Quote:

 

http://www.wsj.com/articles/affordable-care-act-sign-ups-near-6-4-million-1419352035
Affordable Care Act Sign-Ups Near 6.4 Million
Almost 6.4 million people selected a health-care plan on the federal marketplace or were automatically re-enrolled in the first month of the Affordable Care Act’s open-enrollment season this fall, Health and Human Services Secretary Sylvia Mathews Burwell said Tuesday.

That figure compares with about 5.4 million people who had selected plans using the federal exchange in the original enrollment period of Oct. 1, 2013, through March 31, 2014.

High consumer demand in mid-December helped boost the total, which includes about 1.9 million new consumers who obtained private coverage through the federal exchange, Ms. Burwell told reporters.

She said 4.5 million people who got coverage through the federal site in 2014 were re-enrolled. Of those, more than 30% returned to the site to re-enroll while the rest were re-enrolled automatically, but she didn’t supply actual numbers....

Quote:

 

http://kaiserhealthnews.org/news/as-docs-face-big-cuts-in-medicaid-pay-patients-may-pay-the-price/

As Docs Face Big Cuts In Medicaid Pay, Patients May Pay The Price

Andy Pasternak, a family doctor in Reno, Nev., has seen more than 100 new Medicaid patients this year after the state expanded the insurance program under the Affordable Care Act.

But he won’t be taking any new ones after Dec. 31. That’s when the law’s two-year pay raise for primary care doctors like him who see Medicaid patients expires, resulting in fee reductions of 43 percent on average across the country, according to the nonpartisan Urban Institute.

“I don’t want to do this,” Pasternak said about his refusal to see more Medicaid patients next year. But when the temporary pay raise goes away, he and other Nevada doctors will see their fees drop from $75 on average to less than $50 for routine office visits.

“We will lose money when they come to the office,” he said.

[...]

State Impact Differs

Despite the concerns, most states say they’ve seen no evidence the increase has resulted in greater doctor participation — mostly because it was temporary. The bonus boosted pay rates for primary care doctors who saw Medicaid patients to the same level as they are paid by Medicare.

Because Medicaid reimbursement rates for doctors vary by state, however, the pay bump varied from no change in Alaska, Montana and North Dakota, to a 50 percent raise or more in California, New York, New Jersey, Michigan, Florida and Rhode Island, according to the Urban Institute.

Only a handful of states have acted to continue the Medicaid pay boost using their own funds, including Maryland, Alabama, Colorado, Iowa and Mississippi. Connecticut will continue the raise, but not for primary care services done in hospitals.

[...]

Low reimbursement rates are not the only reason doctors’ avoid Medicaid. High patient no-show rates also make private physicians reluctant about participating, Duarte said.

Kaveh Safavi, global managing director of Accenture Health, said physicians have always gone in and out of the Medicaid program as a business decision. Others participate because they feel a social obligation, especially if they practice in an area where patients don’t have other health care options.

“There are a lot of dynamics at play … though historically, things have not changed [doctors’ participation] as much as when states make payment changes,” he said.

[...]

Stephen Zuckerman, senior fellow at the Urban Institute, said the states that will use their own funds to continue the fee increase were typically paying higher-than-average Medicaid rates already. But the most populous states — among them, New York, California and Illinois — are not doing that.

“It’s an open question of whether more doctors will quit Medicaid or stop seeing new Medicaid patients,” Zuckerman said. “But these cuts cannot help.”

[...]

But a December report by the Health and Human Services’ Office of Inspector General found that about half of Medicaid doctors listed as participating in managed-care plans don’t have availability or don’t contract with the health plan at all.

Jeff Myers, president of Medicaid Health Plans of America, the trade group, said the plan’s provider directories should be updated but the findings don’t mean patients can’t get care. He pointed to federal documentation showing increasing patient satisfaction.

Other experts note that the pay raise was just one way the health law tried to ensure that newly covered Americans would have a place to get care. Funding to community health centers was also boosted by $11 billion from 2011 to 2015 to help them expand.

“The Medicaid pay boost was never meant to be a silver bullet,” said Leonardo Cuello, director of health policy at the National Health Law Program, an advocacy group for low-income Americans.

Still, the provider fee cuts have him worried. “It won’t sink the ship but … I’m concerned it will contribute to access problems.”

Baldo

Dec 25 2014, 01:29 PM

It was hocus-pocus with lots of smoke & mirrors and behind the curtain was Gruber, Biden, Reid, Pelosi, and the Grand Wizard himself Obama!

We will only know the damage after obama leaves office and rides away with his hundreds of millions promised by the crony capitalists with a Hi Ho Suckers!

longstop

Dec 25 2014, 03:33 PM

Baldo

Dec 25 2014, 01:29 PM

It was hocus-pocus with lots of smoke & mirrors and behind the curtain was Gruber, Biden, Reid, Pelosi, and the Grand Wizard himself Obama!

We will only know the damage after obama leaves office and rides away with his hundreds of millions promised by the crony capitalists with a Hi Ho Suckers!

