Fewer PPOs Offered On Exchanges Next Year
Kaiser Health News (11/26) reported that consumers seeking to enroll in preferred provider organization (PPO) plans “are finding far fewer of those plans offered on the insurance marketplaces next year,” and “the premiums are rising faster than for other types of coverage.” A Kaiser analysis found that while “the average premium for the least expensive closed network silver plan—principally HMOs—rose from $274 to $299, a 9 percent increase, the average premium for the least expensive PPO or other silver-level open access plan grew from $291 to $339, an 17 percent jump.” Rex's Thoughts: this comment is spot on but it does miss telling the people that the HMO plans they are able to get also have smaller networks of doctors and hospitals to keep the costs down to this “affordable” level. No matter how you look at it you’re still out of pocket over $6000 as an individual when you have large medical claims!
Liberals, Conservatives Draw Different Lessons From ACA “Turmoil”
The New York Times (11/28, Pear, Goodnough, Subscription Publication) reported that “turmoil” in health insurance markets, “volatile” premiums, and the collapse of 12 of 23 nonprofit insurance cooperatives under the ACA have “emboldened advocates on both sides of the political spectrum, providing ammunition to conservatives who want to shrink the federal role and liberals who want to expand it.” The Times said that determining whether these problems “are just temporary setbacks for the law, as the White House contends, or signs of fundamental problems, as Republicans say, is not clear.” Rex's Thoughts: these problems will be fundamental problems to the point in time that the government decides to pass more penalties or “taxes” as they like to call them. At that time they will figure out a way to bully more people into participating.
Health Republic Closing Today
USA Today (11/30, Tumulty) reports that about 200,000 New Yorkers “will see their Health Republic policies expire on Monday, marking the demise of the 12th health insurance co-op established under the Affordable Care Act.” Customers “who haven’t chosen a new plan by Monday will be automatically enrolled in one of three other health plans, which will cover them for December.” Meanwhile, HealthCare.gov CEO Kevin Counihan “said his agency is working to provide more flexibility’ for the remaining co-ops and give them technical assistance.”
The Wall Street Journal (11/28, Ramey, Subscription Publication) reported that the shutdown has left New York’s physicians and hospitals in a tough spot. According to a survey by the Medical Society of the State of New York, 43 percent of physicians have claims unpaid by the insurer. MSSNY President Joseph Maldonado, MD, said the situation will make physicians more wary of participating in health reform initiatives in the future. Rex's Thoughts: I think it’s interesting that doctors can choose to participate or not when the American public has to participate or pay a penalty. I wonder how long it will take the government to decide they will have to tell doctors to participate or pay a penalty?
States Apply For ACA Section 1332 Waivers For 2017
The Washington Times (11/27, Howell) reported that the ACA’s Section 1332 waivers start in 2017, and President Obama “faces a major decision” about whether he will “welcome or resist experimentation with his top domestic achievement.” The waivers were intended to allow states “to find better ways of insuring their residents than the top-down approach in place right now.” The story mentions expected waiver applications from Hawaii, Massachusetts, and Arkansas. So far, “HHS hasn’t issued specific guidance,” according to state officials. Centers for Medicare and Medicaid Services spokesman Aaron Albright said, “If states have a plan they would like to discuss, we’ll work with them. We’ll update the guidance as needed.” Rex's Thoughts: did you know they could do this?
Concerning the Uninsured
Overall, the Washington Times (11/26, Howell) reported, about “1.6 million people have selected coverage on HealthCare.gov, the Obama administration said Wednesday.” About a third of them were new customers. “We are three weeks into open enrollment, and we continue to see demand for the quality, affordable health coverage available through the marketplace,” Burwell said, adding, “This Thanksgiving holiday, I encourage families to talk about the importance of getting covered and to visit HealthCare.gov to find the coverage that fits their health needs and their budgets.” Rex's Thoughts: two questions: Is Burwell covered by one of these “quality, affordable” plans through the marketplace? Second, did they want the coverage they had to take or is the penalty starting to have an effect on peoples’ pocketbooks? Stand up America and start analyzing what our leaders are saying on both sides of the aisle before it’s too late!
Lawmakers Mull Drug Imports From Canada Amid Rising Prices
The Hill (11/27, Ferris) examined how the debate over high medication prices “is reigniting the battle over importing prescription drugs from Canada, with all of the leading Democratic candidates endorsing the idea.” Some congressional Republicans also support importation. In a letter last week, Sens. John McCain (R-AZ) and Chuck Grassley (R-IA) asked HHS Secretary Sylvia Burwell to use her power to let patients directly purchase certain drugs. The Hill added that although there is “strong” bipartisan support from Americans, “the drug industry remains dead-set against allowing importation, and it’s unclear whether voter support will translate into legislative action.” Rex's Thoughts: of course because when the drugs are purchased from place like Cannadadrugs.com they cost less and therefore the drug companies make less!
What do you think? Give me a call or email to discuss!