Affordable Care Act

How Iowa Farmer Bureau Designed Less Costly Association Health Plans

by Kelsey Waddill

The Iowa Farm Bureau Federation’s Farm Bureau Health Plan was designed to help unsubsidized Iowans afford a health plan and represents the controversy surrounding association health...

Payers Drive Patient Navigation, Education to Cut Uninsurance

by Kelsey Waddill

Health Care Service Corporation (HCSC) seeks to address uninsurance in the US by developing an education and patient navigation campaign, known as Be Covered, to inform the uninsured of their health...

Verma Testifies to House on ACA Repeal, ACA Replacement Unknown

by Kelsey Waddill

When the House Committee on Energy and Commerce brought in CMS Administrator Seema Verma to testify regarding the White House’s attempts to repeal the Affordable Care Act, the hearing covered...

ACA Enrollment Has New Star Ratings, Enhanced Direct Enrollment

by Kelsey Waddill

In 2020, the Affordable Care Act (ACA) enrollment process will feature quality star ratings, Enhanced Direct Enrollment (EDE), health reimbursement accounts (HRAs) resources, and a more...

Managed Care Organizations Show How Public Option May Lower Premiums

by Kelsey Waddill

Introducing a public option could encourage commercial payers to lower their premiums, a trend reflected in increased competition from Medicaid managed care organizations, researchers from the Urban...

ACA Premiums Will Fall 4% and 20 Payers Join Marketplace in 2020

by Kelsey Waddill

The average premium on Healthcare.gov dropped for a second consecutive year, down by four percent, CMS announced. Delaware saw the highest Healthcare.gov premium decline, where the premium for a...

Oscar Appeals Dismissal of Anti-Trust Lawsuit Against Florida Blue

by Kelsey Waddill

Oscar Insurance Company of Florida (Oscar) has appealed the federal court’s dismissal of the company’s anti-trust lawsuit against Florida Blue, the company announced in an emailed...

Healthcare Coverage Informs Job Decisions For 50% of Americans

by Kelsey Waddill

The fear of having no healthcare coverage drives Americans’ decisions regarding employment, according to a recent study by the TransAmerica Center for Health Studies. The study surveyed 3,760...

UHC Medicare Plan Suspended for Failing to Meet Medical Loss Ratio

by Kelsey Waddill

In a letter released on September 11, CMS informed UnitedHealthcare that its Medicare contract H5322 through Care Improvement Plus failed to meet its medical loss ratio requirement for the third year...

NJ Prepares for Consumer Activity on State-Based Exchanges

by Kelsey Waddill

The New Jersey Department of Banking and Insurance announced that it will offer $2 million for health navigators to help enrollees and re-enrollees with the transition from a federal-facilitated...

Members with Pre-Existing Conditions May Be Impacted by ACA Debate

by Kelsey Waddill

If the Affordable Care Act (ACA) was not in effect in 2018, 45 percent of families would have one non-elderly adult with a pre-existing condition for which they might be declined from healthcare...

More Payers Will Join ACA Health Insurance Marketplace In 2020

by Kelsey Waddill

After seven years of instability and decreasing involvement from payers, the Affordable Care Act exchanges, or the federal health insurance marketplace, will expand in 2020, the Robert Wood Johnson...

Health Insurance Tax May Rise $1.2 Billion Due to New CMS Payment Rule

by Kelsey Waddill

The health insurance tax, mandated in the Affordable Care Act, will be back in effect in 2020 and is set to generate $15.5 billion in taxes due to CMS’s new 2020 payment rule. “This new...

Uninsurance Rises to 8.5%, First Major Increase Since ACA Passed

by Kelsey Waddill

In 2018, 8.5 percent of the nation did not have health insurance coverage at any point during the year, the Census Bureau’s report revealed, arguably the first rise in the uninsurance rate since...

Individual Insurance Market Vaults Rebates to Historic $1.3 Billion

by Kelsey Waddill

Healthcare payers will be paying back $1.3 billion in rebates to consumers, and the individual health insurance market played a significant role, a study by the Kaiser Family Foundation (KFF)...

Anthem Faces Challenges in GA with Contract Dispute, New Partnership

by Kelsey Waddill

Anthem is preparing its members in the event that its contract with Northeast Georgia Health Systems (NGHS) ends this month, while it faces potential challenges over its new partnership with the...

Medicare Advantage Payment Cuts Did Not Affect Member Care Access

by Kelsey Waddill

Contrary to the negative predictions, Medicare Advantage beneficiaries’ access to care and health plan affordability did not change between 2009 to 2017, according to a recent study published in...

Digital Payments May Help Individual Market Premium Collections

by Kelsey Waddill

Only half of individual health insurance market members pay their premium bill on time, potentially pointing health plans toward digital payment tools for premium collections, finds a recent Aite Group...

Uninsurance Rate Rises as More Attain Employer-Sponsored Coverage

by Kelsey Waddill

Between 2016 to 2017, 700,000 more individuals became uninsured, a recent study by the Robert Wood Johnson (RWJ) Foundation found. This rise in uninsurance comes at a time when the economy is thriving,...

Off-Exchange Individual Health Plans Have Highest Disenrollment

by Kelsey Waddill

The individual health insurance market decreased another five percent in the beginning of 2019 following the individual mandate repeal, the Kaiser Family Foundation (KFF) reported. After the enactment...