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Healthcare reform news updates....

Updated: Oct 6, 2023

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Healthcare Reform News Updates

Health Insurance Topics:#OurCare Trumpcare Print September 13, 2019 News

📷Stay up-to-date on Healthcare Reform.

Below is a summary of recent events to help you stay current on healthcare reform news all in one place. To make your voice heard on these issues, visit, a non-partisan movement that lets you share your opinion on healthcare legislation with friends, family, and even Washington D.C.!

Healthcare Reform News Update for September 13, 2019

Massachusetts 2020 ACA Plan Premiums Will Increase 4%

Insurance coverage for 2020 Affordable Care Act plans in Massachusetts will rise an average of 4%, according to state officials.

The average unsubsidized silver plan premium for a 42-year-old resident will be $473 per month.

The Massachusetts Health Connector exchange will include nine insurance companies offering 56 different health plans for individuals and families.

Healthcare Reform News Update for September 11, 2019

Kaiser: MLR Rebates Will Reach a Record High in 2019

Health insurance companies will pay out a record-high total of $1.3 billion in medical loss ratio (MLR) rebates to 2019 Affordable Care Act plan enrollees, according to a new analysis from the Kaiser Family Foundation.

Insurer MLR payouts are as follows, according to the report:

$743.3 million in the individual market, an average of $270 per member$250 million in the small business market, an average of $1,180 per employer$284.1 million in the large business market, an average of $10,650 per employer

This is the largest MLR rebate total since the $1.1 billion payout in 2012.

The MLR limits the amount of premium costs insurers can spend on overhead expenses, such as administrative costs, marketing, and profit. Companies exceeding the limits must issue rebates to consumers in the form of premium credits or checks.

Report: Number of Privately Insured Americans Held Steady in 2018

The percentage of people covered by private health insurance remained statistically the same between 2017 and 2018, according to a new report from the U.S. Census Bureau.

In 2018, 67.3% of Americans purchased private health insurance plans through employers, directly from insurance companies, or through TRICARE. This is a 0.4% decrease from 2017.

The overall uninsured rate increased slightly from 7.9% to 8.5%, mostly due to a decrease in Medicaid participants.

Other findings include:

The percentage of people with Medicare coverage grew from 17.4% to 17.8%.The percentage of uninsured children increased from 4.9% to 5.5%.States with the largest percentage of uninsured residents were Texas (17.7%), Oklahoma (14.2%), Georgia (13.7%) and Florida (13%).

Healthcare Reform News Update for September 5, 2019

Minnesota Shortens ACA Enrollment Period for 2020

This year, Minnesotans will have 20 fewer days to enroll in individual health plans on MNsure, the state’s Affordable Care Act exchange. The enrollment period for 2020 plans will run from Nov. 1 to Dec. 23, with coverage beginning on Jan. 1.

In past years, residents could sign up for ACA plans in late December and early January for coverage that began on Feb. 1.

According to MNsure, the revised enrollment period will help ensure that consumers have coverage for the entire year in 2020.

Healthcare Reform News Update for August 30, 2019

Maine to Adopt State-Run ACA Exchange

Maine plans to create a state-run Affordable Care Act exchange beginning in 2021, Governor Janet Mills (D) announced Thursday.

The new state-based marketplace intends to use the federal government’s enrollment platform before moving to a fully state-run system. Legislation to authorize the exchange will be introduced next year.

The shift would give the state more control to help consumers and small employers, Mills says.

Trump Administration Rejects Idaho’s ACA Medicaid Expansion Request

Health and Human Services (HHS) denied Idaho’s Affordable Care Act waiver request to expand its Medicaid program.

HHS said the state’s waiver application was incomplete and did not demonstrate that the program would be cost neutral.

Governor Brad Little (R), who was “surprised and disappointed” by the decision, intends to resubmit the waiver with additional information.

Healthcare Reform News Update for August 28, 2019

Rhode Island Gains Approval for Reinsurance Program

Health and Human Services has approved Rhode Island’s Affordable Care Act waiver application to create a new reinsurance pool.

The program is expected to lower premiums for 2020 ACA health plans by 5.9% and increase enrollment by about 1 percent.

