Insurer Mounts Offensive And Defensive Strategies On Health Law
Cigna Corp. has geared up with a high-powered team of executives to find new business under the health law while also preserving current benefits for customers and for the company.
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Cigna Corp. has geared up with a high-powered team of executives to find new business under the health law while also preserving current benefits for customers and for the company.
Insurers, lawmakers and state insurance regulators continue to debate what may and may not be included in a calculation of the medical loss ratio. Separately, debate is also ongoing over how much power individual states have to enforce provisions of the health care law.
The new health overhaul law aims to end all annual dollar limits on health insurance policies by 2014, but insurers that offer limited-benefit plans can seek waivers so they can continue to offer them. Many employers want to keep the plans, criticized by consumer advocates as skimpy.
House leaders are taking the unusual step this week of interrupting the August recess to call members back to consider state aid legislation that includes $16 billion in federal Medicaid assistance. The Senate approved this funding package last week.
It takes some work, but patients can help control health care costs by avoiding unneeded care and negotiating prices, among other things.
This week, HHS issued rules on high-risk health insurance pools as well as guidance on children's coverage issues. Two new polls focused on seniors and health reform, and both political parties continued to position themselves for the fall elections.
During the health reform debate, people with pre-existing conditions lobbied for affordable health insurance. Now, HHS has issued new rules on how high-risk pools will work.
Deficit and debt drive cuts in jobs and services
A look at the new health law's long-term-care program and the plan to close the Medicare drug doughnut hole.
This week's health policy news was marked by new administration rules regarding the appeals process for denied health insurance claims and continuing state-level efforts to implement high risk pools.
The Obama administration issues regulations that will set some minimum requirements for the process, including allowing patients to appeal the insurer's decision to an independent outside panel.
The health overhaul prohibits new insurance plans from charging higher copayments or coinsurance amounts for out-of-network emergency services or from imposing other coverage limitations that wouldn't apply to in-network care.
This week, news outlets covered the Obama administration as it began implementing parts of the new health law and also unveiled a national HIV/AIDS strategy. And, Capitol Hill is still reacting to the president's recess appointment of Dr. Donald Berwick to head the agency overseeing Medicare and Medicaid.
Panel's recommendations on preventive care will determine which services are covered fully by insurance. That could make it a political lightning rod for lobbyists and disease advocates and conflict with its tradition of scholarly dedication to the science of randomized medical trials.
AHIP walks reporters through the process of how actual premiums are calculated for the individual and small group market.
Under the new health law, many insurers will have to publicly report how much they plan to raise premiums and why, but consumer advocates say draft rules on how much information is required to justify "unreasonable" increases fall short.
Democrats had hoped to extend health insurance subsidies for newly laid off workers, extend extra Medicaid payments to the states, and pass a long term Medicare 'doc fix' before the July 4 recess. But all they could accomplish was a short-term Medicare fix.
The new health law mandated that the government set up a website to help consumers understand all of their insurance options. The site, www.healthcare.gov, launched July 1.
The new health care law promises to make it easier for part-time workers to find and buy affordable coverage, starting in 2014. Until then, they don't have a lot of options.
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