May 16, 2012
The Department of Health and Human Services issues
guidance on Federally-Facilitated Exchanges, FFE, which will operate “in any State where a State-based Exchange is not operating.” Although the Affordable Care Act “allows each State the opportunity to establish an Affordable Insurance Exchange (‘Exchange’) to help individuals and small employers purchase affordable insurance coverage… the [ACA] directs the Secretary of HHS to establish and operate an FFE in any State that does not elect to do so, or will not have an operable Exchange for the 2014 coverage year, as determined by January 1, 2013,” according to the guidance. Under the Exchange final rule, States have the option to pursue a Partnership model and “administer plan management functions, in-person consumer assistance functions, or both. In non-Partnership FFE States, FFEs will perform these functions.” The guidance explains “1. How States can partner with HHS to implement selected functions in an FFE, 2. Key policies organized by Exchange function, and, 3. How HHS will consult with a variety of stakeholders to implement an FFE.”
The guidance details the plan management and in-person consumer assistance functions and also notes that “HHS, by law, retains authority over each FFE. Specifically, as HHS is responsible for Exchange implementation, we will approve State Partners to perform plan management or consumer assistance functions, and retain authority over inherently governmental functions (certification of specific [Qualified Health Plans], selection of Navigators, etc.) carried out by the State Partner on an ongoing basis.” In addition, the guidance addresses topics such as quality reporting, eligibility assessments (for the exchanges and Medicaid/CHIP), consumer education and outreach, the Federally-Facilitated Small Business Health Options Program, and stakeholder input.
May 11, 2012
The POLITICO-George Washington University
Battleground Poll asks registered voters who they think is better able to handle health care, if the 2010 law should be repealed and if it went too far. They also have voters identify what issue they think is most important for Congress to consider.
The
Washington Post asks Virginians how important health care will be in their vote for U. S. Senate this year.
Registered voters weigh in on which presidential candidate they think is stronger on the issues of health care and Medicare in a new
Reuters/Ipsos poll.
May 11, 2012
A new
report from the National Academy of Social Insurance focuses on one of the core functions of health insurance exchanges: “the series of oversight activities that federal officials have called ‘plan management.’” According to the report, “The U.S. Department of Health and Human Services (HHS) has defined plan management to encompass a broad range of functions, including certifying qualified health plans (QHPs), collecting and reviewing rate and benefit information, managing contracts with QHPs, monitoring ongoing compliance issues, recertifying and decertifying QHPs, and running an open enrollment process.” In the report, the authors “focus on a subset of plan management activities most closely analogous to what state and federal regulators are currently doing: granting licenses and ensuring solvency, assessing network adequacy, reviewing rates and policy forms, regulating marketing practices, improving plan quality, and conducting ongoing oversight.”
The authors conclude that ultimately, the entity “responsible for plan management, whether at the state or federal level, will need to balance the [Affordable Care Act’s] requirements for greater front-end review of carriers and plans with the need to develop a management process that supports and sustains an adequate mix of quality carriers to serve consumers in the exchange. This will be particularly true for the small business exchange (SHOP), in which there are limited incentives for health plans to participate. For the individual market exchange, the incentives to participate are stronger and plans will be less deterred by a robust review and approval process.”
May 11, 2012
A new policy
brief from Health Affairs and the Robert Wood Johnson Foundation “explains trends in wellness programs, details changes in the law starting in 2014, and highlights issues to watch.” More than two-thirds of firms with three or more employees that offer health benefits offer some sort of wellness program, according to the
2011 Kaiser Employer Health Benefits survey and “Employers are also linking participation in wellness programs to employees' costs for health coverage--for example, by reducing premium contributions for workers who are in wellness programs, or by reducing the amounts they must pay in deductibles and copayments when they obtain health services.”
According to the brief, “Concerns… have been raised that, by instituting programs designed to alter employees' behavior, employers may be crossing the line with regard to privacy issues. Another concern is that tying the cost of insurance to the ability to meet certain health status goals could discriminate against low-income individuals or racial and ethnic minorities… In addition, some critics warn that wellness program requirements may be used to discourage employees from participating in their employers' health benefits plan by making their participation unaffordable.”
May 11, 2012
Under the Affordable Care Act (ACA), “businesses that have fewer than 25 full-time workers and average wages of less than $50,000 are now eligible to receive a tax credit of up to 35 percent of the cost of the health insurance that they provide for their workers,” explains a new
brief by the Small Business Majority and Families USA. The analysis contains estimates of “the number of small businesses that are eligible for this new tax break in tax year 2011 and how many workers could potentially benefit as a result.” The analysis finds that “more than 3.2 million small businesses, employing 19.3 million workers across the nation, will be eligible for this tax credit when they file their 2011 taxes. In total, these small businesses are eligible for more than $15.4 billion in credits for the 2011 tax year alone, an average of $800 per employee.” The analysis breaks down the estimates by state, number of small businesses, number of people, and total number employed by small businesses eligible for credit. The analysis also includes data broken down by race and ethnicity.
