Sunday Short Cuts

If the U.S. Supreme Court decides later this month that 34 states including New Jersey are not permitted to share in federal subsidies used to lower the cost of Obamacare premiums, Gov. Chris Christie said Congress should "fix" the law to preserve the money.

The Republican governor and unannounced presidential candidate has been critical of the Affordable Care Act, calling it a "failed" program last year.

But when asked what he thinks ought to be done if the nation's highest court rules that only the 16 states that operate their own "exchanges" — an online hub to sell health insurance coverage — can receive subsidies, Christie did not call for rolling back the program.

"Congress should fix it," Christie said speaking outside the Corner View Restaurant in Concord, N.H. "If Congress messed up the statute, the Congress and the President created the statute; they should fix it. If they're saying it's not what they intended, then go back and fix it."

"It's an easy thing to do. The Congress and the President should work together to fix it," Christie said.

In another rebuke of the Obama administration’s efforts to expand health care to the uninsured, Florida’s Republican-led House of Representatives soundly rejected a plan on Friday that state officials said would have covered as many as 650,000 residents.

It was the third time that legislators had considered and spurned some version of health care expansion since passage of the Affordable Care Act, and it represented a victory for Gov. Rick Scott, a Republican, who had changed his mind in the past on whether to support any such enlargement but was firmly opposed this time.

(NOTE: As I noted yesterday, the "nearly 40,000" number is extremely exaggerated; the true number is either 8,200 or 12,635, depending on your perspective):

Hawaii's health insurance exchange announced on Friday that it will be shutting down, and its nearly 40,000 enrollees will be transitioned to the federal Obamacare marketplace, Healthcare.gov.

...According to Hawaii Health Connector CEO Jeff Kissel, Hawaii's health exchange will become a state-run exchange that uses HealthCare.gov, which is similar to the setup in Nevada, New Mexico and Oregon.

For most of West Virginia, Highmark will remain the only option available in the state’s Affordable Care Act marketplace for 2016, and enrollees on and off the exchange are likely to see rate increases in the coming year.

According to West Virginia Insurance Commissioner Mike Riley, only one other insurer filed to enter West Virginia’s marketplace in 2016, and only in 15 counties. CareSource, a managed-care nonprofit based in Dayton, Ohio, will offer plans in Boone, Brooke, Cabell, Clay, Hancock, Kanawha, Lincoln, Marshall, Mason, Ohio, Pleasants, Putnam, Wayne, Wirt and Wood counties.

“We’re pleased that another carrier has chosen to do business here in West Virginia,” Riley said. “Certainly, they come with good credentials.”

Unlike Highmark, which operates on a fee-for-service model, CareSource uses a per-payer, per-month system and receives set rates for the number of consumers it insures. One of the nation’s largest Medicaid managed-care plans, CareSource covers 1.4 million people in Ohio, Indiana and Kentucky. CareSource entered the marketplace in Ohio in 2013 with its non-Medicaid plans, CareSource Just4Me, and expanded its marketplace presence into Indiana and Kentucky in 2014, according to Fran Robinson, media relations manager for CareSource.

Minnesota health insurers are defending the dramatic premium increases they are seeking on the grounds that rates are so low that their companies have been hurt financially.

Several insurance plans are asking for average rate increases that range from 13 to 73 percent, proposals that have been denounced by Minnesota politicians. Gov. Mark Dayton called the proposed rate hikes "outrageous."

A big question for insurers is why some of the plans are proposing double-digit increases for individual and family coverage when spending on healthcare is growing at only 3 percent.

Gov. Peter Shumlin's administration says it has met a critical deadline for correcting key functions of customer service in Vermont Health Care Connect, the state health care exchange. But critics remain skeptical.

The system was offline at the end of May when state employees and contractors put in long hours to meet a self-imposed deadline to address what's known as "change-of-circumstance" functionality. Change of circumstance, however, isn't quite ready for primetime. Lawrence Miller, chief of health care reform for the administration, says the state has conducted successful testing of the technology, but it hasn't yet been "validated" by the private insurance carriers to which the changes are being transmitted.

While some states are expecting double-digit increases in individual health care insurance premiums next year, some Washington insurers on the state exchange plan to lower their rates for 2016.

Most Washington residents who buy health insurance through Washington Healthplanfinder, however, should expect to pay more next year. A big chunk of those increases is tied to an exchange user fee collected to pay to run the state exchange, Washington’s answer to the federal Affordable Care Act.

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