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Tag: PPACA

ACA Allies To Focus On Uninsured In 18 States

Supporters of the Affordable Care Act said they’ll debut a campaign this month in 18 U.S. states to promote a law still poorly understood by those designed to benefit most.

Enroll America, a Washington-based nonprofit group, said it will hold 50 community events to kick off the effort in states with high numbers of uninsured residents, from California to Texas to Florida. An advertising campaign will follow as the law approaches the Oct. 1 opening of enrollment for subsidized insurance plans.

Click here to read more.

Will the Affordable Care Act’s (“ObamaCare”) Federal Health Insurance Exchanges Be Ready On Time? Finally the Facts!

Will the Affordable Care Act’s (“ObamaCare”) Federal Health Insurance Exchanges Be Ready On Time? Finally the Facts!
After months of speculation on just where the Obama administration is toward the development of the new health insurance exchanges, the Government Accountability Office (GAO) has issued a 48-page report complete with timelines and a detailed report on just where the Obama administration is––or at least was last month.

The key summary:
“Much progress has been made, but much remains to be accomplished within a relatively short amount of time. CMS’s timelines provide a roadmap to completion; however, factors such as the still-­evolving scope of CMS’s required activities in each state and the many activities yet to be performed—some close to the start of enrollment—suggest a potential for challenges going forward. And while the missed interim deadlines may not affect implementation, additional missed deadlines closer to the start of enrollment could do so. CMS recently completed risk assessments and plans for mitigating risks associated with the data hub, and is also working on strategies to address state preparedness contingencies. Whether these efforts will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined. ”

Re the Data Hub:
“FFEs [the federal exchanges] along with the data services hub services are central to the goal under PPACA of having health insurance exchanges operating in each state by 2014, and of providing a single point of access to the health insurance market for individuals. Their development has been a complex undertaking, involving the coordinated actions of multiple federal, state, and private stakeholders, and the creation of an information system to support connectivity and near real-­time data sharing between health insurance exchanges and multiple federal and state agencies. Much progress has been made in establishing the regulatory framework and guidance required for this undertaking, and CMS is currently taking steps to implement key activities of the FFEs, and developing, testing, and implementing the data hub. Nevertheless, much remains to be accomplished within a relatively short amount of time. CMS’s timelines and targeted completion dates provide a roadmap to completion of the required activities by the start of enrollment on October 1, 2013. However, certain factors, such as the still-­unknown and evolving scope of the exchange activities CMS will be required to perform in each state, and the large numbers of activities remaining to be performed—some close to the start of enrollment—suggest a potential for implementation challenges going forward. And while the missed interim deadlines may not affect implementation, additional missed deadlines closer to the start of enrollment could do so. CMS recently completed risk assessments and plans for mitigating identified risks associated with the data hub, and is also working on strategies to address state preparedness contingencies. Whether CMS’s contingency planning will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined.”
That about sums up the whole report––CMS has been outwardly optimistic but is clearly struggling to make the deadlines.

While the GAO report gives us a clear sense of where CMS was as of about May, we are now essentially in the dark again. As the GAO report says, whether the exchanges will be ready or not now depends upon key dates between May and October.

Why can’t the administration build upon this report and keep us informed?

Some opponents of “ObamaCare” will take satisfaction in the problems the Obama administration is having getting this thing launched.

Let’s be clear, even if the launch has to be delayed or is just a mess at the start, this will eventually get launched and the Affordable Care Act will be central to the health insurance and health care system for years to come––under the best scenario for Republicans they won’t be able to repeal or fundamentally change the law until after Obama leaves office.

But, Democrats do need to be concerned about what a messy launch would mean to them in the November elections.

Health insurers, and proponents of the law, need to be worried about what a messy launch would do toward the goal of getting the healthy to sign up for coverage. If the healthy stay away from the exchanges out of concerns for administrative problems that could undermine the financial sustainability of the insurance reforms.

You can access the full report here.

You can also access the companion report on the small business (SHOP) exchanges here.

Source:  Health Policy & Market Blogspot

Kaiser’s Obamacare Rates Surprise Analysts

Kaiser Permanente has offered some of the highest rates in the California health exchanges next year. It denies that it is doing so to avoid treating many of the sickest newly insured patients.

In California’s new state-run health insurance market, Kaiser Permanente will cost you.

The healthcare giant has the highest rates in Southern California and some other areas of the state, surpassing rivals such as Anthem Blue Cross and other smaller competitors. The relatively high premiums from such a strong supporter of the federal healthcare law surprised industry analysts, and it has sparked considerable debate about the company’s motives.

Some experts say Kaiser intentionally bid high to avoid drawing too many customers next year who are sick or who have been uninsured for years and may be costlier to treat. Others suspect Kaiser was worried that lower premiums would bring an influx of newly insured patients that could overwhelm its in-house roster of doctors and hospitals.

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California Exchange Shows Lower Premiums…or Does It?

The health insurance exchange Covered California has been making headlines recently. Thirteen insurance carriers have submitted plans to be offered on the state-based health insurance exchange come 2014 and the premium rates released for these plans are lower than federal actuaries and budget forecasters had expected. Covered California has predicted that rates for individuals in 2014 will range from two percent above to 29% below average small-employer premiums this year.

These rates are surprising given the recent flood of studies performed by independent entities such as the Academy of Actuaries, the Congressional Budget Office and the Milliman Index, which all predict that, once the health reform law is implemented, insurance premiums in the exchanges, especially those for the young and healthy, are likely to spike in most states.

But are they?  The California data release compares individual plan coverage rates to small-employer plan rates—an apples-to-oranges comparison. The pure, unsubsidized premium costs of individual coverage versus employer coverage normally shows that individual market rates are lower, given that group purchasers often opt for richer plan designs. A more appropriate comparison might have been the cost of projected individual rates in California for this year versus next year. Forbes’ Avik Roy did such an analysis and found that the difference in mandated benefits and rating changes will result in individual-market price increases of between 64% and 146% when you compare 2013 individual premium rates with proposed 2014 exchange rates. It’s true that the availability of subsidies will reduce the amount many exchange consumers will pay out of pocket for their coverage, but that doesn’t mean the actual premiums will be reduced–far from it.

Clearly, the Obama Administration will take what it can get when it comes to positive press surrounding the health reform law. To further draw attention to the news of California’s lowered premiums, President Obama travelled to San Jose today to give a speech touting the law’s benefits. But even during that address, Obama acknowledged that some Americans are likely to see their premiums rise, although he encouraged them to blame their employers rather than PPACA.

“Employers may be shifting costs through higher premiums or higher deductibles or higher copays,” he said. “There may still be folks out there who are feeling higher costs.”

Source: NAHU, Washington Update

The Looming Premium Rate Shock

Well the confusion has begun! That is to assume that we all were not already there.

The respected publisher Forbes released an article on May 24, 2013 that shocked everyone. Rates to be offered on the California Insurance Exchange effective 01.01.2014 will actually be lower relative to our existing existing market rates.

Forbes contributor Rick Ungar writes that rates will actually be lower, not higher under Obama Care and the first round of rate releases in California proves this.  Surprising even Ungar, an Obama Care supporter!

These assertions are indirectly backed up by the Congressional Committee of Energy and Commerce  attacking a separate House Report on ACA that reports everyone is about to experience rate shock. Only to be followed up by Forbes article stating that there will be rate shock, rebutting its own Ungar article just a few days earlier.

Read the above links to learn more but know that they are both right.

Those sick and currently paying high rates will no longer be discriminated unfavorably by the insurance industry AND those well and health paying low rates will no longer be discriminated favorably by the industry.

It can be argued both ways by honest people.