May 10, 2012
The Centers for Medicare and Medicaid Services issue a
proposed rule that would increase Medicaid rates for primary care services to Medicare levels in calendar years 2013 and 2014. “This minimum payment level applies to specified primary care services furnished by a physician with a specialty designation of family medicine, general internal medicine, or pediatric medicine, and also applies to services paid through Medicaid managed care plans,” according to the proposed rule. The proposed rule “would also provide for a 100 percent Federal matching rate for any increase in payment above the amounts that would be due for these services under the provisions of the State plan as of July 1, 2009.” According to a CMS
release, states would receive an additional $11 billion in Medicaid payments.
May 4, 2012
A
Pew Research Center for the People and the Press poll asks the public their views on the health care law and the Supreme Court.
Quinnipiac University asks voters in Florida, Ohio, and Pennsylvania how they want the Supreme Court to rule on the health care law and if Congress should repeal it.
What do Virginians think of the Affordable Care Act? The
Washington Post conducts a poll to find out.
Asian American registered voters weigh in on which political party is doing a better job handling health care in an
Asian American Justice Center poll.
May 2, 2012
With the Republican presidential primaries wrapping up, a barrage of new television commercials, radio ads, and fundraising emails has marked the start of the general election campaign. The Affordable Care Act (ACA) continues to be a mainstay election topic for candidates from both major parties. While Republicans focus on advocating repeal of the 2010 health care law, President Barack Obama and the Democratic Party have concentrated on the benefits of the law. And one lesser known provision of the ACA has received top billing in several of their campaign materials: the elimination of gender rating for health insurance premiums.
Gender rating refers to the practice of charging women higher health insurance premiums than men. With the exception of states that already prohibit or limit gender rating, women are frequently charged higher premiums because they require health care services that men do not need, like regular gynecological visits and maternity care. The ACA will eliminate this insurance practice by 2014. This blog post looks into Americans’ views of this provision, finding that the majority of Americans like the idea of getting rid of gender rating, but at the same time most aren’t aware that the health reform law already has plans to do so.
Awareness Of Gender Rating Prohibition Is Low
In
Kaiser’s April Health Tracking Poll, roughly a third (35 percent) of Americans were aware that the health reform law prohibits insurance companies from charging women higher premiums than men, down from about half (48 percent) in June 2010, just three months after the ACA was signed into law. Although the provision directly impacts women, particularly those under the age of 50, women as a whole were no more likely than men to be familiar with it. Democrats were more likely than Republicans to be aware of this provision (43 percent versus 25 percent), but still fewer than half were familiar with its inclusion in the law.
But, Favorability Of Provision Is High
While relatively few Americans are aware that the ACA includes the gender rating provision, many Americans like the idea of leveling the playing field for health insurance premiums. Overall, six in ten (61 percent) have a favorable view of this provision, a number that rises to seven in ten (69 percent) among women as a group, and about three-quarters among women under age 50 (73 percent of whom back it).
When it comes to the opposite sex, men as a whole are less supportive of the measure, with roughly half (52 percent) supporting it; though that number rises to 57 percent among younger men compared to 47 percent among their older counterparts.
As is true for public opinion on the law as a whole, there is a partisan gap on this provision, albeit a much smaller one. While the measure is overwhelmingly popular among Democrats (74 percent) and looked favorably upon by a solid majority of independents (59 percent), Republicans are a little less enthusiastic. But still, half (51 percent) of Republicans, the law’s most fervent opponents, like that the law gets rid of gender rating. There is also a gender gap on the issue within the Republican party: nearly two-thirds (63 percent) of women who align themselves with the Republican party or lean Republican favor the gender rating prohibition, compared to fewer than half of Republican or Republican-leaning men (43 percent).
May 1, 2012
The Department of Health and Human Services awards $728 million for two capital programs for community health centers. "One will
provide approximately $629 million to 171 existing health centers across the country for longer-term projects to expand their facilities, improve existing services, and serve more patients,” states an HHS
release. “This program will expand access to an additional 860,000 patients. The second set of awards will
provide approximately $99.3 million to 227 existing health centers to address pressing facility and equipment needs.” According to HHS, ”The awards are part of a series of capital investments that are made available to community health centers under the Affordable Care Act, which provides $9.5 billion to expand services over five years and $1.5 billion to support major construction and renovation projects at community health centers."
April 27, 2012
Young adults are the focus of a new
Harvard University poll that asks what national issue concerns them, how President Barack Obama is handling health care, and if health insurance is a basic right that requires government assistance if a person cannot afford it.
The Public Religion Research Institute and Georgetown University’s Berkley Center for Religion, Peace, and World Affairs
survey millennials on whether certain categories of religiously affiliated employers, such as Catholic hospitals or universities, should be required to include birth control in their health insurance coverage.
A new survey commissioned by the
John A. Hartford Foundation asks seniors about their experiences accessing care and their interactions with providers during health visits.