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The Patient Protection and Affordable Care Act of March 23, 2010- Part II of a II Part Series

Please also see: The Patient Protection and Affordable Care Act of March 23, 2010- Part I

(10/11/17)- President Trump administration officials have reduced funds for the navigator program by 41%, to $36.9 million from %62.9 million last year. Navigators are the people who assist potential applicants for their health-plan and subsidy assistance that they are eligible for under the terms of the Affordable Care Act.

Among the states hit the hardest are Georgia, down 61%; Michigan, down 72%; New Jersey, down 62%; and Ohio, down71%.

 

(10/2/17)- Trump administration officials announced plans to shut down HealthCare.gov, the website consumers use to sign up for their insurance under the Affordable Care Act for 12 hours on nearly every Sunday during the upcoming enrollment season which runs from November 1 thru December 15. Please keep in mind that the enrollment timeframe has been cut to 45 days from the prior 90 day period during the previous enrollment periods for the 38 states and District of Columbia that use the federal insurance marketplace for enrollment purposes.

The outages will occur from midnight through noon every Sunday except Dec. 10 because the officials claim that weekly maintenance is needed to keep the system operating properly and efficiently.

Officials from the Centers for Medicare and Medicaid Services (CMS) stated that: “Maintenance outages are regularly scheduled on HealthCare.gov every year during the enrollment period.”

(9/4/17)- The Department of Health and Human Services (HHS) announced that it would spend about $10 million on advertisements, including emails, texts, radio ads and digital promotions during the fifth annual open-enrollment period encouraging people to sign up for their health- insurance under the Affordable Care Act.

 

This is a 90% drop from about $100 million spent under the Obama administration during the last open-enrollment period. The Trump administration is also cutting grants to organizations that help consumers understand their coverage and financial aid options under the law.

The $36.8 million in grants given to these organizations represents about a 40% drop from the $62.5 million awarded in the previous enrollment period. The amount of the grant to each individual organization will depend on how successful it is in reaching its enrollment goal.

 

(9/1/17)- The fifth annual open enrollment period, when people can sign up for heath-insurance under the Affordable Care Act, or switch plans will run from November 1 through December 15. In the prior 4 years the open enrollment period lasted for 90 days, whereas for this fifth period it is only a 45 day limitation.

With the November date coming up shortly, administration officials have no concrete plans for a large advertising campaign to encourage people to vote. They have not stated if they will continue to make the subsidy payments to the insurers who enroll sicker individuals.

There have not been any grants given past September to navigator companies that help individuals sign up for their insurance under the act.

(8/27/17)- The good news is that the health insurer CareSource plans to offer Affordable Care Act exchange plans in counties that did not have marketplace offerings under the law next year.

CareSource is a nonprofit that focuses mainly on Medicaid individuals, and has actively sought out those counties that did not have a health insurance marketplace under the act. At last count there had been about 82 counties in the U.S. that lacked the marketplace.

For additional information on this topic please see our item dated 6/17/17 below

(8/23/17)- President Trump administration officials have extended the grants to the almost 100 community organizations that help people enroll in their health-care coverage under the terms of the Affordable Care Act, but only through the month of September, as we noted in our item dated 8/13/17 below. Under the Obama administration $63 million was awarded in grants.

With the next open enrollment period starting on November 1 being cut to a 45 day period from 90 days in all prior sign-up periods, it will make things even tougher for these navigator organizations. The administration recently ended $23 million worth of contracts with 2 companies that help people sign up under the act.

Making things even tougher to get people to sign-up for coverage will be the fact that the Centers for Medicare and Medicaid Services will not run any ads this year encouraging people to get coverage. The administration officials have not stated if the Internal Revenue Service would  enforce any penalty on those who do not sign up

(8/17/17)-The nonpartisan Congressional Budget Office (CBO) released the results of its study that showed that if subsidies to insurance companies are dropped, insurers would increase premiums for health-care coverage by about 20% next year. That in turn would mean the government would incur additional costs because of the financial assistance it provides to low income people.

The CBO study was prepared at the request of House Democratic leader Nancy Pelosi of California and Steny H.Hoyer, the Democratic House whip of Maryland.

There is a case pending before the U.S. Court of Appeals for the District of Columbia Circuit because the lower ruled that the subsidies were illegal since Congress had never appropriated money for that purpose..

 (8/13/17)- The Centers for Medicare and Medicaid Services (CMS)-awarded $63 million last year in grants to about 100 community organizations that helped people sign up for their health-plans under the Patient Protection Act. These expediters are known as “navigators”. These grants for the navigators are set to run through September 2018, but the contracts specifically state that the funding would be based on performance.

That means the Trump administration could end the funding for the contracts as early as September 2017. The administration has already cut back funding for ads encouraging  people to enroll in the act.

