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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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Re: UnitedHealthcare to cut around 700 docs for MA seniors on Medicare Advantage—to offset ACA costs

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ACA rates to go up, some places as much as 23 percent

Posted by Olog-hai on Wed Aug 6 00:46:05 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Obamacare rates to soar by as much as 23 percent in 2015

• Rate hikes will vary from state to state next year, with Florida appearing hardest-hit so far
• Many insurers with more modest increases have been keeping rates down by limiting which doctors, hospitals and prescription drugs are covered
• California could see rates skyrocket if voters approve new authority for the insurance commissioner in November
• A federal court ruling, if it stands, would hike monthly costs by as much as $450 because the federal government would no longer be able to subsidize rates in 36 states

By David Martosko, U.S. Political Editor
Published: 11:04 EST, 5 August 2014 | Updated: 11:31 EST, 5 August 2014

Sticker shock is around the corner for many Americans with government-brokered medical coverage, as insurance companies are beginning to apply their first-year costs to next year's premiums.

In the case of Florida, some consumers will pay as much as 23 percent more when their plans are renewed in the fall, according to the Florida Office of Insurance Regulation.

When that agency released its projections on Monday, 23 percent was the upper end of the bad news. But some consumers in the Sunshine State could see their premiums drop by 5 percent instead.

That's because many insurance companies have been controlling costs by limiting the number of doctors, hospitals and prescription drugs their plans will cover in 2015.

The average in Florida will come out to a 13.2 percent hike.

The numbers in virtually every state are all across the board, with the biggest rate hikes announced to date coming in states where the federal government runs the Obamacare marketplaces.

States like California, which runs its own exchange, appear to be escaping with more modest increases for 2015. Its regulators have announced a 4.2 percent 'weighted average' hike.

That percentage itself could be hiding a spread of rate increases and decreases similar to Florida's.

Covered California, the state's Obamacare exchange, said on July 31 that 13 percent of the state's consumers would see hikes of 8 percent 'or more' next year.

The Los Angeles Times reported that some rates in Los Angeles are expected to rise by 16 percent.

But the worst news in California is yet to come: Dave Jones, the state's insurance commissioner, said current numbers are 'merely a pause in the double-digit rate increases we've seen historically.'

In November voters will consider Proposition 45, a measure that would expand Jones's authority to set insurance rates.

Insurers, Jones told the Times, may be holding rates down in anticipation of the new system, provided it passes.

Complicating things further is a recent ruling from the Federal Court of Appeals in Washington, D.C. that found it's illegal for the government to extend health insurance subsidies to consumers in states that didn't set up their own exchanges.

If the decision stands, people in 36 states would likely see their out-of-pocket expenses skyrocket.

The subsidies amount to as much as $450 per month in some states like Wyoming and Mississippi. Residents of Utah and Tennessee would lose the least, an average of about $150 per month.

A separate court ruled the same day that those subsidies are constitutional. The Obama administration is appealing the ruling it disagrees with.

Any increase, no matter how modest, will likely bring catcalls from conservatives and other Republicans.

President Barack Obama promised Americans during his 2008 presidential campaign — and long afterward — that his Affordable Care Act law would bring health care savings of $2,500 per family each year, on average, by the end of his first term in office.

He also promised on dozens of occasions that Americans could 'keep their health care plans' if they wanted to.

That promise quickly vanished as insurers sent millions of cancellation notices since existing plans often didn't conform to the lengthy and byzantine collection of mandatory benefits Congress decided every American must have.

Those requirements, as much as any other factor, have driven up costs.

Some opinion-shapers are beginning to dissect the reasons for rate hikes, and new taxes are part of the picture.

Obamacare will 'result in insurance plans being taxed more than $100 billion between 2014 and 2022,' the right-leaning Las Vegas Review-Journal editorial board wrote on July 23, 'with the Congressional Budget Office concluding that the taxes "would be largely passed through to consumers in the form of higher premiums for private coverage".'

The Review-Journal has called for a complete repeal of the law.

In a CNN poll released July 23, twice as many Americans say the law has hurt them compared with those who say it helped.

'Thirty-five percent of Americans told pollsters that Obamacare has made them and their families worse off. Just 18 percent believe they are better off.

