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Insurers Plan to Significantly Raise Premiums – Citing huge losses on ACA plans.

Continued Disapproval Of ACA – A new survey released by the Pew Research Center found that 54 percent of consumers still disapprove of it. Data show 31 percent of respondents believe the ACA “has had a mostly negative effect on them and their families.”

An End To Protections For People With Serious Illnesses, Pre-Existing Conditions. – The ACA’s protections for people with pre-existing conditions are raising costs and limiting options for everyone. Under the ACA, insurers cannot charge higher premiums for people with serious illnesses, or deny coverage because of pre-existing conditions. Suggestions are to end these protections, and create risk pools by states so that these consumers “can get affordable coverage. … You dramatically lower the price for everybody else. You make health insurance so much more affordable, so much more competitive and open up competition.”

Medicare Physician Reimbursement Proposal Could Reduce Number Of Practices. – A new proposal “designed to change how Medicare pays clinicians represent[s] the most sweeping overhaul the CMS has made in a long time to the business of running a physician practice.” The objective is to have most Medicare reimbursements “flow through payment models that reward doctors for the quality of care they deliver, not just how many patients they see.” These changes could “upend the way medicine is practiced today, accelerating the move toward hospital employment and making the small group practice a thing of the past.”

Audit Finds IRS Overpaid Some ACA Plan Enrollees By $8 Million. – An audit conducted by the Treasury Inspector General for Tax Administration found the “IRS mistakenly overpaid more than $8 million to HealthCare.gov customers and Obamacare users in California, and cheated tens of thousands of others out of nearly $2 million in 2015 because the government relied on incorrect information to figure their taxes.” Data show some “70,850 filers received $8.3 million in federal subsidies that they didn’t deserve, while roughly 69,400 taxpayers missed out on $1.9 million they should have got.” The article says the issue resulted “from erroneous forms the government sent to about 800,000 customers, which used the wrong benchmark to measure what their Obamacare payments should have been.”

More Employers Hiring Freelancers Due To Costs Associated With ACA. – Employers are getting rid of health benefits by shrinking their full-time workforce and hiring freelancers due to the increase in costs caused by the Affordable Care Act. Data show about “one-third of companies intend to work towards ‘eliminating’ healthcare benefits because of the ACA…and 60 percent of companies intend to hire more freelance employees than full-time employees.”

Here are some headlines you’re nor hearing unless you’re paying really close attention to the ACA (Affordable Care Act), aka Obamacare.

12 failed co-ops which were created under the Affordable Care Act could cost taxpayers $1.2 billion – Four of the remaining co-ops created under the Affordable Care Act are experiencing weak enrollment, which is another indication that the startups remain on shaky ground. Data show these four co-ops have not yet signed up a minimum of 25,000 members, a crucial threshold which allows them to cover costs.

UnitedHealthcare to Drop Obamacare Exchanges in most states by 2017 – UHC expects to loose $650mm this year.

Despite ACA, Patients Still Subject To Surprise Medical Bills – Surprise medical bills happen most often in an ER visit when a hospital contracts with medical providers – including doctors, surgeons, anesthesiologists, lab technicians – that do not accept the same insurance plans the hospital does.

The maximum out-of-pocket costs will rise – Consumers can expect to pay more for healthcare costs. OOP expenses will rise to $7,150 for an individual / $14,300 for a family. Placing a significant financial burden on middle-income Americans who need a substantial amount of care.

State Medicaid Agencies Want Congress to Repeal ACA Insurance Tax – Medicaid agencies want lawmakers to permanently repeal the tax on health insurers. The article says “most private health insurance plans have had to pay the tax themselves,” but “states that contract with Medicaid managed-care plans have had to cover the premium tax to ensure that the health plans receive actuarially sound rates.” Some 38 states and Washington, DC contract with Medicaid managed-care plans.

HealthCare.gov Continues To Be Vulnerable To Hackers – The GAO reports that security flaws ‘will likely continue to jeopardize the confidentiality, integrity and availability of HealthCare.gov.

It’s been six years since the ACA was signed into law. How’s it going?

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services. We can customize a wellness plan for your budget and culture.

Sixty-four year-old grandfathers incur nine times more medical expenses than their eighteen year-old grandsons. But under small group ACA adjusted community rating, their health premiums can be no more than three times the cost charged to their second generation progeny, who now pay more to subsidize their forefathers.

Female rates have always been within the 3:1 age ratio due to the expenses of childbearing years. So the major impact of ACA adjusted community rating falls on the cost of young men.

The ACA also eliminated health risk rating for small groups. Thus small employer groups composed chiefly of young male or healthy employees are paying much higher health premiums than necessary to cover their risk.

Many small employers are migrating from fully-insured plans that are priced by adjusted community rating to partially self-funded plans that are priced for their own employees’ actual age, gender, and health risk profile.

Employee Benefit Advisors can help you with Level Funding, Traditional Self-Funding, and Employer Group Stop Loss Captives. Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

A special thanks to TCC Benefits Administrators for the content in this blog.