ACA Market May Be In For Turbulent Ride, CMS Data Suggest
The Centers for Medicare & Medicaid Services noted it found inconsistencies in the number of claims on exchanges. “As you pull ... subsidized dollars out of the system, it means margins will be lower and people are going to be paying higher premiums,” one health care strategist says.
Fierce Healthcare:
New CMS Data Suggest Future ACA Market Turmoil
The Centers for Medicare & Medicaid Services (CMS) this week released new data fueling a narrative of rampant broker fraud on the Affordable Care Act (ACA) exchanges. Plans received data finding 23% of enrollees did not have a claim in 2019. That number jumped sharply to 35% last year. (Tong, 8/12)
CNN:
Republicans Are Quietly Rolling Back Obamacare. Here’s How
President Donald Trump and congressional Republicans are no longer promising to repeal Obamacare, but that doesn’t mean they have given up efforts to take down the landmark health reform law. Unlike in 2017, when the late GOP Sen. John McCain’s dramatic thumbs-down dashed his caucus’s hope of overturning the Affordable Care Act, Republicans barely mentioned Obamacare as they swiftly pushed Trump’s massive domestic agenda package through Congress this year. Instead, they focused their talking points on eliminating fraud in Medicaid and protecting the program for the most vulnerable. (Luhby, 8/12)
NPR:
The Hidden Costs Of Cutting Medicaid
With the passage of the big Republican tax and spending bill, the federal government is poised to reduce support for Medicaid and the insurance marketplaces established by the Affordable Care Act. The Congressional Budget Office estimates that these cuts could cause 10 million Americans to lose health insurance by 2034. Lawmakers have justified these cuts as a necessary step to address the bigger budget deficit exacerbated by tax cuts and other spending increases in the big bill. However, that doesn't capture how these cuts will send costs spilling out around society, to be paid by hospitals, clinics, individuals and then in the end, back to the federal government. (Crawford, 8/12)
KFF Health News:
Medicaid Cuts Could Have Vast Ripple Effects In This Rural Colorado Community
In southern Colorado’s San Luis Valley, clouds billow above the towering mountains of the Sangre de Cristo range. A chorus of blackbirds whistle as they flit among the reeds of a wildlife refuge. Big, circular fields of crops, interspersed with native shrubs, give it a feel of bucolic quiet. But amid the stark beauty in one of the state’s most productive agricultural regions, there was a sense of unease among the community’s leaders as Congress debated a budget bill that could radically reshape Medicaid, the government health program for low-income people. (Daley, 8/13)
KFF Health News:
KFF Health News’ ‘An Arm and a Leg’: A Wild Health Insurance Hustle
When a New York couple purchased a health insurance plan from a telemarketer, they thought it covered everything they wanted: doctor visits, tests, and medicine. But then came the unexpected bills for thousands of dollars, forcing them to skip crucial medical care. In their series “Health Care Hustlers,” Bloomberg reporters Zachary Mider and Zeke Faux revealed how this couple and thousands of other people signed up for health plans by unknowingly agreeing to work fake “jobs.” (Weissmann, 8/13)
KFF Health News:
Listen To The Latest 'KFF Health News Minute'
Aug. 7 Sam Whitehead reads the week’s news: New Trump administration policies could limit patient access to qualified medical interpreters, and physicians often miss the signs of iron deficiency in older adults. (Cook, 8/12)
Also —
Louisiana Illuminator:
Louisiana Paid Nearly $10 Million For Health Care Dead Medicaid Beneficiaries Didn't Receive: Audit
A review of how Louisiana keeps its Medicaid rolls up to date found the state paid out benefits for more than 1,000 people over the past six years after they died. Nearly $10 million was paid to managed care organizations over that period, even though no health care services were actually provided. The Louisiana Legislative Auditor conducted its study as part of Gov. Jeff Landry’s Fiscal Responsibility Program, which he has branded LA DOGE. It looked specifically at how state health officials keep track of when Medicaid beneficiaries die and whether outside data sources could help that process. (Larose, 8/12)
