Feds keeping us in the dark : 11 co-ops “are either on a corrective action plan or enhanced oversight. More than $900 million of the original $2 billion in loans has been lost.

Feds Hide Secret List Of 11 Staggering Obamacare Insurers

 

 A man looks over the Affordable Care Act (commonly known as Obamacare) signup page on the HealthCare.gov website in New York in this Oct. 2, 2013 photo illustration. (REUTERS/Mike Segar)

Richard Pollock

Federal officials have a secret list of 11 Obamacare health insurance co-ops they fear are on the verge of failure, but they refuse to disclose them to the public or to Congress, a Daily Caller News Foundation investigation has learned.

Just in the last three weeks, five of the original 24 Obamacare co-ops announced plans to close, bringing the total of failures to eight barely two years after their launch with $2 billion in start-up capital from the taxpayers under the Affordable Care Act.

All 24 received 15-year loans in varying amounts to offer health insurance to poor and low income customers and provide publicly funded competition to private, for-profit insurers. The eight co-ops to announce closings served populations in ten states: Iowa, Nebraska, Kentucky, West Virginia, Louisiana, Nevada, Tennessee, Vermont, New York and Colorado.

Nearly half a million failing co-op customers will have to find new coverage in 2016. More than $900 million of the original $2 billion in loans has been lost.

 

The 11 unidentified co-ops appear to be still operating but are now on “enhanced oversight” by the federal Centers for Medicare and Medicaid, which manages the Obamacare program. The 11 received letters from CMS demanding that they take urgent actions to avoid closing.

Aaron Albright, chief CMS spokesman, said 11 co-ops “are either on a corrective action plan or enhanced oversight. We have not released the letters or names.” He gave no grounds for withholding the information from either the public or Congress.

CMS officials have stonewalled multiple congressional inquiries into the co-op financial problems. The latest congressional inquiry came in a September 30 letter to CMS acting administrator Andy Slavitt demanding transparency over the troubled program.

“We have long been concerned about the financial solvency of CO-OPs,” three House Ways and Means committee members wrote to Slavitt. “Which plans have received these warnings or have been placed on corrective plans,” the congressmen asked. To date, they have received no reply.
Insurance commissioners in Vermont were the first to refuse to license the federally approved co-op there in 2013 because they feared those financial plans were unrealistic. But then the dominoes began to fall this year, resulting in at least eight co-op failures. And if CMS officials are to be believed, more failures may be on the way.

Sen. Charles Grassley , a senior member of the Senate Finance Committee who has been an outspoken critic of the troubled co-op program, said transparency should be a top priority for the faltering program.

“Since the public’s business generally ought to be public, CMS should have a good reason for not disclosing which co-ops are troubled,” he said.



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Roughly 1 million Texans are unable to qualify for Medicaid under Texas' stringent restrictions and unable to afford to purchase plans offered under the Affordable Care Act.

Working poor Texans struggle in Medicaid, ACA gap

by MARK WIGGINS / KVUE News and photojournalist PETER HULL

Bio | Email | Follow: @MarkW_KVUE

kvue.com

Posted on February 5, 2014 at 6:29 PM

Updated today at 6:41 PM

AUSTIN -- For 28-year old Irma Aguilar, raising four young children while working a full-time job is difficult enough.

Suffering from a damaged disc in her neck and debilitating high blood pressure that leaves her dizzy and bouts of anxiety, she needs medical coverage. An assistant manager at a national pizza chain, the San Antonio resident earns too much to qualify for Medicaid, but too little to qualify for discounted plans on the health insurance marketplace.

"It just makes me feel like, how am I supposed to get help? I thought that working hard for your money was supposed to help you go on in life and help you get some kind of insurance, and we can't even get that," said Aguilar. "We're the ones working hard. We're the ones doing everything, and we can't even get a penny out of it. We don't get nothing. So, do I have to stop working and let my kids drain and me drain so that way I can get help? It's just not fair to me, and it's not fair to my kids."

Roughly 1 million Texans are in a similar situation: unable to qualify for Medicaid under Texas' stringent restrictions and unable to afford to purchase plans offered under the Affordable Care Act. On Wednesday, representatives of dozens of organizations gathered at the Texas Capitol to launch a new campaign demanding something be done for them.

