What’s New in Health Care Reform: Sept. 14

shutterstock_158366573What'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.

Uninsured Rate Goes down, Largely Due to Obamacare

The number of people without health insurance decreased by 1.3% between 2014 and 2015, according to a new report released by the Census Bureau. In 2015, 9.1% of the population, or 29 million people, was uninsured. This was down from 10.4%, or 33 million people, in 2014. The coverage gains occurred among the private insurance market, largely attributable to Obamacare, and government coverage like Medicaid or Medicare. While other surveys have shown similar numbers, the Census Bureau report has a large sample size and is regarded as highly reliable. Via Morning Consult.

Read article

Obama Hopeful on Spending, Zika Funds after Meeting Congress Leaders

President Barack Obama said after meeting with the top four congressional leaders that he was encouraged that lawmakers would be able to pass short-term spending legislation to keep the government open during the 2017 fiscal year. Democrat Obama said he was hopeful about reaching agreements with the Republican-majority Congress on funding to fight the Zika virus and for disaster relief after flooding in Louisiana. Via Reuters. 

Read article

Insurance Executives Ask for Changes to Obamacare

Health insurance executives went to the White House and called for changes to Obamacare that they say are necessary to keep the health care exchanges working. The executives discussed a series of their long-running complaints about Obamacare, including tightening up the rules for extra sign-up periods, shortening grace periods for people who fail to pay their premiums, and easing restrictions on setting premiums based on someone’s age. Via The Hill.

Read article

The Reality of the Health Insurance Marketplace

It's become a yearly ritual: As the Affordable Care Act (ACA) continues to settle into place, inevitable growing pains get portrayed by critics as doom for health reform. This year, we're seeing it again. Many of these claims are detached from the facts, and blind to what health care was like before the ACA was passed. But that doesn't mean there aren't issues and room for improvement. It's important to start with the context. Via CNN.

Read article

Another Piece of Obamacare Falls Short

An Obamacare provision designed to inject a protective extra layer of competition into fledgling insurance markets fell into near-oblivion—and its failure has made Obamacare’s mounting challenges even more acute. Under the unwieldy name of the Multi-State Plan Program, the federal government was supposed to contract with two private health plans, at least one a nonprofit. Each is required to offer coverage in all 50 states by next year. But it’s fallen short, reaching fewer states than anticipated, and offering plans that mirror options people already have. Via Politico.

Read article

Obamacare Sustainable Even if Congress Doesn't Act

The latest challenge—a target of growing physician anger and frustration nationwide—is a 2015 federal law that changes the way Medicare pays doctors. Many fear it will sharply increase the financial pressures that physicians in rural, solo, and small practices face. The Medicare Access and CHIP Reauthorization Act was Congress’s boldest step since the 2010 Affordable Care Act to push the health care system to reward quality over quantity. The law, which passed with bipartisan support, seeks to use monetary incentives and performance measures to promote better care. It replaced a widely derided reimbursement formula that Congress regularly ignored because it would have cut payments to doctors. Via The Hill.

Read article

"Simple Choice Plans" to Debut in 2017 Marketplace Enrollment

Despite much hand-wringing about health insurers exiting the marketplaces where people buy individual coverage, in many areas, consumers will likely still have a choice of plans when the 2017 open enrollment starts in November. Aiming to make picking a plan easier, the federal government, which runs the marketplaces in roughly two-thirds of states, is encouraging insurers to offer “simple choice plans” as an option this fall. The six new standardized plan designs will eliminate many of the moving parts that have bedeviled consumers trying to make apples-to-apples comparisons between plans. The government is providing guidelines for a simple choice plan at each of the bronze, silver, and gold levels, and three more silver options for people who qualify for cost-sharing reductions based on their income. Via Kaiser Health News.

Read article

Voters’ Top Health Care Issues: Medicare and Affordability

When it comes to health care issues, voters are most concerned with topics that rarely come up on the campaign trail: Medicare’s future and access to, and affordability of, health care, according to a new Kaiser Family Foundation poll. Via Morning Consult.

Article No Longer Available

Health-Care Exchange Sign-Ups Fall Far Short of Forecasts

Enrollment in the insurance exchanges for President Obama’s signature health care law is at less than half the initial forecast, pushing several major insurance companies to stop offering health plans in certain markets because of significant financial losses. As a result, the administration’s promise of a menu of health-plan choices has been replaced by a grim, though preliminary, forecast: Next year, more than one in four counties are at risk of having a single insurer on its exchange, said Cynthia Cox, who studies health reform for the Kaiser Family Foundation. Via Washington Post.

Read article


Andy Tofilon

Andy Tofilon is a Marketing Segment Manager at Mayo Medical Laboratories. He leads strategies for corporate communications, public relations, and new media innovations. Andy has worked at Mayo Clinic since 2003. Outside of work, Andy can be found running, hiking, snapping photos, and most importantly, spending time with his family.