Healthcare Reform News Update for August 23, 2019

CMS Publishes ACA Plan Star Ratings

While some major plans ranked below the national average, over 63 percent of Affordable Care Act plans received above average star ratings in new data published by the Centers for Medicare and Medicaid Services,

The average rating for ACA plans in the five-star system was 3.8 stars. The percentage of plans in each ratings category are:

One star: 1.5 percentTwo stars: 3.6 percentThree stars: 36.2 percentFour stars: 45.1 percentFive stars: 18.5 percent

The ratings are based on 38 different measures, including medical care quality management, member experience, and plan administration.

ACA Helped Reduce Racial Coverage Gaps

The Affordable Care Act helped lower racial and ethnic disparities in insurance coverage, according to new analysis from Commonwealth Fund.

Between 2013 and 2017, the coverage gap between blacks and whites fell from 11 percentage points to 5.3. During the same period, the gap between Hispanics and non-Hispanic whites dropped from 25.4 percentage points to 16.6.

In states that implemented ACA Medicaid expansion, the coverage gap for Hispanics declined by over 18 percentage points. For states that did not expand the program, the gap was reduced by 6.9 percent.

Oscar Health Plans to Offer ACA Plans in Additional States for 2020

Oscar Health announced that it will offer Affordable Care Act plans in six new states and 12 new markets to in 2020.

New markets include:

Florida, including Miami, Tampa, Ocala, and DaytonaPhiladelphia, PADenver, CORichmond, VAAtlanta, GAKansas City, MI and KSHouston, TX

The company will also expand its services in Dallas-Fort Worth, TX and Western Michigan.

Plan details will be available after regulatory approval.

Healthcare Reform News Update for August 21, 2019

New Medicare Advantage Plan Launched for Chicago Area

Health2047 is launching a new Medicare Advantage plan in 2020 geared toward helping traditionally underserved seniors.

Zing Health, available in Cook County, will use local teams to coordinate with physicians and hospitals in order to help improve access to care.

Healthcare Reform News Update for August 20, 2019

CMS Announces Updates to Hospital Star Ratings for 2021

The way hospital star ratings are determined will change beginning in 2021, according to the Centers for Medicare and Medicaid Services.

The agency will finalize the changes after a public listening session and the formation of a technical expert panel.

In the meantime, CMS will refresh the ratings on the Hospital Compare website in early 2020 using the current methodology.

Alignment Healthcare to Expand Presence in California

Alignment Healthcare announced that its Medicare Advantage plans will be available in more California counties in 2020, doubling from eight to 16.

The company will increase its offerings from 10 health maintenance organization (HMO) plan to 22 HMO and preferred provider organization (PPO) plans.

Healthcare Reform News Update for August 16, 2019

2020 ACA Exchanges to Include CMS Star Quality Ratings

Plans sold on the 2020 Affordable Care Act exchange will display their quality star ratings to help improve transparency and quality, the Centers for Medicare and Medicaid announced yesterday.

The five-star system is based on enrollee opinions on in-network healthcare providers, the care they received, customer service, and overall experience with the health plan.

The national rollout of the quality star ratings comes after pilot programs in Virginia, Wisconsin, Michigan, Montana, and New Hampshire.

Study: Uninsured Rate Rose Between 2016-2017

Between 2016 and 2017, the uninsured rate rose for the first time since 2013, when the Affordable Care Act went into effect, with 700,000 people losing health coverage, according to a new study from The Urban Institute

The study shows that the uninsured rate fell every year between 2013 and 2016, with 18.5 million people gaining coverage. The uninsured rate then increased from 10% in 2016 to 10.2% in 2017. The increase was concentrated primarily in states that did not enact ACA Medicaid expansion.

Some of the findings:

The uninsured rate remained stable at 7.6% for Medicaid expansion states.The uninsured rate for the states that did not expand Medicaid increased from 13.7% to 14.3%.Coverage losses mostly affected non-Hispanic white people, black people, people with some college, and those living in the South and Midwest.

Healthcare Reform News Update for August 14, 2019

States See Increase in ACA Marketplace Insurers

The average number of state insurers on the Affordable Care Act marketplace is rising slightly from 3.5 this year to four in 2020, according to the Kaiser Family Foundation.

Greater stability in the ACA marketplace has enabled insurers to expand into new counties and/or new states for 2020 plans.

In California, 87% of enrollees will have three or more carriers to choose from for 2020 plans. Anthem Blue Cross, Blue Shield of California, and Chinese Community Health Plan are all expanding into new counties.Anthem will expand its coverage in Virginia.Centene will enter into new markets.Bright Health will expand into six additional states.Oscar will begin offering coverage in Colorado, Pennsylvania, Virginia, and additional areas in New York and Texas.

