affordable care act

Cover Oregon Consumers Face Tight Window as All Must Make Switch

The move from the state website to the federal one means all 97,000 consumers must re-enroll to stay insured. But an open enrollment window set up before the law took effect means they’ll have just one month to sign back up or face a lapse in coverage. One insurance agent suggests the state extend 2014 plans into February to ensure a smooth switch for consumers.

Update: The article has been appended with comments from Cover Oregon staff.

Health Co-Op Leads Market in Low Rates, but Hospitals Appear to Be Pocketing Savings

None of the insurers are passing on any savings in health insurance costs now that hospitals are offering less free care. Oregon’s hospitals traditionally passed the cost of that so-called charity care onto consumers, but the ACA has provided them with a windfall revenue stream, as insurers and consumers are unable to share in that savings.

The Insurance Division has wrapped up its public hearings for proposed health insurance plan changes, with the last ones on Monday. The hearings and a review are required for all individual and fully insured small business health plans sold in Oregon.

State Fixes Funding Problem for Poor Women’s Contraceptive Care

The Affordable Care Act expanded the state Medicaid program to 350,000 new members, but it didn’t pay providers as well as a separate reproductive health program for uninsured women, provoking concerns from Rep. Mitch Greenlick that the state may be inadvertently hurting Planned Parenthood and other women’s health providers.

The state has stepped in to solve an unintended consequence of the Affordable Care Act -- reproductive health providers had gotten paid less to cover women insured by Medicaid than they did from an existing state program designed specifically to offer free contraceptive services.

Insurance Division Begins Process to Better Regulate Provider Networks

A chief goal of the division is to create more transparency for consumers shopping on Cover Oregon or elsewhere to ensure they know what physicians and services they’ll be getting before they pick a health plan. The division also wants to give clear guidelines to insurers for compliance.

The Oregon Insurance Division is responding to concerns about inadequate networks on Cover Oregon and intends to ask the Legislature for authority to regulate health insurance networks so consumers know upfront whether a plan covers the doctors or other providers they want.

What Led to Failures of the Public Health Insurance Exchanges?

In this op-ed article, the author suggests there were simultaneous failures in establishing the computer systems supporting the Affordable Care Act.

In Part 1 I suggested some reasons there were several simultaneous failures in the establishment of the computer systems supporting the Affordable Care Act including:

PacificSource Tells Insurance Division It Set Its Rate Hike Too High

PacificSource asks the Insurance Division to lower its proposed rate hike from 15.9 percent to 10.8 percent. Providence and Kaiser successfully lobbied the division last year to lower their requested premium rates after they had been priced above the competition.

PacificSource Health Plan has asked the Oregon Insurance Division to correct the filing from what it first a proposed -- an enormous 15.9 percent hike -- and lower it to a 10.8 percent hike, still several times higher than the rate of inflation.


Cambia Adjusts to Post-ACA Insurance World

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The parent company of Regence BlueCross BlueShield invests in startups, boosts its for-profit subsidiary, but insurance still contributes 99% of revenue.

The parent of Oregon’s largest health insurance company expects to pay $81 million in fees starting later this year, under a provision of the Affordable Care Act.

Why Did the Federal Government and Several States Have So Many Problems Setting Up the Computer Programs for the Public Exchanges?

Not only did those involved underestimate the complexity of the projects, they also had some latent hostility toward private insurers, according to this author.

OPINION: While mountains of commentary appeared about the problems with the so-called “roll out” of the computer system for the federal Affordable Care Act, there were also similar problems in several states that had decided to run their own public exchanges.


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