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Posts Tagged ‘advance premium tax credits’

Iowa may be first state with no health insurers on exchange – SFGate

June 12th, 2017 Comments off

DES MOINES, Iowa (AP) — Iowa could be the first state in the nation with no health insurance company willing to offer policies on its Affordable Care Act exchange next year unless President Donald Trump’s administration approves a stopgap proposal, Iowa Insurance Commissioner Doug Ommen said Monday.Ommen said he and officials from two major Iowa insurance carriers met last week with Centers for Medicare & Medicaid Services officials in Washington to pitch a proposal that would save the Iowa market from collapsing.Several counties in Missouri, Ohio and Washington state have no insurer for next year, but Iowa would be the first state to lose all insurers on an ACA exchange.

Source: Iowa may be first state with no health insurers on exchange – SFGate

The dreaded adverse selection death spiral appears to have gained a grip on Iowa’s non-group medical insurance market. The item reports Iowa Insurance Commissioner Doug Ommen is asking the federal government to redirect advance premium tax credit subsidies to improve the spread of risk in the state’s pool by attracting more younger individuals and using some of the those dollars to cover higher cost people.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Loss of ACA cost sharing reduction subsidies means higher spending on premium assistance, California exchange analysis finds

April 17th, 2017 Comments off

SACRAMENTO, Calif. — Covered California on Friday shared with the Congressional Budget Office (CBO) an analysis that shows that a decision not to provide ongoing direct federal funding for cost-sharing reductions would have immediate and dramatic effects on rates, federal spending and the viability of exchanges across the nation.“The impact of not providing direct federal funding of cost-sharing reductions is enormous, and not only puts the viability of the individual market in many states in peril, but would be a bad deal for the federal budget — costing more than $47 billion over the next 10 years,” said Peter V. Lee, executive director of Covered California.“Without the direct federal support for cost-sharing reductions, some health plans will leave the individual market entirely, and those who stay will raise rates significantly,” Lee said. “While the market in California is likely to be relatively stable, for other states there is grave uncertainty. But what is certain is that not funding cost-sharing reductions would actually cost the federal government billions more because of the interplay between rising premiums and subsidies.”

Source: Covered California Daily News: Options to Stabilize the Individual Market Can Reduce Federal Spending and Lower Premiums

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Looking at Costs and Risks, Many Skip Health Insurance – NYTimes.com

April 22nd, 2014 Comments off

Looking at Costs and Risks, Many Skip Health Insurance – NYTimes.com.

The Patient Protection and Affordable Care Act’s reforms of the individual health insurance market — a mix of carrots and sticks aimed at restoring the market to functionality — may fall short for many who will remain medically uninsured for various reasons.

For self-employeds, The New York Times piece shows the calculation on whether to participate is sharply focused on the present state of their health and finances. It also identifies what might be termed “older invincibles” — middle aged people in good health who don’t believe they will have a major illness or injury that will make buying coverage worth the cost, which rises with age. For some, that even includes factoring in advance premium tax credit subsidies.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

The next IT challenge for the health benefit exchange marketplace

December 27th, 2013 Comments off

In addition to the grueling IT challenge state health benefit exchanges have faced processing the initial surge of enrollments for 2014 coverage for individuals and small employers, their next IT test will be how well they serve as agents of the federal Internal Revenue Service.

The exchanges provide a critical tax reporting and monitoring function for the IRS, reporting small employer contributions to exchange qualified health plans (QHPs) offered their workers and advance income tax credits to subsidize QHPs purchased by individuals. The exchanges also track and report changes in monthly income of households purchasing tax-subsidized QHPs. Finally, the exchanges are charged with processing requests under the various exemption categories specified in the Affordable Care Act that allow individuals to avoid tax penalties for not having health coverage starting in 2014 or to qualify to purchase catastrophic plans.

The key test will be how well the exchanges work on an ongoing basis to obtain and process taxpayer reported data and interface with IRS data obtained through the federal data services hub that serves both federally operated and state-based exchanges. How proficiently and accurately the exchanges execute that function isn’t likely to be fully known until early 2015 when individuals and small businesses file their 2014 tax returns. That’s also when individuals must reconcile amounts they received as advance tax credits reported by the exchanges to purchase exchange-based plans with their actual earnings.

Presumably performing this critical tax function will be easier in the nearly three dozen states where the federal government is operating the exchanges. But with the IT snags in the enrollment process, there can be no guarantees it will go smoothly.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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