Industry: Healthcare & Social Assistance
Aug. 1, 2017

Major health insurers in some states are seeking increases as high as 30% or more for premiums on 2018 Affordable Care Act plans, according to new federal data that provide the broadest view so far of the turmoil across exchanges as companies try to anticipate Trump administration policies. Big insurers in Idaho, West Virginia, South Carolina, Iowa and Wyoming are seeking to raise premiums by averages close to 30% or more, according to preliminary rate requests published by the U.S. Department of Health and Human Services. Insurers face a mid-August deadline for completing their rates. The companies have until late September to sign federal agreements to offer plans in 2018.

Aug. 1, 2017

California consumers buying insurance for 2018 through the state’s insurance exchange will see average premiums increases of 12.5 percent, but by comparison pricing, many could limit their premium hikes to 3.3 percent, Covered California officials announced Tuesday.

The increase was a little lower than the average 13.2 Covered California premium hike implemented this year, despite uncertainty over the future of the Affordable Care Act amid Republican attempts to repeal the law.

. . . That “ongoing uncertainty” could mean that roughly 650,000 consumers who buy Covered California’s most popular insurance plans, those in the silver tier, will face a double whammy on their premium prices. The exchange said it may have to add a 12.4 percent surcharge to premiums in that tier because insurers are worried about continued federal funding that lowers out-of-pocket costs for enrollees.

June 29, 2017

TWO STATES, Rhode Island and Indiana, have been able to make major changes to the traditional Medicaid programs, which allowed them to curb costs and enhance their recipients' quality of care. Patient satisfaction went up sharply. In 2009 Rhode Island sought and won an unprecedented waiver from Washington. . . As Alexander noted, "These reforms, in turn, gave patients greater independence and better outcomes, and their satisfaction soared. . . . The imaginative remedies we implemented were so responsive and customized to our patients' needs that their experiences and health improved even as we spent less." . . . Indiana instituted even better Medicaid reform. The Hoosier State has long pushed the idea of health savings accounts (HSAs) coupled with high-deductible health insurance that covers catastrophic medical expenses. As the state has observed: "About 96% of [the state's] employees have voluntarily elected to enroll in a consumer-driven health plan option. In its first four years of offering [such options] to state employees, the state saved 10.7% annually, as employees used hospital emergency departments at lower rates, had fewer physician office visits, lower prescription costs and a higher generic-medication dispensing rate." . . .Now the Hoosier State is expanding this state-employees concept and applying it to its Medicaid recipients.

June 23, 2017

Assembly Speaker Anthony Rendon put the brakes on a sweeping plan to overhaul the health care market in California Friday, calling the bill “woefully incomplete.” Rendon announced plans to park the bill to create a government-run universal health care system in Assembly Rules Committee “until further notice” and give senators time to fill in holes that the bill does not currently address. “Even senators who voted for Senate Bill 562 noted there are potentially fatal flaws in the bill, including the fact it does not address many serious issues, such as financing, delivery of care, cost controls, or the realities of needed action by the Trump administration and voters to make SB 562 a genuine piece of legislation,” Rendon said.


There will be two sources of financing for Healthy California. The first is the same public health care revenue sources that are presently providing about 71 percent of all health care funding in the state. These include Medicare and MediCal, which together provide nearly 50 percent of all health care funding in California at present. It also includes tax subsidies for health care expenditures by individuals and households in the state, which provide about 9 percent of the state’s total health care funding. The Healthy California bill is explicit in stating that the State will work to obtain waivers in all of the present areas of public health funding, so that these present funding sources will continue to finance Healthy California. Assum ing the state is successful in obtaining these waivers, these funds will provide $225 billion in funding for the state’s single -payer program. That means that the remaining $106 billion to fund Healthy California will need to be provided by new revenue sources in the state.

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