WASHINGTON (AP) — Changing the way it does business, Medicare on Friday unveiled a far-reaching overhaul of how it pays doctors and other clinicians.
The goal is to reward quality, penalize poor performance, and avoid paying piecemeal for services. Whether it succeeds or fails, it’s one of the biggest changes in Medicare’s 50-year history.
The complex regulation is nearly 2,400 pages long and will take years to fully implement. It’s meant to carry out bipartisan legislation passed by Congress and signed by President Barack Obama last year.
A growing number of people in Obamacare are finding out their health insurance plans will disappear from the program next year, forcing them to find new coverage even as options shrink and prices rise.
At least 1.4 million people in 32 states will lose the Obamacare plan they have now, according to state officials contacted by Bloomberg. That’s largely caused by Aetna Inc., UnitedHealth Group Inc. and some state or regional insurers quitting the law’s marketsfor individual coverage.
Sign-ups for Obamacare coverage begin next month. Fallout from the quitting insurers has emerged as the latest threat to the law, which is also a major focal point in the U.S. presidential election. While it’s not clear what all the consequences of the departing insurers will be, interviews with regulators and insurance customers suggest that plans will be fewer and more expensive, and may not include the same doctors and hospitals.
It may also mean that instead of growing in 2017, Obamacare could shrink. As of March 31, the law covered 11.1 million people; an Oct. 13 S&P Global Ratings report predicted that enrollment next year will range from an 8 percent decline to a 4 percent gain.
Bill Clinton, the husband of the Democratic presidential nominee, knocked President Obama’s signature piece of legislation — the ObamaCare health care law — as “the craziest thing in the world.”
“You’ve got this crazy system where all of a sudden 25 million more people have health care, and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half and it’s the craziest thing in the world,” the former president railed at a rally in Michigan on Monday.
Clinton also said the system is hurting moderately successful small businesses — the ones that aren’t doing poorly enough to be subsidized and fall just above the line.
“On the other hand, the current system works fine if you’re eligible for Medicaid, if you’re a lower-income working person. If you’re already on Medicare or if you get enough subsidies on a modest income that you can afford your health care,” Clinton said.
ST. PAUL, Minn. (AP) — Minnesota’s top health insurance regulator says the state’s individual market is in “an emergency situation” amid big rate increases for next year.
Department of Commerce Commissioner Mike Rothman said Friday that the five companies offering plans through the state’s exchange or directly to consumers were prepared to leave the market for 2017. He said big rate increases were the tradeoff to convince all but one company to remain for now.
Rate increases finalized this week range from a 50 percent average hike for HealthPartners plans to a 67 percent jump on average on UCare.
Ridgewood NJ,Just when you thought the 2016 presidential campaign could not get any crazier ,Hillary Clinton’s new anti-Trump poster child is literally a porn star who was accused of driving the getaway vehicle for a murder attempt and later threatening to kill a judge.
Hillary Clinton brought up Alicia Machado, who won the Miss Universe pageant owned by Trump back in 1996, during the debate on Monday night, claiming that Trump once called her “Miss Piggy” because she gained a lot of weight while representing the pageant.
The irony of Clinton accusing Trump of being abusive to women is not lost on anyone familiar with the President Clinton era so called “Bimbo Eruptions ” and the Hillary run war room looking to threaten and discredit any women who dared accuse Bill Clinton of infidelity and sometimes even rape allegations .
Alicia Machado past reads like a telenovela, including being accused of acting as an accomplice in an attempted murder,threatening to kill a judge, anal porn scenes for cash and the former Miss Universe was also reportedly the baby mama for the child of a notorious Mexican drug kingpin Gerardo Alvarez-Vazquez.
So Trump called a beauty contestant not a chess master, overweight when she gained over 50 pounds after winning the Miss Universe pageant. Not only that Trump fought with the pageant that he owned to help her keep her job ; sent her to the gym and spa in an attempt to get her back in shape after she lost many endorsement deals.
We would prefer like many that we get back to talking about jobs, trade , Obamacare , immigration ,taxes you know real issues that effect even those that live in Ridgewood .
