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Monday, Nov 18 2024

Full Issue

Health Executives Banking On Political Risks To Preserve ACA Subsidies

Some Republicans oppose extending enhanced tax credits for Affordable Care Act insurance plans that are set to expire at the end of 2025. Not doing so, though, would risk millions of people losing coverage, many of whom live in red states. Health care executives are optimistic that the subsidies will be extended even when Republicans take power.

The health care industry鈥檚 interest isn鈥檛 necessarily rooted in political analysis. It鈥檚 financial: Those subsidies are worth $25 billion annually. Insurance companies that sell ACA plans retain some of that federal revenue as profit. Hospitals and doctors who treat patients with ACA coverage benefit from those plans鈥 higher payment rates and avoid bad debt if those patients had no insurance coverage at all. Oscar Health鈥檚 business heavily depends on Congress renewing those subsidies. The publicly traded insurer sells only ACA plans. Over the summer, Oscar forecast its ACA membership would decline 18% over a two-year period if the enhanced subsidies went away. (Herman, 11/18)

But eliminating the subsidy increase poses political risks. If subsidies fall to their pre-2021 level, experts say, many new subscribers would choose not to renew their coverage 鈥 the nonpartisan Congressional Budget Office predicted that 3.4 million more people would become uninsured 鈥 and many of them live in states that lean heavily Republican. Health policy research organization 麻豆女优 said that if the subsidy expansion expires, premiums would more than double in 12 heavily Republican states 鈥 including Texas, West Virginia and Alaska 鈥 while rising less sharply in many blue states. (Weil, 11/17)

The results of a study by the Pennsylvania Insurance Department (PID) reveal some startling problems with the Affordable Care Act marketplace. The biggest issue found was the inaccuracy of health insurer provider directories, which can delay care, hinder scheduling and result in surprise out-of-network billing, the agency said. The study found that only 13% of the provider listings had accurate contact information, and up to 44% of providers were unreachable because of incorrect information. The most common inaccuracies involved outdated contact information and incorrect specialty listings, which can mislead patients and lead to care delays and unexpected charges. (Coller, 11/15)

In other news about Social Security 鈥

Efforts to get the Senate to vote on a bill to expand Social Security benefits are intensifying, as the House-passed Social Security Fairness Act enjoys rare bipartisan support but has only a short window of time 鈥 six weeks 鈥 to be passed. Decades in the making, the legislation would eliminate a provision that reduces Social Security payments to some retirees who also collect a pension from jobs that aren't covered by the retirement program, such as state and federal workers including teachers, police officers and U.S. postal workers. It would also end a second provision that reduces Social Security benefits for those workers' surviving spouses and family members. (Gibson, 11/15)

The House has passed legislation that would provide full Social Security benefits to millions of people, pushing it one step closer to becoming law. The Social Security bill on Tuesday won bipartisan support in the House, 327-75, in what is now the lame-duck period for Congress. The bill now heads to the Senate, where passage is not assured despite considerable support. Here鈥檚 what to know about the legislation and what could happen next. (11/16)

麻豆女优 Health News: Social Security Tackles Overpayment 鈥業njustices,鈥 But Problems Remain

In March, newly installed Social Security chief Martin O鈥橫alley criticized agency 鈥渋njustices鈥 that 鈥渟hock our shared sense of equity and good conscience as Americans.鈥 He promised to overhaul the Social Security Administration鈥檚 often heavy-handed efforts to claw back money that millions of recipients 鈥 including people who are living in poverty, are elderly, or have disabilities 鈥 were allegedly overpaid, as described by a 麻豆女优 Health News and Cox Media Group investigation last year. 鈥淚nnocent people can be badly hurt,鈥 O鈥橫alley said at the time. (Hilzenrath and Fleischer, 11/18)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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