Affordable Care Act
Obamacare: Health Industry News Recap: 7/6-7/10 – What we learned this week
Published on July 21, 2015
Health Insurance Premiums are rising:
Some health insurance companies around the country are seeking rate increases of 20 percent or more. While this may come as a shock, keep in mind, increases of 10 percent or more are subject for review under federal rules. You can thank the 2010 health law for establishing the rate review process, which requires insurance companies to disclose and justify large proposed increases.
So, what are the chances that the insurance companies get their way and prices in 2016 by 20%-40%?
According to Avalere Health, price hikes such as the ones proposed are possible, but most plans are proposing more modest increases. Many of these rate increases vary from state to state, as well as by plan. Two plans in Tennessee may be dramatically affected, but that doesn’t necessarily mean the 30 other plans within that state will be as well. (The New York Times)
The uninsured rate for young adults continues to lower. However, many are still confused about how their insurance works.
Recent data suggests that Obamacare is reducing the number of uninsured people in the U.S. However, a recent study shows that young people entering the insurance market for the first time do not understand what they’re buying.
Before the opening of the marketplaces, people buying their own coverage tended to be individuals with higher incomes and more familiarity with how insurance works. (The Washington Post) Reuter’s Lisa Rapaport reports that many young adults are unaware of what basic insurance terms mean, like deductible or co-insurance. Researchers also found that some continue to remain uninsured, because they find the coverage to be unaffordable.
Lead researcher Dr. Charlene Wong of the Children’s Hospital of Philadelphia and the University of Pennsylvania says, “Their confusion over these basic terms can have real consequences on their cost exposure down the road.”
Read more: (Reuters)
Children who are in the state of California illegally will now be eligible for Medi-Cal.
California’s Gov. Jerry Brown announces a budget deal that grants health coverage to poor children lacking legal immigration status. About 170,000 children who have long relied on safety-net clinics and emergency rooms will now have access to Medi-Cal.
Supporters of this ruling argue that access to more health facilities may improve long –term health. Unfortunately, there are still about 1.16 million low-income adults in California illegally and ineligible for comprehensive Medi-Cal services, but supporters believe this is a good start for the fight for their right to health insurance. (Kaiser)
Not everyone is in favor of funding health care for undocumented immigrants.
John Eastman, a professor of law at Chapman University in Orange, said, “We’re talking about transferring tens of millions of dollars from taxpayers — citizens and lawful permanent residents — to those who have flouted our nation’s immigrations laws.” (California Healthline)
Big name insurance companies are merging- should you be worried?
There have been lots of talk and rumors of insurance companies moving, and merging, but so far just Aetna has announced a $37 billion deal to acquire rival Humana. The five biggest insurance companies- Aetna, Anthem, Cigna, Humana, UnitedHealth, may become the biggest three according to The New York Times.
So, should consumers be worried?
A survey of more than 100 large employers by benefits consultancy Aon Hewitt (AON) indicates 46% of companies “believe it will result in fewer health plan options for them and their employees.” (Forbes)
Others are suggesting that “bigger insurance companies mean increased leverage and unfair power over negotiating rates with hospitals and physicians,” the AARPwrote. “More often than not, consolidation increases costs and reduces options for consumers.”
Insurance companies are saying that “there is little evidence that shows mergers in health insurance increase costs.” (CNN Money)
It looks like only time will tell.
The Supreme Court ruling on gay marriage leaves U.S. firms unclear on spousal benefits
The United States Supreme Court’s decision legalizing same-sex marriage ensures legal protections and benefits for married same-sex couples nationwide, but many U.S. companies are still self-insured.
Employers who are self-insured are governed by a 1974 Act, which has no language preventing discrimination based on sexual orientation.
In a Reuters survey of 60 large U.S. employers, nearly half said they were already providing benefits to same-sex spouses before the Supreme Court ruling last month, including 13 that are based in states where gay marriage was illegal.
Reuter’s, Kylie Gumpert acknowledges the many companies that have moved in that direction, but fears that the “lack of legal clarity” could lead to some negative lawsuits and injustice to same-sex spouses.
Are there enough health plan choices for consumers on the Obamacare exchanges?
According to an analysis released by Avalere earlier this week, consumers who bought insurance on the health exchanges last year had access to one-third fewer doctors and hospitals, on average, than people with traditional employer-provided coverage.
Obamacare exchanges, as a rule, offer fewer plans to customers than the policies available outside the exchanges. However, the exchanges are the only place that eligible customers can receive federal tax credits to lower the cost of their monthly premiums.
In response to the report, a spokeswoman for the insurance lobbying group America’s Health Insurance Plans said that a “key point to keep in mind” is that “consumers who are shopping on the exchanges are increasingly price sensitive.”
Read more: CNBC , The Washington Post
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