House GOP reveals AHCA: Update - Repeal of ACA IS BACK ON

tru_m.a.c

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Anthem talk of pullout in Georgia puts a cloud over ACA exchanges

In Georgia, Blue Cross is currently the only exchange health insurer in 96 of the 159 counties. Even a partial pullout would create a vacuum in areas of the state.

Anthem Inc., the parent company of Blue Cross and Blue Shield of Georgia, “is leaning toward exiting a high percentage of the 144 rating regions in which it currently participates,” Jefferies analysts David Windley and David Styblo said in a research report.

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Anthem talk of pullout puts a cloud over ACA exchanges
 

Bleed The Freak

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How do yall brehs explain this? Do you think Obama (boogeyman) being out of the picture has actually helped this bill? Or do we just blame this on general stupidity of Americans?





Once the boogeyman black man was gone and people realized the repeal was gonna hurt them they actually researched it.....smdh
 

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How do yall brehs explain this? Do you think Obama (boogeyman) being out of the picture has actually helped this bill? Or do we just blame this on general stupidity of Americans?




They didn't want a black person saving them. Now the ACA is getting called ACA more often instead of BlackManCare. Americans are just incredibly limited when it comes to anything African American, especially when a black man is in charge.
 
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Meadows: Freedom Caucus would back bill that got rid of 3 ObamaCare regs

Vice President Pence offered this week to get rid of three regulations: essential health benefits, which mandate what services insurers must cover; community rating, which says insurers can't charge sick people more for insurance; and guaranteed issue, which says insurers must cover people with pre-existing conditions.

"The majority of the Freedom Caucus would be favorably inclined to vote for that," Meadows said at a Politico event Thursday, adding that they would need to see the bill text before committing.
Meadows and Freedom Caucus members argue that those regulations drive up premium costs for healthy people.

Meadows: Freedom Caucus would back bill that got rid of 3 ObamaCare regs
 

tru_m.a.c

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Estimates: Average ACA Marketplace Premiums for Silver Plans Would Need to Increase by 19% to Compensate for Lack of Funding for Cost-Sharing Subsidies
Estimated Increases Range from 9% in North Dakota to 27% in Mississippi

A new Kaiser Family Foundation analysis finds that the average premium for a benchmark silver plan in Affordable Care Act (ACA) marketplaces would need to increase by an estimated 19 percent for insurers to compensate for lost funding if they don’t receive federal payment for ACA cost-sharing subsidies.

Established by the health law to reimburse insurers for the cost of reducing out-of-pocket costs for lower-income people buying marketplace plans (with incomes from 100% to 250% of the poverty level), the subsidies have been challenged in a lawsuit from the U.S. House. With a legal appeal pending, the federal government and Congress are in a position to choose whether to continue reimbursing insurers for their cost.

Among 12.2 million people who selected a 2017 ACA marketplace plan, about 58 percent, or 7.1 million, are receiving cost-sharing reductions. An earlier Foundation analysis of 2017 plans found the subsidies lower combined medical and prescription drug deductibles by as much as $3,354 and reduce annual out-of-pocket maximums by up to $5,587.

The Foundation’s new analysis examines the amount insurers would need to increase premiums to make up for the lack of funding, if federal payments cease for the cost-sharing reduction program.



The analysis – based on cost-sharing subsidy payments and benchmark premiums in federal marketplace states in 2016, the most recent data available — finds that the estimated premium increase for silver plans would be higher (21%) in states that did not expand Medicaid under the ACA than in states that expanded Medicaid (15%). Cost-sharing subsidies are generally higher in states that have not expanded Medicaid because they have a larger share of enrollees with incomes from 100% to 150% of the poverty level, who get the biggest cost-sharing reductions.

Estimated premium changes vary for the 38 states that used healthcare.gov in 2016, ranging from 9 percent in North Dakota to 27 percent in Mississippi.



Estimates: Average ACA Marketplace Premiums for Silver Plans Would Need to Increase by 19% to Compensate for Lack of Funding for Cost-Sharing Subsidies
 

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How Has the ACA Changed Finances for Different Types of Hospitals? Updated Insights from 2015 Cost Report Data

Using data through fiscal year 2015, this new analysis finds that the Medicaid expansion under the ACA increased Medicaid revenue by $5.0 million per hospital, reduced costs of uncompensated care by $3.2 million per hospital, and improved average operating margins by 2.5 percentage points. This study also finds that the financial benefits of the Medicaid expansion on hospitals’ profit margins were strongest for small hospitals, for-profit and non-federal-government-operated hospitals, and hospitals located in nonmetropolitan areas.

