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Morning Briefing

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Friday, May 17 2019

Full Issue

Wash. Governor Says State Is Leading Nation To Brighter Future With Public Option, But It's Not Yet Clear How Much Patients Will Save

Even sponsors of the legislation acknowledge the state plans may save consumers only 5-10% on their premiums. Other news on insurance markets in the states comes from North Carolina, Georgia and Houston.

Millions of Americans who buy individual health insurance, and don't qualify for a federal subsidy, have been hit with sticker shock in recent years. Instability and uncertainty in the individual market — driven in part by changes Congress and the Trump administration made to the Affordable Care Act — have resulted in double-digit premium increases. Now Washington state has passed a law designed to give consumers another choice: a new, "public option" health insurance plan that, in theory, will be cheaper. (Jenkins, 5/16)

This week, state treasurer Dale Folwell released the details of the contracts he wants North Carolina’s health care providers to sign if they want to participate in the health plan covering state employees, retirees and their families. The contracts, part of what Folwell is calling the Clear Pricing Project, reworks the way that health care providers are reimbursed. Some providers, in particular hospitals, will feel the pinch under the plan, which pegs prices paid by the State Health Plan to those paid by the federal Medicare program for services. (Hoban, 5/17)

Jim Beck, Georgia’s insurance commissioner, is now officially suspended from office in the wake of his federal indictment Tuesday on charges of fraud and money laundering. Beck announced Thursday that he was voluntarily taking a suspension. The insurance department said that in his absence, Drew Lane, the chief deputy commissioner, would perform the duties of commissioner as outlined under state law. (Miller, 5/16)

Houston employer-based health plans are paying hospitals more than double, and in some cases quadruple, what Medicare would pay for the same treatment, a new national study has found. The findings by the RAND Corporation, released last week, examined what hospitals charged employer health plans in 25 states from 2016 to 2018. The biggest gap came in out-patient payments, which in Houston were as high as 448 percent of Medicare. That means a procedure that be might cost Medicare $1,000 would cost an employer-based plan $4,480. (Deam, 5/16)

Kaiser Health News: ‘Sham’ Sharing Ministries Test Faith Of Patients And Insurance Regulators

Sheri Lewis, 59, of Seattle, needed a hip transplant. Bradley Fuller, 63, of nearby Kirkland, needed chemotherapy and radiation when the pain in his jaw turned out to be throat cancer. And Kim Bruzas, 55, of Waitsburg, hundreds of miles away, needed emergency care to stop sudden —and severe — rectal bleeding.Each of these Washington state residents required medical treatment during the past few years, and each thought they had purchased health insurance through an online site. But when it was time to pay the bills, they learned that the products they bought through Aliera Healthcare Inc. weren’t insurance at all — and that the cost of their care wasn’t covered. (Aleccia, 5/17)

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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