Obamacare News of the Day

Las Vegas Review-Journal: Own a small business? Brace for Obamacare pain ["The changes put as many as 90,000 policies across Nevada at risk of cancellation or nonrenewal this fall…"]

• Local insurance brokers are reporting spikes ranging from 35 percent to 120 percent on policies that renew from July to December. The increases are especially acute among employers with workforces made up of younger, healthier men. That’s because Obamacare prohibits offering lower rates to healthier groups. It also narrows the allowed premium gap between older and younger enrollees.
• “It’s like if there were no more safe-driver discounts with State Farm,” said local insurance broker Frank Nolimal of Assurance Ltd. “Everybody has the same rate, whether you have three DUIs, or you’re a (nondrinking) churchgoing Mormon.”But moderately skilled or low-skilled people making $8 to $14 an hour working for landscaping businesses, fire-prevention firms or fencing companies could lose work-based coverage because the plans cost so much relative to salaries.
• Employees who keep their coverage might see leaner take-home pay, which could hurt the economy. Nolimal [a local insurance broker] said one business client whose monthly premiums will rise from $160 to $340 in June plans to shift most of the increase onto his employees.

The Boston Globe: Mass. Scrapping flawed health insurance website Next steps have uncertainties for users, insurers [This seems to be a case of Obamacare destroying Romneycare]

• Massachusetts plans to scrap the state’s dysfunctional online health insurance website, after deciding it would be too expensive and time-consuming to fix, and replace it with a system used by several other states to enroll residents in plans. Simultaneously, the state is preparing to temporarily join the federal HealthCare.gov insurance marketplace in case the replacement system is not ready by the fall.
• The strategy announced Monday will still cost an estimated $100 million, and it creates many uncertainties, especially for insurance companies and consumers. Some customers might eventually need to change insurance plans.
• “It’s obviously incredibly disappointing,” he said. “I don’t know where the ball was dropped, but this is a very difficult situation and I can’t imagine that Massachusetts, one of the leading software states in the country, is having such a difficult time building a functioning website.”Massachusetts had the first online health insurance marketplace in the country, created under its landmark 2006 law mandating coverage for most residents. The website worked well until it was revamped last year to meet the demands of the federal Affordable Care Act.
• [RELATED] Voice of San Diego: California's Still Struggling to Set Up SHOP [SHOP, the Small Business Health Options Program, is Obamacare's small business health exchange]
  • California’s new insurance marketplace for small businesses is off to a rough start. It has enrolled  just a fraction of eligible companies, with most being deterred by technology glitches, paperwork delays and customer service problems.
  • The program, designed to make insurance more affordable and easier to purchase for small businesses, has only signed up  1,200 companies. There are roughly 700,000 small businesses in the state, and more than half could be eligible for tax credits under the health law, according to the Small Business Majority, a national organization of small businesses.

The Wall Street Journal: Residents of Some States Get Larger Health Insurance Subsidies

• In all, 85% of the Americans buying coverage through new online insurance exchanges got financial assistance to offset the cost of their premiums, according to enrollment data released by the Obama administration. The administration’s figures also suggest that the percentage is far from uniform across the states, for reasons that are likely linked to the way the law is structured.
• Some 94% of enrollees in Mississippi sought and received the subsidies, and in Florida, North Carolina, Arkansas, Wisconsin, South Dakota, Wyoming, Idaho and Maine the proportion was also 90% or more. Meanwhile, in the District of Columbia, the figure was 16%, in Hawaii, it was 38%, and in Vermont and Colorado it was around 60%. Washington, New York and Kentucky hovered around 75%.
• The availability of subsidies under the law is tied to two factors that differ widely from state to state: household income and local insurance prices.

Fox News: FBI reportedly probing Oregon's botched ObamaCare launch

• The Wall Street Journal reports that the FBI has interviewed several people as part of the inquiry. The Oregonian reported that the bureau held a 90-minute meeting with a former Republican lawmaker who detailed potential wrongdoing -- including suspicions that the state showed the feds a misleading demonstration to keep money flowing.
• A U.S. House committee already is probing the Oregon debacle, as is the Government Accountability Office.
• The state received more than $300 million in federal grants to launch and operate the health care system. Much of what it has spent so far has gone to Oracle Corp.  But the system never fully got off the ground, forcing residents to use a hybrid online-and-paper process to buy insurance.

McKnight's Long-Term Care News & Assisted Living: Cash-strapped feds to cut back Medicare oversight this year, OIG official says

• The Department of Health and Human Services Office of the Inspector General anticipates reducing Medicare and Medicaid oversight activities overall by 20% in fiscal year 2014, said Gloria Jarmon, OIG deputy inspector general for audit services.
• The House subcommittee generally did not share the provider perception that fraud and abuse oversight has become too onerous. Many members said that more has to be done and lambasted CMS and OIG for being ineffectual. Rep. Jim Gerlach (R-PA) said the witnesses should be “embarrassed” by their organizations for allowing improper Medicare payments to reach $50 billion annually.
• Rep. Jim McDermott (D-WA) — who in the past has introduced significant long-term care legislation regarding rehab care and payments — warned that payment changes under the Affordable Care Act could lead to particularly insidious forms of fraud and abuse. For example, payments are increasingly linked to quality measures, and detecting providers who are manipulating these quality metrics could be much harder than, say, busting a fraudster operating a false storefront, he said.

Health Affairs: Vertical Integration: Hospital Ownership Of Physician Practices Is Associated With Higher Prices and Spending [Many health care observers/analysts have contended that Obamacare, through Accountable Care Organizations (ACOs) and other changes in Medicare reimbursement under the law, encourages provider consolidation and what is known as "vertical integration"]

• We found that an increase in the market share of hospitals with the tightest vertically integrated relationship with physicians—ownership of physician practices—was associated with higher hospital prices and spending. We found that an increase in contractual integration reduced the frequency of hospital admissions, but this effect was relatively small. Taken together, our results provide a mixed, although somewhat negative, picture of vertical integration from the perspective of the privately insured.