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http://www.kaiserhealthnews.org/Stories/2014/October/14/Modest-Premium-Hikes-Higher-Consumer-Costs-Likely-For-Job-Based-Plans.aspx

Modest Premium Hikes, Higher Consumer Costs Likely For Job-Based Plans

Fall is enrollment season for many people who get insurance through their workplace. Premium increases for 2015 plans are expected to be modest on average, but the shift toward higher out-of-pocket costs overall for consumers will continue as employers try to keep a lid on their costs and incorporate health law changes.

Experts anticipate that premiums will rise a modest 4 percent in 2015, on average, slightly higher than last year but lower than typical recent Increases.

“That’s really low,” says Tracy Watts, a senior partner at benefits consultant Mercer. (such cheerful news!)

[...]

More employees can expect to be offered high-deductible health plans linked to health savings accounts or health reimbursement arrangements in 2015. Nearly three-quarters of companies with more than 1,000 workers offer such plans, according to the 2014 Towers Watson/National Business Group on Health employer health care survey. Nine percent said they planned to add them in 2015.

For a growing number of employees, those plans may be the only ones available through work. For 2015, 30 percent of large employers said they expected to offer only an account-based plan to workers, nearly double the percentage that did so in 2014, the Towers Watson/NBGH survey found.

For some consumers, however, those plans raise concerns about the cost of care. A new survey by The Associated Press and the NORC Center For Public Affairs Research found that people with high deductible plans were twice as likely as those with traditional health insurance to report that they did not go to a doctor when sick or injured because of concerns about the costs. (That does NOT read like a plan for a healthier America.)

When employers shift toward plans with higher deductibles, they often try to sweeten the deal for employees by offering to put money into the financial accounts to help defray the workers’ increased cost, says Brian Marcotte, president and CEO of the National Business Group on Health. The extra cash—an average $600 per employee—is often tied to wellness activities such as agreeing to get health screenings, says Marcotte. As employees evaluate their health plan offerings this fall, it’s worth checking to see if such incentives are offered. (Most often matching funds from employees. Obamacare is loading businesses with heavier management loads here!)

Also this year, workers may find it increasingly expensive to cover their spouses, especially if they have coverage available through their own jobs.

Employers have been increasing workers’ costs to cover dependents, including spouses, in recent years. Nearly half of employers say they’ve hiked employee contributions for dependent coverage, and another 19 percent plan to do so in 2015, according to the Towers Watson/NBGH survey. Upcoming increases are particularly aimed at spouses, including $50 to $100 monthly surcharges for spousal coverage, says Sandy Ageloff, a senior consultant at benefits consultant Towers Watson. (Less discretionary spending income for American workers.)

“Legally under the Affordable Care Act, plans can’t exclude coverage for kids,” says Ageloff. “But they’re really trying to shift the onus back on to spouses.”

This fall, employees who work for small businesses may see fewer changes in their coverage than those who work for large companies. In March, the Obama administration announced that individuals and small businesses with plans that didn’t comply with health law coverage and cost requirements could be extended until 2017. (Pen and phone legislation!)

As many as 80 percent of companies with up to 50 employees opted to renew their non-compliant plans for 2014, says David Chase, national health care policy director at the Small Business Majority, an advocacy group. A similar percentage will likely try to do so this year as well, he says.

“That’s going to be a popular option for folks, if their states allow it,” Chase says. It’s up to states to determine whether insurers can continue to sell small group plans that don’t meet the requirements of the health law.

There could be a downside, however. “Sticking with the same plan doesn’t mean sticking with the same premium,” Chase says. “Those premiums could go up more than ACA-compliant plans.”

• 
  
• Were the motive or policy goals of a bill the touchstone, no revenue measure would ever be subject to the Origination Clause. Amici’s Senate colleagues surely could articulate a broader “purpose” in raising whatever funds they deem required. The income tax could easily (and largely truthfully) be characterized as a bill to provide for national defense and foreign diplomacy, or to facilitate any other federal program. No tax is levied to raise money for its own sake, and all monies raised are “incidental” to other government goals. Under the panel’s approach, the Origination Clause would be toothless.
  
  The panel decision is particularly troublesome when combined with its broad view that the taxing power may be exercised regardless of any regulatory purpose that may be beyond Congress’ authority, and regardless whether the revenue purpose is secondary. This combination leads to a constitutional whipsaw whereby otherwise unconstitutional regulatory measures are deemed taxes yet are immunized from the Origination Clause, despite whatever revenue-raising function justified them as taxes for constitutional purposes.
  
  Not only is such a Catch-22 contrary to the original meaning of the Origination Clause, neither does it fit the pattern of any prior case rejecting an Origination Clause challenge. In every prior case there existed constitutional authority independent of the tax power to to enact the monetary exaction that was upheld. In each case, those money-generating provisions were simply a means of implementing a separate Congressional power.
  