Ridgewood NJ, Rep. Scott Garrett (NJ-05) called on the Food and Drug Administration (FDA) to express concerns over the near monopoly currently held by Mylan Pharmaceuticals on the EpiPen (epinephrine injection) which is used in the treatment of severe allergic reactions. The price of these life-saving devices has skyrocketed recently, making them unaffordable for many Americans families.
“Like many government bureaucracies, the Food and Drug Administration stifles innovation and creates unnecessary roadblocks that end up hurting the American people,” said Garrett. “In this case, their short-sightedness has made a common treatment that millions of Americans rely on prohibitively expensive. The FDA has a job to protect Americans and ensure the food and drugs we use are safe, but they also need to make sure their actions don’t hurt the very people they’re trying to protect.”
The letter, signed by a number of Members of Congress, asks the EPA to allow other companies to make alternatives to the EpiPen product by streamlining the FDA review process. Specifically, the letter asks:
– If the FDA can clarify whether any barriers exist to the approval of safe alternative products to EpiPens.
– How many alternatives to Mylan’s EpiPen are currently being reviewed by the FDA
– Where these alternatives are in the review process
A couple of months back we posted 9 charts that, at least in our minds, debunked the myth of the “Obama Recovery” despite suggestions from the administration that any such efforts were just a futile attempt at “peddling fiction” (our original post: “These Are The 9 Zero Hedge Charts Showing “Obama’s Recovery” That Angered The Washington Post”).
Turns out that Harvard likes to dabble in “fiction peddling” as well:
By Susan K. Livio | NJ Advance Media for NJ.com
on September 12, 2016 at 8:18 PM, updated September 13, 2016 at 8:38 AM
TRENTON — Faced with “a deteriorating financial condition,” another health insurance carrier is pulling out of New Jersey’s health exchange marketplace created under the Affordable Care Act, forcing 35,000 policy holders to find a new plan in 2017, the state’s top insurance official announced Monday night.
Health Republic Insurance of New Jersey will serve customers through the end of the year, state Department of Banking and Insurance Commissioner Richard Badolato said.
The state is working out a “rehabilitation” plan that preserves the carrier’s financial assets so medical providers will be reimbursed for the care they provide consumers for the remainder of the year, Badolato said in a statement late Monday.
“We will also be assisting individual consumers as they transition to a new plan during the open enrollment period this fall,” Badolato said. “Similarly, we will work with small employers as they seek replacement plans for their businesses.”
Eight of the states that will determine the Senate majority in November are likely to see significant reductions in the number of insurers participating in ObamaCare marketplaces.
The likely departures of insurers in Illinois, Wisconsin, Florida, Pennsylvania, Ohio, North Carolina, Arizona and Missouri are pushing the healthcare law toward the center of some of the most competitive Senate races in the country.
GOP strategists say Obama-Care’s troubles this year are morphing into a perfect storm for their candidates, providing a boost in a year when the party is defending 24 Senate seats.
“It feels like there’s a sleeping giant that’s about to awaken on the campaign trail,” veteran Republican strategist Ron Bonjean said. “It really does seem like an easy target, an easy layup for Republicans to score points.”
Health insurers have been fleeing the marketplaces over the last year, citing steep financial losses. The departures, which have included industry leaders like UnitedHealth Group and Aetna Inc., are cutting into the choices people have when selecting ObamaCare plans.
Next year, exactly half of all states are expected to see fewer ObamaCare options in at least one county, according to data compiled by the Kaiser Family Foundation.
An analysis of the Kaiser data by The Hill found that the exits from ObamaCare align with some of the biggest battlegrounds for Senate Republicans this year.
Every county in Ohio, a crucial swing state, is on track to lose at least two insurers compared to last year. All of the counties in Pennsylvania, Indiana, Missouri, Arizona and Illinois are also expected to lose at least one option, according to Kaiser.
It’s extremely unlikely Democrats will have to change the ticket. But even some Clinton allies say there should be a clearer process.
By KYLE CHENEY
Updated 09/12/16 06:01 PM EDT
A former Democratic National Committee chairman says President Barack Obama and the party’s congressional leaders should immediately come up with a process to identify a potential successor candidate for Hillary Clinton for the off-chance a health emergency forces her out of the race.
