Leasing a new building will in Spokane will “help UW expand its medical school program in Spokane. The school’s plans to grow have been a point of contention over the last year as Washington State University also announced plans to start the state’s second publicly-funded medical school in Spokane.
By Phil Galewitz
Idaho on Saturday becomes the latest state to launch its own health insurance exchange under the federal health law, with marketplace officials promising an easier shopping experience for consumers and greater responsiveness to insurance agents.
But the exchange, yourhealthidaho.org, will be challenged to do as well as the federal insurance exchange during the first open enrollment period that ended last March.
About 76,000 Idahoans signed up for private coverage at healthcare.gov, one of the most successful enrollments in any state.
While Idaho has some of the lowest insurance costs in the nation, its uninsured rate has traditionally exceeded the national average.
In 2013, Republican Gov. C.L. “Butch” Otter and powerful business leaders — who dislike Obamacare — persuaded the legislature to build a state exchange to keep control in Boise and save money for consumers. Continue reading
This five-minute cartoon video from the Kaiser Family Foundation explains health insurance using fun, easy-to-understand scenarios. It’s a light-hearted treatment of a difficult topic, breaking down important insurance concepts, such as premiums, deductibles and provider networks.
The video explains how individuals pay for coverage and obtain medical care and prescription drugs when enrolled in various types of health insurance, including HMOs and PPOs.
By Nina Martin
ProPublica, Nov. 11, 2014
The 2011 merger of the two remaining hospitals in Troy, N.Y., had many potential benefits 2014and one huge hurdle. Samaritan was secular, committed to providing the widest possible spectrum of reproductive and maternity care to its Albany-area patients.
St. Mary’s was Catholic, limiting or banning many reproductive options2014 and any merger partner had to abide by the same rules. It took several years of negotiations among three different health systems, much back-and-forth with women’s advocates, and the sign-off of the local bishop. But in the end, the parties struck a deal that all of them could live with.
The centerpiece was the brand-new Burdett Care Center, housed on Samaritan’s second floor. To all appearances, Burdett was a typical maternity ward. But in reality, it was a separately incorporated hospital-within-a-hospital, secular and thus free from the Catholic restrictions that Samaritan had agreed to follow.
In Washington state, Catholic health systems also have pressured doctors with admitting privileges to stop helping terminally ill patients who want to make use of the state’s “death with dignity” law.
Complicated? Yes. Cumbersome? Very. Still, as a compromise to preserve access to care in Troy, “it’s worked very well,” said Lois Uttley of the nonprofit group MergerWatch, which helped broker the arrangement.
Soon, though, compromises between Catholic health systems and their non-Catholic partners may be rarer and harder to achieve, and that could have profound implications for women’s access to reproductive services in hundreds of communities across the U.S.
The U.S. Conference of Catholic Bishops is meeting in Baltimore this week, and members are considering whether to begin the process of revising, and likely tightening, its directives governing health care mergers and partnerships. Continue reading
By Mary Agnes Carey
Haven’t thought about the health care law for a while? Now’s the time.
Passed in 2010, the law requires most Americans to have health insurance or pay a fine.
While many Americans get health coverage through their employers, starting Nov. 15 consumers who currently have insurance through the federal or state online marketplaces, or exchanges, set up by the law can reenroll.
If you want your coverage to renew or begin by Jan. 1, you’ll have to complete your application by Dec. 15.
Last year the federal website, healthcare.gov, as well as some state-run websites,experienced severe technical difficulties, frustrating consumers trying to sign up for the exchanges. Nonetheless, more than 7 million people bought insurance plans in the exchanges and about 8.7 million signed up for Medicaid and the Children’s Health Insurance Program, or CHIP.
The Congressional Budget Office estimates that in 2015 exchange enrollment will grow to 13 million and the increase in Medicaid and CHIP enrollment will rise to 11 million, but the Department of Health and Human Services projects that exchange enrollment next year will be under 9.9 million.
This time around, federal and state officials have promised easier-to-use, streamlined applications. Federal officials say healthcare.gov is undergoing testing to make it better able to handle high demand.
Here’s what you need to know for the coming enrollment period. Continue reading
From the Healthcare.gov Blog
November 10, 2014
Open Enrollment is the period when you can sign up for or renew a health plan through the Health Insurance Marketplace. Open Enrollment for 2015 coverage starts November 15, 2014 – just 4 days away.
Here are 5 important things to know:
- 2015 Open Enrollment lasts from November 15, 2014, to February 15, 2015.
- You must enroll by December 15, 2014, if you want your coverage to start on January 1, 2015.
- If you don’t enroll in a health plan by February 15, 2015, the only way you can get health insurance for 2015 through the Marketplace is if you qualify for a Special Enrollment Period. You may qualify if you have a qualifying life event such as marriage, birth or adoption of a child, or loss of other health coverage.
- You can apply for Medicaid or the Children’s Health Insurance Program (CHIP) at any time of year. If you qualify, you can enroll immediately.
- You can preview 2015 health plans and estimated prices before you apply.
Washington Healthplanfinder Opens for Second Enrollment Period on Nov. 15
Exchange Readying for Launch; Pop-Up Mall Tour Launching This Weekend across the State
Washington Healthplanfinder, the online health insurance marketplace created under the Affordable Care Act in Washington State, opens for enrollment this Saturday, Nov. 15.
