Category Archives: Health & Human Services

Humana to quit Obamacare exchanges in 2018, providing fuel for Trump’s ‘repeal’ efforts

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From Yahoo:  While Republicans continue to grapple with plans to repeal and replace Obamacare and stabilize health insurance rates, Humana (HUM) is the first major insurer to say it is dropping out of the individual market for 2018.

“Based on our initial analysis of data associated with the company’s health-care exchange membership following the 2017 open enrollment period, we continue to see further signs of an unbalanced risk pool,” said Humana CEO Bruce Broussard, on a conference call with analysts Tuesday. “Therefore, the company has decided that it cannot continue to offer this coverage for 2018.”

In the wake of the news, President Donald Trump tweeted that the insurer’s decision was another example of the failure of the Affordable Care Act, and he reiterated his plan to “repeal, replace & save healthcare for ALL Americans.”

The health insurer made the announcement with its earnings update, following the mutual termination of its $34 billion merger agreement with Aetna (AET) earlier in the day. The two insurers agreed to part ways , after a federal court judge blocked the deal on antitrust grounds.

Humana now expects to earn $10.80 to $11.00 per share for 2017, excluding anticipated losses on its exchange business.

Humana cut back its Affordable Care Act exchange participation to 11 states last July, when the Department Of Justice sued to block its deal with Aetna. The insurer said that despite efforts to mitigate losses on its exchange plans in 2017 through narrower networks and selective market participation, it is seeing early signs of high pharmacy utilization among its new members.

Right now, the insurer estimated that it will lose a modest $45 million on ACA exchange plans, but it cautioned that this is an early estimate and “a number… that we’re going to have to evaluate.”

Other health insurers have threatened to pull out of the individual market if there is no clarity from Capitol Hill or Trump’s health officials on stabilizing the markets, but Humana is the first to say that it will pull out altogether.

Leading up to 2017 open enrollment, the exchange markets experienced tremendous turbulence last year, after most major insurers, including Humana, cut back on participation after suffering big losses on exchange plans.

Humana is a leading Medicare Advantage plan provider, and executives said that they don’t believe that they can achieve the same kind of health-care models on the Obamacare exchanges that they achieve with health plans for seniors.

The company does not hold out hope for more detail on Republican “repeal and replace” plans in the near term.

“We’re really feeling that this organization needs to stay focused on what we do well,” Broussard said, and the company can’t do that with Obamacare plans. “I think with that particular program, the way it is designed today and most likely the way it is designed in the future, will limit our ability… to get back into that marketplace.”

DCG

 

 

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NY gov requires insurance companies to cover contraception

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From Fox News: New York governor Andrew Cuomo said Saturday said he was requiring health insurance companies to cover medically necessary abortions and most forms of contraception at no cost to women, a move that further protects and safeguards coverage under the federal Affordable Care Act.

The state department of financial services is mandating that health insurers in New York provide for at least one form of FDA-approved contraception exceeding a month’s supply at a time. And women must be provided medically necessary abortions without co-pays or deductibles.

President Donald Trump and Republican members of Congress have said they will repeal the health care act as soon as possible, and that is why New York must act fast to ensure women’s access to coverage and care, Cuomo said.

“These regulatory actions will help ensure that whatever happens at the federal level, women in our state will have cost-free access to reproductive health care and we hope these actions serve as a model for equality across the nation,” Cuomo said. “Women deserve to make a fair wage and the same salary as any man, they deserve to work in an office free of sexual harassment, they deserve comprehensive paid family leave, and they deserve control over their health and reproductive decisions.”

The regulations go a step further to ensure insurance companies can’t skirt laws in any way to deny coverage. Insurance companies would face steep fines if found to be violating the mandate.

DCG

Hollyweird libtard tweets sick joke about abortion

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A serious case of TARD: Michael Ian Black

Michael Ian black is an American comedian (which I’m sure will probably enable him to use the “it was a joke” non-apology for his tweet, if his PR agent deems it necessary), actor, writer and director. Yesterday he tweeted the following:

“Not a recommendation to the Republicans trying to replace Obamacare, but aborted babies are A LOT cheaper than babies carried to term.”

All because he’s got butt hurt about the republicans trying to repeal Obamacare, which he’ll never have to purchase in his life seeing that his net worth is $1.5 million.

