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Have Employer Coverage? GOP Proposals Will Affect You Too (Part 2)
As Senate Republican leaders continue to craft their bill to repeal and replace the Affordable Care Act (ACA), most attention has been focused on the number of individuals who would lose coverage if the legislation is enacted. To be sure, the ACA coverage expansions—through Medicaid and subsidized Marketplace plans—have been a lifeline for millions of people, particularly those who are low income, and have reduced the number of individuals without coverage to record lows. But the legislation that passed the House and the bill now under consideration in the Senate could also affect the more than 150 million peop...
Source: Health Affairs Blog - July 6, 2017 Category: Health Management Authors: JoAnn Volk and Sabrina Corlette Tags: Following the ACA Insurance and Coverage ACA repeal and replace employer-sponsored coverage Employer-Sponsored Insurance Essential Health Benefits Source Type: blogs
Patient Access to Medical Services Varies by Individual Physician ’ s Will to Fight Insurance Companies
American healthcare reform debates are focused on strategies to provide “access” to medical services for all. Lack of insurance (or under-insurance) seems to be the primary focus, as it is falsely assumed that coverage provides access. Unfortunately, the situation is far more complicated.
Once a person has health insurance, there is no guarantee that they will receive the medical services that they need. Not because their plan is insufficiently robust, but because the roadblocks for approval of services (provided in the plans) are so onerous that those providing the service often give up before they receive i...
Source: Better Health - July 3, 2017 Category: American Health Authors: Dr. Val Jones Tags: Health Policy Opinion Administrative Burden Coverage Is Not Care Health Insurance Roadblocks Pre-Authorization Underinsured Source Type: blogs
Amended Senate Bill Includes Waiting Period for Those Who Let Coverage Lapse
On June 26, 2017, the Republican Leadership released an amended version of the Senate Better Care Reconciliation Act. It is very similar to the version they released on June 22, but includes two changes.
First, it amends a couple of provisions of the stability and innovation funds section to allow both short and long-term funds to be used to purchase health insurance benefits. This was apparently done to align the program more closely with the CHIP program. The stability and innovation fund is being created through the CHIP program, reportedly so as to incorporate CHIP’s abortion funding restrictions.
Second, it ma...
Source: Health Affairs Blog - June 26, 2017 Category: Health Management Authors: Timothy Jost Tags: Featured Following the ACA Insurance and Coverage ACA repeal and replace coverage gap waiting period Source Type: blogs
Sounding The Alarms On Children ’s Health Coverage
We reported on this trend in a recent Health Affairs article, in which we found that in 2013, nearly one-third of children in low-income working families above the poverty line got their health coverage through Medicaid or CHIP, up 8 percent from just six years earlier.
Today, more than 40 percent of children and adolescents in this country are now covered by Medicaid and CHIP, second only to employer-sponsored insurance. As a result, children are disproportionately vulnerable to health care reforms that cut public programs. In making any changes, caution is needed, as is an awareness of the many factors leading to familie...
Source: Health Affairs Blog - June 26, 2017 Category: Health Management Authors: David Rubin Tags: Following the ACA Medicaid and CHIP Public Health Quality ACA repeal and replace AHCA Source Type: blogs
ACA Round-Up: QHP Application Deadline Passes, House v. Price, Special Enrollment Periods
June 21, 2017, was the last day for insurers to file qualified health plan applications in the 39 states that use HealthCare.gov, including federally facilitated marketplace (FFM), plan management, and state-based marketplace-federal platform states. There were reportedly a few additional defections, including Anthem from Wisconsin and Indiana, but most insurers are back from last year, and a there are a few new entrants, notably Centene in several states.
According to slides posted at the CMS REGTAP.info website, insurers may make any changes they wish to their plan filings until August 16, 2017, except for adding plans...
Source: Health Affairs Blog - June 25, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage house v. price special enrollment periods Source Type: blogs
Medicaid Round Two: The Senate ’s Draft “Better Care Reconciliation Act Of 2017”
Although it differs in important details, the draft Medicaid provisions of the Better Care Reconciliation Act — the Senate’s version of Affordable Care Act “repeal and replace” — share the vision of its House-passed counterpart, the American Health Care Act: to, as much as possible, shield the federal government from the cost of Medicaid. Like the House, the Senate would accomplish this goal by fundamentally altering the terms of Medicaid itself rather than by ending it and replacing its entitlement structure with a new, successor program as Congress did in 1996 when it replaced the Aid to Families with...
Source: Health Affairs Blog - June 24, 2017 Category: Health Management Authors: Sara Rosenbaum Tags: Featured Following the ACA Medicaid and CHIP Uncategorized ACA repeal and replace block grants Medicaid per capita cap Trumpcare Source Type: blogs
Will Senate Republicans Get 50 Votes to Repeal the ACA?
By DAVID INTROCASO
THCB readers are well aware this coming week Senate Republicans plan to begin debate on passing their amended version of the House-passed American Health Care Act (AHCA), titled the Better Care Reconciliation Act. As of today, June 23rd, immediate reactions by Republican senators to the June 22nd released discussion draft have been limited largely because members immediately left town after the draft’s release. The Congressional Budget Office’s (CBO’s) score, that will again be influential, is expected this Monday or Tuesday. Senate debate on the legislation will likely begin next W...