How Has the ACA Changed Finances for Different Types of Hospitals? Updated Insights from 2015 Cost Report Data
 

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Aetna Follows Wellmark's Lead, Will Exit Iowa Insurance Exchange In 2018

Iowa will soon have only two insurance carriers providing individual healthcare policies. Connecticut-based Aetna has become the second company this week to announce it will stop selling insurance policies on Iowa’s public exchange in January 2018.

In the absence of Aetna and Wellmark, Iowa has only two insurers providing individual policies. Minnesota-based Medica and Wisconsin based-Gundersen both have until this summer to decide if they'll continue participation in Iowa's individual insurance exchange.

Medica provides policies for the entire state, but Gundersen only offers coverage to people living in Allamakee, Clayton, Fayette, Howard and Winneshiek counties.

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Aetna Follows Wellmark's Lead, Will Exit Iowa Insurance Exchange In 2018
 

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Meadows: Freedom Caucus would back bill that got rid of 3 ObamaCare regs

Vice President Pence offered this week to get rid of three regulations: essential health benefits, which mandate what services insurers must cover; community rating, which says insurers can't charge sick people more for insurance; and guaranteed issue, which says insurers must cover people with pre-existing conditions.

"The majority of the Freedom Caucus would be favorably inclined to vote for that," Meadows said at a Politico event Thursday, adding that they would need to see the bill text before committing.
Meadows and Freedom Caucus members argue that those regulations drive up premium costs for healthy people.

Meadows: Freedom Caucus would back bill that got rid of 3 ObamaCare regs
So they essentially want to send Insurance back to pre-obama care, but with higher premiums across the board for larger profits for insurance companies?
 

tru_m.a.c

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House GOP Moves To Add ‘Invisible Risk Sharing Program’ To AHCA

On April 6, 2017, as Congress headed out the door for its spring recess, a new amendment to the American Health Care Act was submitted to the House Rules Committee by congressmen Gary Palmer (R-AK) and David Schweikert (R-AZ). The amendment would create a federal “invisible risk sharing program” within the AHCA’s Patient and State Stability Fund (PSSF) program.

The “invisible risk sharing program,” is apparently modeled on similar programs that were implemented by Maine in 2011, and more recently by Alaska, in both instances successfully reducing premiums in the individual market.

The amendment would appropriate $15 billion for the program for a period beginning on January 1, 2018 and lasting until 2026. It would also allocate to the program any PSSF funds that were appropriated for any particular year that remain unallocated at the end of that year. The Centers for Medicare and Medicaid Services Administrator would be charged with developing a federal invisible risk sharing program within 60 days after the enactment of the legislation. States would be able to take over the program beginning in 2020.

CMS would define who would be eligible for the program. To this end, CMS would develop a list of high-cost medical conditions that would automatically qualify individuals for program participation. Applicants for insurance coverage would apparently be asked to complete a health status statement to be used to identify them for program qualification. Health insurers would also be able to voluntarily qualify individuals who did not qualify automatically at the time of application. Funding cannot be used under the program to pay for abortions for which federal funding is otherwise not available.

Insurers would cede to the program some proportion of the premiums that they received for individuals qualified for the program. Under the Maine program, insurers paid 90 percent of premiums for eligible individuals into the program. This created a disincentive for insurers identifying participants to the program inappropriately. CMS would establish the dollar thresholds above which it would make payments to health insurers under the program and the percentage of each claim above those thresholds that the program would cover. In Maine, the program reimbursed insurers for 90 percent of claims for qualified individuals between $7,500 and $32,500, and 100 percent of claims above that amount.

Insurer participation in the program would apparently be voluntary. The program does not require state matching fund contributions, as are required for receipt of PSSF funding for other purposes; indeed, it would initially be a nationwide program. Because it distributes funding by the cost of claims rather than by state, support would automatically be adjusted for the higher cost of care in some areas.

Invisible risk sharing is in fact a form of reinsurance. ACA reinsurance as originally conceived was similarly targeted at high-cost medical conditions, although as implemented it was simply based on high-cost claims. Invisible risk sharing avoids the problems of traditional risk pools — instead of segregating high-cost individuals in a separate insurance programs where they would likely face higher premiums and interruption of continuity of care, it offers them the same coverage and access to the same providers as would be available to healthier enrollees for the same premium. Were the program adequately funded, it could also make premiums more affordable for all enrollees. It would not only reduce the total cost of claims that insurers would have to cover from their premiums, it would also reduce the risk margins they would have to otherwise build into their premiums, although it also might diminish their incentives to manage high-cost conditions. If reduction of premiums attracted younger and healthier individuals into the market, it could reduce premiums further.