Ugly man, inside and out.

h/t Twitchy

DCG

U.S. judge blocks transgender, abortion-related Obamacare protections

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U.S. District Judge Reed O’Connor

From Yahoo: A federal judge in Texas on Saturday issued a court order barring enforcement of an Obama administration policy seeking to extend anti-discrimination protections under the Affordable Care Act to transgender health and abortion-related services.

The decision sides with Texas, seven other states and three Christian-affiliated healthcare groups challenging a rule that, according to the judge, defines sex bias to include “discrimination on the basis of gender identity and termination of pregnancy.”

In granting an injunction one day before the new policy was to take effect, U.S. District Judge Reed O’Connor held that it violates the Administrative Procedure Act, a federal law governing rule-making practices.

The judge also ruled that plaintiffs were likely to prevail in court on their claim that the new policy infringes on the rights of private healthcare providers under the Religious Freedom Restoration Act.

As explained in O’Connor’s 46-page opinion, the plaintiffs argued that the new regulation would “require them to perform and provide insurance coverage for gender transitions and abortions, regardless of their contrary religious beliefs or medical judgment.”

The same judge issued a similar court order in August blocking a separate Obama administration policy that would have required public schools, over the objections of 13 states, to allow transgender students to use restrooms of their choice.

It was not immediately clear whether the Obama administration, which has just 20 days left in office, would seek to appeal the latest injunction.

White House spokeswoman Katie Hill decried the ruling. “Today’s decision is a setback, but hopefully a temporary one, since all Americans – regardless of their sex, gender identity or sexual orientation – should have access to quality, affordable health care free from discrimination,” she said.

The Affordable Care Act (ACA), also known as Obamacare, was passed in 2010 with an anti-discrimination section designed to prevent insurers from charging customers more or denying coverage based on age, race, national origin, disability or sex.

The rule in dispute on Saturday was adopted by the U.S. Health and Human Services (HHS) Department to implement those provisions, including definitions for sex discrimination that encompassed transgender and abortion services.

According to the court opinion, gender identity was defined under that rule as “an individual’s internal sense of gender, which may be male, female, neither, or a combination of male and female, and which may be different from an individual’s sex assigned at birth.”

The state of Texas has led a string of legal cases brought by Republican-controlled states contesting various social policies advanced by President Barack Obama, most notably his 2014 executive action to protect millions of immigrants in the United States illegally and give them work permits.

That plan, challenged by Texas and other states, has been barred by the courts. But the U.S. Supreme Court in 2012 and 2015 issued rulings that kept the Affordable Care Act, his top legislative achievement, intact.

DCG

Nearly half of Americans want to keep ObamaCare

I’ll bet that those in favor of Obamacare didn’t receive an 80 percent increase notice for their health care premiums for 2017.

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Via NY Post: Barely a quarter of Americans want ObamaCare completely dismantled, while nearly half want it kept as is — or even expanded, pollsters said Thursday.

In a post-election poll commissioned by the nonpartisan Kaiser Family Foundation, 26 percent of respondents said they want all of the Affordable Care Act repealed. Pollsters found that 19 percent of those surveyed said they like the status quo, and 30 percent want ObamaCare expanded.

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President-elect Donald Trump — who spent the campaign trashing ObamaCare and promising to repeal it — has already backtracked on that pledge.

Trump now says he wants to keep at least two major ObamaCare provisions — allowing children to remain on a parent’s plan until age 26, and barring insurers from denying coverage based on pre-existing conditions.

That approach seems to match with 17 percent of poll respondents, who want ObamaCare scaled back but not thrown out entirely.

Republican respondents, at a 52 percent clip, were strongly in favor of killing ObamaCare altogether, this poll found. But even that’s a shift down from 69 percent of GOP backers who said a month ago they wanted all of ObamaCare trashed.

This poll was conducted between Nov. 15 and 21 with a margin of error of plus or minus 3 percentage points.

DCG

Happy Halloween: I just received the worst trick ever…

My health insurance company sent my notice for my 2017 health care plan. Guess how much my premium is going up?

EIGHTY PERCENT. Yep. A big fat 80%. Fortunately, my deductible remains at $14,300 (obvious sarc).

Starting next year, my monthly plan will cost MORE than 50% of my take-home pay.

liar

And I’m not the only one facing this type of an increase.

