Short Cuts

CodeBaby, a provider of Intelligent virtual assistant technology, today announced Connect for Health Colorado® and Access Health CT have expanded the use of CodeBaby as a way to increase consumer education and improve the online experience for customers purchasing health insurance during the 2016 open enrollment period.

Connect for Health’s virtual assistant, Kyla, can be found at key points in the website, presenting important information in a clear manner, assisting users in making informed decisions, and providing decision support for critical choices. In time for this year’s open enrollment, Connect for Health has expanded Kyla to the Subsidy Eligibility System so that the avatar can answer questions, help people determine if they are eligible for subsidies, and walk them through the enrollment process.

This issue brief reflects lessons learned from how consumers handled the new intersections between health coverage and the tax filing process in 2015. Drawing on public data as well as Enroll America’s private survey research and outreach efforts, this issue brief examines the policy framework underpinning the linkages between taxes and health coverage, messaging considerations and opportunities, and effective partnerships to maximize enrollment. Based on this analysis, the report concludes with recommendations for policymakers and other enrollment stakeholders about how to improve the consumer experience.

When patients need simple health care, they can get impatient about having to wait.

That’s prompted more health care systems to stress convenience.

This month, North Memorial Health Care will open two easy-access clinics in new Hy-Vee grocery stores in New Hope and Oakdale, hoping that shoppers might add treatment for warts, fever and other ailments to their grocery lists.

The resurgence of retail health clinics by hospital operators comes as they also pump money into online programs that let patients tap into care through computers and smartphones without leaving home.

This one is a heck of an eye-opener, considering the ongoing technical problems Vermont has had with their exchange website...

A new federal report shows Vermont Health Connect to be the best state-run health care exchange in the nation.

Democrats in the Wisconsin Legislature are pushing a bill designed to prevent large increases in health insurance rates, but it’s doubtful Republicans who hold a majority and control the legislative agenda will get behind it.

The bill would require insurance companies give consumers 60 days’ notice for rate increases and require the state Office of the Commissioner of Insurance to hold public hearings on rate increases of more than 10 percent.

Over a year and half into Medicaid expansion and the launch of Kynect, the state’s health insurance exchange program, Kentucky is among the nation’s leaders in reducing its uninsured population.

As a result of providing more services to more people throughout the commonwealth, however, Kentucky hospitals are reporting healthy improvement in their revenues.

Native Americans can get an exemption from the requirement that everybody have health insurance. Under the health law, however, many Native Americans can get coverage under Medicaid, which serves low-income Americans, or buy subsidized plans through insurance exchanges. That allows them to receive treatment from private doctors and hospitals rather than rely solely on government and tribal facilities.

And the coverage allows Indian health facilities, which tribal leaders say are chronically underfunded, to bill insurers for care they already provide. And that additional revenue means doctors and hospitals can also offer new services.

Advocates also see the health law as a chance to reduce the health disparities that have long afflicted Native Americans, including rates of diabetes that are three times higher than the U.S. population and a life span that is four years shorter.

While the Republican nominee for governor says he would dismantle the state health-insurance exchange branded as Kynect, a GOP senator is talking about not only keeping it, but expanding it to other states to pay for the other big feature of federal health reform: expanded Medicaid.

Sen. Ralph Alvarado of Winchester made the suggestion at a legislative committee meeting where Kynect Director Carrie Banahan said it would be "disastrous" to move Kentuckians to the federal Obamacare exchange, as Republican gubernatorial nominee Matt Bevin has said he will do if elected.

Alvarado, a physician, said his concerns about Obamacare in Kentucky are mostly monetary because the state will have to start paying 5 percent of the Medicaid expansion costs in 2017, rising to the reform law's limit of 10 percent in 2020.

...Alvarado suggested that Kynect become a regional exchange and charge other states for its services, using the profit to pay for the expansion.

The Washington Health Benefit Exchange and Healthplanfinder, the state’s marketplace and website where people can buy individual and subsidized health insurance under health reform, have gone through some big changes lately.