Forty-six percent, almost half of Americans, say the law has made no difference in their lives.

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Re: ACA rates to go up, some places as much as 23 percent

Posted by SelkirkTMO on Wed Aug 6 01:09:43 2014, in response to ACA rates to go up, some places as much as 23 percent, posted by Olog-hai on Wed Aug 6 00:46:05 2014.

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Re: ACA rates to go up, some places as much as 23 percent

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Re: ACA rates to go up, some places as much as 23 percent

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Re: ACA rates to go up, some places as much as 23 percent

Posted by bingbong on Wed Aug 6 08:38:40 2014, in response to ACA rates to go up, some places as much as 23 percent, posted by Olog-hai on Wed Aug 6 00:46:05 2014.

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ACA could be undone by wording "glitch"?

Posted by Olog-hai on Tue Aug 26 05:03:51 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Could a wording 'glitch' doom Obama's healthcare law?

By David Savage
August 25, 2014 5:00 AM

When a federal appeals court ruled last month that a seemingly arcane wording flaw in the Affordable Care Act should invalidate a central part of the law, many of those who drafted the statute five years ago reacted with shock and anger.

In 2009, they had spent months piecing together a compromise that sought to create a national system of subsidized insurance — but one run by the states. Now, they fear their work could be undone by what some call a "drafting error" and others portray as a political miscalculation.

The judges from the U.S. Court of Appeals for the District of Columbia Circuit based their ruling on language saying that subsidies would be offered for health policies bought through an "exchange established by the state."

That wording meant only marketplaces established by 14 states, including California, would qualify, the three-judge panel ruled; 5 million people in 36 states where consumers used the federal government's exchange should not get subsidies.

(Another federal appeals court panel, in Virginia, took the opposite view in a ruling issued the same day. Until the litigation is over, subsidies are continuing in all states.)

The ruling seems likely to propel Obamacare once more before the Supreme Court, where opponents came within a single vote of overturning the law in 2012.

That prospect has sparked an intense debate over how the disputed language ended up in the law.

The story begins in 2009, when Democrats held a solid majority in both houses of Congress. In the House, most Democrats favored having one nationwide federal insurance exchange. They predicted — correctly, as it turned out — that many Republican-controlled states would balk at extending insurance to low- and middle-income residents.

But in the Senate, some Democrats worried over the specter of a "federal takeover." They insisted that states have a prime role.

To complicate matters further, two Senate committees adopted health bills. The more conservative Finance Committee relied entirely on states to set up exchanges; its bill said low-income buyers would receive a federal subsidy for insurance obtained "through an exchange established by the state."

The more liberal Health Committee included a "federal fallback" in case some states refused to cooperate. Its bill said the federal government "shall establish and operate a Gateway" for insurance in any uncooperative states, and their low-income residents "shall be eligible" for subsidies.

When the two bills were merged at the end of 2009, the "shall be eligible" promise for all low-income residents was dropped. Left intact was the Finance Committee provision that said subsidies would be provided for insurance purchased through an "exchange established by the state." The Senate approved the bill on Dec. 24, 2009.

Two surprises followed. In January 2010, Republican Scott Brown won the Massachusetts Senate seat long held by the late Sen. Edward M. Kennedy, depriving Democrats of the 60 votes needed to end filibusters. Because the Senate faced a stalemate, House Democrats agreed to adopt the Senate's bill as written, without further tinkering.

Then, once the bill became law, more than half the states signaled they would not operate insurance exchanges, leaving the task for Washington.

Conservative opponents of the law soon spotted a potential weakness. In September 2011, the Cato Institute's Michael Cannon said the "Obamacare glitch" could block insurance subsidies in all the states that relied on a federal exchange.

Lawsuits soon followed.

Congressional staff members who worked on the law insist that everyone intended to provide subsidies nationwide. They didn't focus on the now-crucial phrase, they said. And they admit they did not foresee a rebellion among conservative states.

"This was an issue no one thought of. We were focused on hundreds of other issues — abortion, illegal immigrants, the size of the subsidies. Yes, you can look back now and say, 'That was stupid. Why didn't we catch it?'" said Harvard University health policy professor John McDonough. "That's why every major law has a technical corrections bill afterward."

