Cleaning Out the In Box: ACA forces Insurance Co's to pay back $1.9B; SCOTUS has already shot down Halbig argument & much more
2019 OPEN ENROLLMENT ENDS (most states)
Time: D H M S
OK, with all the fuss about the Halbig decision, people have been flooding me with a bunch of stories about both that as well as other ACA-related topics. I can't address them all fully, so here they are in bite-sized format:
Millions of Americans can expect to get a refund from their insurance companies this year, at an average of about $80 dollars per family, thanks to a little-known Obamacare provision that’s helping people save money on their premiums. According to a new report released by the Health and Human Services Department on Thursday, Americans across the country have received a total of $1.9 billion dollars in rebates since this provision first took effect in 2011.
In fact, it was Justice Scalia himself, together with Justices Anthony Kennedy, Clarence Thomas, and Samuel Alito, who interpreted the health reform statute precisely this way in the 2012 health reform case—holistically, and assuming the statutory text makes subsidies available on state and federal exchanges alike.
In their joint dissent, they wrote:
“Congress provided a backup scheme; if a State declines to participate in the operation of an exchange, the Federal Government will step in and operate an exchange in that State.”
While record numbers of Americans sign up for the larger Medicaid health insurance program for the poor, financial issues are emerging for medical care providers in the two dozen states that didn’t go along with the expansion under the Affordable Care Act.
Reports out in the last week indicate the gap between those with health care coverage is widening between states that agreed to go along with the health law’s Medicaid expansion and those generally led by Republican legislatures and GOP governors that are balking at the expansion.
American Progressive Life & Health Insurance Company of New York has become the first company to withdraw from the New York State Health Exchange after failing to file a 2015 rate proposal.
The company, also known as Today’s Options of New York, operated in 37 counties across New York State, but only 384 people signed up for its plans under the first year of the Affordable Care Act....
"As soon as people got insured, they all showed up at once, wanting to deal with the problems they couldn't deal with for years," said John Guerreiro, a primary care doctor in northwestern Oregon.
Under the federal overhaul, the state this year added nearly 360,000 people to the Oregon Health Plan, its version of Medicaid. It was more than twice the number projected and swelled the state Medicaid rolls to nearly 1 million people, about a quarter of the state's population.
Washington state Insurance Commissioner Mike Kreidler says a new enrollment period may be needed next month to help consumers whose health insurance applications have gotten stuck online at the Washington Health Benefit Exchange. The exchange has put into effect a series of system fixes that have so far failed, and insurers say the repairs done in late June have created new problems.
(Yes, the is PR directly from the insurance company's website, but it was sent from someone I respect so I'm posting it):
from A life saved, thanks to Kaiser Permanente care
[Diana Parret] lost her job and her employer-paid health insurance in December 2013. And then she stopped by the concierge kiosk at our Fresno Medical Center in January and spoke with a representative about health care reform. Parret got basic information about Kaiser Permanente coverage options and federal financial help...She enrolled in a Kaiser Permanente plan and was on her way toward a life-saving diagnosis. Parret had an office visit scheduled with ob-gyn Amanda Reeve, MD, within days of her coverage taking effect...“It was great that we were able to get Diana into the office so quickly,” Dr. Reeve says. “In the end, the coordinated care she received created the best possible outcome for her.” The day after surgery, Parret received good news: The cancer had not spread, and no further treatment was necessary. “It’s like I had the best insurance in the world,” she says. “Everything that happened to me in that month really was a miracle.
MacEwan rolled out projections for exchange enrollment for 2015 coverage: 233,000 people are expected to buy commercial health plans (“Qualified Health Plans” or QHPs). The 2015 enrollment period, beginning Nov. 15, ends on February 15, 2015.
Molly Nollette from the Office of the Insurance Commissioner said her office has estimated that the number of uninsured in the state has been reduced by 38 percent since Oct. 1 of last year, but it’s not clear whether that accounts for Washington’s marked population growth.
Large health insurer CareFirst BlueCross BlueShield filed revised proposed rates for individual health plans to be offered on the District’s health insurance marketplace, DC Health Link, for plan year 2015. The revision reflects a 4 percent decrease from their originally proposed 2015 rates.
Big news for the South Carolina health insurance marketplace in 2015!SChealthconnector.org has recently learned that Time Insurance (also known asAssurant Health) has filed plans and rates in South Carolina for the 2015 plan year. Although we must note that nothing is yet confirmed, this is a very positive development for South Carolina residents looking for quality, affordable health insurance on the South Carolina Health Insurance Exchange.
Due to CMS regulatory requirements and the resulting cost implications and financial burdens, Contra Costa Health Plan has informed Covered California that it will not seek recertification for the 2015 Plan Year.
This difficult decision to withdraw had to be made because the new requirements pose administrative and financial burdens that could impact our ability to fulfill our mission to serve the most vulnerable people in Contra Costa County. This will affect about 1,100 of our 138,000 CCHP members.
The Arkansas Insurance Department today announced that five companies plan to sell health insurance plans on the Arkansas Health Insurance Marketplace in 2015, the second year for the regulated marketplace created by the Affordable Care Act. The issuers that have filed are Arkansas Blue Cross Blue Shield, the national multi-state Blue Cross Blue Shield, Celtic Insurance Company (selling in Arkansas as Ambetter), and two companies owned by the parent companyQualChoice Holdings: QualChoice Life and Health Insurance Company, Inc. and QCH Health Plan Inc. (QualChoice Holdings is itself owned by Catholic Health Initiatives, which acquired the company earlier this year.)