Source: The Health Care Blog - June 24, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized AHCA CBO David Introcaso Repeal Replace Senate Republicans Source Type: blogs
A Primer For Conservatives: Health Insurance is not Really Insurance
By MICHEL ACCAD, MD
Is health insurance a plan to help healthy people mitigate against an unexpected illness, or an income subsidy to help the sick pay for medical care?
Conservatives ought to have a clear answer to that question. Not long ago Congressman Morris Brooks from Alabama did not and found himself on the receiving end of liberal ridicule.
By suggesting that those who take better care of themselves should pay lower health insurance premiums, Brooks implied that health insurance is indeed a type of insurance arrangement. After all, the risk adjustment of premiums is a practice proper to all other kinds of insurance...
Source: The Health Care Blog - June 23, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Examining How Senate Republicans Frame Their Health Care Bill
Discussion Draft of Senate Amendment to H.R. 1628
Help stabilize collapsing insurance markets that have left millions of Americans with no options.
Short-Term Stabilization Fund: To help balance premium costs and promote more choice in insurance markets throughout the country, this stabilization fund would help address coverage and access disruption – providing $15 billion per year in 2018 and 2019; $10 billion per year in 2020 and 2021.
Jason Chung writes: S. 106(h)(1) specifies that these amounts are intended to “fund arrangements with health insurance issuers to address coverage and access disruption…” Rand P...
Source: The Health Care Blog - June 22, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Jason Chung Senate Bill Source Type: blogs
Follow the Money: Non-Profit Hospital CEOs Quietly Collect Their Millions While US Health Care Reform Battle Rages
ConclusionsThe current inflamed discussion of " Obamacare " and Republican attempts to " repeal and replace " it focuses on the costs of care and how they affect individual patients. Examples include concerns about health insurance premiums that are or could be unaffordable for the typical person; insurance that fails to cover many costs, and thus may leave patients at risk of bankruptcy due to severe illness; poor people unable to or who might become unable to obtain any insurance, and perhaps any health care. Yet there is little discussion of what really drives high and ever increasing health care costs (whil...
Source: Health Care Renewal - June 22, 2017 Category: Health Management Tags: boards of trustees executive compensation health care reform hospital systems hospitals non-profit organizations Source Type: blogs
Building Sustainable Partnerships To Improve Access To Breast Cancer Treatment For Uninsured Women
Breast cancer is a terrifying disease for most women. In the United States, it is the leading cause of cancer deaths among women ages twenty to fifty-nine years. More than 5,100 women are diagnosed with—and at least 1,100 women die from—breast cancer in New York City each year. The breast cancer survival rate is also lower for uninsured women than for those with private health insurance coverage.
Although access to affordable breast cancer screening and treatment has grown substantially over the past few years as a result of increased health insurance coverage options through the Affordable Care Act (ACA), many uninsur...
Source: Health Affairs Blog - June 20, 2017 Category: Health Management Authors: Kumbirai M. Madondo, Janice Zaballero and José Pagán Tags: Costs and Spending Featured GrantWatch Health Professionals Insurance and Coverage Access breast cancer Consumers Health Care Costs Health Care Delivery Health Philanthropy Health Promotion and Disease PreventionGW Hospitals imag Source Type: blogs
Insurance Only Covers What It Says It Will (Usually)
We all purchase insurance for all sorts of things. We have car insurance, home owners insurance, renters insurance, property insurance, flood insurance, and of course medical insurance in addition to many other policies.Recently I have seen commercial on TV that offer insurance for homeowners to cover things like dishwashers, hot water heaters, air conditioners, etc. They show ' customers ' asking their homeowners insurers to cover their broken AC units. After being turned down, the announcer offers home insurance policy to cover the appliances etc. I think - what a scam. I consider this to be the same as the extended...
Source: Caroline's Breast Cancer Blog - June 19, 2017 Category: Cancer & Oncology Tags: health insurance insurance costs Source Type: blogs
How States Are Addressing Uncertainty With 1332 Waivers
While the future of the American Health Care Act is uncertain, states continue to be interested in reforming their health care systems. We believe that states will ramp up efforts to exercise authority they have under existing law to address their state’s health care needs. While Medicaid’s 1115 waivers deservedly get the most attention, the public profile of 1332 waivers is increasing as states look to improve their health care markets.
We have written previously about the promise and challenges of Section 1332 waivers, and believe they provide states with tools to make the Affordable Care Act work better in their sta...
Source: Health Affairs Blog - June 9, 2017 Category: Health Management Authors: Heather Howard and Dan Meuse Tags: Costs and Spending Following the ACA Insurance and Coverage Payment Policy Alaska American Health Care Act Minnesota Oklahoma Section 1332 waivers state health insurance market Source Type: blogs
Replicating Effective Models Of Complex Care Management For Older Adults
Improving our system of care for older adults with complex, chronic illnesses requires wrestling with a vexing dilemma. Models of care that are readily scalable have limited effectiveness, and effective models are difficult to scale. As an example of the former, the patient-centered medical home (PCMH) has become widespread, but its impact on population health and health care costs varies and has been modest overall. As a stand-alone solution, the PCMH appears insufficient to deliver the diverse set of interventions required by chronically ill, older adults with complex needs—a growing segment of the US population th...
Source: Health Affairs Blog - June 7, 2017 Category: Health Management Authors: Ken Coburn, Charlotte Grinberg, Sophia Demuynck and Margaret Hawthorne Tags: Costs and Spending Diffusion of Innovation Featured Medicare chronically ill older adults complex care management health and aging Health Quality Partners Source Type: blogs