Remember this at the polls on November 8th.

electionshaveconsequences

DCG

ObamaCare fallout: As premiums rise, so does cost to taxpayers

Going as planned.

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From Fox News: The Obama administration is trying to calm the panic over soaring ObamaCare premiums by pointing to subsidies many will receive to offset the cost — but analysts and GOP lawmakers counter that those subsidies nevertheless will stick taxpayers with a rising bill. 

With enrollment set to begin Nov. 1, the administration announced Monday that premiums are set rise an average of 25 percent across the 39 states served by the federally run online market. Some states, such as Arizona, will see premiums jump by as much as 116 percent.

Department of Health and Human Services officials are stressing that subsidies provided under the law, which are designed to rise alongside premiums, will insulate most customers from sticker shock.

But the rising cost of subsidies, which already totals tens of billions a year, would be passed on to the taxpayer.

“Taxpayers are already in for a lot,” Tom Miller, resident fellow at the American Enterprise Institute, told FoxNews.com. “The cost doesn’t go away, it just goes into someone else’s pocket.”

In a March report, the non-partisan Congressional Budget Office estimated that subsidies given to enrollees in 2016 would amount to $43 billion in 2016, and predicted the cost would rise to $106 billion by 2026. It also said that over 10 years, ObamaCare provisions would reduce the deficit thanks to tax provisions and cuts to Medicare. That was before the latest announcement by the administration. It’s unclear how exactly the looming premium hikes will affect that picture, though Republicans are now seeking new estimates.

Analysts say it’s safe to assume taxpayer costs will rise. Miller noted that HHS reported an average subsidy of $291 per month in 2016. A 25 percent increase in premiums would theoretically translate into an extra $73 per month, or about $870 a year per person.

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“If you assume conservatively that there’s 10 million people getting subsidies, that’s an extra $8.5 billion in extra costs taxpayers are getting hit by going into next year,” he said.

Other experts warned this is likely to continue as long as premiums keep rising. “Its real simple, premiums are going up and up, and subsidies are going to go up with them,” Douglas Holtz-Eakin, president of the American Action Forum and a former CBO director, told FoxNews.com.

The Department for Health and Human Services, when asked for comment by FoxNews.com, noted that the law’s coverage provisions are set to cost 28 percent less in 2019 than the CBO originally projected, amounting to about $49 billion less than originally predicted when the law was signed in 2010. A spokesman also said the same office predicted that repealing the law would increase the deficit by approximately $350 billion over 10 years.

Holtz-Eakin urged caution on the administration’s analysis. “It’s been a mixed pattern, because the enrollments haven’t been what they expected so it hasn’t been as big of an impact financially,” he said. “The bad news is that spending per person is much higher than anticipated due to subsidy increases because of premium hikes.”

Obama signs Obamacare bill

One of the biggest ObamaCare costs to taxpayers has been absorbed into the Medicaid budget, paid for by both state and federal governments. As a sweetener to get states to go along with the plan, the federal government offered to pick up the cost of expanding Medicaid eligibility up to 133 percent of the poverty line. That siphoned low income — and expensive – customers away from ObamaCare exchanges, seemingly contributing to its current solvency. But that cost – in the hundreds of billions — also is borne by taxpayers.

The CBO projected in 2013 that, in part due to ObamaCare, federal Medicaid spending would more than double over the next 10 years, topping $554 billion by 2023. State governments pay another $160 billion toward Medicaid. “Volume has been greater in Medicaid, and per person costs have been much higher than expected,” Edmund Haislmaier, senior fellow at the Heritage Foundation, told FoxNews.com.

Sensing a spike in taxpayer costs, the Republican-led House Committee on Energy and Commerce has written to the Centers for Medicare and Medicaid Services demanding how much taxpayer money will be spent subsidizing the cost of rising premiums.

“While the Administration continues to focus on premium ‘affordability,’ it ignores the undeniable fact that federal taxpayers are subsidizing these premium increases through tax credits,” the letter from Chairman Fred Upton, R-Mich., says. “The Committee is concerned that the federal taxpayer continues to bear the burden of subsidizing the growing cost of health care insurance.”

The committee is demanding estimates of the amount of money spent covering rising premiums by Nov. 7.

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DCG