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From Kaiser Health News:

Kaiser Health News Original Stories

3. Political Cartoon: 'Wheels Off?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Wheels Off?'" by Chip Bok.

Here's today's health policy haiku:

PREGNANT WOMEN IN FLORIDA FACE NEW REALITY

Bug spray, long sleeves, or
Stay indoors. Zika spread means
Hard calls for women.

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Summaries Of The News:

Health Law Issues And Implementation

4. With Aetna Pullback, Many Marketplaces Will Have Only One Insurer In 2017

The lack of competition, highlighted in two new reports from consultants Avalere and McKinsey, will be most acute in Southern and rural areas. Also, a look at how the decision by Aetna is affecting the exchanges in Minnesota and Georgia.

The Hill: How ObamaCare Is Splitting In Two 
Increasingly, there are two ObamaCares. There’s the one in coastal and northern areas, where the marketplaces include multiple insurers and plans. And there’s the one in southern and rural areas, where there is often little competition, a situation that can lead to higher premiums. (Sullivan, 8/22)

The New York Times' The Upshot: Obamacare Options? In Many Parts Of Country, Only One Insurer Will Remain
So much for choice. In many parts of the country, Obamacare customers will be down to one insurer when they go to sign up for coverage next year on the public exchanges. A central tenet of the federal health law was to offer a range of affordable health plans through competition among private insurers. But a wave of insurer failures and the recent decision by several of the largest companies, including Aetna, to exit markets are leaving large portions of the country with functional monopolies for next year. According to an analysis done for The Upshot by the McKinsey Center for U.S. Health System Reform, 17 percent of Americans eligible for an Affordable Care Act plan may have only one insurer to choose next year. (Abelson and Sanger-Katz, 8/21)

Politico Pro: Fewer Insurers Will Compete For Obamacare Customers In 2017
Pullbacks by national insurers and failed co-op plans are leading to a significant decline in exchange competition for 2017, according to two new analyses of rate filings. Seventeen percent of potential Obamacare customers may have just one insurer selling exchange products in their area, according to the McKinsey Center for U.S. Health System Reforms. That’s up from just 2 percent of customers who had only one coverage option for this year. (Demko, 8/19)

Bloomberg: Choices May Be Limited For Obamacare Shoppers, Avalere Says 
The latest evidence comes in a study from consulting firm Avalere Health, which examined areas, known as rating regions, that insurers use to set premiums and decide where to offer plans to individuals under the Affordable Care Act. According to Avalere, 36 percent of the approximately 500 rating regions in the U.S. may have just one health insurer when the 2017 signup season starts on Nov. 1. Another 19 percent could have just two carriers. There was far more competition this year, with about two-thirds of rating areas having three or more health insurers vying for customers’ business, according to Avalere. (Tracer, 8/19)

Morning Consult: Regions With One Obamacare Insurer Could Spike Next Year, Analysis Shows
It’s an increase over 2016 levels, according to Avalere data, which shows that 4 percent of ratings regions — which are geographic areas used to set insurance premium rates — had just one insurer offering plans on the exchanges in 2016. Pinal County in Arizona is, as of now, the only county in the country expected to have no insurers offer plans next year. (McIntire, 8/19)

USA Today/Milwaukee Journal Sentinel: Health Insurers Eye Steep Increases As Enrollment Period Nears
With the fourth open-enrollment period set to begin this fall for the marketplaces set up by the Affordable Care Act, it’s becoming clear that the market for health insurance has not evolved as expected, or hoped. The market is smaller than projected. The people who have bought health plans overall are sicker than predicted. And health insurers have incurred larger losses than anticipated. (Boulton, 8/22)

The Star Tribune: Fears For Competition Grow On Exchanges 
Last week, Minnesota regulators issued a request for proposals from groups that might be willing to step in and sell coverage on the state’s MNsure exchange, particularly in counties outside the Twin Cities metro. It came after Blue Cross and Blue Shield of Minnesota announced in June a pullback that could cut options in 11 rural counties. The request came on the same day that Connecticut-based health insurance giant Aetna announced it would stop selling next year coverage on 11 of 15 state exchanges where it currently competes. (Snowbeck, 8/20)

