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Report finds state differences in EHBs

Posted on October 23, 2014

A new report from University of Pennsylvania researchers, funded by the Robert Wood Johnson Foundation, finds that significant state variation exists in the Affordable Care Act (ACA) essential health benefits (EHB), which insurers must cover to offer plans on the exchanges. 45 states consider chiropractic care an EHB, 26 states include autism spectrum disorder services in their EHB package, and only five states considered weight loss programs and acupuncture as EHBs. The report states that the variation in EHB requirements is mostly a result of allowing states to determine their own essential health benefit package by using a “benchmark plan” already offered in the state as a model.

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Survey assesses impact of high deductibles

Posted on October 14, 2014

A new poll conducted by the The Associated Press and the NORC Center for Public Affairs Research suggests that high deductibles remain a significant barrier to health care for many privately insured Americans. The survey finds that of privately insured adults under age 64, about one in five said they don’t go to a doctor when they are sick despite having health coverage. A similar number of survey respondents reported going without preventive care and cutting back on retirement savings, or having to use all their savings for care. These issues were particularly acute among the 26 percent of respondents with high deductible plans. Consequently, about half of those surveyed said they preferred higher premiums over higher out-of-pocket costs.

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Georgetown releases report on post-ACA network design

Posted on September 23, 2014

Researchers at Georgetown University’s Center on Health Insurance Reforms (CHIR) conducted a six-state case study to assess changes in the network design of plans offered through the health insurance marketplaces, as well as the response of state officials in the face of consumer and provider concerns. The report finds that insurers have narrowed their networks, relative to what they offered in the past, however states and insurers reported few consumer complaints about the ability to obtain medically necessary care in-network. Most of the study states are unlikely to take action to change their standards for network adequacy, however, half of the states studied will require insurers to provide better, up-to-date provider directories, so that consumers can better understand which providers are in which plan networks before they buy.

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GAO report finds insurers aren’t separating abortion funds

Posted on September 17, 2014

A new Government Accountability Office (GAO) report found that 15 insurers in a sample of 18 are selling Affordable Care Act (ACA) plans that do not segregate funds to cover abortion from their ACA subsidies, despite the ACA requirement  that insurers collect separate payments from customers for abortion coverage. The report was commissioned by House Republican leadership amid concerns that  customers were able to use federal health care subsidies on insurance policies that cover abortion procedures. However, about half of the states have passed laws forbidding exchange plans from covering abortion at all, so this issue may not be nationally pervasive.

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KFF releases 2014 Employer Health Benefits Survey

Posted on September 10, 2014

The Kaiser Family Foundation (KFF) released its annual Employer Health Benefits Survey, which provides a snapshot of health coverage in the workplace. The 2014 survey results show that annual premiums for employer-sponsored family health coverage are up 3 percent from last year, continuing a recent trend of moderate premium growth.  Premiums increased more slowly over the past five years than the preceding five years (26 percent vs. 34 percent) and well below the annual double-digit increases recorded in the late 1990s and early 2000s. This year’s increase also is similar to the year-to-year rise in worker’s wages and general inflation.

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Studies examine insurance rates of children and parents under the ACA

Posted on September 10, 2014

Two studies by the Urban Institute show that the provisions of the Affordable Care Act (ACA) have in many cases helped to insure more parents, but have not been as successful at increasing coverage for their children. The studies found that nationally, between September 2013 and June 2014, the estimated uninsured rate for parents fell 2.4 percentage points from 16.7 percent to 14.3 percent. However, for the same time period, no statistically significant change was found in the estimated uninsured rate for children under age 17. Additionally, findings suggest that the majority of uninsured children are eligible for Medicaid or the Children’s Health Insurance Program (CHIP)  but are not yet enrolled. The implications of these studies could be important as Congress considers whether to reauthorize funding for CHIP beyond 2016.

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CAP proposes model to control health care costs

Posted on September 8, 2014

The Center for American Progress released a report proposing an approach known as the “Accountable Care States” in order to control health care costs. The model will keep costs down by giving states flexibility and incentives to control costs. A state that designates itself an Accountable Care State will be accountable for health care costs, quality of care, and access to care with sizable financial rewards for keeping overall costs low. Using Congressional Budget Office (CBO) data, the report estimates that if half of the states participate, the Accountable Care States model would yield $1.7 trillion in savings on total health care spending over 10 years.

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OIG releases report on federal exchange contracts

Posted on August 26, 2014

The US Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a report which provides an overview of the contracts that contributed to the development of the Federal Marketplace. The Centers for Medicare and Medicaid Services (CMS) relied, and continues to rely, extensively on contractors to operate the Federal Marketplace under the Affordable Care Act (ACA). The report analyzes the planning, acquisition, management, and performance oversight of these contracts, but does not make recommendations.

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CBPP releases report on alternative Medicaid expansion approaches

Posted on August 22, 2014

The Center on Budget and Policy Priorities (CBPP) released a report to help state policymakers design waiver proposals for alternative approaches to expanding Medicaid. Arkansas, Iowa, and Michigan have all been granted waivers by the federal government to expand their Medicaid programs through alternative methods. The report outlines what federal officials have previously permitted and refused to help newly interested  states successfully obtain a waiver.

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Study finds less market competition contributes to higher premiums

Posted on August 13, 2014

A study by the Urban Institute analyzed marketplaces in 10 states finding that in states largely dominated by one insurer, such as Alabama, Arkansas, Rhode Island and West Virginia, premiums are generally higher. In the more competitive markets- Colorado, Maryland, Massachusetts, New York, Oregon, and Virginia, the authors often found limited provider networks, which allows insurers to keep premiums low. However, these limited networks may hinder access to certain providers

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