The White House on Wednesday announced a new ObamaCare delay that will allow some consumers to keep health plans that do not meet the law's standards until past the end of the Obama presidency. The unprecedented move, first reported by The Hill on Monday, will protect vulnerable Democrats in the midterm elections by staving off a wave of cancellation notices that would have hit patients in the final weeks of the campaign. The policy also means that one of the key features of the Affordable Care Act — minimum healthcare benefit requirements — will not be in place for all Americans when President Obama leaves office. Senior administration officials insisted that the change will not substantially alter the Affordable Care Act and emphasized that their focus was on flexibility for individuals. “Given how complex the law is and how many different circumstances people face, we want to show that we don't have a one-size-fits-all approach,” one official told reporters on a conference call. Obama and many Democratic lawmakers made promises that consumers could keep their current coverage under the healthcare law, and Republicans were eager to use those statements as leverage in their effort to retake the Senate. The administration explicitly gave cover to 13 vulnerable Democratic lawmakers, including Sen. Mary Landrieu (D-La.) and Rep. Ron Barber (D-Ariz.), by saying the extension was developed in “close consultation” with those members. Under the new rules, insurers in states that allow the extension will be able to maintain policies that do not provide the minimum benefits required by ObamaCare. The policy prolongs the administration's “keep your plan” fix from last fall and applies to the individual and small-group insurance markets, potentially affecting 1.5 million people, officials said. The timetable will allow consumers to renew old health plans for the last time on Oct. 1, 2016, meaning some plans will continue into 2017 under the next president. Administration officials denied that the 2016 campaign season will see its own wave of cancellation notices, predicting that most people will have migrated into the new marketplaces by then. “We don't anticipate any wave of cancellation notices” in 2016, one official said. The latest policy change also streamlined reporting requirements under the employer mandate, made the controversial “risk corridors” program budget neutral and finalized rules for the small business "SHOP" program and stopped a temporary fee from hitting the self-insured health plans typically run by unions. Additionally, the administration extended the next open enrollment period by one month and ordered it to start in November of this year rather than October. This will mean that consumers won't see the marketplace premiums until after the election, another move that could benefit Democrats. But the biggest news related to ObamaCare’s standards for medical coverage, which were forcing many insurers to cancel old policies until the administration announced a fix last fall. Under the Affordable Care Act, health plans are required to offer 10 medical benefits that the Obama administration deems essential. Some of the services are popular, such as prescription drug coverage, but others, such as maternity and pediatric care, have been criticized as expensive as well as being unnecessary for many policyholders — older people, for example. Nonetheless, the White House has consistently argued its requirements improve health insurance standards and shield consumers from unexpected costs associated with bare-bones policies. “There are a number of Americans, fewer than 5 percent of Americans, who’ve got cut-rate plans that don’t offer real financial protection in the event of a serious illness or an accident,” Obama said in Boston in October. “Remember, before the Affordable Care Act, these bad-apple insurers had free rein every single year to limit the care that you received, or use minor preexisting conditions to jack up your premiums or bill you into bankruptcy. So a lot of people thought they were buying coverage, and it turned out not to be so good.” The latest extension follows a series of controversial changes to the rollout of the Affordable Care Act, many designed to ease pressure on consumers and a beleaguered White House that has struggled to implement the law. The last-minute adjustments have angered insurance companies and provided fodder for Republican claims that Obama officials are rewriting the law as they go. Administration officials portrayed Wednesday's announcement as an attempt to stop the trend of frequent changes that have characterized the rollout since last year. “The goal here is to provide certainty and clarity as early into 2014 as possible, so that insurers, businesses, consumers and insurance commissioners all know what is coming and can plan for it,” an official said. The official added that “no [additional] major changes are anticipated at this point” for 2014 and 2015.
From The Hill
A new analysis of Medicaid enrollments says that only 2.4 to 3.5 million people have newly registered for the program since October under the healthcare law. Figures released by consulting firm Avalere Health are significantly lower than the Obama administration's total estimate for people who have been determined eligible for Medicaid since October: 8.9 million.
Federal health officials have frequently cited the rush of interest in Medicaid as a bright spot in ObamaCare's rollout. The law allows states to expand the program to more low-income patients using mostly federal dollars. Avalere researchers found that Medicaid enrollments have increased in states regardless of their choice on the expansion. "Medicaid applications have increased 27 percent on average from October to January compared to application rates before [the law]," said Avalere senior manager Jenna Stento in a statement. "Application rates in expansion states increased 41 percent over the same period." The report also noted a spike in enrollments in January, attributed to more effective processing of applications.
From The Hill
The revelation this week that 4 million people have signed up for private insurance coverage through the Affordable Care Act (ACA) failed to resolve lingering healthcare industry concerns about enrollment shortfalls. According to a blog post by Marilyn Tavenner, administrator for the Centers for Medicare & Medicaid Services (CMS), error rates for the technologically challenged HealthCare.gov website are low and response times are “consistently less than half a second.” Based on the latest enrollment figures, Obama administration supporters predict that the administration’s goal of 7 million sign ups by the end of open enrollment on March 31 is within reach. But healthcare advocates said the lack of critical details on the latest enrollment figures raise important questions. “We’re still waiting to see how many of those folks have paid the first month’s premium and how many were previously insured,” said Chad Mulvany, director of healthcare finance policy, strategy and development for HFMA. The Obama administration has declined to detail how many of the enrollees have yet paid their premiums on the new plans to activate their coverage. Various studies have indicated that 20 percent of ACA exchange enrollees nationwide never sent premium payments on their new coverage, which effectively cancels the policies. Similarly, ACA coverage of previously insured people would not count toward the law’s goal of reducing the number of uninsured, from the perspective of many healthcare providers. Some insurers have warned that even when overall enrollment appears healthy, disproportionate shares of sicker enrollees could undermine the coverage. For hospitals, a significant shortfall could have consequences beyond a larger-than-expected share of their uninsured patients continuing to require charity care. Specifically, ACA cuts to disproportionate share hospital (DSH) payments were based on the enrollment projections—not actual enrollments. HFMA plans to urge CMS to either recalculate the DSH cuts based on either a recent estimate that enrollees will total 6 million or recalculate the cut based on actual enrollments, Mulvany said. From HFMA
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