What’s New in Health Care Reform: Oct. 28


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.

Republicans To CMS: Lower “Insurer Bailout” Pay

Top Republicans on Capitol Hill’s health committees are asking the Obama administration to lower payment rates for insurers who benefit from a controversial “reinsurance” program in the Affordable Care Act. House Energy and Commerce Chairman Fred Upton (R-Mich.), Senate Health, Education, Labor and Pensions Chairman Lamar Alexander (R-Tenn.) and House Education and Workforce Chairman John Kline (R-Minn.) sent the Centers for Medicare and Medicaid Services a letter, obtained by Morning Consult, calling for reduced reimbursement and to allow certain plans to not participate. Via Morning Consult.

Investigation Finds Errors In Coverage And Payments Under Affordable Care Act

Federal investigators from the Government Accountability Office said that they had discovered many errors in eligibility decisions under the Affordable Care Act that had led the government to pay for duplicate coverage for some people and an excessive share of costs for others. Via NY Times. 

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Premiums Expected To Rise In Many Health Care Markets

Premiums are expected to rise in many parts of the country as a new sign-up season under President Barack Obama's health care law starts Nov. 1. But consumers have options if they're willing to shop, and an upgraded government website will help them compare. Via Yahoo! News.

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Health Care Co-op Closings Narrow Consumers’ Choices 

The grim announcements keep coming, picking up pace in recent weeks. About a third, or eight, alternative health insurers created under President Obama’s health care law to spur competition that might have made coverage less expensive for consumers are shutting down. The three largest are among that number. Only 14 of the so-called cooperatives are still standing, some precariously. Via NY Times.

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Federal Health Insurance Site Opens Sunday For Window Shopping

The federal health insurance exchange that serves consumers in 38 states will open for browsing Sunday. The site will be faster and easier to use, and it will allow consumers to calculate their out-of-pocket costs, Department of Health and Human Services officials said. Via USA Today.

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Obama Administration Unveils Health Care Premiums For 2016

When consumers turn on their laptops and tablets Monday morning, they should be able to check premiums for 2016 under President Barack Obama's health care law. Rates are going up in many parts of the country as a new sign-up season starts Nov. 1. But people have options if they shop around, and an upgraded government website will help them compare costs and benefits. Via CBS News.

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Healthcare.Gov Premiums Have Bigger Increase For 2016

About 70 percent of those who return to the federal insurance exchange when open enrollment starts Nov. 1 will pay less than $75 a month after they receive tax credits, a government analysis released shows. The Centers for Medicare and Medicaid Services also reported that for this third open enrollment about 80 percent of consumers shopping again on Healthcare.gov will be able to pay less than $100 a month after tax credits. Via USA Today.

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House Passes Bill Including Repeals of Health Reform Provisions

The House of Representatives, on a near party-line vote, approved legislation that would repeal key parts of the health care reform law, including the employer and individual mandates. Aside from repealing the employer and individual mandates, the measure also includes repeal of the Patient Protection and Affordable Care Act's excise tax on costly health care plans and a tax on manufacturers of medical devices. Via Business Insurance.

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Agreement Is Seen As Short-Term Relief For Medicare And Social Security

The budget agreement reached by congressional leaders and the White House will prevent a sharp increase in Medicare premiums for more than 15 million older Americans and a deep cut in Social Security benefits for nine million disabled workers, but it will not alter the long-term financial outlook for either program, lawmakers and budget experts said. AARP, a lobby for older Americans, praised the agreement, though it said the legislation “will not provide a long-term solution to the funding challenge facing the Social Security disability insurance trust fund.” Via NY Times.

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Some Health Plans Have No In-Network Doctors In Key Specialties

As many as 14 percent of health plans sold on the federal government's insurance exchange are missing doctors in at least one common specialty from their networks, according to a study published in JAMA, the journal of the American Medical Association, by researchers at Harvard's T.H. Chan School of Public Health. The means patients may find themselves facing big medical bills for care they thought they had bought insurance to cover. Via NPR.

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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.