Many former Senate aides say other parts of the law make clear the federal exchange is the stand-in for a state exchange and that, as a result, subsidies should be allowed. That's the position taken by the Obama administration and upheld by the U.S. 4^th Circuit Court of Appeals, based in Virginia.

One provision that administration lawyers point to says if a state refuses to create an exchange, the health secretary shall "operate such exchange within the state" and "take such actions as are necessary to implement" the law.

Still others point out that no one advised states that failing to establish an exchange could deprive their citizens of subsidies.

"I would hope the courts take a look at the intent and the overall structure of the law, because the intent was very clear," said David Bowen, former health policy advisor for Kennedy.

Some are troubled that a legal claim, once seen as a long shot, has gained such traction. Topher Spiro, a former Senate health policy staffer now at the Center for American Progress, said he viewed the lawsuits as "silly, not to be taken seriously."

"Other than a few right-wing activists, no one thought this was a legitimate challenge," he said.

All the backward looks at the law's intent may not determine the outcome, however. The Supreme Court is likely to have the final word, and its conservatives, led by Justice Antonin Scalia, frequently say they decide cases based on what a law says, not what Congress may have intended.

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Re: ACA could be undone by wording ''glitch''?

Posted by bingbong on Tue Aug 26 09:58:35 2014, in response to ACA could be undone by wording "glitch"?, posted by Olog-hai on Tue Aug 26 05:03:51 2014.

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Re: ACA could be undone by wording ''glitch''?

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Re: ACA could be undone by wording ''glitch''?

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Re: ACA could be undone by wording ''glitch''?

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Re: ACA could be undone by wording ''glitch''?

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Re: ACA could be undone by wording ''glitch''?

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Re: ACA could be undone by wording ''glitch''?

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Re: ACA could be undone by wording ''glitch''?

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Re: ACA could be undone by wording ''glitch''?

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Re: ACA could be undone by wording ''glitch''?

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Re: ACA could be undone by wording ''glitch''?

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Re: ACA could be undone by wording ''glitch''?

Posted by Dave on Wed Aug 27 07:46:12 2014, in response to Re: ACA could be undone by wording ''glitch''?, posted by bingbong on Tue Aug 26 22:02:59 2014.

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Surgery rates go up under ACA (16%–24% depending on procedure); hospitals consolidate

Posted by Olog-hai on Mon Sep 1 15:10:57 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Surgery Prices Surge With Innovation and Consolidation Under Obamacare

Posted: Aug 31, 2014 1:24 PM EDT
Updated: Aug 31, 2014 1:24 PM EDT

The price to remove a gall bladder or replace a hip has spiked more than 20 percent during the past five years, according to an analysis of data collected for NBC News.

Surgery has bloomed into a $500 billion industry in the United States, where 80 to 100 million procedures are performed annually — a per-capita rate that's some 50 percent higher than in the European Union, said Dr. John Birkmeyer, a researcher and adjunct professor at the Dartmouth Institute and in the university's Community & Family Medicine program.

The reason? Expensive yet safer technologies and hospital consolidations that create medical monopolies, according to doctors and researchers.

For hospitals, surgery is the No. 1 revenue source. That encourages medical center administrators to ensure operating suites remain humming — an assembly-line mentality that can lead to unnecessary procedures and spiraling prices, experts say.

“The cost of surgery is growing at a surprising rate,” said Birkmeyer, a leading researcher on healthcare trends. He bases his calculations on national Medicare claims data.

A price check on four of the most common procedures reveals the inflationary trends hitting ORs since 2009:

• Hernia repair, up 16 percent, with a "total fair price" of $5,056, according to Healthcare Bluebook.
  
  
• Gall bladder removal, up 21 percent, with a "total fair price" of $5,532.
  
  
• Hysterectomy, up 19 percent, with a "total fair price" of $11,780.
  
  
• Hip replacement, up 24 percent, with a "total fair price" of $22,606.

The cost-increase data was generated for NBC News by Healthcare Bluebook, an online guide that helps consumers shop for the best prices in their areas for various medical services. The dollar amounts show the “total fair price” for each surgery as estimated by the website.

Overall, health care inflation has averaged about 4 percent per year during the past five years, Dr. Jeffrey J. Rice, chief executive officer of Healthcare Bluebook, based in Brentwood, Tennessee.

