Insurance Commissioners Call For Health Plans To Expand Their Networks Of Providers
The commissioners are recommending new standards to make sure consumers have adequate access to doctors and hospitals, The New York Times reports. In other news about the marketplaces' enrollment, a look at a novel plan in Portland, the problems left when New York's co-op closes and a variety of stories to help guide consumers picking a plan.
The New York Times:
Regulators Urge Broader Health Networks
The nation’s insurance commissioners are recommending sweeping new standards to address complaints from consumers about limited access to doctors and hospitals in health plans sold under the Affordable Care Act. Limited networks of health care providers are a feature of many insurance policies offered in the public marketplaces, or exchanges, where people with low incomes can often obtain subsidies that reduce their monthly premiums to $100 or less. Such “narrow networks,” consumers say, often do not include the doctors they need for specialized care for themselves or their children. (Pear, 11/8)
Marketplace:
Neighborhood Competition In The Health Care Market
Health care systems are competing in the market around both price and quality. Nonprofit health co-ops are struggling to provide affordable insurance coverage, while for-profits are also trying to keep business afloat under new federal laws. In Oregon, health insurers will be raising premiums next year. But one for-profit company, recently launched in Portland, is going lower. Zoom Performance Health Insurance offers what it calls “a full stack” of care in neighborhood clinics. ... Zoom doesn’t accept Medicare or Medicaid. It’s too early to say if it’s cherry-picking young, healthy consumers to cut costs, said David Rosenfeld of the Oregon consumer watchdog group OSPIRG. “I think it’s very reasonable to argue that Zoom’s model of care would more naturally appeal to younger people,” Rosenfeld said. (Sevcenko, 11/6)
The New York Times:
New Yorkers Face Hard Decisions After Collapse Of Health Republic Insurance
Health Republic and the 11 other co-ops set to close this year make up more than half of the total plans established under the Affordable Care Act. The 23 organizations — nonprofit start-ups with consumer-led boards — were set up as alternatives to government-run plans and were intended to create competition with companies like Aetna and Anthem. The plans took off but soon encountered financial and political difficulties. ... Congress also made deep cuts to the funds meant to boost struggling co-ops, reducing that budget by 60 percent. Health Republic has now become a cautionary tale and a warning to other struggling insurers. The company has also become a source of anxiety, from Albany to Long Island, as some New Yorkers try to determine what insurance plan to sign up for next. (Casey, 11/6)
USA Today:
Health Insurance Is A Tough Sell When Tax Credits Are Low
Those eligible for the lowest subsidies to buy health insurance were the least likely to sign up for 2015 plans, studies show, another indication of the challenge of boosting enrollment for President Obama's signature health care law in 2016. The percentage of those choosing health plans dropped from about 75% for those earning $23,540 to about 14% for those earning about $47,000, new research from the Urban Institute and the Robert Wood Johnson Foundation (RWJF) shows. Premium tax credits available on the federal and state insurance exchanges decrease as consumers earn closer to 400% of the federal poverty limit, which is about $47,000 for an individual. (O'Donnell, 11/6)
Kaiser Health News:
‘Do The Math’ When Shopping For A Health Plan This Open Enrollment Season
With the health insurance markets open for next year’s enrollment, Eve Campeau says she’s planning to look carefully at the fine print. Last time she shopped, she switched to a plan with a lower monthly premium, but found herself paying far more out-of-pocket for medications and doctor visits. While she might be saving money on the premium, she is reluctant to go to seek medical care because of the up-front cost. (Appleby, 11/9)
Kaiser Health News:
Consumer Confusion Continues In Obamacare’s Third Year
Recording and mixing music is Vernon Thomas’ passion, but being CEO and producer of Mantree Records is not his day job. He’s an HIV outreach worker for a local county health department outside Newark, N.J. He took what was to be a full-time job in May because the gig came with health insurance – and he himself has HIV, the virus that causes AIDS. But then the county made it a part-time job – and Thomas lost that coverage before it started. (Mogul, 11/9)
Kaiser Health News:
Five Things Young Adults Should Know About Buying Health Insurance
Imagine what you could do with $2,000. If you’re between 18 and 34, you might travel somewhere fun. Maybe buy a big TV. But would you buy health insurance? Take it from another millennial: Think about insurance if you don’t have any. (Gillespie, 11/9)
Also, The Washington Post examines how the Medicaid expansion is playing out in some red states.
The Washington Post:
The Controversial Part Of Obamacare That Even GOP-Led States Are Keeping
Republican-led states that expanded Medicaid are sticking with the change, despite qualms and intense political pressure within the GOP about embracing a key part of President Obama’s health-care law. GOP governors and legislators have balked at repealing expansion partly because of the benefit of providing federally funded health insurance to large numbers of constituents, analysts say. They also wish to keep the billions of dollars of federal funds that the Affordable Care Act (ACA) — also called Obamacare — gives states that broaden Medicaid. (McCartney, 11/6)