The following states will have eight or more insurers in 2020: California, Massachusetts, Michigan, New York, Ohio, Texas, and Wisconsin.

The states with only one insurer for 2020 are Alaska, Delaware, Mississippi, and Wyoming.

Healthcare Reform News Update for August 13, 2019

ACA Exchanges Lost 2.5 Million Unsubsidized Enrollees from 2016 to 2018

Unsubsidized Affordable Care Act exchange enrollees declined by 40 percent between 2016 and 2018, a loss of 2.5 million customers, according to a new report from the Centers for Medicare & Medicaid Services.

The loss of more than a million customers in 2017 and 1.2 million customers in 2018 corresponded to premium hikes of 21 percent and 26 percent, respectively, in those years.

The number of subsidized enrollees during the same period rose slightly with a 4 percent increase.

Healthcare Reform News Update for August 8, 2019

Medicare Will Cover CAR T-cell Cancer Therapy

Medicare will now cover CAR T-cell gene therapy when it is provided in healthcare facilities enrolled in the FDA risk evaluation and mitigation strategies program, according the Centers for Medicare & Medicaid Services.

These types of therapies use a patient’s own immune system to combat certain types of lymphoma and leukemia. CMS said it will also approve the therapy for additional uses when recommended by CMS-approved medical guidelines.

Healthcare Reform News Update for August 7, 2019

New Survey Shows Consumer Neutrality on Medicare for All Plans

Close to half of adults surveyed neither support nor oppose Medicare for All and other healthcare expansion proposals, according to a new study on consumer attitudes.

Urban Institute surveyed respondents on their opinions regarding access to care, costs, and other factors. The survey differs from other recent polls in that it offered respondents the option to remain neutral, instead of being forced into giving an opinion.

Some of the findings include:

40.7% of respondents neither support nor oppose Medicare for All.45% of respondents neither support nor oppose a public option plan.Young adults, nonwhite and Hispanic adults and those with low incomes were more likely to support than oppose Medicare for All. Those with higher incomes were more likely to oppose.29.8% of all respondents support Medicare for All.27.8% of all respondents oppose Medicare for All.Medicare for All Supporters list universal coverage and affordability as important factors influencing their support. Opponents list higher taxes, wait times, and quality of care as their top concerns.

Healthcare Reform News Update for August 1, 2019

Senate to Vote on ACA Waiver Requirements

Democratic senators will force a vote over the Trump administration’s decision to make it easier for states to apply for Affordable Care Act waivers.

The new rule gives states the ability to offer tax subsidies for plans that fall short of ACA requirements, including plans that fail to protect people with pre-existing conditions.

The resolution is not expected to pass the Republican-controlled Senate.

Colorado ACA Reinsurance Program Approved

The Centers for Medicare & Medicaid Services on Wednesday approved Colorado’s request to run an Affordable Car Act reinsurance program beginning next year.

The program is projected to increase 2020 enrollment by 3% and lower premiums by 16%.

Healthcare Reform News Update for July 31, 2019

2020 Medicare Part D Premiums Expected to Decrease

The Centers for Medicare & Medicaid Services has projected that premiums for 2020 Medicare Part D prescription drug plans will decline for the third year in a row.

The average Part D premiums will be $30 per month, which is 13.5% less than in 2017, according to a CMS press release issued Tuesday. The price reduction will save enrollees roughly $1.9 billion in premium costs.

CMS attributed several cost-cutting measures for the price reduction, including:

elimination of the “gag clause,”reducing out-of-pocket costs for biosimilar products, andrequiring explanation of benefit notices to include price increases and lower-cost therapeutic alternatives.

Pilot Program Enables Medicare Providers Access to Patient Claims Data

The Centers for Medicare & Medicaid Services is launching a new pilot program called Data at the Point of Care that gives healthcare providers direct access to claims data for their Medicare patients.

CMS’s Blue Button computer interface will help physicians and clinicians easily access and assess a patient’s medical history.

“This data gives them more information about their patients, so they are better able to impact their care, and it allows them to do the analysis about their patient population,” said CMS Administrator Seema Verma.

The pilot program is scheduled to begin in September. Medicare beneficiaries will be automatically included in the program unless they contact Medicare to opt out.

