Kaiser Health News Original Stories

3. Political Cartoon: 'Fine Line'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Fine Line'" by Steve Kelley and Jeff Parker, from 'Dustin'.

Here's today's health policy haiku:


HHS offers
New rules for exchange plans. Will
They please insurers?

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Health Law Issues And Implementation

4. HHS Draft Rule For 2017 Insurance Includes Standards For Networks Of Doctors, Hospitals

The proposal would mandate the number of doctors and other health care providers to provide better access. It would also meet some of the concerns of insurers and offer states an easier way to handle their insurance marketplaces.

The Washington Post: HHS Proposes More Consumer-Friendly Rules For ACA Health Plans
Federal health officials Friday proposed changes to the rules for health coverage sold through insurance exchanges, including a possible floor for how many doctors and other providers each plan must include. The rules are intended to make it easier for consumers to compare their options in the marketplaces created under the Affordable Care Act. They would define standard deductibles and co-payments, and allow insurers to sell plans with that specific benefit design. (Goldstein, 11/20)

Modern Healthcare: CMS May Impose Minimum Provider Network Standards For ACA Plans
The CMS has proposed mandating minimum network standards for health plans sold on the federal insurance marketplace in 2017 as part of an effort to handle the broad shift toward narrow provider networks. The Affordable Care Act requires that all medical policies on the exchanges have enough in-network hospitals and doctors for members so that “all services will be accessible without unreasonable delay.” In addition, ACA-compliant plan networks must update their provider directories monthly and include at least 30% of essential providers. (Herman and Dickson, 11/20)

The Wall Street Journal: Health Law’s 2017 Enrollment Period, End Of Election Campaigns To Coincide
The next sign-up season for 2017 health coverage under the Affordable Care Act will begin just as the 2016 election campaigns draw to a close, under draft rules released by the Obama administration on Friday afternoon. The open enrollment period for people buying insurance on their own for 2017 will start Nov. 1, 2016, and end Jan. 31, 2017, federal officials outlined in the draft rules. In earlier iterations of regulations, they had suggested starting as early as Oct. 1, before appearing to settle on the same dates they are using for this year’s open enrollment period, which is now three weeks under way. (Radnofsky and Wilde Mathews, 11/20)

USA Today: Insurers: Obamacare Changes Needed Soon To Protect Us From Losses
Federal regulators on Friday proposed potential solutions to some of the Obamacare problems that led UnitedHealth Group to warn it may exit the health exchanges in 2017, but the government also may make it tougher for insurers to limit the number of doctors and hospitals in their plan networks. The proposed rule from the Centers for Medicare and Medicaid Services would reduce insurers' administrative costs, maintain fee levels and improve the accuracy of a payment formula designed to minimize insurers' risks when taking on new customers. (O'Donnell, 11/21)

The Hill: Feds Take Steps To Bolster Finances Of State-Run Health Exchanges
The Obama administration on Friday proposed a new type of partnership between state and federal health marketplaces in an attempt to address the mounting financial pressures on state-run exchanges. Under the new model, states would be allowed to use federal resources like call centers or website platforms while maintaining their own decision-making power. (Ferris, 11/20)

5. Key Insurers On Health Law Exchanges Reaffirm Commitment To That Market

Despite the announcement by UnitedHealthcare on Thursday that it might leave the marketplaces set up by the health law, insurers Aetna, Anthem and Molina said they are meeting expections in their marketplace business.

The Wall Street Journal: Aetna, Anthem Say Individual Commercial Business Is On Track
Health insurers Aetna Inc. and Anthem Inc. on Friday said their individual commercial businesses have performed within expectations lately, a day after UnitedHealth Group Inc. said it was considering exiting the Affordable Care Act’s exchanges. The statements could be a sign that big problems with business on government exchanges aren’t widespread across insurers. (Becker, 11/20)

The Associated Press: Insurers Reassure Investors About ACA Exchange Business
Health insurers rallied Friday to ease investor and customer concerns about the Affordable Care Act's public insurance exchanges a day after the nation's biggest insurer questioned its future in that still-developing market. Blue Cross-Blue Shield insurer Anthem and Medicaid coverage provider Molina Healthcare both said they are making money off their exchange business, and Anthem joined Aetna, the nation's third-largest health insurer, in reaffirming its 2015 earnings forecast. (Murphy, 11/20)

Reuters: Aetna, Anthem Reassure Investors On Obamacare Business
U.S. health insurers Aetna Inc and Anthem Inc on Friday sought to reassure investors that their Obamacare businesses had not worsened after UnitedHealth Group Inc warned of mounting losses in that sector. Aetna and Anthem said their individual insurance businesses, which include the plans created by President Barack Obama's national healthcare reform law, had performed in line with projections through October. Both backed their earnings forecasts for 2015. (Humer, 11/20)

The Hill: Major Insurers Anthem, Aetna Standing Behind ObamaCare Plans
Health insurance giants Anthem and Aetna are standing behind their ObamaCare plans one day after a top competitor warned it might pull out of the exchanges. In a statement on Friday, both companies backed their 2015 forecasts and said they remained committed to the exchanges. (Ferris, 11/20)

Bloomberg: Hospitals Feel Pain As UnitedHealth Eyes Health-Exchange Exit
The possible departure of insurance leader UnitedHealth Group Inc. from the Affordable Care Act signals worsening prospects for hospitals already facing a slowdown in gains from the program. ... Hospitals, including for-profit chains HCA Holdings and Tenet Healthcare, have already agreed to cuts in Medicare reimbursements, expecting they'd see fewer uninsured patients, said Sheryl Skolnick, an analyst with Mizuho Securities USA Inc. in New York. The administration has predicted slow growth in sign-ups under the ACA, and UnitedHealth's announcement suggests insurers are less willing to participate. (Lauerman, 11/20)

And concerns also continue about the effect of pending mergers among major insurers -

The New York Times: States Urged To Review Health Insurer Mergers
Consumer advocates and antitrust experts are urging state regulators to closely examine the proposed mergers of major health insurance companies, saying they threaten to leave consumers with fewer choices and higher prices. On Friday, David A. Balto, an antitrust lawyer and former federal regulator, asked the National Association of Insurance Commissioners, composed of state officials, to create a working group to help regulators conduct their reviews. (Abelson, 11/20)

6. Health Law Gives Young Adults Freedom To Make Job Decisions: Study

The ability to stay on a parent's health care plan is giving millennials more career flexibility and time, according to a new study. But it is proving difficult to persuade young Americans to buy their own insurance, The Milwaukee Journal-Sentinel reports. And in another gauge of public opinion, a new Gallup poll shows growing discontent with Obamacare.

The Washington Post: How Obamacare Helped Millennials Chill Out
Although young people have been slow to sign up on their own [for insurance following the health law's passage], insurance plans have to cover dependent children through age 26, resulting in increased coverage— and a lot more young people who don't necessarily have to work in order to have access to health care. New research suggests that some of those young people are taking advantage of the newfound freedom, and are feeling pretty good about it. (DePillis, 11/21)