Implementation issues: Actuaries under the microscope, tax subsidy projections and finding money for high-risk pools

Apr 19 2013

Health law backers question the predictions of insurance "rate shock," because they are made by actuaries who have close ties to the industry. Meanwhile, news outlets report on a study that projects who will get the health law's tax subsidies on a state-by-state basis.

Kaiser Health News: Health Insurance Actuaries In the Hot Seat On 'Rate Shock'
Few aspects of the Affordable Care Act are more critical to its success than affordability, but in recent weeks experts have predicted costs for some health plans could soar next year. Now health law supporters are pushing back, noting close ties between the actuaries making the forecasts and an insurance industry that has been complaining about taxes and other factors it says will lead to rate shock for consumers (Hancock, 4/18).

USA Today: Study: Most Health Subsidies To Aid Working Families
The majority of tax subsidies to help Americans pay for health insurance starting in January will go to working families, according to a nationwide study to be released Thursday and obtained by USA TODAY (Kennedy, 4/18).

Kaiser Health News: Capsules: Report: Health Law Tax Credit Could Benefit 26 Million
As experts focus on the cost of requiring everybody to have health coverage next year, a new study highlights the broad reach of federal subsidies to help people pay for it. Nearly 26 million Americans will be eligible for tax credits under the Affordable Care Act to partly offset the cost of insurance in online state marketplaces, says Families USA, a consumer interest group that supports the health law (Hancock, 4/18).

Oregonian: More Than 400,000 Oregonians Will Be Eligible For New Federal Health Care Tax Credits: Report
About 400,000 Oregonians will be eligible for new federal tax credits to help pay for health insurance premiums next year, according to a study released by a pro-reform advocacy group. The study, released by the nonprofit Families USA, for the first time puts a number on those whose income qualifies them for a sliding scale of tax credits available under the federal Affordable Care Act. The law was passed by Congress in 2010 to expand health care coverage. The tax credits will in some cases eliminate premium costs, and in other cases they will lower those costs. To qualify, recipients will have incomes ranging from 138 percent to 400 percent of the federal poverty level (Budnick, 4/17).

Also in the news, the health law's struggling high-risk pools draw congressional attention -

The Hill: Dems Offer Alternate Ways To Fix ObamaCare's High-Risk Pools
A new bill from House Democrats would reopen enrollment in ObamaCare's struggling temporary insurance plan by raising taxes on cigarettes. The measure from Rep. Frank Pallone (N.J.) and colleagues counters GOP legislation that would shore up the Pre-Existing Conditions Insurance Plan (PCIP) using funds for public and preventive health initiatives. The Republican bill was introduced Monday and marked up Wednesday morning (Viebeck, 4/17).

Modern Healthcare: GOP Backs Prevention Cuts To Fund High-Risk Pool
House Republicans moved to divert money from the healthcare reform law's prevention and public health fund to shore up a program the law created to give temporary relief to Americans who can't otherwise afford health insurance because of pre-existing conditions. The committee voted 27 to 20 along party lines to approve H.R. 1549, known as The Helping Sick Americans Now Act. The legislation would fund the Pre-Existing Condition Insurance Plan through the remainder of the year. HHS suspended enrollment in February after the $5 billion appropriated for it ran dry (Block, 4/17).

And the latest on health exchanges and consumer "helpers" -

CQ HealthBeat: Navigators, Assisters, Counselors Pack The Ranks Of Exchange Helpers
When enrollment in the new health insurance exchanges launches in October, states with federally operated exchanges may have far fewer government-funded people to help consumers choose plans than states that decided to run their own exchanges. Yet many of those states with federal exchanges are also home to the largest crowds of uninsured people who will need information and hand-holding when they sign up for coverage (Norman, 4/17).