Further causing surgical costs to surge: The U.S. health care economy is built on a tilted foundation. Insurance-company contracts can vastly differ from one hospital to another just blocks away, skewing prices for the same treatments.

“There is almost always a 500 percent — or more — variation for health care services in most cities,” Rice said. “For example, an MRI may cost $500 at one facility and over $3,000 at another facility across the street.”

Surgeons know this, of course. Their fees, dictated by insurance contracts or by Medicare, are included in the overall price of any operation.

“I can take out a gall bladder, and a surgeon in the next room can take out another gall bladder, but he or she may be with a different network of doctors or a different hospital system that negotiated better (insurance) contracts,” said Dr. Paul A. Ruggieri, a general surgeon in Fall River, Massachusetts. “He or she can get paid 20 to 30 percent more than what I get paid regardless of the outcome.”

Those hospital “systems” and doctor “networks” are rooted in a consolidation of care that's been steadily gobbling up a greater share of the U.S. medical landscape and are a chief driver of the rising surgical prices, according to Birkmeyer, Rice and Ruggieri.

“Hospitals and their pricing systems have, for a very long time, been shielded from competitive market forces,” said Ruggieri, author of “The Cost of Cutting,” out Tuesday. “Hospitals have been allowed to charge whatever they want to charge to third-party payers (insurers). There's been no transparency to the public in how hospital pricing is determined.”

And as more local hospitals end competitions and merge, the idea of winning new patients through lower prices vanishes, the experts said.

Consider Boston. In 1994, Massachusetts lawmakers allowed Brigham and Women's Hospital and Massachusetts General Hospital to consolidate into a one system known as Partners HealthCare. According to the New York Times: “Investigations by the state attorney general's office have documented that the merger gave the hospitals enormous market leverage to drive up health care costs in the Boston area by demanding high reimbursements from insurers that were unrelated to the quality or complexity of care delivered.”

The Affordable Health Care Act — or Obamacare — fueled even more hospital consolidations, Birkmeyer asserts.

The law created Accountable Care Organizations (ACOs) that “incentivize doctors and other providers to work together to provide more coordinated care to their patients,” former Health and Human Services Secretary Kathleen Sebelius wrote in March 2013. These ACOs “agree to take responsibility for the cost and quality of their patients' care, (and) to improve care coordination and safety.”

They also boost the costs of surgeries, Birkmeyer asserts.

“That drive toward hospitals forming bigger conglomerations of networks and physician practices has reduced competition, and in a non-Medicare population, has enabled hospital systems in many parts of the country to charge far more,” Birkmeyer said.

At the same time, OR innovation — great for patients, tough on wallets — has bumped up surgery prices.

Those tech advances include robotic surgeries, now performed hundreds of thousands of times a year for certain procedures, including hysterectomies. A doctor sits near the operating table at a console, where he or she can manipulate robotic arms while watching through a 3-D viewfinder.

“Those have very positive effects in respect to recovery or the risks of complications for patients,” Birkmeyer said.

“But technology is very costly for hospitals and, ultimately, those costs get passed to insurers — and to the rest of us.”

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Re: Surgery rates go up under ACA (16%–24% depending on procedure); hospitals consolidate

Posted by bingbong on Mon Sep 1 15:56:54 2014, in response to Surgery rates go up under ACA (16%–24% depending on procedure); hospitals consolidate, posted by Olog-hai on Mon Sep 1 15:10:57 2014.

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Re: Surgery rates go up under ACA (16%–24% depending on procedure); hospitals consolidate

Posted by orange blossom special on Mon Sep 1 18:15:38 2014, in response to Re: Surgery rates go up under ACA (16%–24% depending on procedure); hospitals consolidate, posted by bingbong on Mon Sep 1 15:56:54 2014.

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Re: Surgery rates go up under ACA (16%–24% depending on procedure); hospitals consolidate

Posted by SelkirkTMO on Mon Sep 1 18:40:16 2014, in response to Re: Surgery rates go up under ACA (16%–24% depending on procedure); hospitals consolidate, posted by orange blossom special on Mon Sep 1 18:15:38 2014.

