Tag Archives: Underinsured

Price Vows ‘Access to Coverage’ Under Health Executive Order

Posted on by • Posted in Uncategorized • Tagged , , , , , , • Leave a comment

https://morningconsult.com/2017/01/24/hhs-nominee-vows-access-to-coverage-under-aca-executive-order/

Image result for health insurance access

President Donald Trump’s nominee to be the nation’s top health official would not promise every American would get to keep their coverage under an executive order signed last week.

“What I commit to the American people is to keep patients at the center of health care, and what that means to me is making certain that every single American has access to affordable health coverage,” Rep. Tom Price (R-Ga.) told Finance Committee ranking member Sen. Ron Wyden (D-Ore.) when asked if he would commit to no one losing coverage.

The distinction between “access” to health insurance and “health coverage” appears to be a growing division between members of Congress and Trump, who vowed insurance for everyone in interviews ahead of his inauguration.

Why risk adjustment is a crucial component of individual market reform

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , • Leave a comment

https://www.brookings.edu/blog/up-front/2017/01/25/why-risk-adjustment-is-a-crucial-component-of-individual-market-reform/

Related image

The mantra of ‘Repeal and Replace’ has escalated in recent weeks, though what, specifically, the ‘Replace’ component might look like is still unclear. However, many of the current proposals include, at a minimum, some type of continuous coverage provision that allows people with chronic health conditions who have continuously maintained coverage to buy health insurance at standard rates. For example, Paul Ryan’s A Better Way proposal and Tom Price’s Empowering Patients First Act would each prohibit insurers from charging sicker patients more than standard premiums in the individual market as long as they have maintained continuous coverage since before becoming sick.

Such provisions are important to keep patients from seeing their health insurance premiums sky-rocket after becoming sick, which would defeat the purpose of insurance in the first place. However, these provisions also require that insurers sell policies to these patients at premiums that they know will not cover their expected health care spending, generating losses for the insurance company. On its own, this would create a situation where insurers have a strong financial incentive to avoid enrolling these sicker patients.

Risk adjustment combats disincentives to provide coverage for sicker patients

In order to mitigate these incentives for insurance companies to avoid sicker patients, policymakers will need to include a risk adjustment program in any replacement reforms that require insurers to issue insurance to any applicant (also known as “guaranteed issue”) and set limits on adjusting premiums to fully reflect an enrollee’s health status. Continuous coverage provisions are one example of such limits, but risk adjustment will be necessary to combat against adverse selection across a wide range of potential reforms.

A risk adjustment program would make behind-the-scenes financial transfers to insurers to adequately compensate them for enrolling these sicker patients when they are not allowed to charge the individual higher premiums. Risk adjustment will be necessary to promote a well-functioning market where private insurers compete based on the value they deliver and not simply by avoiding sicker patients.

Incomes Aren’t Keeping up with Employees’ Health Plan Costs

Posted on by • Posted in Uncategorized • Tagged , , , , , , • Leave a comment

http://www.commonwealthfund.org/interactives-and-data/infographics/2016/incomes-arent-keeping-up-with-employees-health-plan-costs

Premium Trends

 

Healthcare Triage: Republican Plans for The Affordable Care Act

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , , , , • Leave a comment

Healthcare Triage: Republican Plans for The Affordable Care Act

Image result for Healthcare Triage: Republican Plans for The Affordable Care Act

After campaigning for years on a plan of “repeal and replace Obamacare,” Republicans finally have the means within their grasp to make much of that possible. They control the presidency, the House, and the Senate. The filibuster still poses some potential threats to their plans, but it’s also within their means to abolish its widespread use in such a way that they could both repeal the Affordable Care Act and replace it with something of their own design.

What would that be? In contrast to what many say, there are Republican plans out there to consider. They’re the topic of this week’s Healthcare Triage.

The Meaning of ‘Access’ to Health Care

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

https://www.theatlantic.com/health/archive/2017/01/price-access/514262/

Related image

Why Republicans like HHS nominee Tom Price are emphasizing “universal access” over “universal coverage”

‘Not Turning Back’: California Governor Vows To Protect State’s Health Care

Posted on by • Posted in Uncategorized • Tagged , , , , , • Leave a comment

http://khn.org/news/not-turning-back-california-governor-vows-to-protect-states-health-care/

Gov. Jerry Brown (Neon Tommy via flickr)

In an unusually impassioned speech, Gov. Jerry Brown vowed Tuesday to protect California’s health care gains under Obamacare against Republican attempts in Washington, D.C., to roll them back.

“More than any other state, California has embraced the Affordable Care Act,” Brown told state legislators and appointees in his annual State of the State address at California’s Capitol. “I intend to join with other Governors and Senators, and with you, to do everything we can to protect the health care of our people.”

Brown said California would not “turn back” on advances it’s made in health coverage under pressure from the new Republican administration in Washington. Under the new federal leadership, he said, the “future is uncertain and dangers abound.”

Health coverage for Californians under the Affordable Care Act “has come with tens of billions of dollars from the federal government,” said Brown. “Were any of that were to be taken away, our state budget would be directly affected, possibly even devastated.”

