In an article dated February 28, 2017, the author discussed a GOP plan to make health insurance more portable by allowing consumers to take their plans with them if they move, retire, or change jobs. Although a popular idea for many, it does present some structural concerns due to the setup of insurance markets and networks.
From NPR, “What If You Could Take It With You? Health Insurance, That Is”
Except from the article:
“To be truly portable, consumers must be offered plans regardless of their health status, age or other considerations. Before the health law was enacted, insurers could reject people with medical conditions. But the ACA prohibits insurers from redlining sick people or charging them higher premiums. Although popular in opinion polls, those Obamacare provisions may face some changes under the GOP plans.”
United Healthcare, the largest health insurance provider in the country, recently announced that it is considering the possibility of ending its participation in the healthcare insurance exchange networks established under the Affordable Care Act. According to UnitedHealthcare, the company’s earnings are down, due, at least in part, to its participation in the exchange networks and, as a result, the company will, at the very least, decrease its marketing efforts in connection with the networks. While United Healthcare is the largest insurance provider yet threatening to pull its plans from the exchange programs, more than a dozen smaller health insurers have already dropped out of the programs, having previously covered approximately 800,000 individuals.
Experts opine that if this trend continues, the lower number of plans available to consumers on the exchange networks could defeating the goals of the Affordable Care Act. State and federal governments may be forced to intervene to ensure the continued viability of the exchange networks. Such invention could include a federal insurer bailout program, making participation on the exchange a prerequisite to offering plans elsewhere in the state, or mandating that private insurers offering insurance through Medicare and Medicaid offer plans on the exchanges.
Since the implementation of the Affordable Care Act (“ACA”), millions of Americans have enrolled in Medicaid. However, the government has not ensured that the new beneficiaries will have access to doctors. In fact, many Medicaid recipients are finding that they have to wait months due to shortages of doctors who accept Medicaid. Daniel R. Levinson, the inspector general of the Department of Health and Human Services, blames the lack of access on variations in standards between states. More specifically, most states rely on private insurance companies to comply with Federal rules in providing Medicaid beneficiaries with “adequate access to all services covered.” However, “adequate” is defined by each state. Some states opt for a “time and distance” standard for access, others set a maximum number of days a patient may have to wait to see a doctor, and some base the standard on a doctor/patient ratio. The result has left many Medicaid patients waiting up to 60 days to see a specialist, while others are forced to travel great distances because their state only requires one primary care provider for every 2,500 beneficiaries.
Mr. Levinson believes that the federal government should be more involved in developing and enforcing state standards of access. However, insurance companies worry that if the federal government forces a larger pool of doctors who accept Medicaid, it will upset the low premiums resulting from insurers limiting access.
According to an anonymous source working for Health and Human Services, a “malicious code” was inserted into the healthcare.gov website in July. The website contains personal information about millions of Americans who purchased health insurance following implementation of the Affordable Care Act. Although it appears that no personal information was compromised, the hacker bypassed the website’s security in an attempt to control the website during future attacks, raising concerns about the website’s vulnerability.
The Supreme Court recently held in Burwell v. Hobby Lobby Stores, Inc.that the Department of Heath and Human Services (“HHS”) could not require three closely held corporations to provide health-insurance coverage for “methods of contraception that violate the sincerely held religious belief’s of the companies’ owners.” Justice Alito’s opinion stated that such regulations violate the Religious Freedom Restoration Act (“RFRA”) of 1993 by creating a substantial burden on the free exercise of religion. The Court’s 5-4 decision rejected HHS’s argument that owners of a corporation forfeit RFRA protections.
The McClatchy Company owns 30 daily U.S. newspapers, and like other large U.S. companies, such as General Electric, Time Warner and the International Business Machines Corporation, it has chosen to reexamine “all” of its health care plans—which includes its health care plan for retirees. McClatchy’s current insurance coverage for retirees does not meet the standards set by the Affordable Care Act. Though nothing in the Act requires McClatchy to end its health care plan for retirees, the company will steer its former employees to the insurance exchanges.
Various partisan organizations use the media to wage their battles in the war surrounding the Affordable Care Act (ACA). However, one outfit in particular, Generation Opportunity, a conservative group based in Virginia, has launched a campaign (described as “creepy”) aimed at convincing younger people not to enroll in the insurance exchanges. In order to sway this population, Generation Opportunity made a video featuring a young woman visiting the gynecologist. The young woman is in stirrups; her female doctor leaves the room unexpectedly—in order to make way for “a leering Uncle Sam” brandishing a speculum. The woman squirms and screams out of fear. The president of Generation Opportunity claims that the goal is to educate the younger population, and not to insinuate rape. The group made a similar video geared to the young, male population, in which Uncle Sam snaps on his rubber glove.