Demographics - Why The Great Recession Started (And Won't End Anytime Soon)

http://www.zerohedge.com/news/2014-12-22/demographics-why-great-recession-started-and-wont-end-anytime-soon

Quote:

 

http://www.heritage.org/research/reports/2014/12/measuring-choice-and-competition-in-the-exchanges-still-worse-than-before-the-aca

Measuring Choice and Competition in the Exchanges: Still Worse than Before the ACA

• 
  
• My guiding principle is, and always has been, that consumers do better when there is choice and competition. That’s how the market works. Unfortunately, in 34 states, 75 percent of the insurance market is controlled by five or fewer companies. In Alabama, almost 90 percent is controlled by just one company. And without competition, the price of insurance goes up and quality goes down.
  — Barry - September 9, 2009

[...]

2015 State-Level Choice and Competition
[...]
The Government Accountability Office (GAO) measured insurer competition in the pre-ACA individual market using a broader methodology than Heritage’s analysis.[5] According to the GAO, 1,232 carriers sold fully insured individual-market coverage nationwide in 2013, and this analysis finds that only 310 insurers are selling coverage on the exchanges nationwide in 2015. (See Appendix Table 2.)[6] Thus, the ACA’s exchanges are 75 less competitive than the pre-ACA individual market under the GAO’s methodology.
[...]

Quote:

 

http://dailycaller.com/2014/12/24/obamacare-created-insurer-goes-under-is-taken-over-by-the-state/print/

Obamacare-Created Insurer Goes Under, Is Taken Over By The State
Posted By Sarah Hurtubise On 5:59 PM 12/24/2014

An Obamacare-created and taxpayer-funded insurance company in Iowa has been taken over by the state due to a financial crisis.

CoOportunity Health is Iowa’s insurance cooperative — a nonprofit insurance company created by the Affordable Care Act to supposedly undercut the large, for-profit insurers that Democrats castigated as “greedy” and “evil” during the debate over health care reform.

After just beginning to offer plans in 2013, the company’s already insolvent and has now been taken over by the state of Iowa, insurance commissioner Nick Gerhart announced Wednesday. CoOpportunity doesn’t have enough cash on hand to be sure it can pay claims for its 120,000 customers, if necessary. The company has only $17 million in cash and assets, Gerhart said.

The federal government’s Obamacare administrator the Center for Medicare and Medicaid Services initially gave CoOportunity a $112 million loan award in Feb. 2012, but doled out an additional $32.7 million emergency award to keep the company solvent in September of this year.

That wasn’t enough to keep it in business. CoOpportunity’s management expected to receive more federal money than they did, putting them in continuing financial peril.

The nonprofit insurers were single-payer advocates’ answer to private insurance companies, which some argued hiked premiums just to pad their profits. But after its initial year of Obamacare, CoOportunity was struggling so much that it ended up having to up its premiums in Iowa by 19 percent on average.

“It’s a difficult situation,” Gerhart said. Customers’ coverage will continue for now, but Gerhart expects that most customers will switch to other insurers operating on Iowa’s and Nebraska’s Obamacare exchanges by the end of the open enrollment period on Feb. 15. It’s no longer accepting new sign-ups for coverage.

The state of Iowa, in the form of Gerhart himself, is in charge of the company now, according to Dana McNeill, a CoOpportunity vice president.

The Obamacare-created company has been bleeding cash over the past several months. Its net cash and investments fell from $121.5 million on Oct. 31, just a month after receiving a solvency loan from the Obama administration, to $17 million on Dec. 12, the Des Moines Register reports.

It’s far from the only Obamacare-created company that’s in peril. The Obama administration handed out almost $3 billion in loans to get the co-ops started in 2013. They were included in the law to placate critics on the left who advocated a public insurance option and lost.

In Sept. 2014, the administration handed out another round of solvency loans to a number of co-ops who needed help staying in business. Six state co-ops received a total of almost $268 million in extra loans to help keep the companies solvent and in business.

Even since then, the administration issued two last-minute solvency loans, which it kept quiet for weeks. Kentucky Health Cooperative received an extra $65 million emergency solvency loan days before the second open enrollment period launched and the co-ops began to sign up new customers — but CMS did not announce the loans until Dec. 15, along with another last-minute $23 million solvency loan to Wisconsin’s Common Ground Healthcare Cooperative.

Meanwhile, large, private insurance companies are doing better than ever under Obamacare’s mandate to hold health insurance and its generous subsidies to purchase exchange coverage.

longstop

Dec 25 2014, 03:33 PM

Baldo

Dec 25 2014, 01:29 PM

It was hocus-pocus with lots of smoke & mirrors and behind the curtain was Gruber, Biden, Reid, Pelosi, and the Grand Wizard himself Obama!

We will only know the damage after obama leaves office and rides away with his hundreds of millions promised by the crony capitalists with a Hi Ho Suckers!

Demographics - Why The Great Recession Started (And Won't End Anytime Soon)

http://www.zerohedge.com/news/2014-12-22/demographics-why-great-recession-started-and-wont-end-anytime-soon