing with the issue of health care right away. By having a court case to point to, Republicans could delay the health care showdown between their party and the White House – and even one within the GOP itself.

The stakes are high, especially after Democratic losses

Congressional midterm losses aside — when it comes to health care, Democrats might be even more stung by the party’s big losses in governors’ mansions and state legislatures on Election Day. Democrats were counting on a few more gubernatorial wins, which would have boosted the number of states expanding Medicaid or starting state exchanges. The more folks who are insured through ACA, the more entrenched the law becomes – which in turn makes it harder to dismantle. In theory, public pressure isn’t supposed to have an impact on Supreme Court decisions, but the difference between a smooth rollout and a bad one in the law’s second open enrollment period certainly impacts how difficult it would be to gut the law in the future.

Read the full article here.

Contact Steven G. Cosby, MHSA with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

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