Tag Archives: Uninsured
Paul Ryan Makes Huge (Yet Really Obvious) Admission About Obamacare
House Speaker Paul Ryan (R-Wis.) hasn’t lost his grip on reality, he revealed Monday during an interview with conservative radio host Jay Weber.
Ryan admitted that a victory by Democratic presidential nominee Hillary Clintonwould mark the end of his quixotic quest to repeal the Affordable Care Act. That may seem like an obvious conclusion, but it qualifies as a noteworthy statement because it’s coming from the man who oversaw dozens of hopeless votes to overturn the 6-year-old health care law.
During the discussion on WISN, Weber laid out a series of “hard truths” with respect to the stakes in the presidential and congressional elections if Republicans fail to win the White House and lose the Senate, including Democrats being able to confirm Clinton’s Supreme Court nominees.
Here’s Weber and Ryan discussing the Affordable Care Act:
http://www.healthcaredive.com/news/ryan-accepts-aca-here-to-stay-if-clinton-wins/429898/
What the 2016 presidential election could mean for the future of the ACA
http://www.healthcaredive.com/news/2016-president-election-ACA-future-healthcare/429843/
At the federal level, the nation’s two major political parties have vastly different visions for the future of healthcare. The election will help to determine which course the nation follows for the foreseeable future. What are the likely outcomes depending on who wins the presidency?
As Insurers Cut Brokers’ Commissions, Consumers May Have One Less Tool For Enrollment
With open enrollment set to begin today, some health insurance brokers are already fielding questions about coverage and whether existing plans will still be available next year. For an increasing number of brokers, there’s also another question: Will they get paid?
Some insurers — including Cigna and Aetna — will not pay licensed agents and brokers a commission for helping people enroll in individual health insurance coverage for 2017 in many states, while others have reduced their commissions. They join United Healthcare, which dropped commissions on new business this year in many states.
That is already prompting some brokers to step back from the exchanges when open enrollment begins this week, which could be a hurdle for consumers who normally would seek help from brokers in navigating the complexities of insurance coverage. (Government-supported navigators are still available.)
In Nevada, where the largest carrier in the state has cut commissions for new business and another has dropped payments to $10 a month per customer, broker Vickie Mayville is weighing her options.
“It sometimes takes four hours to ensure clients have the right plan,” said Mayville, who runs her own agency in Las Vegas. “I will help my clients and anyone referred to me, but I’m not actively seeking out new clients.”
Uninsured In Coal Country: Desperate Americans Still Turn To Volunteer Clinics
http://khn.org/news/uninsured-in-coal-country-desperate-americans-still-turn-to-volunteer-clinics/
Six years after the passage of the Affordable Care Act, and despite 20 million more Americans gaining health insurance, considerable gaps in health care remain.
The decision by states like Virginia not to expand Medicaid and the lack of dental and vision coverage even for those with insurance have meant that the demand for RAM’s free mobile clinics has stayed strong.
An ACA primer: Much more than insurance
http://www.healthcaredive.com/news/an-aca-primer-much-more-than-insurance/429497/
Remember the Affordable Care Act? Enacted in 2010, it expanded healthcare insurance to millions of uninsured Americans and increased access to care. But the ACA is much more than expanded coverage; it set in motion a variety of reforms in the healthcare delivery systems aimed at lowering costs and improving quality of care.
That fact was lost on presidential candidate Donald Trump, who told Fox News recently, “I don’t use much Obamacare, I must be honest with you, because it is so bad for the people and they can’t afford it.” Trump’s comments imply Obamacare is an insurance plan people can buy, which is not the case. As we wrap up year six since the ACA was enacted, here‘s what the law is really about and how it impacts providers.
Vermont’s all-payer ACO will begin in January
In January, Vermont will become the first state in the nation to move to a voluntary all-payer accountable care organization model, the CMS announced Wednesday.
The Vermont program is modeled after a similar one from Maryland, but the Maryland program covers only hospitals. The Vermont ACO will cover Medicare, Medicaid and commercial payers, requiring those who participate to pay similar rates for all services.
The CMS is giving Vermont $9.5 million in start-up funding to support the transition. The demonstration, funded through a 1115 waiver, will last five years.
“This model is historic in terms of its scope, aiming to include almost all providers and people throughout the state in an all-payer ACO model to drive improved quality, better care coordination, healthier people, and smarter spending,” the CMS’ Chief Medical Officer Patrick Conway said in a statement.
“We will become the first state in America to fundamentally transform our entire health care system so it is geared towards keeping people healthy, not making money,” said Vermont Gov. Peter Shumlin, who earlier this year traveled to Washington to negotiate a deal with HHS Secretary Sylvia Mathews Burwell.
The state aims to have 70% of its insured residents covered by an ACO by 2022. The model will be considered an advanced alternative payment model under the new Medicare reimbursement program, making participants eligible for a performance bonus.
ER visits continue, despite insurance
Emergency rooms and hospitals are among the most expensive places to get health care. One of the big selling points for Obamacare was the idea that if people get insurance, they’ll have better preventive care and end up in the ER a lot less.
Today we have new data that buries that idea.
Though people with insurance are taking advantage of more preventive care, they’re also still going to the ER. A prior study, done by the same economists, found when you give people insurance, they use more health care services — more doctor’s visits, flu shots, prescriptions, even hospitalizations.
Dr. Renee Hsia, of the University of California San Francisco Emergency Department, said she treats many insured patients.
“We have noticed that as our patient population gets older and frailer and we have more complex diseases, there are higher-acuity things presenting to the ED,” she said.
Hsia said other reasons the insured keep showing up include patients’ doctors sending them to the ER, or people can’t get a primary care appointments quickly.
Harvard economist Kate Baicker, one of the co-leads on the paper, said people need to be clear about the impact of insurance.
“Insurance makes the emergency department affordable,” she said. “People didn’t go [when they were uninsured] because of the big bill they got when they showed up. Now that it’s more affordable, people go more.”
Based on their findings, Baicker said insurance also improves people’s financial security and reduced their rate of depression.
Clinton vs. Trump: 5 critical election issues
While Hillary Clinton vows to forge ahead with Obamacare if she is elected president, Donald Trump would scrap it altogether. The end results would be two very different forms of healthcare, and industry leaders have much to consider.
Brill“Many different factors are weighing on managed care executives such as the costs of pharmaceuticals, diagnostics and devices; the impact of consolidation amongst hospitals, physicians, health plans; and the losses in the exchange marketplace,” says Managed Healthcare Executive editorial advisor Joel V. Brill, MD, chief medical officer, Predictive Health, LLC, which partners with stakeholders to improve coverage of value-driven care. “With each of these factors, plans can, at least at a high level, make some educated guesses about the relative risk of each factor and impact to the bottom line.”
The election results, however, are much less certain, which from a risk perspective, weighs heavily on the minds of healthcare executives, Brill says. “How can you plan for business knowing that whatever you are doing currently could be upended in the beginning of November?”
To help provide some clarity, Managed Healthcare Executive identified five of the top industry issues, reviewed the candidates’ platforms for each, and asked industry experts to weigh in.
Healthcare Triage News: Health Care Reform, and the Issues We Face
Healthcare Triage News: Health Care Reform, and the Issues We Face
As we approach the election this fall, it seems like the news media report on little else. Unfortunately, too little news coverage addresses health care reform. That’s wackadoo, because there is still so much to be done to improve the cost, quality, and access for patients within the US health care system.
So let’s talk about the major health policy issues we in the US face. This is Healthcare Triage News.
HENRY KOTULA 