Policy and Regulation

2017 ACA Open Enrollment Data Shows 12.2M Marketplace Signups

by Thomas Beaton

During the 2017 ACA Open Enrollment Period (OEP), more than 12.2 million healthcare consumers purchased or renewed insurance through Healthcare.gov or their local state exchanges, said CMS in a new...

Tom Price: American Health Care Act CBO Score is Inaccurate

by Thomas Beaton

HHS Secretary Tom Price, MD, released a statement that decried several findings from the Congressional Budget Office’s (CBO) score of the American Health Care Act (AHCA). The CBO estimates that...

CBO Score Confirms Industry’s American Health Care Act Concerns

by Thomas Beaton

After the Congressional Budget Office released their cost estimate on the American Health Care Act (AHCA) several healthcare industry leadership groups reaffirmed their concerns about the bill, which...

Industry Groups Express Concerns Over Proposed ACA Repeal Bills

by Jacqueline LaPointe

Earlier this week, House Republicans started a potential Affordable Care Act repeal by introducing the American Health Care Act. But some industry groups recently expressed concerns that the...

HHS Secretary Price Voices Support for House ACA Repeal

by Thomas Beaton

The Secretary of the Department of Health & Human Services Secretary (HHS) penned a letter to the two House Republicans behind the American Health Care Act praising the new legislation that would...

House Republicans Propose Two New Bills to Replace ACA

by Thomas Beaton

On Monday, the House Ways and Means Committee and the House Energy and Commerce Committee proposed two bills that together will effectively repeal and replace the Affordable Care Act. Combined the...

Experts Lay Out Strategy for Achieving Universal Coverage

by Thomas Beaton

Experts from the Harvard Business School, Duke University, and David Geffen School of Medicine at UCLA debate the viability of an individual mandate as a means of achieving universal coverage without a...

Bill Would Make Health Insurance Liable for Antitrust Laws

by Thomas Beaton

Proposed legislation supported by the American Hospital Association passed the House Judiciary Committee earlier that if approved by Congress make health insurance companies liable for anti-competitive...

Researchers Expect ACA Repeal Adverse Effects on Uninsured

by Thomas Beaton

Authors of a recent viewpoint published in the Journal of the American Medical Association foresee health and financial risks the uninsured patient population following a partial or complete repeal of...

Impact of Wage Level Variation on Employer-Sponsored Plans

by Thomas Beaton

Findings from a recent study of healthcare utilization and spending by four self-insured employers show a correlation between wage levels and the types of services received. Based on data on 42,936...

CMS Continues Extension of Transitional Coverage into 2018

by Thomas Beaton

The Centers for Medicare & Medicaid Services (CMS) has again extended its policy enabling states to permit health plans additional time to bring coverage into compliance with the Affordable Care...

Market Monopoly Cause of Court Blocking Cigna-Anthem Merger

by Thomas Beaton

The full opinion of United States District Court for the District of Columbia blocking Anthem’s acquisition of Cigna became publicly available earlier this week and provides details into the...

Single-Payer Reform Purported to Save Estimated $504 Billion

by Thomas Beaton

A possible repeal of the ACA threatens to eliminate the coverage of 26 million Americans, but the authors of a recent commentary in the Annals of Internal Medicine contend that reforming to a...

GOP Leaders Unveil Proposed ACA Repeal, Replacement Plans

by Thomas Beaton

GOP leaders have unveiled their latest proposal to repeal and replace the Affordable Care Act with new health insurance regulations. The outline includes cutting federal Medicaid expansion, moving more...

After Terminated Merger, Cigna Demands $13B from Anthem

by Thomas Beaton

UPDATE: Anthem has secured a restraining order against Cigna preventing the final dissolusion of the merger.  The temporary order will be reviewed during a Delaware Chancery Court hearing on...

Aetna, Humana Terminate Merger Deal After Court Defeat

by Thomas Beaton

Aetna and Humana have scrapped their merger plans after the Department of Justice blocked the deal due to antitrust concerns.  Aetna will pay Humana a $1 billion termination fee, included as part...

Payers with Larger Market Share Have More Negotiating Power

by Thomas Beaton

Payers that dominate the local market are able to negotiate lower physician office visit prices than their smaller peers, found investigators from Harvard Medical School. Health insurance companies...

Proposed ACA Replacement Moves Coverage Choices to the States

by Thomas Beaton

Several Republican lawmakers have introduced the “Patient Freedom Act” as a proposed replacement of the Affordable Care Act, emphasizing state authority and local decision-making in the...

ACA Health Insurance Exchanges Bring Challenges for 2017

by Vera Gruessner

The Affordable Care Act (ACA) health insurance exchanges will have some key differences next year. Health insurance companies have faced various obstacles when selling health plans through the...

Affordable Care Act Replacement Seeks Automatic Enrollment

by Vera Gruessner

Since the Presidential election of Donald J. Trump, a number of differing viewpoints came out emphasizing how the Patient Protection and Affordable Care Act will be impacted. For the last several...