  In this case, with an exclusive reliance on the taxing power, the shared responsibility penalty was constitutionally justified solely as a revenue-raising tax. Courts may not look behind the constitutional “object” or purpose for this measure to any other motives that Congress may have harbored. Congress may exact money for a variety of constitutional ends, but when it attempts to achieve these ends by using its power to tax the people, such a measure is a bill for raising revenue that must originate in the House.

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http://www.forbes.com/sites/michaelcannon/2014/10/15/how-obamacares-victories-count-against-it-in-sissel-v-hhs/

How ObamaCare's Victories Count Against It In Sissel v. HHS

Randy Barnett has an excellent post at the Volokh Conspiracy about his recent amicus brief requesting the D.C. Circuit grant en banc review of Sissel v. HHS. (Sound familiar?) Sissel challenges the constitutionality of ObamaCare’s individual mandate — which the Supreme Court ruled could only be constitutional if imposed under Congress’ taxing power — on the grounds that this, ahem, tax originated in the Senate rather than the House, as the Constitution’s Origination Clause requires.

[...]

You guys think Halbig is worthy of en banc review? Fine. If the Sissel panel erred, the downside is even greater.

We’ll see whether the D.C. Circuit thinks the Constitution is as worthy of its protection as ObamaCare.

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http://www.nytimes.com/2014/10/16/us/us-says-consumers-must-renew-policies.html

U.S. Says Consumers Must Renew Health Insurance Policies

WASHINGTON — The Obama administration began notifying consumers on Wednesday that they should return to the federal health insurance marketplace to renew coverage for next year.

In addition, the officials said, consumers should update information on their income and family size and should compare their current insurance with alternatives, which could offer better coverage at a lower cost.

Kevin J. Counihan, the chief executive of the federal marketplace, said the notices were being sent to 7.3 million people enrolled in health plans purchased through the exchange, HealthCare.gov, which serves three dozen states. Mr. Counihan, speaking at a conference of insurance executives and consumer advocates, outlined what he described as five easy steps for consumers.

“Step 1 — review your coverage,” Mr. Counihan said. “Plans change, people change.

Step 2 — starting Nov. 15, log in and update your application. Make sure your household income and other information is up-to-date.

Step 3 — compare your current plan with other plans that are available in your area.

Step 4 — choose the health plan that best fits your budget and health needs.

Step 5 — enroll.” The open enrollment period runs from Nov. 15 through Feb. 15. But, Mr. Counihan said, “for coverage starting Jan. 1, the consumer must enroll in a health plan by Dec. 15.”


Consumers who have already signed up and who take no action will, in most cases, have coverage automatically renewed in the same or similar health plans. Federal subsidies will also be the same, though premiums are likely to change, and consumers will not always be able to stay with their current doctors because health plans can change their provider networks.
The lazy will likely suffer increases.

“There is going to be a lot of confusion,” said Rachel Klein, director of the enrollment program at Families USA, a consumer group. But she said, “The uninsured want health insurance and will persevere to get it.”

Insurers expressed concern about consumers who choose to leave one health plan and sign up for another offered by a different insurance company. The federal government is not planning to send a notice to the first insurer terminating the consumer’s enrollment. As a result, consumers may receive bills or invoices from both companies. And conceivably, insurers said, if premiums are paid from bank accounts by electronic funds transfer, the money could be deducted twice.

Katie Dzurec-Dunton, the director of compliance and regulatory affairs at Maine Community Health Options, the state’s most popular plan on the exchange, said she worried that “we will get no notification of any kind” in these cases. Insurers will hesitate to shut off coverage for consumers if the companies do not receive explicit instructions to do so, she said. Mr. Counihan said the renewal process would work well for most consumers, but might not be “perfect for every enrollment transaction.”

Aaron Albright, a spokesman at the federal Centers for Medicare and Medicaid Services, said that insurers would not receive termination notices, but could assume that an individual’s coverage ends on Dec. 31 unless the insurer is told otherwise by the government. In late December, the federal marketplace will send enrollment files to insurers indicating whose coverage has been renewed for 2015.

Esther Krofah, a health-policy specialist at the National Governors Association, voiced another concern. “Consumers,” she said, “will receive multiple notices from the marketplace and insurers and will need to pay careful attention to the complex messages.” The notices could differ because enrollment records kept by insurers and the government differ in many particulars.

The Obama administration began notifying insurers this week of its preliminary decisions to approve health plans for sale in the federal marketplace this fall. But insurers cannot begin sending renewal notices to customers until they receive signed contracts from the government in November. This conflicts with rules and laws in some states, which require insurers to inform consumers two or three months before the renewals take effect on Jan. 1.