"It's a moral responsibility to address this situation," said Sister J.T. Dwyer of the Seton Health Care Family. "Our mission is to care for and improve the health of those we serve with a special concern for the poor and vulnerable. So, wouldn't we be interested in this? These are the vulnerable people who are left out."

With 6 million uninsured individuals, Texas leads the nation in the number of residents without health care coverage. A project of the Cover Texas Now Coalition, Texas Left Me Out is a campaign to compel lawmakers to develop a solution to insuring Texas' working poor who fall in the coverage "gap" resulting from the U.S. Supreme Court's decision not to require states to expand Medicaid to those unable to afford coverage through the health insurance marketplace. 

"The problem is that, because the law was written assuming that the Medicaid piece would be there, they said nobody below the poverty line is going to get the sliding scale of subsidies with premiums in the new health insurance marketplace," said Anne Dunkelberg, associate director of the progressive Center for Public Policy Priorities.

For a $15 billion investment in state money, over the next 10 years Texas would draw down about $100 million in federal funds, which Texans will be taxed for regardless. Gov. Rick Perry has opposed expanding Medicaid, calling the system "broken." Instead, Perry has advocated for a block grant which the federal government has thus far seemed disinclined to provide.

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Older People Lead Sign-Ups for Insurance

By MICHAEL D. SHEAR and ROBERT PEARJAN. 13, 2014

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Attendees at an Affordable Care Act enrollment event in LaGrange, Ky., in October. Luke Sharrett for The New York Times

WASHINGTON — People signing up for health insurance through the Affordable Care Act’s federal and state marketplaces tend to be older and potentially less healthy, officials said Monday, a demographic mix that could threaten the law’s economic underpinnings and cause premiums to rise in the future if the pattern persists.

Questions about the law’s financial viability are likely to become the next line of attack from its critics, as lawmakers gear up for the midterm elections this fall. Republicans quickly seized on the government’s progress report on Monday as evidence that the health insurance law would not work.

But administration officials expressed optimism that more young people would sign up in the months ahead, calling the latest enrollment numbers “solid, solid news” for the health care law. They said that interest in obtaining insurance through the marketplaces was increasing sharply across all age groups and that youth outreach efforts would become more aggressive as the March 31 open enrollment deadline approached.

Graphic

Health Exchange Enrollment Picked Up in December

Nearly 2.2 million people picked a health insurance plan through the exchanges established by the Affordable Care Act through Dec. 28.

OPEN Graphic

“We’re pleased to see such a strong response and heavy demand,” said Kathleen Sebelius, the secretary of health and human services. “Among young adults, the momentum was particularly strong.”

Of those who signed up in the first three months, administration officials said, 55 percent are age 45 to 64. Only 24 percent of those choosing a health insurance plan are 18 to 34, a group that is usually healthier and needs fewer costly medical services. People 55 to 64 — the range just below the age at which people qualify for Medicare — represented the largest group, at 33 percent.

The latest figures about enrollment add pressure on the Obama administration after a disastrous rollout of the HealthCare.gov website in October. Senior officials said they understood the stakes and were working to increase sign-ups. The White House recently hired Marlon Marshall, the deputy national field director for Mr. Obama’s 2012 presidential campaign, to run a campaign-style effort aimed at increasing sign-ups, especially among young people.

Brendan Buck, a spokesman for the House speaker, John A. Boehner, Republican of Ohio, predicted that the White House would fail to meet its goals and said that insurance premiums would rise.

“There’s no way to spin it: youth enrollment has been a bust so far,” Mr. Buck said. “When they see that Obamacare offers high costs for limited access to doctors — if the enrollment goes through at all — it’s no surprise that young people aren’t rushing to sign up.”

The demographic information, which had not been broadly available until Monday, also offers the first concrete evidence about whether the national health care experiment will work the way it has in Massachusetts, where a government marketplace also offers insurance to people who do not receive it through their employers. Officials said they were optimistic because the pattern of sign-ups among young people looked similar to the one they had seen in that state, which had a surge in sign-ups as the deadline approached.

