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The Week in Healthcare

News last week focused on the latest cost estimates for the Affordable Care Act, understanding the SHOP marketplace, and new data on next year’s health insurance premiums. Highlights include: USA Today reported that the Congressional Budget Office estimates that the Affordable Care Act will cost $5 billion less than originally projected for 2014. The new report shows that from 2015 to 2024, the law is expected to cost $1.38 trillion, which is $104 billion less than prior projections. The cost for 2014 is estimated at $36 million. Small-business owners have choices to make about providing coverage for their employees. The Wall Street Journal’s Market Watch gives details on the Small Business Health Options Program (SHOP). For 2014, SHOP is open to employers with 50 or fewer full-time workers. Employers can purchase health insurance through a broker now or use online enrollment starting in November. Statisticians who worked with insurers to project 2015 insurance premium rates are expecting to see an average increase of around 7%. According to a USA Today article, this is well below recently reported double-digit increases. “The double-rate increases we’ve been hearing are probably exaggerated,” says Dave Axene, a fellow with the Society of Actuaries, adding that there would be wide variation across the country. “That’s not what we’re seeing from the actuarial organizations — I guess we’re being a little bit more optimistic.” But Axene did warn that there could be wide variations in actual costs.

The Week in Healthcare

News last week focused on the effect of the Affordable Care Act on the uninsured rate, latest stats on the newly insured and a national effort that would give states authority over health care policy. Highlights include: NBC News reported on a new Gallup poll that shows the rate of people without health insurance is falling. In the fourth quarter of 2013, the rate was at an all-time high of 18 percent. At the start of 2014, it had fallen to 15.6 percent. “The uninsured rate has been falling since the fourth quarter of 2013, after hitting an all-time high of 18 percent in the third quarter — a sign that the Affordable Care Act, commonly referred to as ‘Obamacare,’ appears to be accomplishing its goal of increasing the percentage of Americans with health insurance coverage,” Gallup says. The Rand Corp. also released a survey about the effect of ACA on health insurance coverage. An article in the LA Times said that at least 9.3 million more Americans have health insurance now than in September 2013. This figure does not include marketplace signups in late March and early April. According to an article in The Advocate, a House committee advanced a bill that would have Louisiana join an interstate compact aimed at giving states authority over healthcare policy.  “Healthcare decisions should be made in states,” said state Rep. Paul Hollis, R-Covington, sponsor of House Bill 1090. Eleven states have indicated their support for the national effort, but critics say it is unlikely to garner the required congressional approval.

The Week in Healthcare

News last week focused on confusion about the Affordable Care Act, an extension for those who couldn’t complete enrollment in time, and details on the individual mandate. Highlights include: CNN reported on a Kaiser Family Foundation poll that found six in 10 uninsured adults are not aware that open enrollment ends March 31. Of the uninsured surveyed, half said they don’t plan to purchase insurance this year. They mainly said cost was the reason. And more than 40 percent of those polled said they didn’t know about federal subsidies to lower costs. Health and Human Services officials said in a USA Today article that the March 31 deadline will be extended for those who tried to enroll, but didn’t finish the process. “Open enrollment ends March 31,” said Julie Bataille, Centers for Medicare and Medicaid Services spokeswoman. “We are experiencing a surge in demand and are making sure that we will be ready to help consumers who may be in line by the deadline to complete enrollment—either online or over the phone.” A Huffington Post article tells people what they need to know about the individual mandate, or penalty for not purchasing insurance. Unless they qualify for an exemption, most Americans will be required to have insurance. Exemptions include things like not making enough money to file a federal income tax return, being homeless or not being able to find a health plan that costs less than 8 percent of income. The penalty is the greater of $95 for each adult or 1 percent of household income. The penalty increases to $695 or 2.5 percent of income by 2016.

