Affordable Care Act

Obamacare Health Industry News Recap: 9/7-9/11: What we learned this week

Published on September 11, 2015


  • Health Insurance Signups Near 10 Million in Midyear Report

According to the federal government, about 9.9 million people have signed up and paid for health insurance under President Barack Obama’s health care law as of June 30.
The Obama administration said late last year that it had a goal of 9.1 million of paid enrollments by the end of 2015. Enrollment is official only when a customer makes their first month’s premium payment.
The U.S. Department of Health and Human Services said that 84 percent of those, or more than 8.3 million, were receiving tax subsidies to help with the cost.
In 2014, the enrollment number peaked at around 8 million in the spring and dropped to 6.3 million by the end of the year. Hanging on to customers is a major priority for as well as state-run exchanges, amid a growing sense that it may take three to five years for the taxpayer-subsidized markets to approach their full potential.
“They still have a tough hill to climb over the next couple of years to increase enrollment and get more people covered,” said Larry Levitt of the nonpartisan Kaiser Family Foundation.
Officials also said that as of the end of June about 423,000 customers had their coverage for 2015 terminated because they failed to provide sufficient documentation of citizenship or immigration status required to be eligible for Obamacare plans.
Another 976,000 households have had adjustments made to the federal subsidies they receive to help pay for their Obamacare plans’ premiums, and/or to the assistance they get in paying for out-of-pocket health expenses, officials said. Both the subsidies and cost-sharing aid are tied to people’s annual income levels, and can be adjusted if a household’s self-reported income differs from data showing actual income.
Read more: (The New York Times, CNBC)

  • When cheap is good: Obamacare exchange options

A new federal report finds that the cheapest individual health plans in counties around the United States became increasingly available on government-run exchanges in 2015, the second year of enrollment on those marketplaces.
The Government Accountability Office’s report looked at the prices for plans for individual coverage in 1,886 counties in 28 states where sufficient data was available. The GAO examined plans sold both on the government exchanges, as well as those sold outside the marketplaces, either directly by the insurers themselves, or via Web-based and traditional brick-and-mortar brokers.
More plans are available outside Obamacare exchanges than on the exchanges.
However, people with incomes up to four times the federal poverty level can qualify for federal subsidies to help pay for their individual health plans only if they buy coverage through Obamacare exchanges that are run by the federal government or individual states. About 84 percent of the current 9.9 million Obamacare exchange customers pay reduced premiums because of those subsidies.
The GAO report also found an increase this year in the number of U.S. counties where customers had at least six Obamacare plans to choose from in each of the four major levels of coverage.
For example, in 38 states examined, the percentage of counties where six or more silver plans were available grew from 80 percent in 2014 to 94 percent this year, the GAO said.
For bronze plans, the second-most popular type of exchange plans, at least six plans were available in 80 percent of the counties in 2014. That increased to 88 percent of the counties this year, according to the report.
Read more: (CNBC)

  • AMA: Insurance mergers will raise premiums

The American Medical Association says the proposed mergers between four of the nation’s largest health insurers will drive up costs for patients and hurt the quality of care.
Using data from the study, the AMA argues that the potential Anthem-Cigna linkup could harm consumers in 85 metropolitan areas in 13 states: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, and Virginia.
The AMA says the merger could also “raise significant competitive concerns” in other metropolitan areas, 111 cities in all. “A lack of competition in health insurer markets is not in the best interests of patients or physicians,” said Dr. Steven Stack, the AMA’s president, in a news release.
Among the cities where the AMA expects that mergers would enhance insurer’s market power, here are the metro areas that could see the biggest changes in market concentration:
Anthem-Cigna merger
1. Dalton, Ga.
2. Indianapolis
3. Lafayette, Ind.
4. Richmond, Va.
5. Terre Haute, Ind.
6. Rochester-Dover, N.H.
7. Bangor, Maine
8. Manchester, N.H.
9. Kokomo, Ind.
10. Lewiston-Auburn, Maine
Aetna-Humana merger
1. Macon, Ga.
2. Springfield, Ohio
3. Louisville, Ky.
4. Elizabethtown, Ky.
5. El Paso, Texas
6. San Antonio, Texas
7. Jacksonville, Fla.
8. St. George, Utah
9. Lexington-Fayette, Ky.
10. Rockford, Ill.
Read more: (Money, CNN Money)

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