Co-ops struggle to enroll people

Jun 13 2014

Elsewhere, Oregon officials are planning on limiting access to a new, pricey hepatitis C drug to state health plan members. Also, UnitedHealthcare is considering entering Georgia's health care exchange next year. 

The Wall Street Journal: Mixed Bag For Health Co-Ops
Many of the nonprofit health-insurance cooperatives created by the Affordable Care Act have enrolled far fewer people than they had hoped, according to figures obtained by a Republican-led House committee, calling into question their viability. Fourteen of the 23 co-ops reported to the panel that, as of April 1 or later, they had enrolled significantly fewer people than they had projected for 2014 when they obtained $2 billion in federal loans from a fund created under the health law. The shortfalls create steeper obstacles for the plans to succeed and repay the loans (Radnofsky, 6/11).

The Oregonian: Facing A $168-Million Price Tag For New Hepatitis C Drugs, Oregon Health Plan Balks
Eyeing a $168-million annual price tag for two costly new hepatitis C drugs, state officials hope to limit access to a small fraction of the 20,000 Oregon Health Plan members afflicted by the liver disease. The new drugs, Sovaldi and Olyssio, offer a cure that lacks the side effects of current treatment. But at $1,000 a pill, the cost adds up quickly -- to $84,000 for a three-month treatment. Other states by law must cover the drugs for their Medicaid programs. And private insurers are under pressure from Medicare to do the same (Budnick, 6/11).

Georgia Health News: Georgia Exchange May Get Another Big Player
UnitedHealthcare says it's considering offering health plans in Georgia's insurance exchange for 2015. The giant insurer's potential entry into the state's exchange could increase competition in terms of premiums and choice of medical providers. State exchanges, required under the Affordable Care Act, are designed to help consumers find and purchase health coverage. They can be run by either the individual state or the federal government. Georgia, like most other states, has opted for federal administration. Last year, just five health insurers offered plans in the Georgia exchange (Miller, 6/11).

More problems at health law coverage processing centers --

St. Louis Post-Dispatch: Wentzville Health Care Processing Problems Came From Computer Snafus, Feds Say
The same computer problems that hampered individuals from signing up for the Affordable Care Act last fall also plagued workers at an ACA processing facility in Wentzville, where whistleblowers have alleged that little work was being done, the government agency overseeing the project said Wednesday. The contractor, Serco Inc., a British firm with U.S. headquarters in northern Virginia, was the subject of allegations from employees and former employees that workers read, slept or played games while on duty because of the lack of work. On Wednesday, a spokesman for the Centers for Medicaid & Medicare Services said that Serco -; whose workers process paper applications and check documentation submitted in support of Affordable Care Act applications -; "experienced the same tech issues that were widely reported last fall with healthcare.gov" (Raasch, 6/12).