Healthcare Reform News Update for July 30, 2019

Latest Kaiser Poll Shows Bipartisan Support for ACA Provisions

A majority of Americans prefer that the Affordable Care Act’s provisions remain in place and that future healthcare measures build on the existing law, rather than be replaced with a Medicare for All plan, according to a new Kaiser Family Foundation poll.

A majority of both Republican and Democratic respondents believed that it’s “very important” to maintain key provisions of the ACA, including protections for people with pre-existing conditions and pregnant women, no-cost preventive services, no annual or lifetime limits, and keeping young adults on their parents’ plan up to age 26.

Among Democrats, 55% favor expanding the ACA, and 39% prefer a Medicare for All approach.

Support for Medicare for All plans decreased from April, with Democratic support slipping from 80% to 72%, and Republican support dropping from 27% to 15%.

Among Democrats, 55% favor expanding the ACA, and 39% prefer a Medicare for All approach.

Other findings include:

65% favor a public option plan that would compete with private health insurance plans. However, views shifted when presented with arguments both for and against the approach.83% have a favorable opinion of Medicare.76% have a favorable opinion of employer health plans.Medicare, Medicaid, and employer coverage are viewed more favorably than individual health plans. But a majority rate their own coverage positively, whether they have private or public coverage.

Trump Administration Rejects Utah’s Partial ACA Medicaid Expansion

The Centers for Medicare and Medicaid Services denied Utah’s request to partially expand its Medicaid program under the Affordable Care Act.

Under the ACA, residents earning 138% of the federal poverty level (FPL) are eligible for the program. Utah’s plan would expand Medicaid only to those making up to 100% of the FPL.

CMS said it does not plan to approve funding for any state that implements limited enrollment.

Healthcare Reform News Update for July 25, 2019

Bright Health Expands Into 13 New Markets for 2020

Bright Health announced that it will double its locations in 2020 by expanding into 13 new markets in seven states for Affordable Care Act health plans and Medicare Advantage plans.

If approved by regulators, the new markets will increase the company’s availability to a total of 22 markets in 12 states.

New Bright Health plan locations for ACA plans include:

Colorado: Summit CountyFlorida: Jacksonville, Orlando, Palm Beach, TampaNorth Carolina: Charlotte, Winston-SalemNebraska: StatewideOklahoma: Oklahoma CitySouth Carolina: Greenville

New Bright Health plan locations for Medicare Advantage plans include:

Florida: Orlando, Palm BeachIllinois: ChicagoNebraska: OmahaOhio: ClevelandSouth Carolina: GreenvilleTennessee: Memphis

Report: Medicare Could Save $57M By Providing Free Home-Delivered Meals

Medicare could save about $57 million per year by providing free meals to recently hospitalized seniors, according to a new report from the Bipartisan Policy Center.

By analyzing data from seniors with multiple chronic conditions, the study found that providing meals for one week after a hospitalization could prevent nearly 10,000 hospital readmissions every year.

The meals would cost approximately $101 million, but Medicare would save more than $158 million in payments for return hospital stays.

Currently, some Medicare Advantage plans cover meal-service delivery. The report recommends that lawmakers add the benefit to Original Medicare in limited circumstances.

Healthcare Reform News Update for July 24, 2019

Senate Committee Announces Plan to Overhaul Medicare Part D

The Senate Finance Committee announced its bipartisan legislation designed to lower drug costs.

The proposal, called The Prescription Drug Pricing Reduction Act, would overhaul Medicare Part D in significant ways, including:

Putting a cap on drug prices, which would keep drug makers from raising prices above the rate of inflation.Lowering the threshold that activates the catastrophic phase for Medicare Part D users from more than $8,000 to $3,100 by 2022.Revising the catastrophic coverage drug payment model so that insurance companies pay 60 percent of the costs, and the government and drug makers each pay 20 percent.

The proposal is projected to save Medicare beneficiaries $27 billion in out-of-pocket costs and $5 billion in premiums over 10 years.

Committee leaders Senators Chuck Grassley (R-IA) and Ron Wyden (D-OR) said that the committee plans to vote on the legislation on Thursday.

Healthcare Reform News Update for July 22, 2019

Federal Judge Backs Expansion of Short-Term Plans

A federal judge upheld the Trump administration’s expansion of short-term health insurance plans, which don’t meet Affordable Care Act standards.

