November 22, 2017
Happy Thanksgiving! There will be no MMR this week Thursday and Friday. We will be back Monday, November 27.
ACA sign-ups are high, but may miss the mark of past years
ACA sign-ups are outpacing projections, with about 300,000 people signing up in the first several weeks of the enrollment period. However, because the open enrollment period was cut in half—down from three months to just 45 days—the weekly pace of signups would need to double to match the number of sign-ups in past years. There are typically two spikes over the course of the enrollment period: Consumers signing up before the end of the year to obtain coverage starting January 1 and young, healthy Americans signing up because of outreach and advertising. Research has demonstrated that repeated television advertising increases enrollment. With a 90 percent cut to outreach and advertising this year, healthy, young people who are critical to the success of the health law may not enroll.
Insurers could recoup funds in risk-corridor lawsuit
Oral arguments are scheduled to begin Jan. 10 in a pair of lawsuits filed by health plans seeking to recoup funds owed under the ACA’s risk corridor program. The program aimed to protect insurers that entered the ACA exchanges from the high costs of covering expensive enrollees. However, the government underpaid insurers because it significantly underestimated the cost of covering new members. In 2014, the government had only enough funds to cover about 13 percent of insurer claims, and the amount of funds owed insurers has grown to about $12 billion. Insurers have filed at least three dozen lawsuits seeking to recover these funds.
Many families cannot afford deductibles
Many low-income families cannot afford even moderate deductibles, according to a Kaiser Family Foundation study. Roughly 40 percent of all non-elderly households don’t have enough liquid assets to cover high deductibles of 3,000 for an individual or $6,000 for a family. Among families whose income makes them eligible for the ACA’s premium subsidies, 60 percent lack the assets to cover a high deductible and 44 percent couldn’t cover the deductible for a mid-range plan ($1,500 for an individual or $3,000 for a family). High deductibles are becoming more common, and ACA repeal and replace proposals could drive deductibles even higher.
Medicaid and CHIP now cover almost 75 million people
New data from CMS find that Medicaid and CHIP now cover almost 75 million people. Total enrollment in the two programs has risen by 38 percent in states that expanded Medicaid and 12 percent in non-expansion states. The attention around expansion also plays a role, as it prompted people who were already eligible for the program, but had never signed up, to explore their options. The high number of enrollees in the programs exposes some of the challenges of repealing and replacing ACA, as doing so could cost many people their health coverage.
Murkowski supports repeal of individual mandate
Sen. Lisa Murkowski (R- AK) has signaled support for repealing the ACA’s individual mandate
. Senate Republicans can only lose two votes to pass their tax bill, which includes repeal of the mandate, through a budget process that requires only a simple majority, and Murkowski’s vote could be key. Although she did not say she fully supports the tax bill, her support of the repeal of the individual mandate could make her more likely to vote in favor of the bill. Many insurers and health policy experts say that repeal of the mandate
would lead to fewer people signing up for ACA plans, a rise in premiums and fewer insurers participating in the markets.
Rural Community Hospital Demonstration Program expands
An additional 13 hospitals will join the Rural Community Hospital Demonstration Program, which helps hospitals provide care in underserved communities. The program reimburses hospitals for the total cost of inpatient services for Medicare beneficiaries as opposed to standard Medicare reimbursement rates, which typically only cover about 80 percent of inpatient costs. The extra funds allow the hospitals to recruit staff and keep up with the rising costs of technology and equipment. Eligible hospitals must be located in a rural area, have fewer than 51 acute-care beds, provide 24-hour emergency services and not be designated as a critical-access hospital.
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