In the battle over who is to blame for high prices Obamacare insurance, a new study finds that the reason is fewer insurers competing for customers, a new study finds.
As state policymakers consider expanding their Medicaid programs under the ACA, they should study the experiences of other states.
Premiums in California’s health insurance exchange will rise by an average of 8.7% next year. The average increase in California is smaller than the double-digit hikes expected around the nation, due largely to a healthier mix of enrollees and more competition in its marketplace. Still, health insurance prices keep growing faster than wages and general inflation as a result of rising medical costs overall, squeezing many middle-class families who are struggling to pay their household bills.
Health insurance companies in Colorado have asked to increase premiums by an average of 5.94 percent for 2019 in the Obamacare market, according to rate filings.
No insurers are leaving the exchange, and every county will have at least one health insurer offering coverage. The requested average premium increase for individual gold plans is 6.85 percent, and 12.3 percent for silver plans. For bronze plans, the requested average premium increase is 0.9 percent. Anthem’s filings requested a decrease in premium rates.
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Despite receiving billions of dollars in taxpayer money, Medicaid insurers are lax in ferreting out fraud and neglect to tell states about unscrupulous medical providers, according to a federal report released Thursday.
The U.S. Health and Human Services’ inspector general’s office said a third of the health plans it examined had referred fewer than 10 cases each of suspected fraud or abuse to state Medicaid officials in 2015 for further investigation. Two insurers in the program, which serves low-income Americans, didn’t identify a single case all year, the report found.
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The expansion in coverage due to the Affordable Care Act (ACA) increased the number of insured Americans by 20 million. Although access to health insurance has expanded significantly in recent years, and the ACA instituted important protections for patients, those who gained insurance through ACA health insurance exchanges are being offered plans that make them bear an increasing portion of their healthcare costs since the law was implemented. Access to health insurance is not sufficient if patients cannot afford to purchase coverage or utilize their benefits due to high premiums, high out-of-pocket costs, limited networks, and insufficient state and federal patient protections.
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The Centers for Medicare and Medicaid Services announced that it would suspend $10.4 billion in risk adjustment payments, which are designed to compensate insurers that enroll sick, expensive patients. Unlike with other ObamaCare subsidy programs, risk adjustment payments shuffle money from insurers with relatively healthy populations to others. Some co-ops have sued on grounds that the funding formula is unfair to small insurers. In January a federal court in Massachusetts ruled the formula wasn’t arbitrary and capricious. But a month later a federal judge in New Mexico said it was. The left is complaining that HHS halted the payments too casually, but on all the evidence the Trump Administration is trying to abide by the ruling while the courts resolve the dispute. This is called following the law.
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Over the weekend, former Centers for Medicare and Medicaid Services (CMS) acting administrator and Obamacare defender Andy Slavitt took to Twitter to denounce what he viewed as the Trump administration’s “aggressive and needless sabotage” of the health care law:
Unfortunately for Slavitt, the facts suggest otherwise. The Trump administration took actions to comply with a federal court order that vacated rules promulgated by the Obama administration—including rules CMS issued when Slavitt ran the agency. If Slavitt wants to denounce the supposed “sabotage” of Obamacare, he need look no further than the nearest mirror.
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Need for Reform