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LA restaurants add 3% surcharge because of ADA healthcare costs

Posted by Olog-hai on Thu Sep 4 04:42:22 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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The 3% Surcharge Catches On: The Lucques Group Introduces Healthcare For Employees

By Besha Rodell
Tue, Sep 2, 2014 at 10:14 AM

Back when Republique opened late last year, the most hotly debated aspect of the restaurant was not the food or the redesign of the iconic building in which it's housed, but rather the 3% surcharge added to all checks to cover healthcare for the restaurant's employees.

On Yelp and in comments on this website and others, customers vowed never to give the restaurant their business. Many claimed the surcharge was politically motivated. Others wondered why the restaurant didn't simply roll the cost of employee healthcare into menu prices to avoid the controversy.

Now another high profile restaurant group in L.A. has decided to follow the same path. The Lucques Group, Suzanne Goin and Caroline Styne's group of restaurants that includes Lucques, Tavern and A.O.C., as well as a number of offshoots of those businesses, sent out a press release over the weekend announcing that beginning on Sept. 1, they too would be adding a 3% charge on all bills in order to pay for employee health insurance.

They also name a number of other restauranteurs that they worked with to create a plan to offer coverage, intimating that these folks, too, would be adding a 3% charge. Those names include Josh Loeb and Zoe Nathan of Rustic Canyon, Josiah Citrin of Mélisse, and David Lentz of The Hungry Cat.

The release goes into great detail to address some of the complaints that were leveled at Republique when their healthcare fee was implemented. On the issue of politics:

The major point is that this is not a political statement or endorsement of any kind. Our desire to offer health benefits is not tied to the Affordable Care Act, which at this point wouldn’t require businesses to provide health benefits to their employees until January 2016 at the earliest, and where ultimately businesses of our size might not be required to provide health benefits at all. We are doing this because, quite frankly, we believe it’s the right thing to do, and that as a community of independent and family run restaurants we want to provide the best work environment we can so that we can provide long term jobs and careers for our staff instead of the usual transient employment that is associated with the restaurant business.

On the issue of the economics of a surcharge rather than raising menu prices:

The cost of offering these benefits is significant and the reality is that restaurants, particularly smaller restaurants like the ones many of us own, have a very high ratio of staff members to revenue and run on very slim profit margins. Successfully run restaurants generally make between 5-10% net profits so a health care benefit which eats away 3% of gross sales will take away anywhere from 30% to 50% of annual profits for a restaurant. We’ve discussed simply raising menu prices, but ultimately food prices are tied in many ways to the ingredients we purchase. Those ingredient costs have increased astronomically recently so we’re already struggling with working creatively to keep menu prices down and don’t feel it’s right to try to factor health care costs into menu prices as well. We’d rather keep our menu costs as an accurate refection of our ingredient prices so that customers know that if we have to raise them it’s because we can’t avoid passing on our increased costs.

One of the main criticisms of the surcharge for employee health insurance, both at Republique and in San Francisco — where a 2008 law requires restaurants with more than 20 workers to collect funds to cover employee health insurance — is that there is no way of knowing whether the funds collected are actually going to employee health costs or not. In San Francisco, this has been a real issue, with many restaurants failing to use surcharge funds for their intended goal.

Goin and Styne address this as well, saying that they aim for complete transparency. "We pledge to provide details of total monies collected and how those funds were used to any interested party upon request," they say, adding that those figures will be available on March 1 for the previous calendar year.

The result is that all employees working 30 hours or more at these restaurants will have an HMO plan paid for as of Oct. 1. And also that, with these big names jumping onboard, the 3% surcharge could soon become the rule rather than the exception.

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Re: LA restaurants add 3% surcharge because of ACA healthcare costs

Posted by Olog-hai on Thu Sep 11 12:17:54 2014, in response to LA restaurants add 3% surcharge because of ADA healthcare costs, posted by Olog-hai on Thu Sep 4 04:42:22 2014.

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Nearly 250,000 Virginians to lose health care plans due to ACA

Posted by Olog-hai on Thu Sep 11 12:19:40 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Re: Nearly 250,000 Virginians to lose health care plans due to ACA

Posted by SelkirkTMO on Thu Sep 11 12:24:26 2014, in response to Nearly 250,000 Virginians to lose health care plans due to ACA, posted by Olog-hai on Thu Sep 11 12:19:40 2014.

