What’s New in Health Care Reform: Nov. 11

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What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.


Scrutiny Falls On Failed Obamacare Co-Op

New York state is investigating the failed Obamacare nonprofit health insurer there over “inaccurate” financial representations to the government. The insurer, Health Republic, is one of 12 out of 23 Obamacare non-profit health insurers known as co-ops that are shutting down because of financial problems. Via The Hill.

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Supreme Court Accepts Challenge To Health Law’s Contraceptive Mandate

The Supreme Court agreed to hear another challenge to the Affordable Care Act, this time to decide whether religiously affiliated organizations such as universities, hospitals, and charities can be free from playing any role in providing their employees with contraceptive coverage. Via Washington Post. 

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The Controversial Part Of Obamacare That Even GOP-Led States Are Keeping

Republican-led states that expanded Medicaid are sticking with the change, despite qualms and intense political pressure within the GOP about embracing a key part of President Obama’s health-care law. GOP governors and legislators have balked at repealing expansion partly because of the benefit of providing federally funded health insurance to large numbers of constituents, analysts say. Via Washington Post.

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Health Insurance Is A Tough Sell When Tax Credits Are Low

Those eligible for the lowest subsidies to buy health insurance were  the least likely to sign up for 2015 plans, studies show, another indication of the challenge of boosting enrollment for President Obama's signature health care law in 2016. The percentage of those choosing health plans dropped from about 75% for those earning $23,540 to about 14% for those earning about $47,000, new research from the Urban Institute and the Robert Wood Johnson Foundation (RWJF) shows. Via USA Today.

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Marketplace Plans Covering Out-Of-Network Care Harder To Find

Health plans that offer coverage of doctors and hospitals outside the plan’s network are getting harder to find on the insurance marketplaces, according to two analyses published this week. Two-thirds of the 131 carriers that offered silver-level preferred provider organization plans in 2015 will either drop them entirely or offer fewer of them in January, an analysis by the Robert Wood Johnson Foundation found. Those cutbacks will affect customers in 37 states, according to the foundation. Via Kaiser Health News.

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Doctors, Hospitals Say ‘No’ To Obamacare Plans

Government health officials worked diligently this year to improve consumer experience on Healthcare.gov and make sure people know what they are getting for their money when they pick health insurance. But one thing is out of the government's control: whether doctors and hospitals will agree to accept patients who buy these plans. Via U.S. News & World Report.

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Health Care Reform Law's Auto-Enrollment Rule Repealed

Repealing the health care reform law's automatic enrollment requirement will help employers, but that move does not open the door to repeal of other law provisions employers are urging legislators to junk. In rare speedy and bipartisan action last month, Congress passed and President Barack Obama signed budget legislation to prevent a government shutdown and default on its obligations. Via Business Insurance.

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Health Care Reform Leads to Huge Spike in Malpractice Lawsuits

Health care reform is all about making the process of providing medical care and treatment to patients more efficient. According to a report from the Washington Post, however, a new study published in the British Medical Journal suggests that cutting costs in health care could lead to a dramatic spike in malpractice lawsuits.Via BABW News.

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Beyond Medicine: The Road From Health Insurance To Health

Now that as many as 6.4 million low- and middle-income Americans across 34 states have health insurance as a result of the Affordable Care Act, it’s worth asking this question: When does health insurance turn into actual health? Via Common Health.

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Health Systems Dipping Into The Business Of Selling Insurance

In addition to treating what ails you, a number of health care systems aim to sell you a health insurance plan to pay for it. With some of the most competitively priced policies on the marketplaces, “provider-led” plans can be popular with consumers. But analysts say it remains to be seen how many will succeed long term as insurers. Via Kaiser Health News.

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Kelley Schreiber

Kelley Schreiber is a Marketing Channel Manager at Mayo Medical Laboratories. She is the principle editor and writer of Insights and leads social media and direct marketing strategy. Kelley has worked at Mayo Clinic since 2013. Outside of work, you can find Kelley running, traveling, playing with her new kitten, and exploring new foods.