Paul D. Wingle, the exchange strategy chief at Aetna, asked federal officials how to reconcile the federal and state requirements. Michael Adelberg, a senior official at the Centers for Medicare and Medicaid Services, said that federal officials were in discussions with state insurance regulators and would probably issue guidance on the question.

Baldo

Oct 17 2014, 11:42 PM

NY Times

Unable to Meet the Deductible or the Doctor

[...]

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http://rt.com/usa/195948-budget-review-obamacare-costs/

Obamacare likely to cost $300 billion more than thought – Congressional Budget Office

The real cost of Obamacare will be hundreds of billions of dollars more than expected, Republican members of the Senate Budget Committee now say, and will greatly increase the federal deficit during the next decade.

Contrary to claims made by the White House, United States President Barack Obama’s hallmark health care plan will actually have a tremendous toll on the government, GOP members of the SBC committee allege in a new report.

According to an analysis of data received by the Congressional Budget Office, Senate Republican say so-called Obamacare won’t reduce the federal budget deficit by $180 billion by 2019 as predicted, but will actually set the US back another $131 billion in the hole.

The CBO hasn’t officially investigated the cost of Obamacare since the summer of 2012, Senate Budget Committee Ranking Member Jeff Sessions (R-Alabama) says in the report, and complications in the two-plus years since have, according to his group’s analysis, caused costs to change tremendously.

• 
  
• “The most recent CBO estimate, released in July 2012, indicated the law was projected to reduce the deficit by $109 billion over the 10-year period from FY 2013–2022. Nevertheless, considerable changes have occurred since then: a botched rollout of the insurance exchanges; unilateral changes made by the Administration to exempt certain groups from complying with key aspects of the law; technical adjustments to CBO’s baseline projections for federal health spending; updated economic forecasts; a better understanding of the labor market effects of the legislation; and a new 10-year budget window,” the report reads in part. “Together these changes have significant implications for the sign of the deficit impact of the Democrats’ health law.”
  
  “f nothing had changed since 2012,” the report continues, “then the legislation would be projected to reduce the deficit by $180 billion” by 2024.

After reviewing new data, however, that number changes drastically. In all, GOP analysts say the difference between the 2012 prediction and the latest analyses amounts to $311 billion.

• 
  
• “Altogether, the SBC Republican staff analysis finds that after taking these significant changes since 2012 into account, the Democrats’ health care law will increase the budget deficit by $131 billion over the current 10-year budget window (FY 2015–2024),” the report finds. “This estimate is arrived at by taking the $180 billion in projected deficit reduction from the CBO 2012 extrapolation and then accounting for the lower net cost of the coverage provisions ($83 billion), the lower estimated federal health care savings under the plan ($132 billion), as well as the lower projected revenue levels when including the labor market effects of the legislation ($262 billion).”

Meanwhile, other figures concerning Pres. Obama’s Affordable Care Act could fluctuate in only the next coming days: although Americans were allowed to begin enrolling in the healthcare program last October 1, this time around they will have to wait until November 15 — 11 days after the upcoming mid-term elections.

• 
  
• “This is more than just a glitch,” Tim Phillips, president of free-market Americans for Prosperity, said in a statement last week. “The administration’s decision to withhold the costs of this law until after Election Day is just more proof that Obamacare is a bad deal for Americans.”

Last year’s scheduled launch of the ACA was ultimately marred by a number of incidents, including major problems with the program’s website and the inability for many people to retain old insurance providers. In July 2014, a survey conducted by the Henry J. Kaiser Family Foundation determined that 53 percent of respondents viewed the ACA unfavorably.

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http://news.investors.com/politics-obamacare/101714-722269-obamacare-bronze-plan-premiums-to-jump-in-2015.htm

ObamaCare Bronze Plan Premiums To Jump 14% In 2015



[...]

While some potential enrollees may opt out because of the higher cost of bronze, some young adults may instead pick catastrophic plans available to those under 30. The latter scenario is also not great news for ObamaCare exchanges, since catastrophic plan members are grouped separately, leaving the main risk pool relatively older and more costly.

In general, double-digit ObamaCare premium increases have been the exception rather than the rule, leading news outlets and health policy experts to deride earlier predictions by the law's critics that rates would spiral this year.

Perhaps the clearest evidence of the benign rate environment for 2015 came from an analysis by the Kaiser Family Foundation . The authors found that the cost of the benchmark silver plan would fall an average 0.8% in the same 16 cities that IBD looked at.

Further, the report found that the after-subsidy cost of the second-lowest-cost silver plan would also fall an average 0.8%.

IBD relied upon the same bronze and silver premium data that Kaiser foundation researchers collected. So what accounts for the dramatic difference in findings about the path of bronze and silver premiums?

There are two big reasons for the difference. First, Kaiser researchers calculated after-subsidy premiums for someone whose expected income in 2015 is the same as in 2014, while IBD's illustration assumes income rises with inflation.