U.S. District Judge Richard Leon said that extending the duration of the plans from three to 12 months with the ability to renew for up to 36 months would have minimal “potential negative impact” to enrollment in ACA plans.

The Association for Community Affiliated Plans argued against the extension and said it planned to appeal.

Healthcare Reform News Update for July 18, 2019

Coverage for Chronic Disease Treatments Expanded for High-Deductible Plans

The Trump administration announced new guidance, effective immediately, that gives chronically ill patients with high-deductible plans access to coverage for certain services before they meet their deductible amounts.

The Internal Revenue Service, Treasury Department, and Health and Human Services reclassified 14 services as preventive treatments for conditions such as asthma, congestive heart failure, and diabetes. Some of the services patients can now access without a deductible include insulin, glucometers, inhalers, blood pressure monitors, beta-blockers, statins, and antidepressants.

The guidance was in response to an executive order from President Donald Trump to expand the use of health savings accounts paired with high-deductible plans to fund care for the chronically ill.

Premiums for Michigan 2020 ACA Plans Are Expected to Drop

Proposed rates for 2020 Affordable Care Act plans in Michigan will drop. This is a reversal from the rate increases insurance companies have requested in past years.

Only two of the state’s nine ACA insurers requested rate hikes. Molina Healthcare requested the largest decrease of almost 9 percent.

ACA insurer rate decrease requests include:

Molina Healthcare: -8.8%Blue Cross Blue Shield: -7.7%McLaren Health Plan: -5.9%Meridian Health Plan: -3.6%Blue Care Network: -1.2%Total Health Care USA: -0.6%Priority Health: -0.1%

ACA insurer rate increase requests include:

Physicians Health Plan: 0.6% increaseOscar Insurance: 8.3% increase

Oscar Health Will Offer Medicare Advantage Plans

Oscar Health announced Wednesday that it will enter the Medicare Advantage market in 2020 with plans available in New York City and Houston.

In New York, the company is offering plans in partnership with Montefiore Health System. In Houston, the company is pairing with several regional providers including Houston Methodist, HCA Houston Healthcare, and St. Joseph Medical Center.

Pending approval by regulators, the plans will be available during Open Enrollment this fall.

Healthcare Reform News Update for July 17, 2019

House Will Vote to Repeal ACA’s Cadillac Tax

The U.S. House of Representatives is expected to pass a bill today that will repeal the Affordable Care Act’s never-implemented “Cadillac tax” on high-cost employer-sponsored health plans.

The measure imposes a 40% excise tax on plans that exceed $11,200 for individuals and $30,150 for families. It’s currently scheduled to begin in 2022.

The bill is sponsored by Representative Joe Courtney (D-CT) and 367 co-sponsors. The Senate’s companion bill, the Middle Class Health Benefits Tax Repeal Act of 2019, has 42 signers.

Surprise Billing Proposal Could Save More Than $7B

Legislation in the Senate to eliminate surprise medical bills would save the federal government $7.6 billion over 10 years, according to the Congressional Budget Office.

The CBO projects that the proposal would increase spending by $18.7 billion and raise revenue by $26.2 billion. Savings would come from tax subsidies paid out for Affordable Care Act plans and a 1% reduction in employer plan premiums.

Details of surprise billing legislation are still being deliberated in House and Senate committees.

Healthcare Reform News Update for July 16, 2019

Medicare Considering Covering Acupuncture for Back Pain

A new Medicare proposal would cover acupuncture for beneficiaries with chronic low-back pain as an alternative to opioid treatments, which can become addictive.

Health and Human Services Secretary Alex Azar announced Monday that the coverage would apply only to patients enrolled in clinical trials or other CMS-approved studies. The agency would then use results of those trials to determine further acupuncture coverage options.

CMS is gathering public input before finalizing the proposal.

Healthcare Reform News Update for July 15, 2019

Appeals Court Blocks Trump Administration’s Exemptions to ACA Contraception Rules

The 3rd U.S. Circuit Court of Appeals upheld a decision to block the Trump administration from “allowing employers with moral and religious objections” to deny birth control coverage mandated by the Affordable Care Act.

The ACA requires that employer-sponsored health plans include birth control coverage with no copays. In 2017, President Trump signed an executive order encouraging federal agencies to expand “conscience-based objections” to the mandate.

The panel of three judges sided with Democratic state attorneys general from Pennsylvania and New Jersey who argued that the new exemption rules contained “serious substantive problems.”

