ACA Affordable Care Act

Anthem Leaves Ohio ACA Exchange

Anthem has announced that it will pull out of Ohio’s Affordable Care Act (ACA) individual insurance marketplace for the 2018 plan year.

FY 2018 Budget Released

The White House has released its budget proposal for fiscal year (FY) 2018 and presented it to Congress. Totaling at $4.1 trillion, the proposal requests $69 billion in discretionary budget authority and $1,046 billion in mandatory funding to help the Department of Health and Human Services (HHS).

WI – State Seeks CMS’ Permission to Implement Medicaid Eligibility Limit

Wisconsin has announced plans to seek federal approval to implement eligibility and other changes to its Medicaid program. According to the waiver summary, Wisconsin plans to submit an application to amend its Medicaid demonstration that would enable the state to impose monthly premiums for beneficiaries with incomes above 20% of federal poverty level, ranging from $1 to $10 per household based on household income.

CT – State Insurers Request Rate Increases on Individual and Group Plans

Health insurers in Connecticut have submitted health insurance rate request individual and small group plans in 2018. A total of 10 health insurance companies have made 14 filings on individual and small group plans that provide coverage to approximately 270,000 people in the state. The average rate requests range from 3.6% to 33.8%.

UnitedHealth Announces Plans to Shut Down Free-of-Charge Primary Care Startup

UnitedHealth Group has announced plans to shut down its subsidiary insurance startup which offered unlimited primary and behavioral care at no charge.

Aetna to Exit all ACA Insurance Marketplaces in 2018

Aetna has announced plans completely withdraw from the ACA insurance exchanges for 2018, citing financial losses as the deciding factor, specifically its individual commercial products lost nearly $700 million between 2014 and 2016 and could lose another $200 million this year.

CMS Announces Change Intended to Streamline Exchange Plan Enrollment

CMS has released guidance stating that it will no longer require U.S. residents enrolling in exchange plans via a direct enrollment pathway to complete the enrollment process on HealthCare.gov.

American Health Care Act (AHCA) Passes House, Advances to Senate

The American Health Care Act passed the House of Representatives by 217-213 on May 4.

CMS Releases Final Market Stabilization Rule

CMS published a final rule intended to help improve the risk pool and stabilize the Affordable Care Act insurance exchanges for 2018. Under the final rule, the 2018 open enrollment period for the individual market is shortened from three months to six-weeks.

CMS Issues Final Rule for Insurers in ACA Market

CMS has issued the final market stabilization rule for insurers in the Affordable Care Act market that includes a shortening the open enrollment period for 2018.

Uninsured Rate Swells to 11.3% in Q1

Gallup-Healthways Well-Being Index poll shows uninsured rate increased to 11.3% in the first quarter of 2017 from a record low of 10.9% in the last half of 2016.

Study Finds Federal Funding Shields State Budgets from Medicaid Expansion Costs

A new study has found that Medicaid expansion led to an 11.7% increase in overall spending on Medicaid, which was accompanied by a 12.2% increase in spending from federal funds. No significant increases were observed regarding spending from state funds from the expansion, nor any significant reductions in spending on education or other programs.

Unitedhealth Posts Strong Earnings Growth in First Quarter

United Healthcare reported first-quarter revenues of $48.7 billion – a 9.4% year-over-year increase from last year. The insurer says that due to 3% insurance tax in Affordable Care Act, plan premiums will likely rise in 2018.

PA – CMS Announces $10M for State’s Medicare Rural Health Model

CMS has granted the Pennsylvania Department of Health $10 million in startup funds to set up its new alternative payment model for Medicare in rural hospitals. The model will be tested over seven years, four of which will be partially funded by CMS.

FL – House Pulls Back from Medicaid Premiums Proposal

The Florida House opted to back away from a wide-ranging Medicaid bill proposal that sought to require Medicaid beneficiaries to pay monthly premiums.

FL – House, Senate Subcommittees Propose Medicaid Cuts in Budget Drafts

Florida’s House and Senate budget proposal recommends cuts to the state’s share of Medicaid by $238.6 million drafts. Under the proposed budget, Florida hospitals would see a 7% decrease in the Medicaid reimbursement rate, as well as a decrease in federal matching funds.