Affordable Care Act

Obamacare Health Industry News Recap: 11/2-11/6: What we learned this week

Published on November 06, 2015


Obamacare 2016 Open Enrollment Period

  • Obamacare Open Enrollment 2016: Everything You Need to Know

Open enrollment for individual health insurance for 2016 through Obamacare, or the Affordable Care Act, begins Nov.1 and ends January 31, 2016.
Keep in mind, open enrollment is typically the only time during the year when you can select a new health insurance plan for the following year (exceptions include a job loss or new baby.)
Also, if you want your coverage to start on January 1, 2016, your enrollment deadline is December 15th.
Here are five things to focus on when choosing your 2016 healthcare plan:

  1. Don’t just focus on monthly premiums.
  2. Consider the subsidies.
  3. “Silver” plans get cost-sharing reductions.
  4. Consider the coverage.
  5. Use drug and doc “tools”.

Read more: (Money)

  • Obamacare prices increase for those who don’t get subsidies

New analyses show that people who buy the cheapest health plans on the biggest Obamacare exchange without getting financial assistance are facing the largest increases for premiums and out-of-pocket costs in 2016.
Average prices of bronze-plans on the marketplace are rising 11 percent for nonsubsidized customers over 2015 prices.
Avalere Health found that the average price of the lowest-cost bronze plan in states was rising by an average of 16 percent. Avalere said the average price of the lowest-cost silver plan was rising by 13 percent, compared to the 3.2 percent rise that was seen for 2015 plans.
HealthPocket found that average premiums for the most popular types of plans, known as “silver plans,” are going up nearly as much — 10 percent — for customers who are unsubsidized.
HHS said that the average premium for closely watched types of silver plans was rising by 7.2 percent before subsidies were taken into account. The department also said 86 percent of current customers can find a plan with lower premiums, before subsidies, by shopping among available options.
“Consumers will continue to have affordable choices in 2016,” said Richard Frank, HHS’ assistant secretary for planning and evaluation. “While every market is different, and the reasons for rate changes vary, what’s important for consumers to understand is that about 8 out of 10 returning consumers will be able to buy a plan with premiums less than $100 a month after tax credits; and about 7 out of 10 will have a plan available for less than $75 a month.”
Read more: (CNBC)

  • Marketplace Plans Covering Out-Of-Network Care Harder To Find

According to two analyses published this week, health plans that offer coverage of doctors and hospitals outside the plan’s network are getting harder to find on insurance marketplaces.
Robert Wood Johnson Foundation’s analysis found two-thirds of the 131 carriers that offered silver-level preferred provider organization plans in 2015 will either drop them entirely or offer fewer of them in January. Those cutbacks will affect customers in 37 states, according to the foundation.
Keep in mind, silver plans are the most popular plan sold on the marketplaces.
Preferred provider organization plans, or PPOs, typically offer coverage for doctors and hospitals that aren’t in the plan’s network, but require consumers to pay a larger share of the cost. In contrast, health maintenance organizations, which make up roughly half of the plans offered on the exchanges, generally don’t cover any care provided outside the plan’s network.
Avalere Health also documented a steady decline in PPO plans within the 37 states that use the federal marketplace.
It may be possible that in at least half-dozen states there may be no silver-level PPO plans available on the marketplace, according to the study.
Read more: (Kaiser Health News)

  • Small Businesses Snub Obamacare’s SHOP Exchange

The small business health insurance exchange created by the Affordable Care Act is still struggling to catch on after two years in operation.
According to the latest federal data released in May, about 85,000 people from 11,000 small businesses, have coverage through the online marketplace known as SHOP (Small Business Health Options Program) nationally. Those totals do not include employers that began coverage in 2014 and have not yet renewed their coverage through for 2015.
A market data firm reported that it’s less than 1 percent of people with coverage in the U.S. small group insurance market that in 2013 had about 16.7 million people enrolled in health plans.
“When you look at the cost and look at the take up rate, it certainly raises questions” about whether SHOP has been worthwhile, said Alissa Fox, senior vice president of the Blue Cross Blue Shield Association. “We never thought the business equation made sense.”
The Obama administration hoped SHOP would make it easier and cheaper for small employers to offer coverage to employees and for their workers to have a choice of plans.
Unlike the federal- and state-run health insurance exchanges for individuals that limit sign-up to a certain period during the year, the SHOP exchanges allow companies to enroll at any time.
Read more: (Kaiser Health News)

We’ll let you know when we publish anything new.