Connecticut ACA Insurers Propose Rate Increases for 2020 Plans

Anthem and ConnectiCare, the two insurance companies on Connecticut’s state healthcare exchange, have proposed premium increases for individual Affordable Care Act plans in 2020.

Anthem has requested an average 15.2 percent rate increase for individual plans sold on and off the exchange and an average 14.8 percent rate increase for small group health plans.

ConnectiCare requested a 4.9 percent rate increase for individual plans sold on and off the exchange.

The companies attributed rising healthcare costs, the aging population, and the newly reinstated Health Insurance Tax (HIT) as factors in their proposals.

Healthcare Reform News Update for July 12, 2019

Cancer Patients Face Substantial Financial Burden

A recent study from the Centers for Disease Control and Prevention shows that the annual out-of-pocket expenses for cancer survivors is increasing with 25 percent experiencing problems paying their bills and 34 percent worried about their costs.

Average out-of-pocket spending for cancer survivors is $1,000 per year compared to $622 per year for people who’ve never had cancer. And those costs are growing. Even with health insurance in place, cancer patients incur an additional financial burden from  things such as traveling to treatment and being away from work.

Other findings from the study:

Out-of-pocket expenses were highest among cancer survivors ages 18-64 and those who were unemployed.Cancer survivors ages 40-49 reported the highest percentage of “material or psychological financial hardship.”A higher percentage of minority racial/ethnic cancer survivors reported “material or psychological financial hardship.”“Cancer survivors [are] more likely to be older, female, non-Hispanic white, married, privately insured,” full-time employees, more educated, and have more chronic conditions compared to people who’ve never had cancer.

Narrow Medicare Advantage Networks Limit Access for Some Enrollees

Finding a doctor in a Medicare Advantage (MA) plan network can be difficult for many enrollees, especially if they live in rural areas.

Government audits have found that nearly half of the entries in MA directories had incorrect addresses, phone numbers, or doctors who were not accepting new patients. The American Journal of Managed Care found that a Google search for participating doctors could be more accurate than using a plan’s directory.

A Kaiser Family Foundation study from 2017 found that MA plans included “46 percent of all physicians in a county, on average.” Access to psychiatrists is the most restricted, with 23 percent in a county’s plan on average, followed by cardiothoracic surgeons, neurosurgeons, plastic surgeons, and radiation oncologists.

Rural beneficiaries can be especially burdened by narrow MA networks. A study of California MA plans showed that some enrollees in rural areas lived over 100 miles from in-network specialists.

Healthcare Reform News Update for July 10, 2019

Appeals Judges Question Validity of ACA’s Individual Mandate

A panel of three federal appeals court judges pressed the state attorneys general defending the Affordable Care Act on Tuesday over whether the law remains constitutional without its individual mandate penalty.

In the two hours of oral arguments, two Republican-appointed judges appeared skeptical about the constitutionality of the individual mandate. Judge Kurt Engelhardt suggested that severing the tax penalty from the ACA should be the job of Congress rather than the courts.

The two judges also questioned whether either side of the lawsuit had any legal standing to initially challenge the ACA or appeal the lower-court’s decision.

Carolyn Dineen King, the only Democratic-appointed judge, did not ask questions during the hearing.

The judges did not indicate when they would issue their ruling, but it is expected in the coming months.

California 2020 ACA Premiums Show Record Low Increases

Proposed premium increases for 2020 ACA plans in California are the lowest in the state exchange’s history, with an average hike of 0.8%, officials said. That’s down from an average increase of nearly 9% for 2019 plans and a five-year average increase of 8.4%.

Proposed bronze plan rates will increase an average of 5.7%, and silver plans will decrease an average of 4.3%.

Covered California Executive Director Peter Lee said the rate stabilizations were due to new state-funded tax credits to middle-class enrollees and a new state penalty imposed on uninsured residents.

All of the state’s 11 ACA insurers will return for 2020, and Anthem Blue Cross will expand into the Central Coast, parts of the Central Valley, Los Angeles County and the Inland Empire.

Minnesota 2020 ACA Premiums Show Modest Increase

Proposed 2020 ACA premiums in Minnesota show only slight increases compared to this year’s rates.

Proposed average individual rate changes for the state’s four ACA insurers are as follows:

Medica: down 1.4%UCare: up 0.3%HealthPartners: up 2.1%Blue Cross HMO: up 4.8%

In the state’s small group market, the proposed rate increases were between 3 and 6%.

