Insurance Co-Ops Set Up By Health Law Face Economic Challenges
Three of the 23 insurance startups have failed, despite initial funding from the federal government. Also in news about the health law, an examination of which states are getting the bulk of premium subsidies, the most recent auditor report on the problems that hobbled the launch of the healthcare.gov website, and a study looking at the penalties being levied on hospitals.
The New York Times:
Tough Going For Health Co-Ops
Late last month, the Nevada Health Co-op became the third casualty among 23 insurance start-ups created under the federal health care law to inject competition for coverage in certain parts of the country. Set up as nonprofits with consumer-led boards, the co-ops were designed to provide affordable insurance coverage to individuals and small businesses. They were intended under the law to offer alternatives — and hopefully cheaper prices — to the plans sold by large established insurance companies in some regions. (Abelson, 9/15)
Modern Healthcare:
Premium Subsidies Flow Heavily To Populous, Poor States
More than half of this year's $27 billion in Affordable Care Act premium subsidies are going to five states, which has created a big but risky business opportunity for health insurers. Many Republican-led states with high numbers of low-income residents are also among the leading recipients of the law's premium subsidies, according to recent CMS data. (Herman, 9/15)
The Fiscal Times:
Auditors Accuse Feds Of Mismanaging $600 Million In Obamacare Contracts
Last July, as the price tag for the Obamacare enrollment system climbed to $2.1 billion, a scathing report by the Government Accountability Office accused the Centers for Medicare and Medicaid Services (CMS) of negligent management practices and lack of oversight of contractors hired to create and fix Healthcare.gov—the primary portal to enroll Americans in Obamacare. Today, the Inspector General for the Department of Health and Human Services went further. They reviewed 20 of the 62 contracts that were awarded to create the federal marketplace for Obamacare—worth a cool $600 million—and found that CMS failed to manage each contract properly. (Leo, 9/15)
The Huffington Post:
Is Obamacare Punishing Hospitals The Wrong Way?
Under the Affordable Care Act, hospitals are fined up to 3 percent of their Medicare payments if too many Medicare patients return to the hospital within 30 days of discharge. By giving hospitals a financial incentive to reduce readmissions, the idea is to encourage better quality care. ... Yet a study published this week in JAMA Internal Medicine suggests that many readmissions are unavoidable, especially those involving patients like our hypothetical homeless man with pneumonia. The authors of the paper, who are all affiliated with Harvard Medical School, examined 29 patient characteristics -- including race, education, disability, alcohol intake and prescription drug benefits -- to see whether they had an impact on readmissions. (Satran, 9/15)
In state news about the health law --
Minnesota Public Radio:
At Community Clinics, Underinsured Replace Uninsured
A few years ago, community health clinics routinely offered care to people with no health insurance. Today, offering care to people who have insurance — but still can't afford care — is becoming more common. (Zdechlik, 9/16)
The Washington Post:
Rates For Health Plans On D.C. Marketplace To Rise 4% On Average
Most D.C. residents who buy health insurance through an online marketplace under the federal Affordable Care Act will see a modest increase in prices next year. Insurance plans for individuals will cost, on average, 4 percent more — a gentler increase than in Maryland, where the most popular plan will cost on average 26 percent more starting in January. (Zauzmer, 9/15)
The Associated Press:
Lawmaker: Hold Off On Vendor Request For Insurance Exchange
A state legislator asked an Arkansas panel Tuesday to hold off on looking at vendors for setting up a state-run insurance exchange as lawmakers look at broader reforms to Medicaid and health care. Sen. David Sanders asked the Arkansas Health Insurance Marketplace's board of directors to delay releasing to vendors a request for qualifications for information technology for the insurance exchange for individual consumers. Sanders co-chairs the marketplace's legislative oversight committee. (DeMillo, 9/15)
And the Obama administration announces new funding for community health centers.
The Hill:
Community Health Centers Get Another $500M Boost Under ObamaCare
The Obama administration is injecting another half-billion dollars into community health centers across the country, which are facing growing demands under ObamaCare. The government-backed health centers, which have expanded massively under the Affordable Care Act, have been put into a new political context this summer as Republicans in Congress try to defund Planned Parenthood. Republicans are arguing that the 1,300 community health centers nationwide could absorb the millions of women who could lose their doctors if Planned Parenthood loses its federal or state funding. (Ferris, 9/15)