Georgia Health News: Blue Cross May Bump Up Rates On Georgia Insurance Exchange
Blue Cross and Blue Shield of Georgia says it is reassessing the premium increases it has previously proposed for the state health insurance exchange, with an eye to revising them upward. This comes in the wake of Aetna’s pullout from the exchange here. Blue Cross, the state’s largest health insurer, reiterated its stance that it will remain in Georgia’s exchange next year. But it won’t have much time to readjust its rate proposal. (Miller, 8/19)

5. Federal Officials Warn Medicaid Enrollees To Drop Subsidized Marketplace Coverage

The government is sending out letters to tens of thousands of people who may have duplicate coverage. Also, a look at how small business owners are feeling pressure to offer insurance, how many marketplace plans often are bare bones offerings and problems in the tanning industry are blamed on the health law.

The New York Times: U.S. Officials Move To End Duplicate Health Care Coverage
The Obama administration is moving to end duplicate coverage for tens of thousands of people who are enrolled in Medicaid and simultaneously receiving federal subsidies to help pay for private health insurance under the Affordable Care Act. ... The action ... comes more than nine months after congressional investigators from the Government Accountability Office said they had discovered the potential for duplicate coverage, with double payment. The potential is significant because low-income people can switch back and forth between Medicaid and subsidized private coverage as their circumstances change. (Pear, 8/21)

The Wall Street Journal: Some Small Businesses Restore Group Health Coverage
Some small companies that dropped group health insurance for their employees are reversing course, driven by a tightening labor market and rising costs and fewer choices for individual coverage. Laura Cottrell, owner of a seven-person home-furnishings and home-improvement products business in St. Louis, dropped group coverage in 2014, not only because of the cost but also the complexities of picking the right plan within a short deadline. Instead, she gave her employees a raise that they could use to buy their own health plans, sparing her from choosing for them. (Simon, 8/21)

The New York Times: Think Your Obamacare Plan Will Be Like Employer Coverage? Think Again
When Obamacare was developed, one goal was to allow middle-class Americans to use the new marketplaces to buy the same kind of health insurance they had at their jobs. People could retire early, or quit a corporate job and become a freelancer, and still have the great care and financial protection that come with high-end plans. But six years into the health law, the reality is that a typical Obamacare plan looks more like Medicaid, only with a high deductible. (Sanger-Katz, 8/21)

The Associated Press: Tanning Industry Blames 10,000 Salon Closings On 'Obamacare'
The tanning salon industry is feeling burned by "Obamacare." Business owners around the country say the little-noticed 10 percent tax on tanning in President Barack Obama's health care overhaul has crippled the industry, forcing the closing of nearly 10,000 of the more than 18,000 tanning salons in the U.S. Experts say the industry is overstating the effects of the "tan tax" and that it has been hurt by other factors, too, including public health warnings about the dangers of tanning and the passage of laws in dozens of states restricting the use of tanning salons by minors. (Kennedy, 8/20)

6. Americans Covered By Obamacare Watch Campaign 2016 With Vested Interests

The Associated Press spotlights the potential impact of this year's elections on the health law and the people that it covers.

The Associated Press: Repeal Or Retain? Election Opens Final Act For 'Obamacare'
Election Day 2016 will raise the curtain on the final act in the nation's long-running political drama over President Barack Obama's health care overhaul. If Republican Donald Trump wins, the unraveling begins. "We have an obligation to the people who voted for us to proceed with 'repeal and replace,'" said Sen. John Barrasso, a Wyoming Republican. If Democrat Hillary Clinton goes to the White House, it gets very difficult for Republicans to keep a straight face about repealing "Obamacare." (Alonso-Zaldivar, 8/20)

The Associated Press: Man Who Owes Insurance To 'Obamacare' Still Voting For Trump
When Bruce Bradford was fired after nearly two decades as a federal police officer, he lost his income, his health insurance and eventually his wife and apartment as his medical problems mounted. He ended up being thrown a lifeline by the very politicians he can't stand. Bradford, a longtime Republican who dislikes big government and what he regards as handouts, obtained insurance and a monthly government subsidy under President Barack Obama's health care overhaul. (Kennedy, 8/20)

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