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Member News: Many health plans are concerned about ramifications of the Republican health care bill. CEO of Kaiser Permanente Bernard J. Tyson said the bill falls short of providing enough assistance for individuals who need help affording health coverage. Steve Shapiro, chief medical and scientific officer of UPMC, said that the legislation would take a financial toll on hospitals, especially those in rural areas. According to Shapiro, hospitals would end up providing more free care because patients lack insurance or can’t pay their bills.
ACHP in the News: The Senate health care bill has drawn criticism and praise from the health care industry. Some groups, including ACHP, appreciate that funding would continue for cost-sharing reduction payments through 2019. The subsidies help low-income individuals afford health coverage and would provide some market stability. While ACHP believes the subsidies are essential to stabilizing the market, we remain troubled by the possible coverage losses, as noted here.
Health care bill moves forward in the Senate
GOP leaders are pushing for a vote on the health care bill this week, but many Senators are saying they would like more time to consider the plan. Lawmakers are voicing concerns over cuts to Medicaid as well the bill’s effect on the cost of premiums and deductibles. At least five Republican Senators oppose the bill and key governors are also expressing doubts.
This morning, Senate Republicans added a provision to instate a six-month lock out for individuals who let their health coverage expire. That provision is meant to encourage healthy people to buy insurance instead of waiting until they get sick. The CBO score will be released early this week and is likely to project major coverage losses.
A large health plan is expressing concern that a little-noticed provision in the Senate health bill could drive up premiums for small-business health plans. The language is complex, but multiple experts who have reviewed the section believe it would reverse key consumer protections in small-business health plans — including the requirement to cover essential health benefits — take away regulatory power from the states, and potentially push up costs for small businesses whose workers are not overwhelmingly young and healthy.
Interactive tool compares health care bills
Kaiser Family Foundation created an interactive comparison tool that outlines the similarities and differences of current health care proposals and the ACA. The tool provides summaries of the bills and includes information on various components of the legislation such as dependent coverage, Medicaid funding and the individual market.
Consumers protected from surprise out-of-network fees in California
California has passed a law ensuring patients who visit in-network facilities will only be responsible for in-network shares of cost even if they are treated by an out-of-network provider. The law goes into effect July 1 and aims at preventing unexpected medical costs for consumers; nearly 1 in 4 Californians have been surprised by bills from out-of-network providers while seeking treatment at an in-network facility.
Anthem Inc. settles data breach case that affected 80 million
Anthem agreed to a $115 million deal over a breach that compromised the data of nearly 80 million consumers in 2015. The United States’ second-largest insurer will cover up to $38 million in attorney’s fees and provide victims with two years of credit monitoring, coverage for out-of-pocket costs and compensation for those who already purchased credit monitoring. The proposed settlement also calls for Anthem to guarantee funding for changes to its data security systems (subscriber’s content).