Most important to consumers, Healthplanfinder is no longer the portal through which customers pay their insurance premiums.

On Tuesday, the organization announced that starting Sept. 24, Qualified Health Plan and Qualified Dental Plan customers will be required to pay their monthly premiums directly to their insurance companies, and the site will no longer accept those payments after Sept. 23.

The change mirrors a stop-gap measure put in place last year after problems plagued the site’s payment mechanism.

I was gone for 10 days and a mountain of ACA/healthcare stories built up in my in-box. No time for even a summary, headlines only. Ready? GO!

Health and Human Services Secretary Sylvia M. Burwell announced today $169 million in Affordable Care Act funding to 266 new health center sites in 46 states, the District of Columbia and Puerto Rico for the delivery of comprehensive primary health care services in communities that need them most. These new health center sites are projected to increase access to health care services for over 1.2 million patients. These awards build on the $101 million awarded to 164 new health center sites in May 2015.

The Alabama House of Representatives on Wednesday narrowly approved a deep cut to the state's Medicaid program as lawmakers continue to deadlock on a solution to the budget shortfall.

The budget cut came out of frustration over the stalemate and is largely seen as a way to build pressure on lawmakers to find some sort of compromise. But opponents called it a dangerous gamble with the health care of the state's most vulnerable people.

Rebecca Santiago clutched a stack of papers about Obamacare and chatted up strangers at the health fair, set up on a Hartford street within view of two homeless shelters. She wanted to know if they had health insurance and, perhaps more importantly, if they’d used it.

One was Darin Zollarcoffer, 48. He had coverage, but no primary care doctor.

“Why not?” Santiago asked.

Now that the Supreme Court has rendered its decision in King v. Burwell on federal subsidies under the Affordable Care Act (ACA) and Open Enrollment is approaching, there is no better time to reflect on the important mission of access to affordable and quality health coverage for the residents of all states. Health insurance is complex; it engages a range of stakeholders from state agencies and insurance carriers to brokers and solution providers, it requires eligibility determination, various payment models, and a myriad of funding mechanisms, to name a few.

Senate Republican leaders this week narrowly averted an intra-party battle over ObamaCare by again promising to get a repeal bill to the president’s desk through budget reconciliation.

MAYAGÜEZ, P.R. — The first visible sign that the health care system in Puerto Rico was seriously in trouble was when a steady stream of doctors — more than 3,000 in five years — began to leave the island for more lucrative, less stressful jobs on the mainland.

Now, as Puerto Rico faces another hefty cut to a popular Medicareprogram and grapples with an alarming shortage of Medicaid funds, its health care system is headed for an all-out crisis, which could further undermine the island’s gutted economy.

Now that Congress and the courts have failed to overhaul Obamacare, states are eyeing the only current remaining opportunity to modify the healthcare law — this time from the inside out.

In addition to the normal off-season "Qualifying Life Events" which allow roughly 7,500 people to select a private policy nationally every day, it looks like up to 100K additional people might be added to either the QHP or Medicaid tally over the next month or so:

CMS will offer a special enrollment period to thousands of enrollees who were incorrectly told that they qualified for fewer subsidies than they should have received or none at all, due to a Social Security-related glitch in the eligibility system that inflated household income.

...Tricia Brooks, a senior fellow at Georgetown University's Center for Children and Families who frequently writes on the issue, estimates that the glitch affects around 40,000 households.

A judge has blasted a California software giant's claim that a cabal of campaign advisers are to blame for the decision to tank the state's $300 million Cover Oregon website project.

Oracle in February sued five campaign advisers and consultants to former Gov. John Kitzhaber, who resigned in February. Oracle argued the exchange was ready to roll out in February 2014, but said advisers led by Patricia McCaig pulled the plug on the project for political reasons.