(8/5/17)- In a letter to the editors of the NY Times’ 8/3/17 edition, entitled “A Bipartisan Fix for Health Care”, Josh Gottheimer, a Democratic, representative from N.J., and Tom Reed, a Republican representative from N.Y. wrote about compromising on the health-care issue to which both parties could agree so that the weaknesses in Obama Care could be improved to benefit all of us.

They wrote that “On Aug.16, insurers must submit their 2018 rates to state regulators for approval; many may be forced to leave the individual-market place altogether.”….

“The costliest 5% of patients account for nearly half of all health-care spending in the country. We propose a dedicated stability fund-essentially a form of reinsurance-that states could use to reduce premiums and limit losses for providing coverage for these high-cost patients””

(7/31/17)- The Republican party’s 7-year attempt to repeal the Affordable Care Act of 2010 continues to meet failure. Republican Senators Susan Collins of Maine, Lisa Murkowski of Alaska  were joined by Senator John McCain, Republican of Arizona and all Democratic senators who, by a 40-51 vote, said “nay” to the last ditch effort to repeal the act.

(7/3/17)- Centene Corp. said it would offer Affordable Care Act health-care market place plans in 40 Missouri counties next year, including  several counties that recently appeared to have no plans being offered. Please see our item dated 6/15/17 below for additional states that Centene will cover in 2018.

The Kaiser Family Foundation said that there are 36 counties in Ohio, Indiana and Nevada that appeared to have no plans covering them in 2018

(6/25/17)- Anthem Inc. said it will exit the health-insurance marketplace in Wisconsin and Indiana in 2018, as well as Ohio as we noted in our item dated 6/8/17 below. MDwise, a small non-profit health insurer said it would also exit the Indiana exchange next year, leaviing 4 Indiana counties at risk of having no insurer under the Affordable Care Act.

On the other hand, Oscar Insurance Corp., said it was planning to expand its exchange offerings to include regions within a half-dozen states.

Initial federal applications to offer 2018 health-insurance market-place plans had to be in by June 21 in the 39 states and District of Columbia under the act. The companies have until late September to make their final decision

(6/15/17)- Reversing the recent trend amongst health-insurance companies withdrawing from the market-place set up under the terms of the Affordable Care Act, Centene announced that it would aggressively expand its coverage areas to include, for the first time, individual policies in Nevada, Missouri and Kansas.

The company said it would also increase its presence in 6 other states. Centene now covers 1.2 million people through state marketplaces.

(6/8/17)- Anthem Inc. announced that it would pull out of the health-insurance exchange in Ohio in 2018, leaving that state without marketplace options under the Affordable care Act. Please see our item dated 5/26/17 below where Blue Cross and Blue Shield of Kansas City announced it would pull out of the market-place leaving some residents there with no options available to them under the act.

Anthem’s exit will lease at least 18 Ohio counties with no health-care market place exchange to choose their coverage. The Kaiser Foundation estimated that 32% of U.S. counties-a total of 1,021 counties are down to just one exchange in 2017-up from 7%, or 225, in 2016.

(5/26/17)- Blue Cross and Blue Shield of Kansas City announced that it would leave the Affordable Care residents in 25 counties in western Missouri with no health-care exchanges in 2018.This could mean that parts of northwestern Missouri residents would have no health-care insurance market place choices under the act.

The company would stop offering exchange plan choices in 30 counties in northwestern Missouri, and 2 counties in Kansas. The move will affect about 67,000 individuals

(5/25/17)- The non-partisan Congressional Budget Office (CBO) estimated that the American Health Care Act (AHCA) that was passed by the U.S. House of Representatives on May 4th to replace Obamacare, would result in 23 million Americans losing their health insurance by 2026. The House acted on the bill before the CBO was able to fully analyze the data from that bill.

The CBO also estimated that the AHCA would reduce the deficit by $119 billion over the coming 10 years. The previous estimate was that it would reduce the deficit by $150 billion

(5/14/17)- BlueCross BlueShield of Tennesee will offer Affordable Care Act (ACA) marketplace health-insurance in the Knoxville region next year, thus filling a void that would have been left when Humana Inc. said it would pull out of all the exchanges that it does business.

Aetna Inc., said it would pull out of the Affordable care health-insurance exchanges next year in Delaware, Nebraska, Iowa and Virginia. The company said its individual plans were projected to lose about $200 million this year

Medica, a nonprofit insurer, said it was considering withdrawing from Iowa’s exchange next year., possibly leaving that state with no insurers in the marketplace under ACA

FOR AN INFORMATIVE AND PERSONAL ARTICLE ON PRACTICAL SUGGESTIONS WHEN SELECTING A NURSING HOME SEE OUR ARTICLE "How to Select a Nursing Home"

by Allan Rubin,
updated October 11, 2017

http://www.therubins.com

To e-mail: hrubin12@nyc.rr.com or allanrubin4@gmail.com

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