Health Executives Banking On Political Risks To Preserve ACA Subsidies
Some Republicans oppose extending enhanced tax credits for Affordable Care Act insurance plans that are set to expire at the end of 2025. Not doing so, though, would risk millions of people losing coverage, many of whom live in red states. Health care executives are optimistic that the subsidies will be extended even when Republicans take power.
Stat:
Hospitals And Insurers Are Optimistic Republicans Will Extend ACA Subsidies
The health care industry’s interest isn’t necessarily rooted in political analysis. It’s financial: Those subsidies are worth $25 billion annually. Insurance companies that sell ACA plans retain some of that federal revenue as profit. Hospitals and doctors who treat patients with ACA coverage benefit from those plans’ higher payment rates and avoid bad debt if those patients had no insurance coverage at all. Oscar Health’s business heavily depends on Congress renewing those subsidies. The publicly traded insurer sells only ACA plans. Over the summer, Oscar forecast its ACA membership would decline 18% over a two-year period if the enhanced subsidies went away. (Herman, 11/18)
The Washington Post:
Millions May Not Have Health Coverage If Subsidies Return To Pre-Biden Level
But eliminating the subsidy increase poses political risks. If subsidies fall to their pre-2021 level, experts say, many new subscribers would choose not to renew their coverage — the nonpartisan Congressional Budget Office predicted that 3.4 million more people would become uninsured — and many of them live in states that lean heavily Republican. Health policy research organization KFF said that if the subsidy expansion expires, premiums would more than double in 12 heavily Republican states — including Texas, West Virginia and Alaska — while rising less sharply in many blue states. (Weil, 11/17)
WKBN:
Pennsylvania Not Happy With Results Of Health Marketplace Study
The results of a study by the Pennsylvania Insurance Department (PID) reveal some startling problems with the Affordable Care Act marketplace. The biggest issue found was the inaccuracy of health insurer provider directories, which can delay care, hinder scheduling and result in surprise out-of-network billing, the agency said. The study found that only 13% of the provider listings had accurate contact information, and up to 44% of providers were unreachable because of incorrect information. The most common inaccuracies involved outdated contact information and incorrect specialty listings, which can mislead patients and lead to care delays and unexpected charges. (Coller, 11/15)
In other news about Social Security —
CBS News:
The Social Security Fairness Act Is Now In The Hands Of The Senate. Here's What Could Happen Next.
Efforts to get the Senate to vote on a bill to expand Social Security benefits are intensifying, as the House-passed Social Security Fairness Act enjoys rare bipartisan support but has only a short window of time — six weeks — to be passed. Decades in the making, the legislation would eliminate a provision that reduces Social Security payments to some retirees who also collect a pension from jobs that aren't covered by the retirement program, such as state and federal workers including teachers, police officers and U.S. postal workers. It would also end a second provision that reduces Social Security benefits for those workers' surviving spouses and family members. (Gibson, 11/15)
AP:
What To Know About The Congressional Push To Expand Some Social Security Benefits
The House has passed legislation that would provide full Social Security benefits to millions of people, pushing it one step closer to becoming law. The Social Security bill on Tuesday won bipartisan support in the House, 327-75, in what is now the lame-duck period for Congress. The bill now heads to the Senate, where passage is not assured despite considerable support. Here’s what to know about the legislation and what could happen next. (11/16)
KFF Health News:
Social Security Tackles Overpayment ‘Injustices,’ But Problems Remain
In March, newly installed Social Security chief Martin O’Malley criticized agency “injustices” that “shock our shared sense of equity and good conscience as Americans.” He promised to overhaul the Social Security Administration’s often heavy-handed efforts to claw back money that millions of recipients — including people who are living in poverty, are elderly, or have disabilities — were allegedly overpaid, as described by a KFF Health News and Cox Media Group investigation last year. “Innocent people can be badly hurt,” O’Malley said at the time. (Hilzenrath and Fleischer, 11/18)