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WA health exchange offline despite deadline

Washington health exchange getting record use

by Associated Press and KING 5 News

Posted on December 23, 2013 at 5:51 AM

Updated today at 5:40 PM

SEATTLE — Washington’s online health insurance exchange was offline overnight until nearly 9 a.m. on Monday morning despite a looming deadline for Washington residents to sign up for health insurance—or at least try to start the process.

Despite hours of unexpected down time, officials at Washington Healthplanfinder were expecting Monday to be their busiest day of traffic since the site opened on Oct. 1, said Michael Marchand, spokesman for the Washington Health Benefit Exchange. Friday was its second busiest day.

The site was down for scheduled maintenance overnight, and the closure was extended for another few hours to run some applications that had previously been stopped by error messages.

The extra work updated and fixed about 5,000 applications plagued by computer glitches that kept consumers from signing up for health insurance, Marchand said. Those people will be notified automatically that their applications are ready for completion.

The Washington exchange has been closed for maintenance in the early morning hours nearly every weekend since October, Marchand said. Monday morning’s efforts were extended because the federal site went down and delayed Washington’s planned work, he said.

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Obamacare to end health plan used by 100,000 New Jerseyans

President Barack Obama pictured signing the Affordable Care Act into law in 2010. As a result of the law, insurers next year can no longer sell or renew New Jersey's "basic and essential" health care plans. (SAUL LOEB/AFP/Getty Images)

By Ed Beeson/The Star-Ledger
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on August 18, 2013 at 11:20 AM

The bare-bones health insurance policy that’s been the plan of choice for New Jerseyans who can’t afford something better is set to go away next year, thanks to the Affordable Care Act.
And what those policy holders will be left with may be a choice among pricey, pricier and priciest.
About 106,000 people in the Garden State are insured under what are known as "basic and essential," or B&E, health care plans, according to state data. Since 2003, all health insurers that operate in New Jersey’s individual health market have been required to sell these plans which, as their name implies, offer only a thin layer of coverage for things such as doctor’s office visits and procedures that don’t involve a hospital stay.
But while B&E plans were meant to help young families get coverage and stanch the drop of enrollment in the individual health market, their relatively low price — as little as a couple hundred dollars a month for some people — made them the most popular option for those who don’t get insurance through an employer or a government program such as Medicare or Medicaid. About 71 percent of those covered by the individual health market have a B&E plan.
Soon no longer.
In addition to requiring most everyone to carry health insurance, the Affordable Care Act — better known as Obamacare — starting next year will force health care plans to cover certain essential services while capping the out-of-pocket fees people pay in addition to their premiums.
As a result, after Dec. 31, insurers won’t be able to sell or renew plans that don’t meet this litmus test. That includes B&E plans.
And these changes won’t come without a cost.
"In general, richer products translate into higher premiums," said Larry Altman, vice president of the Office of Healthcare Reform at Horizon Blue Cross Blue Shield, New Jersey’s largest health insurer.
Uncertain Costs
How much higher than the amounts people pay for B&E?
That can’t be said just yet, for a number of reasons.
First, federal authorities are still in the process of approving the rates for policies that insurers have proposed selling next year. These will be grouped into four broad categories whose names imply the level of coverage they provide: bronze, silver, gold and platinum. There also will be a no-frills "catastrophic" plan for those 30 and under.
Second, the federal health care law has changed the way in which New Jersey insurers set rates. As a result, people may see higher or lower rates for the same type of coverage they have now, depending on their age, gender and even the number of dependent children they have, according to Altman.
"It could go down for one person and go up for their neighbor," he said.
Third, many people who live on low to moderate incomes will be eligible for subsidies in the form of federal tax credits. These are meant to help them buy health insurance through the federal insurance exchange set to go live in New Jersey come Oct. 1. More than 610,000 New Jerseyans should be eligible for a subsidy, according to a recent study by advocacy group Families USA, although the size of the credit will vary based on household income.
Subsidies will be available for those whose income is at or below four-times the federal poverty level, or around $46,000 for an individual or about $94,000 for a family of four.
But absent a subsidy?
"A lot of folks on the individual market will see price increases if they’re not eligible," said Ward Sanders, president of the New Jersey Association of Health Plans, a group that represents health insurers.

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