“Now is the time for all good political leaders to come to the aid of their party,” said Don Fowler, who helmed the DNC from 1995 to 1997, during Bill Clinton’s presidency, and has backed Hillary Clinton since her 2008 presidential bid. “I think the plan should be developed by 6 o’clock this afternoon.”
By Yoav Gonen, Shawn Cohen, Tina Moore and Bruce Golding
September 12, 2016 | 4:42pm
Hillary Clinton was headed to an emergency room following her frightening collapse at the Sept. 11 memorial ceremony — but detoured to daughter Chelsea Clinton’s apartment to keep details of her medical treatment under wraps, The Post has learned.
Secret Service protocol called for the Democratic presidential nominee to be rushed to a state-designated Level I Trauma Center in the wake of her Sunday morning health crisis, sources said.
There’s something about Obamacare that really shines a light on the stupid. And by that I mean stupid politicians, stupid “experts,” and even regular – but stupid – Americans. And in case you missed it, the last few weeks have presented us, and the presidential candidates, with more solid evidence of ACA-related stupidity than usual. Let’s look at the top three contenders on the Obamacare Stupid Bowl ’16:
First, we now know that Obamacare enrollment has fallen short by 24 million people. The real number of enrolled Americans in ACA plans is 11.1 million. Making matters worse is the fact that a major chunk of the people not signing up are the younger and healthier Americans the ACA’s architects were foolishly relying on to help absorb the costs from older and sicker enrollees. This is the continuing development that many call the “Obamacare Death Spiral.”
Second, so many Insurance companies are curtailing their participation in Obamacare exchanges that 31 percent of U.S. counties are likely to have just one insurance company option for health coverage by next year. That’s what we call a monopoly. And in case you don’t know how dangerous monopolies can be in health care, Google the words “Mylan” and “EpiPen” when you get a chance.
It’s Labor Day weekend, and despite unemployment under 5% and nearly 15 million private-sector jobs created since February 2010, nobody’s celebrating.
Workforce participation is stuck near historic lows, six million people are part-timers but want to work full time, and wage growth remains subdued.
Both presidential candidates have talked a good game about jobs and the economy, but neither addresses the real problem. The U.S. job-creation machine—once the envy of the world—is broken, because American corporations cannot create steady, well-paying jobs here in the USA while also providing maximal returns to their investors, who are really in charge.
Citing the financial unsustainability of Obamacare, both the insured and insurers are fleeing Obamacare in increasing numbers, leaving President Obama’s takeover of the nation’s healthcare system on the verge of collapse.
The administration has claimed Obamacare — officially designated the Affordable Care Act — to be a great success, insisting that 20 million previously uninsured Americans now have insurance. But according to a report at The Guardian, that “success” comes at the expense of all the features that were supposed to make the law sustainable.
President Obama and his cohorts imagined that since Obamacare was to be compulsory, millions of healthy young Americans would immediately sign up, and the massive influx of cash paid into the system as insurance premiums would help pay for the higher costs in care doled out to older, sicker enrollees.
Jayne O’Donnell and Tony Leys, USA TODAY Network8:46 p.m. EDT September 1, 2016
Many of next year’s premium rate increases on theAffordable Care Act exchanges threaten to surpass the high and wildly fluctuating rates that characterized the individual insurance market before the health law took effect, interviews with insurance regulators and records show.
With dramatic drops in insurance company participation on the exchanges for some states, decreased competition and other factors are leading to often jarring rate hikes. Some of the states that are facing what are likely among the biggest increases this year — Tennessee, Arizona and North Carolina — were among those the Urban Institutereported in May had the biggest increases last year.
“The reality is, it’s all very justified, unfortunately,” Iowa insurance commissioner Nick Gerhart said Thursday of the premium increases he approved this week of 19% to 43% for about 70,000 Iowans who buy their own policies.
Gerhart warned consumers in a rate hearing in July that if he rejected insurers’ proposed premium increases for 2017, the carriers would likely decline to sell policies in the state. No carriers made an explicit threat to leave Iowa, but the implication was clear, he says: “It gives you less room to maneuver.” Iowa law, he said, requires him to judge proposed premium increases on whether experts find them to be justified by carriers’ projected costs
As other state insurance commissioners gradually sign off on insurers’ rate requests — which should all be decided within a month — many consumers are learning what’s in store for 2017.