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Re: LA restaurants add 3% surcharge because of ADA healthcare costs

Posted by orange blossom special on Thu Sep 11 19:09:04 2014, in response to LA restaurants add 3% surcharge because of ADA healthcare costs, posted by Olog-hai on Thu Sep 4 04:42:22 2014.

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Re: LA restaurants add 3% surcharge because of ADA healthcare costs

Posted by Olog-hai on Fri Sep 12 03:38:09 2014, in response to Re: LA restaurants add 3% surcharge because of ADA healthcare costs, posted by orange blossom special on Thu Sep 11 19:09:04 2014.

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Second ACA open enrollment season to have a new set of problems

Posted by Olog-hai on Sun Sep 14 09:33:24 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Hurdles for Obama health law in 2^nd sign-up season

By Ricardo Alonso-Zaldivar
Sep 14, 2014 7:37 AM EDT

Potential complications await consumers as President Barack Obama's health care law approaches its second open enrollment season, just two months away.

Don't expect a repeat of last year's website meltdown, but the new sign-up period could expose underlying problems with the law itself that are less easily fixed than a computer system.

Getting those who signed up this year enrolled again for 2015 won't be as easy as it might seem. And the law's interaction between insurance and taxes looks like a sure-fire formula for confusion.

For example:

• For the roughly 8 million people who signed up this year, the administration has set up automatic renewal. But consumers who go that route may regret it. They risk sticker shock by missing out on lower-premium options. And they could get stuck with an outdated and possibly incorrect government subsidy. Automatic renewal should be a last resort, consumer advocates say.
  
  
• An additional 5 million people or so will be signing up for the first time on HealthCare.gov and state exchange websites. But the Nov. 15-Feb. 15 open enrollment season will be half as long the 2013-2014 sign-up period, and it overlaps with the holiday season.
  
  
• Of those enrolled this year, the overwhelming majority received tax credits to help pay their premiums. Because those subsidies are tied to income, those 6.7 million consumers will have to file new forms with their 2014 tax returns to prove they got the right amount. Too much subsidy and their tax refunds will be reduced. Too little, and the government owes them.
  
  
• Tens of millions of people who remained uninsured this year face tax penalties for the first time, unless they can secure an exemption.

"It's the second open enrollment, but the first renewal and the first tax season where the requirements of the Affordable Care Act are in place," said Judy Solomon, vice president for health policy at the Center on Budget and Policy Priorities, which advocates for low-income people, and supports the law.

"The fact that it is all going to be occurring within an overlapping and relatively short time frame … means that there will be many issues," she added.

At Foundation Communities, an Austin, Texas, nonprofit serving low-income people, Elizabeth Colvin says more volunteers will be needed this year to help new customers as well as those re-enrolling. Last time, her organization's health insurance campaign lined up 100 volunteers. She figures she will need a minimum of 50 more.

"We have less than half the time than last year, and it's over the holidays," she said. "We have a concern about trying to get more people through the system without shortchanging education, so that consumers know how to use the insurance they're enrolling in,"

Some congressional supporters of the law are worried about more political fallout, particularly because of the law's convoluted connections with the tax system.

"It seems to me there ought to be some way to better educate folks on what they may face in this process," Rep. Mike Thompson, D-Calif., told Internal Revenue Service Commissioner John Koskinen at a hearing last week.

Thompson wasn't impressed when Koskinen said the IRS has put information on its website and is using social media to get out the word.

Rep. Bill Pascrell, D-N.J., said in an interview that he disagrees with making people pay back part of their premium subsidy. That would happen if someone made more money during the year and failed to report it to HealthCare.gov.

"Why should individuals be punished if they got a bump in salary?" said Pascrell. "To me, this was not the ACA I voted on."

Last year the federal website that serves most states crashed the day it went live, and it took the better part of two months to get things working reasonably well. This year, the Obama administration is promising a better consumer experience, but officials have released few details. It's unclear how well system tests are going.

"This coming year will be one of visible and continued improvement, but not perfection," said Andy Slavitt, a tech executive brought in by the Department of Health and Human Services to oversee the operation.

Insurers say they continue to worry about connections not fully straightened out between their computer systems and the government's.

