States balk at $15B Obama healthcare ‘tax’ – The Hill’s RegWatch

A newly unveiled component of President Obama’s healthcare law forcing insurers to pay annual fees is sowing angst in state capitols, where officials view the provision as a $15 billion tax that could disrupt Medicaid programs and other services.

The health insurance providers fee, included in the healthcare reform law over the objections of congressional Republicans, is designed to raise tens of billions of dollars in the coming years.

via States balk at $15B Obama healthcare ‘tax’ – The Hill’s RegWatch.

The Story Behind the Biggest Mistake in Obamacare

The main purpose of the Affordable Care Act (ACA) was to provide health insurance for most of the tens of millions of Americans who don’t currently have any coverage. But after an impossible-to-predict move from the Supreme Court seemed to gut the law’s ability to do that, millions of people will instead get coverage through a drafting error that was never supposed to become law.

via The Story Behind the Biggest Mistake in Obamacare.

Employers Dropping Health Care Coverage Could Benefit Health Care Quality and Cost – Forbes

As a result of an expanded individual market, Americans participating in the health care system might see benefits in three specific areas: cost, transparency and portability.

The benefits would not manifest through Americans losing employer sponsored coverage, but in gaining new coverage from a choice of plans in a more robust individual market.

via Employers Dropping Health Care Coverage Could Benefit Health Care Quality and Cost – Forbes.

White House unveils awaited Affordable Care Act profit margin rule – The Hill’s RegWatch

The measure would implement 85-percent “medical loss ratio” requirements on Medicare Advantage plans and the Medicare Prescription Drug Benefit Program. In other words, plans that deliver services under those plans must spend at least 85 percent of their premiums on “clinical services, prescription drugs, quality improving activities, and direct benefits to beneficiaries,” according to the proposal.

Overhead expenses and profits would be capped at 15 percent.

While those broad contours of the plan were set out in the Affordable Care Act, the healthcare industry has anxiously awaited the proposed language, which details nuances of the forthcoming regulations.

via White House unveils awaited Affordable Care Act profit margin rule – The Hill’s RegWatch.

Senate Democrats air grievances with rollout of healthcare law – The Hill’s Healthwatch

Sen. Bill Nelson (D-Fla.) hammered HHS for inviting Congress to cut funding for a new nonprofit insurance model. Funding for healthcare co-ops was eliminated in the year-end tax deal, and Nelson said officials offered up the program as a place Congress could cut.

“Why was that negotiated away at the 11th hour?” Nelson asked.

Cohen didn’t have an answer.

via Senate Democrats air grievances with rollout of healthcare law – The Hill’s Healthwatch.

Four Key Questions for Health-Care Law – WSJ.com

Even by Washington standards, implementing this law is extraordinarily complex. The federal government last year issued 70,000 pages of guidance, including 130 pages on the look of websites for new marketplaces where many will shop for insurance.

Mr. Obama barely mentioned the law in his State of the Union address Tuesday. If it works as he hopes, he will have secured his legacy and solved the long-festering problem of the uninsured—though not the companion problem of rising costs. If the law flops or provokes a backlash, a future president will be forced into more radical reshaping of the health-care system.

Implementing the act turns on what Paul Keckley, head of the Deloitte Center for Health Solutions, calls “the four major hanging chads.”

via Four Key Questions for Health-Care Law – WSJ.com.

UnitedHealth Weighs In on New Exchange Option – WSJ.com

UnitedHealth said it expected to participate in 10 to 25 or more of the marketplaces, out of what the insurer said could be as many as 100, with each state hosting exchanges for individual plans and for small businesses. However, the insurer also said it had “absolutely no firm commitment to that range,” and its total will change based on the situation in each state.

via UnitedHealth Weighs In on New Exchange Option – WSJ.com.

Post-election flood of ‘Obamacare’ rules expected – Jennifer Haberkorn – POLITICO.com

The once-steady stream of regulations and rules from the Obama administration — instructions for insurance companies, hospitals and states on how to put the law in place — has slowed to a trickle in recent months in an attempt to avoid controversies before the election. Many states, too, have done little public work to avoid making the law an election issue for state officials on the ballot.

But work has been going on behind the scenes — both in the Department of Health and Human Services and at the state level. As soon as Wednesday, the gears and levers of government bureaucracy are likely to start moving at full speed again.

via Post-election flood of ‘Obamacare’ rules expected – Jennifer Haberkorn – POLITICO.com.

Employers’ Use of Health Insurance Exchanges: Lessons from Massachusetts

The Robert Wood Johnson Foundation’s HCFO program is pleased to release a report by grantee Mark A. Hall, J.D., “Employers’ Use of Health Insurance Exchanges: Lessons from Massachusetts.” Hall, a professor of law and public health in the Division of Public Health Sciences at Wake Forest University Medical School, is completing a qualitative investigation of employers’ use of the Massachusetts Connector in order to inform states and the federal government about best strategies for the design and operation of new small-group health insurance exchanges and market regulations.

Big US insurers to keep parts of health care law

Some of the nation’s biggest health insurers will keep some popular parts of President Barack Obama’s health care overhaul even if the law fails to survive Supreme Court scrutiny later this month.

UnitedHealth Group, Humana and Aetna all said Monday that they will continue to cover preventive care such as immunizations and screenings without requiring patients to pay a set fee called a co-payment.

They also said they’d still cover adult children up to age 26 through their parents’ insurance plans. Additionally, they all pledged to continue to offer a simple process for patients who want to appeal when their health insurance claims have been denied.

via News from The Associated Press.