Leveraging an estimated nearly $20 billion federal money, health coverage has been extended to five million Californians under Obamacare, which includes federally subsidized private health plans and an expansion of eligibility for Medicaid, the program for low-income people — known in this state as Medi-Cal.

 

Health Law Coverage Has Helped Many Chronically Ill — But Has Still Left Gaps

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

http://khn.org/news/health-law-coverage-helped-many-chronically-ill-but-still-left-gaps/

Insulin injection pen

As President Donald Trump and Republicans in Congress devise a plan to replace the 2010 health law, new research suggests a key component of the law helped people with chronic disease get access to health care — though, the paper notes, it still fell short in meeting their medical needs.

Research published Monday in the Annals of Internal Medicine found that the number of chronically ill Americans with insurance increased by about 5 percentage points — around 4 million people — in 2014, the first year the law required Americans to have coverage, set up marketplaces for people to buy coverage and allowed for states to expand eligibility for Medicaid, the federal-state insurance plan for low-income people. If states opted into the Medicaid expansion, people with chronic illnesses such as heart disease, diabetes, depression and asthma were more likely to see those gains.

Still, the study suggests, the law fell short in terms of guaranteeing those people could get medical treatment, see a doctor and afford medications.

2017’s States Most Affected by ACA Repeal

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

https://wallethub.com/edu/states-most-affected-by-aca-repeal/31413/

Top-Image-Most & Least Affected States by ACA Repeal

As promised, President Donald Trump on Jan. 20 issued an executive order to undo the Affordable Care Act, or ACA, as his first order of business. Republican senators wasted no time advancing the president’s agenda, either, using a powerful process known as budget reconciliation on Jan. 12 to begin rolling back large sections of the health law. Passage of the resolution followed in the U.S. House of Representatives two days later.

But much of the public as well as members of Congress, including several Republicans, have expressed concern about both the lack of a replacement for the current program and a clear timeline for its implementation — in addition to the cost of repealing the ACA.

Since former president Barack Obama’s signature health-care legislation — more popularly known as “Obamacare” — was passed in 2010, more than 20 million individuals have gained insurance coverage, resulting in the lowest uninsured rate in history by early 2016. Reversal of the law is expected to raise the uninsured rate by an estimated 18 million in the first plan year following repeal, then 32 million by 2026, according to official estimates.

What is clear from the prospect of the ACA’s dissolution is that certain states stand to suffer more than others. In order to assess repeal’s impact on Americans based on where they live, WalletHub’s analysts compared the 50 states and the District of Columbia across seven key indicators of both economic and coverage losses. Our data set ranges from “growth in uninsured population by 2019 post-ACA repeal” to “potential economic impact due to repeal of premium tax credits and Medicaid expansion (2019 to 2023).” Read on for our findings, expert insight and a full description of our methodology.

Everything You Need To Know About Block Grants — The Heart Of GOP’s Medicaid Plans

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , • Leave a comment

http://khn.org/news/block-grants-medicaid-faq/

block-grants

President Donald Trump’s administration made explicit this weekend its commitment to an old GOP strategy for managing Medicaid, the federal-state insurance plan that covers low-income people — turning control of the program to states and capping what the federal government spends on it each year.

It’s called “block granting.” Right now, Medicaid, which was expanded under the 2010 health law to insure more people, covers almost 75 million adults and children. Because it is an entitlement, everyone who qualifies is guaranteed coverage and states and the federal government combine funds to cover the costs. Conservatives have long argued the program would be more efficient if states got a lump sum from the federal government and then managed the program as they saw fit. But others say that would mean less funding for the program —eventually translating into greater challenges in getting care for low-income people.

Block granting Medicaid is a centerpiece of health proposals supported by House Speaker Paul Ryan and Rep. Tom Price, Trump’s nominee to run the Department of Health and Human Services. This weekend, Trump adviser Kellyanne Conway emphasized the strategy as key to the administration’s health policy.

But what would this look like, and why is it so controversial? Let’s break down how this policy could play out, and its implications — both for government spending and for accessing care.

Trump’s Vow to Repeal Health Law Revives Talk of High-Risk Pools

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

Image result for high risk pools

About 27 percent of people under 65 are thought to have some sort of pre-existing condition that will most likely leave them without individual insurance if the law is repealed, according to a recent study. The guarantee of coverage has already become a rallying cry for people who want to keep the law.

The issue “is the third rail” for the Republicans, said Michael Turpin, a longtime health industry executive.

Before the law, a fairly typical life event — like a divorce or the loss of a job — and a relatively minor medical condition could upend a person’s health coverage options. Stories of sick people unable to get coverage when they needed it most were legion.

Mr. Trump insists he wants to keep the pre-existing requirement for insurers, and other top Republicans say people who want coverage should not be turned away. Details about how they will cover people with existing medical conditions have not yet emerged, but many lawmakers have started pushing an idea — known as high-risk pools — that left many people uncovered or with strict limits to their coverage in the past.

The challenge for lawmakers is this: How do you get insurers to cover people who will definitely need costly medical care — and do so without making insurance too expensive for everyone?