Final rates are scheduled to be released in early October.

Healthcare Reform News Update for July 9, 2019

Federal Appeals Court Hearing on ACA Constitutionality Begins Today

The 5th U.S. Circuit Court of Appeals will hear oral arguments today on whether a lower court ruling that declared the Affordable Care Act unconstitutional should be overturned.

The ACA is being challenged by 18 Republican-led states. The three-judge panel will also decide whether the coalition of Democratic states and the U.S. House of Representatives have standing to intervene in the case after the Trump administration declined to defend the health law.

It’s unclear when the panel will make its ruling. However, it’s expected that the case will ultimately be decided by the Supreme Court.

Connecticut Enacts Mental Health Parity Bill

Connecticut Governor Ned Lamont signed a bill into law that will require insurance providers to submit annual reports to state insurance commissioners, detailing their coverage of mental health and substance abuse services.

The new law intends to hold insurers accountable for complying with state and federal laws that mandate equal access to mental and physical health services.

Healthcare Reform News Update for July 8, 2019

Medicare Coverage Expanded for Blood Pressure Monitoring Devices

The Centers for Medicare & Medicaid Services (CMS) has extended coverage of Ambulatory Blood Pressure Monitoring (ABPM) devices to Medicare beneficiaries who have suspected abnormal low blood pressure readings while in a doctor’s office.

Previously, Medicare covered ABPM devices only for patients with suspected “white coat hypertension,” which occurs when a patient’s blood pressure is elevated due to anxiety associated with a clinical setting. The 24-hour monitoring device is now also approved for “masked hypertension,” the inverse of “white coat hypertension,” which causes patients to have lower-than-normal blood pressure readings while in a clinical setting.

The new rule also lowers the definition of hypertension from a reading of 140/90 to 130/80 “to align with the latest society recommendations regarding the diagnostic criteria.”

Healthcare Reform News Update for July 3, 2019

Federal Appeals Court Denies ACA Lawsuit Postponement

The 5th U.S. Circuit Court of Appeals rejected a request from Republican state attorneys general to delay oral arguments in the case to strike down the Affordable Care Act.

The lawyers had asked for a 20-day delay to file briefs relating to questions on whether the Democratic-led states defending the ACA have legal standing to intervene. The court allowed a two-day delay and will hear the case July 9 as scheduled.

Pennsylvania Will Switch to State-based ACA Exchange for 2021 Plans

Pennsylvania Governor Tom Wolf signed legislation Tuesday implementing a state-based Affordable Care Act exchange that’s expected to begin with next year’s Open Enrollment for 2021 plans.

The law also includes a new state reinsurance fund, which could help reduce premiums by as much as 10 percent, state officials say.

The Department of Health and Human Services must approve the law before it can be enacted.

Poll: Majority Support Medicare for All if Healthcare Providers Remain

A majority of voters would back a Medicare for All plan if they could keep their preferred doctors and hospitals, according to a new Morning Consult/Politico survey.

Of those surveyed, 55% of respondents backed a single-payer system that would reduce the role of private insurance companies but allow them to keep their healthcare providers.

But 46% were in favor when told the role of private insurers would be reduced, and 53% approved when not given any specifics about insurers or doctors.

The poll found that general support for a Medicare for All system comes from 77% of Democrats, 27% of Republicans and 50% of Independents.

Healthcare Reform News Update for June 27, 2019

Court Questions Democrats’ Right to Defend ACA

The U.S. Court of Appeals for the 5th Circuit has asked whether the Democrat-led House of Representatives or Democratic states have the legal right to appeal the ruling that struck down the Affordable Care Act.

It’s possible that the panel could toss out the appeal on procedural grounds if it decides that the opposing side does not have the authority to appeal U.S. District Judge Reed O’Connor’s decision to declare the ACA unconstitutional.

A three-judge panel requested that both sides of the lawsuit provide written arguments. Oral arguments will begin on July 9.

Senate Committee Approves Surprise Billing Package

The Senate health committee approved its healthcare package, called the Lower Health Care Costs Act, which includes a cap on how much providers can bill for out-of-network care.

Before approval, an amendment was added to the legislation. The change requires insurers to reveal all physicians and hospitals in their networks so patients can see all available options before choosing a plan.

Committee Chairman Lamar Alexander (R-TN) said that the bill will likely have more revisions before a vote in August.

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