What’s New in Health Care Reform: Oct. 21


What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.

Pressure Building for Congress to Fix Projected Medicare Part B Premium Spike

Advocates for Medicare enrollees and state Medicaid offices say Congress needs to intervene to prevent an expected 52 percent spike in Medicare Part B premiums, preferably in enough time to prepare government and household budgets. Via Modern Healthcare.

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A Looming Tax On High-End Health Plans Draws Fire From Many Sides 

A plan to tax high-value health insurance plans is meeting stiff resistance from both sides of the aisle in Congress despite calls to make employers more demanding health coverage shoppers – and the $87 billion in revenue the tax could generate over the next decade. Via Kaiser Health News. 

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Remaining Uninsured Worry About Costs Of Coverage

Department of Health and Human Services officials predicted that about an additional 1 million Americans would sign up for coverage under the federal health law next year and acknowledged that prospective enrollees are worried about the cost of health insurance, even with the law’s financial help. Via Kaiser Health News.

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Little Growth Predicted on Health Exchanges

In a surprisingly pessimistic forecast, the Obama administration predicted that health insurance enrollment on the Affordable Care Act’s public marketplaces will only inch up from current coverage levels by the end of 2016. After an elaborate analysis of demographic data, Sylvia Mathews Burwell, the secretary of health and human services, said that 10 million people were expected to have marketplace coverage at the end of next year, up only about 100,000 from recent levels and millions short of earlier projections. She called that “a strong and realistic goal.” Via NY Times.

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Bigger Bite For Health Law Penalty On Uninsured

The math is harsh: The federal penalty for having no health insurance is set to jump to $695, and the Obama administration is being urged to highlight that cold fact to help drive its new pitch for health law sign-ups. That means the 2016 sign-up season starting Nov. 1 could see penalties become a bigger focus for millions of people who have remained eligible for coverage, but uninsured. They’re said to be squeezed for money, and skeptical about spending what they have on health insurance. Via The Washington Post.

Tests Of New Features On HealthCare.gov Go To The Wire

With the Affordable Care Act’s third open enrollment period to begin in less than two weeks, federal officials are racing to fix new features of HealthCare.gov that are supposed to make it easy for consumers to find insurance plans that cover their doctors and prescription drugs. The open enrollment period will start on schedule on Nov. 1, but technology teams are still testing new features of the online marketplace with insurers. They have discovered many bugs, have fixed some and are still working on others, said insurers and federal health officials, who have already begun blaming each other for the problems. Via NY Times.

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Health Care Insurers: Three Focus Areas for Differentiation

Health care customer research suggests that close to 20 percent of the policies sold in the upcoming open enrollment period will be shopped by consumers via private and public exchanges. Not simply selected, but shopped – like car insurance, home loans, or even personal electronics. In the next few years, we expect that number to rise to 50 percent or higher as more employers move to private exchanges. Via Customer Think.

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Health Care Services Unit Boosts UnitedHealth Results

UnitedHealth Group Inc. continued to enjoy double-digit revenue growth and respectable gains in medical enrollments during the third quarter of 2015. The Minnetonka, Minnesota-based health insurer reported total revenue of $41.5 billion for the three months ending Sept. 30, an increase of 26.6 percent over results reported for the same period in 2014, driven in large part by the feverish growth of Optum Inc., the company's health care services subsidiary. Via Business Insurance.

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What Employers Can Do to Accelerate Health Care Reform

To move from a reactive posture to a proactive leadership position in driving health care reform, large employers have a lever at their fingertips that they have not often deployed in procuring health care: their purchasing power. Providers and health plans are service suppliers paid by employers. Employers can readily apply market forces and supply-chain tools to improve the performance of both. Via Harvard Business Review.

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Many Low-Income Workers Say ‘No’ to Health Insurance

The Affordable Care Act’s employer mandate, which requires employers with more than 50 full-time workers to offer most of their employees insurance or face financial penalties, was one of the law’s most controversial provisions. Business owners and industry groups fiercely protested the change, and some companies cut workers’ hours to reduce the number of employees who would be eligible. Via NY Times.

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Kelley Luedke

Kelley Luedke

Kelley Luedke is a Marketing Channel Manager at Mayo Clinic Laboratories. She is the principle editor and writer of Insights and leads social media and direct marketing strategy. Kelley has worked at Mayo Clinic since 2013. Outside of work, you can find Kelley running, traveling, playing with her kitty, and exploring new foods.