New and returning customers will able to compare 90 health insurance plans from 10 different insurance companies and see if they qualify for free or low-cost health coverage through www.wahealthplanfinder.org.
Enrollment in Apple Health, Washington state’s Medicaid program, is year-round.
Residents must select and pay for a Qualified Health Plan by Dec. 23, 2014 at 5 p.m. for coverage that begins on Jan. 1, 2015. The enrollment period extends through Feb. 15, 2015.
Those who do not enroll in a health insurance plan in 2015 may be subject to a fine of $325 per individual or up to 2 percent of their income, whichever is greater. Continue reading
By Mary Agnes Carey
The Supreme Court on Friday agreed to hear a case on a subject that’s important to millions of people who receive subsidies to help purchase coverage under the health-care law.
Friday’s decision follows earlier action in July when two U.S. appeals courts issued conflicting rulings on the issue.
KHN’s Mary Agnes Carey answers some frequently asked questions about those court decisions and how they impact consumers.
Q: What did the Supreme Court do?
The justices decided to hear a case that challenges the federal government’s ability to provide subsidies to individuals in nearly three dozen states where the federal government operates the online marketplaces, or exchanges. There are several legal challenges on this issue that are working their way through the courts.
The high court’s decision to accept the case surprised many analysts who thought the Supreme Court might wait until they had a ruling from the full District of Columbia Court of Appeals, one of the other courts considering the issue.
Q: How did the lower courts rule on the subsidy issue?
A three-judge panel from the U.S. Court of Appeals for the District of Columbia Circuit ruled in July that the health law’s subsidies are available only to individuals in states now operating their own health insurance exchanges.
In 2014, only 14 states and the District of Columbia ran their own exchanges, while 36 relied on the federal government. Judge Thomas Griffith, writing the majority opinion in the 2-1 decision, said they concluded “that the ACA unambiguously restricts” the subsidies to “exchanges ‘established by the state.’”
That ruling was later vacated when the full District of Columbia Court of Appeals agreed to rehear the case, which is scheduled for December next month.
In a separate ruling, a three-judge panel for the Fourth Circuit Court of Appeals in Richmond, Va., ruled unanimously for the Obama administration, allowing subsidies to be available to residents in all states.
Judge Roger Gregory, writing the opinion, said while the health law is “ambiguous and subject to multiple interpretations,” the court decided to uphold the IRS’s interpretation of the law that residents of states using the federal exchange are entitled to subsidies.
That Virginia case, King v. Burwell, is the case the Supreme Court said would hear this term.
Q: What was the issue the lower courts decided on?
The case centers on a brief description in the health law that says subsidies will be available “through an exchange established by the state.
In implementing the law, the Internal Revenue Service (IRS) interpreted the law to allow eligible consumers to receive subsidies to help purchase coverage, regardless of whether they are in an exchange run by their state or by the federal government.
Opponents of the law questioned that interpretation, saying that the law as written clearly directs subsidies to state-based exchanges only. But proponents – including several lawmakers who helped write it – said lawmakers fully intended that subsidies be offered on all exchanges no matter if they were administered by the feds or state officials.
Q: I live in a state with a federally run exchange, and I get a subsidy to help me buy coverage. Am I going to lose it?
Current subsidies will likely remain in place until there is a final legal decision on the matter.
White House spokesman Josh Earnest said the administration was confident it would prevail. “The ACA is working. These lawsuits won’t stand in the way of the Affordable Care Act and the millions of Americans who can now afford health insurance because of it,”
Earnest said in a statement Friday. “We are confident that the financial help afforded millions of Americans was the intent of the law and it is working as Congress designed.” Open enrollment begins again Nov. 15.
Supporters of the court challenge to the IRS interpretation on subsidies also maintain their case is strong. “The Supreme Court’s decision is a rebuke to the Obama administration and its defenders, who dismissed as frivolous the plaintiffs’ efforts to defend their right not to be taxed without congressional authorization,” Michael Cannon, director of health policy studies at the libertarian Cato Institute who championed the subsidy appeals, said in a statement Friday. “It is essential that these cases receive expedited resolution, if only to eliminate the uncertainty currently facing states, employers, insurers, and taxpayers.”
Q: If there are legal disputes ongoing about who qualifies to receive a subsidy, do I still have to buy health insurance?
Yes. The law’s “individual mandate,” which requires most people to purchase health insurance or pay a fine, is still in place and has been upheld by the Supreme Court.
Q. What if I get my insurance through work?
This decision applies only to policies sold on the online marketplaces. It does not affect work-based insurance, Medicare or Medicaid, regardless of where you live.
Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
By Julie Rovner
Once again, the Supreme Court will decide whether the Affordable Care Act lives or dies.
Defying expectations, the court announced Friday it has agreed to hear – during this term – a case that challenges the heart of the law: subsidies to help people pay their insurance premiums.
In about three dozen states, the federal government runs the online marketplaces where individuals can find health plans.
At issue is a phrase in the law stipulating that subsidies to help those with incomes under 400 percent of poverty are available only in “exchanges established by a state.”
The authors of the law argue that the rest of the statute makes it clear that subsidies are available not only in state-run exchanges, but in those where the federal government is doing the work of the state. Continue reading