The $15 billion over nine years, however, is likely far less that would be needed to create a credible program, even with insurer contributions. Moreover, the reduction in premiums that would result from the program is unlikely to be sufficient to make coverage affordable for older, lower-income individuals or individuals in high-cost areas given the fixed-dollar, age-adjusted tax credits offered by the AHCA and the changes in age ratios in includes. The lower actuarial values permitted by the AHCA and its repeal of cost-sharing subsidies would also likely leave health care unaffordable for many with chronic diseases even if they could afford insurance premiums.

Finally, there is continuing talk of amending the AHCA further to permit states’ waivers to allow their insurers to avoid the ACA’s guaranteed issue, community rating, and essential health benefit requirements, which could reduce premiums further for healthy people, but only by dramatically increasing premiums and reducing benefits for people with health problems. These changes, if adopted, would significantly undermine the benefits the April 6 amendment offers for improving access to health insurance coverage.

House GOP Moves To Add ‘Invisible Risk Sharing Program’ To AHCA; Other ACA Developments
 

tru_m.a.c

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Next Year, Iowans May Be Unable To Purchase Individual Insurance Policies Under Affordable Care Act

People in 94 of Iowa’s 99 counties may have no options in 2018 for buying individual healthcare polices on the state's insurance exchange that was created under the Affordable Care Act.

Currently nearly 48,000 people have insurance through Iowa's ACA exchange. But recently two of the three insurers providing individual plans announced they were leaving the Iowa market next year.

That left Minnesota-based Medica to be the exchange's likely sole participant. Now Medica is saying that it too may be leaving the state.

“Without swift action by the state or Congress to provide stability to Iowa’s individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today," says spokesman Greg Bury in an emailed statement. "We are examining the potential of limited offerings, but our ability to stay in the Iowa insurance market in any capacity is in question at this point.”

One Iowan who will likely be affected if Medica leaves is Geoff Wood, who has purchased insurance through the exchange for every year that it’s been available. Wood owns a co-working space called Gravitate in downtown Des Moines, and often talks with people who are thinking about starting their own businesses.

"That’s something that we talk a lot about, is what that’s going to be like to insure yourself for the first time," he says. "I’ve been very concerned about all the changes for that reason, just really stunting the growth of new business in our state. As people are kind of job-locked into their existing employment situations."

While Medica is imploring both Iowa and Congress to take action, the Iowa Insurance Commission sees it as the responsibly of the federal government to bring stability to individual marketplace.

"Although individual state markets vary, I am in Washington (D.C.) along with other state insurance commissioners asking for action," says Iowa Insurance Commissioner Doug Ommen via email. "Long-term, the individual health insurance market under the ACA was and still is unaffordable and unsustainable. Iowa needs congressional action as soon as possible."

If nothing happens to salvage the Iowa exchange, Wood says that he or his wife, who is also an entrepreneur, might have to make a major lifestyle change.

"It's very possible that myself or my wife would have to potentially close down one of our businesses and go to work, so that we can provide coverage for our family," he says.

People living Allamakee, Clayton, Fayette, Howard and Winneshiek counties are also able to purchase individual healthcare polices through Gundersen, a Wisconsin-based insurer, and therefore would be less affected is Medica leaves. The company has until June 19 to decide if it will stay in Iowa.

Next Year, Iowans May Be Unable To Purchase Individual Insurance Policies Under Affordable Care Act

Edit for additional info:
The three carriers’ decisions to pull out will affect Iowans who buy individual health insurance either on or off the federal government’s online marketplace. Unless a replacement carrier is found, the change means moderate-income Iowans in most counties would not be able to use Affordable Care Act subsidies to help pay premiums for private insurance. It also means many better-off Iowans who pay their entire premiums without government assistance would lose their individual insurance policies next year.

The change won’t affect nearly 77,000 Wellmark customers who bought individual policies that took effect before Jan. 1, 2014. Those insurance pools are relatively stable, because the policies weren’t subject to Affordable Care Act regulations, including the ban on insurers denying coverage to people with pre-existing health problems.

The insurance carriers’ decisions to stop selling individual insurance will affect more than 70,000 other Iowans who bought more recent policies from Wellmark, Aetna or Medica. And the decisions could mean that other Iowans won’t have options for new health insurance next year if they lose jobs that offer coverage, age out of their parents’ policies or become divorced from a spouse who has an employer-provided plan.

http://www.desmoinesregister.com/st...lth-policies-most-iowa-likely-exit/309664001/
 
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