March 2017

Republicans Release Details of New Health Care Bill to Replace Obamacare


Republicans released a new plan to repeal the Affordable Care Act. The newly proposed American Health Care Act would:
  • Retroactively repeal the ACA's requirement for most Americans to buy health insurance, as of the end of 2015. This may leave insurers wary about offering plans for 2018.
  • End enhanced federal funding at the end of 2019 for states to expand Medicaid to low-income adults.
  • Convert Medicaid to a program of capped per-capita federal grants to the states, starting in 2019. Hospital officials are unsure how this would affect uncompensated care and payment levels.
  • Establish age-based, refundable premium tax credits to help people buy insurance, with the credits phasing down starting at income levels of $75,000 for individuals and $150,000 for families. These credits would be adjusted annually by the consumer inflation rate plus 1 percent.
  • Starting in 2018, repeal most of the ACA taxes that finance the law's premium subsidies, Medicaid expansion, and Medicare benefit enhancements.
  • Retain the ACA's so-called "Cadillac tax" on high-value plans but delay it until 2025.
  • Eliminate the ACA's minimum essential benefits at the end of 2019.
  • Offer states $100 billion over nine years to establish high-risk pools or other mechanisms for stabilizing the individual insurance market.
  • Allow insurers to charge individuals who buy insurance after letting their coverage lapse. Insurers could charge a 30 percent premium penalty for one year, to encourage people to maintain continuous coverage.
  • Allow insurers to charge older customers five times higher premiums than they charge younger people, which is up from the ACA's permitted 3 to 1 age differential.
  • Repeal the ACA's cut in funding for Medicaid disproportionate share payments, which has not yet taken effect.
  • Repeal the ACA's subsidy to reduce low-income enrollees' cost-sharing in private health plans, effective at the end of 2019.
  • Prohibit federal Medicaid funding for Planned Parenthood or any organization that performs abortions, and barring the use of tax credits for purchase of any health plan that covers abortions.
Democrats asked the House Ways and Means Committee to postpone a vote until a hearing could be scheduled citing the need to know how the new bill will be cheaper and covers more people. Republicans defeated the motion, and after 18 hours, approved to clear the bill in the House Panel - sending the new bill over the first major hurdle in passing the new legislation. Groups such as the American Medical Association and the AARP have spoken out against elements of the bill which they fear will lead to fewer people being covered.

As more details are released, Complete Health Systems will keep you updated.

(Source: ModernHealthcare.com)  

Telemedicine - How Cost Effective is it? 

Telemedicine is becoming more mainstream as more and more employers offer this free consultation service as part of the health benefits package. But a study recently published in the journal, Health Affairs, states that telemedicine might actually be driving some costs up. Easy access and low (usually no) cost, encourages patients to seek out consultation for the common cold or high fevers - illnesses patients usually don't seek out treatment for in a typical health care scenario.

Patients who use the emergency room as primary care are not yet utilizing telemedicine which is the group in which the most cost savings will be made. Researchers suggested increasing the cost of telemedicine with patient cost-sharing, but also seeking out those patients who frequently use the ER to encourage them to use telemedicine instead. There is significant savings in telemedicine if the right balance is found. According to the study, on average, a telemedicine appointment costs about $79 compared to $146 for a doctor's visit and $1,734 for an ER visit.

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