On Monday, Multnomah Circuit Court Judge Henry Kantor issued a written opinion ripping Oracle's legal arguments using language that went far beyond his earlier e-mailed notice of the decision. He called Oracle's arguments "totally unsupported by the evidence provided."

Remember that University of Michigan study I posted about last week which claimed that in spite of all the predictions by ACA opponents that expanding Medicaid would make it impossible for enrollees to actually make a doctor's appointment, the opposite ended up being the case?

A new University of Michigan study shows that the availability of primary care appointments actually improved for people with Medicaid in the first months after the state launched the Healthy Michigan Plan, the state’s Medicaid expansion under the ACA. What’s more, it remained mostly unchanged for those with private insurance.

Well, apparently the Michigan results are not an outlier:

Obamacare enrollees on average have one-third fewer choices when it comes to picking doctors and hospitals than those on regular commercial plans, a new study says.

But its authors claim that’s not necessarily a bad thing. And others in the health-care arena believe the findings are misleading and don’t tell the whole story.

The study from Washington, D.C.-based Avalere Health finds that those under Affordable Care Act plans have roughly 66% of the choices compared with those in commercial plans, and the number of options may vary depending on the type of physician needed.

Under Obamacare, enrollees have access to roughly 58% of the oncologists and cardiologists that commercial plan members have. The average goes up when it comes to hospitals, as those using the public exchanges have access to 76% of those care facilities.

Things weren't looking great eight months ago for Dr. Peter Beilenson and Evergreen Health Co-op, the insurance company he created from scratch.

The brand-new insurance company had been counting on Maryland's health exchange to bring in its first members. But the online marketplace was a nightmare for people trying to sign up. With higher prices and less name recognition than competitors like CareFirst BlueCross BlueShield, Evergreen ended the exchange's open enrollment period with just 400 members.

...Fast-forward to today and business is looking up for Evergreen. The companyshifted focus to small business groupsonce it realized it couldn't rely on the exchange alone. Evergreen lowered its premium prices for 2015 individual plans and is locking in the rates on both its individual and small group plans for two years. About 800 people have signed up for Evergreen health plans through the exchange since it opened in mid-November.

With the deadline approaching for individuals to renew healthcare plans purchased on, Aetna has begun to see a surge in customers for 2015, the insurer's new president said on Thursday during a meeting with analysts and investors. has a Dec. 15 deadline for individuals to renew their 2014 plans or select new ones before it will automatically re-enroll them for next year. Enrollment for individual plans is open until Feb. 15, which were created under the 2010 Affordable Care Act, often called Obamacare.

Karen Rohan, whose appointment was announced earlier this month, said that the company expects a surge in enrollment over the next few days and that it was "starting to see" that already. Aetna sells these plans in 17 states.

For each of the first two weeks, has reported that the total QHP enrollments to data are split roughly evenly between new enrollees and renewals, which I find rather interesting; I was figuring that the early days would skew more heavily towards renewals, perhaps by a 2:1 or 3:1 ratio.

Part of this could simply be different states cancelling each other out--after all, all enrollees in both Nevada and Oregon, which were shifted over to this year, are being categorized as "new" since the enrollees had to start over again; between the two states, that's up to around 110,000 current enrollees who would be listed as "new" even if they were it's possible that there are other states with a higher "renewal" ratio which is cancelling those two out.

NOTE: I've decided to make "Short Cuts" the standard name for ACA-related stories which are interesting but which I just don't have time to do full write-ups on. I've also given up on trying to cram the headlines of each story into the blog entry title.

ObamaCare outreach campaigns across the country are diving deeper into the hard-to-reach uninsured populations such as rural areas with hopes of driving up enrollment in its second year, several state directors said Wednesday.

“We have a much better sense because of data from the federal government on where are the uninsured,” Ryan Barker, vice president of health policy for the Missouri Foundation for Health, said in a conference call hosted by Families USA.

The Michigan Primary Care Association said it is trying to “fill the gaps” of health insurance coverage by relocating a majority of its staff to rural, less-populated areas.