Health exchanges are typically portrayed as consumer-oriented, competition-inducing marketplaces in which individuals can comparison shop for health insurance plans. The exchanges proposed under ACA regulations, however, are primarily subsidy delivery systems, secondarily new regulatory agencies, and only distantly involved in solving health care’s critical problems: high, exponentially increasing costs and lack of consumer knowledge. SCDHHS Director Tony Keck’s analysis points out that state health exchanges are required to certify plans as eligible to be sold on the exchange, and perform enrollment, eligibility, and premium collection. In addition, ACA requires state-based exchanges to determine Medicaid eligibility as well as federal premium subsidies for individuals and families making between 138 and 400 percent of the federal poverty level: a massive administrative burden well outside the realm of comparison shopping.
Video: Creating Jobs in the Volunteer State: What Are Businesses Doing?
States Moving on Health Insurance Exchanges
While the law sets certain requirements for the exchanges, Larsen said states have a lot of flexibility in determining how to implement an exchange that best fits their needs and is responsive to local market conditions. That flexibility includes the structure of the exchange, selection of qualified health plans, network adequacy standards, marketing standards, and the role of agents and brokers in the exchange.
Texas House Dems object to state’s request for delay of health insurance rule
Consumer groups, though, are urging U.S. Health and Human Services Secretary Kathleen Sebelius to deny Texas’ request. They say the state’s individual market is healthy, with more than 40 insurers now offering products. Data show that most are able to meet or come close to reaching the standard and afford any rebates, advocates say.
State Health Insurance Exchange ‘Quashed’
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Heineman and Nelson exchange words over health exchanges (AUDIO)
“Well, you know what, we wouldn’t be in this dilemma if Sen. Nelson and President Obama hadn’t created this mess when they passed Obamacare,” Heineman tells reporters when asked about Nelson’s assertion. “The reason we’re forced to move forward in this regard is (because) it’s currently the law of the land. And I’ve made it very, very clear that we’re going to continue to work with the Attorney General and 25 other states, because we think the law is unconstitutional. We’re going to know that answer by June of 2012.”
Affordable Health Insurance For Unemployed
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OUR OPINION: LePage got our attention; now how about a real plan?
These cuts also would result in the state losing federal funds, which match state dollars at a 2-to-1 rate. Under the LePage plan, that money would stop coming into Maine to support doctors, nurses, pharmacies, clinics, group homes and other businesses in the for-profit and nonprofit sectors of our economy.
What is the best group health insurance plan?
The American Medical Association does not rate the best group health insurance plans. However, the American Medical Association, which makes up all of the physicians in good standing in the United States did study which insurance plans denied the most claims. As a policyholder, you may want to avoid the companies that deny claims frequently.
CMS: States’ Health Spending Gap Widens
States with the largest per capita personal spending tended to have the highest personal income per capita, as well as older populations than average. Lower-spending states tended to have the opposite: lower personal income and younger populations. The latter also had lower rates of insurance coverage.
Olympia Business Watch: Brunell: Our state health care exchange should preserve choice
If the Health Care Authority members limits the insurance carriers can participate in the exchange, that will reduce choice. If they limit the types of health plans those companies can offer, that will restrict choice. If they compel insurers to participate in the exchange as a condition of operating in Washington state, that will reduce choice.
State Roundup: Calif. Settles Suit On Kids’ Mental Health Services
The News Journal (Delaware): Children’s Health Insurance Program Carries High Cost As Blue Cross Blue Shield of Delaware’s merger with Pittsburgh-based insurer Highmark progresses toward an expected approval, one loose end stands to gain some attention today: a program to provide health coverage for thousands of uninsured Delaware children. State lawmakers passed legislation last summer calling on Highmark and Blue Cross to provide affordable coverage for Delaware families whose incomes are too high to quality for the state’s children’s health insurance program, or CHIP. … But, behind the scenes, proposed costs of the Blue Cross program have become a big enough sticking point that some political leaders think high costs could undermine the program (Starkey, 12/5).
HHS rolls out new grants for state health care exchanges
Insurance companies “risk management” profits are hugely lucrative, poorly regulated and government politicians are heavily influenced by insurance company lobbyists who pay large political contributions for favorable laws. Health insurance companies want to “cherry pick” customers covering only the most healthy people (deny for pre-existing conditions, preferring mostly younger people) who rarely require medical services thereby they maximize their profits. I request that Government.Executive perform an investigative analysis and breakdown of the customer premiums paid into health insurance companies (think Wall Street brokers) and the expenses paid out by those insurance companies for actual health care costs to doctors, hospitals, medicines, etc. – normally about 30% of premiums collected, whereas, administrative expenses and employees wages account for another 20%. Also show all the remaining 50% costs for advertising, legal expenses paid to avoid paying for health services, excutives compensation and dividends to stock holders. Expenses for advertising, lawyers, profit, bonuses or dividends will not be needed under Obamacare. Obamacare should be cheaper because it needs to cover only direct health care costs to health care providers, doctors, hospitals, medicines, administrative expenses, and employees wages. This is the real reason insurance company executives are against Obamacare.