The Week in Healthcare

News last week focused on the latest enrollment numbers, the call for broader health plans in 2015 and a final push to get people to sign up in Louisiana. Highlights include: In a Reuters article, the Obama administration said that more than 5 million people have enrolled in the Affordable Care Act since open enrollment began on Oct. 1. “The last several days have been the busiest since December,” said Marilyn Tavenner, administrator of the U.S. Centers for Medicare and Medicaid Services. The Congressional Budget Office’s initial forecast of 7 million was scaled back because of technical problems with the rollout. The Washington Post reports that the Obama administration is requiring marketplace health plans to offer a larger number of providers in 2015 after complaints about limited networks. In 2015, health plans on the federal marketplace must include 30 percent – up from 20 percent – of the area’s “essential community providers.” These are usually health centers and other hospitals serving mostly low-income patients. Department of Health and Human Services Secretary Kathleen Sebelius was in New Orleans last week to encourage people to sign up for health insurance. A WVUE report on the event quoted Sec. Sebelius as saying, “A lot of younger, healthier Americans don’t get up every day thinking ‘what I really need is health care,’ so we’re trying to be creative with outreach.” New Orleans Mayor Mitch Landrieu said, “And as of March 1, because of the work of many of the people who are in this room, 17,000 individuals in the New Orleans and Metairie area have enrolled.”

Tune in March 30 for Health Insurance Help Desk Radio Program Featuring Blue Cross’ Mike Bertaut

Tune in to the Health Insurance Help Desk Radio Program on the Louisiana Radio Network on Sunday, March 30, at 8 p.m. for the latest news on the Affordable Care Act. The one-hour call-in show will feature Mike Bertaut, a certified health consultant and senior healthcare economist with Blue Cross and Blue Shield of Louisiana. Bertaut will take your calls and answer all your questions on the ACA. Listen to the show on the following participating radio stations: Alexandria – KSYL – 970 AM Baton Rouge – WBRP -107.3 FM Lafayette – KPEL – 96.5 FM Lake Charles – KLCL – 1470 AM Monroe – KMLB – 540 AM Shreveport – KVKI – 96.5 FM Slidell – WSLA – 1560 AM Thibodaux – KTIB – 640 AM

The Week in Healthcare

News last week focused on a drop in the uninsured rate, confusion about the penalty for not buying insurance and statistics of those signing up in Louisiana. Highlights include: The Washington Post reports that the share of Americans without health insurance is at the lowest level since President Obama took office. The Gallup-Healthways Well-Being Index found that 15.9 percent of U.S. adults are uninsured so far in 2014, down from 17.1 percent for the last three months of 2013. This is equal to about 3 million people getting coverage. With less than a month left for most Americans to buy insurance or face a penalty, most consider the penalty to be pretty small according to NPR. “I’d say the vast majority of people I’ve dealt with really believe that the penalty is only $95, if they know about it at all,” says Brian Haile, senior vice president for health policy at Jackson Hewitt Tax Service. “And when people find out, they’re stunned. It’s much, much higher than they would expect.” In fact, the penalty is the greater or $95 or 1 percent of taxable income. An article on nola.com says that 87 percent of Louisianians who have purchased insurance under the Affordable Care Act are getting financial help to pay for it. Nationally, 83 percent of people got a subsidy. Of those who have gotten coverage, 29 percent are between the ages of 18 and 34. That’s the second highest percentage of young people in any state and higher than the national average of 25 percent.

Deadline to Buy Health Insurance is March 31

Those who don’t purchase by deadline face penalties The deadline to purchase insurance under the Affordable Care Act is Monday, March 31. After that date, most Americans will have to wait until the next open enrollment period that begins Nov. 15, 2014, and ends on Feb. 15, 2015, to purchase insurance through the federal Health Insurance Marketplace. They will also face penalties of 1 percent of their annual income or $95, whichever is higher. “Since last March, we have traveled the state spreading the word about the Affordable Care Act,” said Doug Wilkinson, state coordinator with the Louisiana Healthcare Education Coalition. “As we near the end of the first open enrollment period, we urge those who haven’t bought insurance to get covered today and avoid penalties.” Consumers can buy insurance on the Marketplace at www.healthcare.gov or in person with an insurance agent. To purchase, you will need: A personal email account. You can get one for free from Yahoo!, Gmail, Outlook and others. A Marketplace account that you can create at www.healthcare.gov Social Security numbers and birth dates for each member of your household who needs coverage on this plan. Employer and income information for every member of your household who needs coverage on this plan (pay stubs, W-2 forms, etc.) Policy numbers for any current health insurance plans, if you have coverage. The only way customers can buy insurance on the Marketplace outside of open enrollment is because of a qualifying event such as: Getting married Having, adopting, or placement of a child Permanently moving to a new area that offers different health plan options Losing other health coverage (for example, because of job loss, divorce, loss of eligibility for Medicaid or CHIP, expiration […]