Program To Help Health Insurers Deal With Risk Comes Up Short On Cash
Administration officials announce that a health law program designed to reimburse insurers who underestimated the cost of covering new patients coming into the marketplace has not collected as much money as insurers requested.
The Wall Street Journal:
Health Law’s Program To Ease Insurers’ Risks Has Shortfall
An Affordable Care Act program meant to ease risks for health insurers in the law’s new marketplaces will initially pay many companies less than they expected, likely putting financial strain on some. Federal authorities said that insurers will at first receive only about 12.6% of the money that they requested from the program, known as risk corridors, for 2014, its first year of operation. Insurers have requested approximately $2.87 billion in payments from the program based on their 2014 results. But the pool available to make those payments is just $362 million, which came from collections from other insurers that did relatively well on their marketplace business. (Wilde Mathews and Armour, 10/1)
The Washington Post:
Health Insurers To Receive A Fraction Of What They’re Owed Under ACA Program
Health insurers in the marketplaces created by the Affordable Care Act will be reimbursed this year only 13 percent of the money they are owed under a program designed to help cushion the burden of covering large numbers of people who need expensive medical treatment. ... A senior official with the Centers for Medicare and Medicaid Services said the agency would attempt to pay more of what it owes next year and, if necessary, the year after. But the official, briefing reporters on the condition of anonymity, acknowledged that the ability to fully pay hinges on Congress’s willingness to provide additional money. (Goldstein, 10/1)
The Associated Press:
Insurers Face Health Overhaul Losses For 2014
The insurance industry was disappointed at what its officials called a significant shortfall. "Stable, affordable coverage" depends on adequate funding of the program, said a statement from Marilyn Tavenner, CEO of America's Health Insurance Plans, the industry lobby. "It's essential that Congress and (the administration) act to ensure the program works as designed and consumers are protected." ... Despite the concerns of insurers, the Republican-led Congress is unlikely to allocate any additional money for the program, a temporary stabilization fund that lasts three years. (Alonso-Zaldivar, 10/1)
In other health insurance news -
Kaiser Health News:
Insurers Find Out-of-Network Bills As Much As 1,400 Percent Higher
It’s common knowledge that consumers have to pay more money if they choose doctors or hospitals outside of their insurance plan’s network. But a new analysis prepared by the insurance industry seeks to show just how much more in each of the 50 states. Out-of-network providers charged patients on average 300 percent more than the Medicare rate for certain treatments or procedures, according to the analysis of 2013 and 2014 claims data released Thursday by the America’s Health Insurance Plans. (Gorman, 10/1)