They also are concerned about retaining customers. One quirk troubling the industry is that policyholders who want to update their subsidies and stay in the same plan will have to type in a 14-character plan identifier when they re-enroll online. That's longer than a phone number or a Social Security number, and customers may not know where to find it.

Administration spokesman Aaron Albright says consumers will have several ways to do that. The number will be mailed to them by their insurer as part of their renewal notice, they can get it from a HealthCare.gov call center or they can select the same plan while browsing other options online.

Alex Stevens, a dishwasher at an Austin pizzeria, got covered this year and said he's planning to re-enroll. A skateboarding enthusiast in his late 20s, Stevens broke a leg skating with friends this summer. It was a bad break and he had major surgery the next day. But his insurance paid most of the $55,000 bill, and he only owed $750.

"My mom said she was glad that I have insurance," said Stevens.

As the share of Americans remaining uninsured declines, it's clear the health care law has filled a need for millions of people like Stevens, who work but don't have coverage on the job.

That demand was strong enough to overcome a dysfunctional website the first year of the coverage expansion. The second year will show whether the full program is workable for the people it was intended to serve, or if major retooling will be needed.

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Re: Second ACA open enrollment season to have a new set of problems

Posted by bingbong on Sun Sep 14 09:50:05 2014, in response to Second ACA open enrollment season to have a new set of problems, posted by Olog-hai on Sun Sep 14 09:33:24 2014.

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Big Minnesota health insurer, PreferredOne, departs ACA website citing cost of doing business

Posted by Olog-hai on Tue Sep 16 18:33:50 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Big Minnesota insurer leaves Obamacare site

By Dan Mangan
September 16, 2014

The "Blue Ox" of Minnesota Obamacare is calling it quits.

PreferredOne, the insurer that sold nearly 60 percent of all private health plans on Minnesota's Obamacare exchange, on Tuesday said it would leave that marketplace. PreferredOne's plans were the lowest-cost options on that exchange, known as MNSure.

PreferredOne cited the costs of doing business on MNSure as the reason for its surprising decision, saying that selling plans is "not administratively and financially sustainable going forward," according to KSTP.com, the website of that Minnesota TV News network.

"Our MNsure individual product membership is only a small percentage of the entire PreferredOne enrollment but is taking a significant amount of our resources to support administratively," a company statement obtained by KSTP said. "We feel continuing on MNsure was not sustainable and believe this is an important step to best serve all PreferredOne members."

The insurer's surprising move came just two months before the start of open enrollment in Obamacare plans for 2015 and a month before insurers are expected to release their plan rates for next year.

Read More CEO prescription for health care

PreferredOne's decision is likely to have significant effect not only on its current Obamacare enrollees, but also on people who will be shopping for plans for next year on the exchange, which is now left with just four insurers. The remaining players on the exchange are Blue Cross and Blue Shield, Health Partners, Medica and UCare.

PreferredOne's relatively low-priced plans on MNSure for the 2014 enrollment season were a big reason why 59 percent of the 47,902 people who bought health coverage on the exchange by mid-April selected the insurer.

Those customers now face the prospects of higher rates if they want to remain in those same plans next year, as is their option, while existing customers of other insurers and new customers in the market will have fewer price options from which to choose.

In a statement released Tuesday, MNSure noted that "all consumers currently enrolled through Preferred One will have continued coverage through their existing plan for the rest of 2014."

And the statement said that under state law, customers have the right to renew their current coverage for 2015, but "this mandate does not require it to be offered at the same price."

In a joint statement, MNsure's CEO, Scott Leitz, and Preferred One CEO Marcus Merz said, "Today Preferred One made the decision to not offer health plans through the health insurance exchange in 2015. Simply put, both organizations understand that MNsure is still an evolving partnership. This decision impacts 2015 enrollment."

"Consumers still have at least four, well-known, Minnesota-based carriers who are committed to providing important health coverage to Minnesotans through MNsure, including people who qualify for tax credits and public programs," the CEOs said.

"MNsure and Preferred One will work closely to minimize impact to current enrollees in a Preferred One Plan through MNsure."

PreferredOne is owned jointly by three medical providers in the Minneapolis-St. Paul area. The insurer is Minnesota's fifth largest by revenue, and will continue selling health plans outside of the Obamacare exchange.

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