health insurance
health insurance

Medicaid benefit loss not expected to impact health insurers

An estimated 15 million people will lose their Medicaid benefits this month as a result of the expiration of U.S. government’s emergency pandemic measures. While there’s little doubt the Medicaid benefits loss – what health care industry nerds call “disenrollment” and “redeterminations” – will negatively impact health insurance company revenues, the effect won’t be substantial thanks to a corresponding reduction in claims expenses, according to credit analysts and other industry watchers.

In announcing better-than-expected first quarter earnings on Tuesday, the nation’s largest Medicaid insurer, Centene, said its Medicaid premium revenue would drop to $77 billion in 2024, compared to $84 billion in 2023, and its earnings per share estimates were trimmed to $6.60, down from $7.15 in previous forecasts.

The company squarely put the blame on “redeterminations” of the Medicaid enrollments but said it does not expect a long-term impact. However, it said that the average cost per member of the those retaining Medicaid coverage after redetermination will be somewhat higher than before – what the company called “acuity.” This is likely due to the setting of state payment rates under cost trends of the current Medicaid population.

Rate adjustments anticipated

“We now believe it is prudent to build in a more conservative view of the potential disconnect between rates and acuity that could manifest in some of our states in 2024,” said Centene’s CEO Sarah London. “We view any disconnect as a temporary one. We fully expect that states will ultimately provide sufficient rate adjustments to reflect any changes in acuity of the Medicaid population, but we are building a provision in our 2024 target in case there is a gap in timing in some of our states. In the long term, rate has always equaled acuity in Medicaid.”

Fitch Ratings, the leading provider of credit ratings for global

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High cost of health insurance in Mass. must be fixed, says new report

About four out of five people in Massachusetts who go without health insurance do so because they say they can’t afford it, according to a report out Thursday from the Blue Cross Blue Shield of Massachusetts Foundation, which advocates for equity in health care.

The report highlights barriers that remain in accessing health insurance, even in a state that implemented a health care reform law 17 years ago with affordability as one of its aims, and a state that has the highest percentage in the country of residents — about 97% — who do have health insurance.

“Most of the people who are uninsured, they want insurance,” said Audrey Shelto, president and CEO of the Blue Cross Blue Shield of Massachusetts Foundation. “There are barriers to them getting it.”

Shelto said affordability, limited awareness about subsidized programs and a complex insurance system are all major barriers to getting more Massachusetts residents insured.

In seeking to fix the affordability problem in the state, the foundation’s report offers 13 policy and program recommendations. Those include increasing the number of people eligible for the state’s ConnectorCare program, which offers commercial insurance plans that have low or no monthly premiums, low co-pays and no deductibles.

Shelto said the foundation looked closely at the demographic details of hundreds of thousands of residents who are uninsured in Massachusetts, and found that someone is more likely to be uninsured if they are between the ages of 19 and 34, Hispanic, Black, work for a small business or in a low-wage industry, or pay more than 30% of their income for housing.

For instance, Hispanic residents make up 12% of the state’s population, but the foundation’s analysis of data from an April 2020 state report, finds they account for 23% of those who have gone without

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Advocates worry thousands of Virginians could lose health insurance as pandemic rules come to an end

Hundreds of thousands of people in Virginia may be in danger of losing their health insurance.

When the pandemic struck, Congress responded by passing the Families First Coronavirus Response Act, preventing states from terminating Medicaid coverage. As a result, the number of people who have health insurance skyrocketed. Now, the pandemic-era rules are ending, and the federal government is allowing states to unwind coverage and potentially remove people from the Medicaid rolls.

Jovanna La Fosse worries about her family.

“So, I’m trying to build up my life again, and with the new employment that I have, I don’t have enough coverage for my kids,” she explains. “Medicaid is a very good support for myself and my family, and if they take Medicaid from us, it will be bad for my son who has autism and really needs help with that.”

Freddy Mejia at the Commonwealth Institute says unwinding coverage disproportionately harms children and minorities.

“Recent national analysis suggests that children, Latino and Black individuals are particularly vulnerable to being dis-enrolled while remaining eligible,” Mejia says. “In fact, 74% of children who lose coverage nationally are expected to be dis-enrolled despite remaining eligible for coverage.”

He says more than 300,000 people in Virginia are in danger of losing their health insurance as Virginia unwinds Medicaid coverage and dis-enrolls people over the next year.

This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.

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24.6 million health insurance searches conducted using citizen ID chip numbers | Health

24.6 million health insurance searches conducted using citizen ID chip numbers hinh anh 1A medical worker in Yen Lac Medical Centre, Vinh Phuc, registering a patient for medical examinations using brand-new chip-embedded citizen ID cards. (Photo:VNA)


Hanoi (VNS/VNA) –
More than 24.6 million searches for
health insurance information have been conducted utilising chip-based citizen
identity card numbers.

These searches have been facilitated at 12,401 medical examination
and treatment facilities currently implementing health insurance-covered
medical examination and treatment services.

The national social health insurance database’s 80.3 million
personal information records have been confirmed with the population database,
according to Vietnam Social Security (VSS).

The national population database has received and exchanged more
than 105.6 million social and health insurance records from the VSS system.

With over 24.6 million successful searches for health insurance
information using citizen identification cards with chips, there are currently
12,401 healthcare facilities nationwide that accept health insurance and use
citizen identification cards with chips for health examinations and treatment
(reaching 96.77% of the total number of health insurance facilities
nationwide).

Through the Family Health Insurance Card Renewal service with
reduced contribution rates via the National Public Service Portal and the
Portal of the VSS, 1,073 health insurance card extension applications have been
received and processed by the VSS’s systems and the National Public Service
Portal.

So far, the VSS in two localities (Hanoi and Ha Nam) have
implemented test programmes that have received and processed 24,073
applications for health insurance cards for children under six years old, and
892 applications for funeral allowance in the interconnection of birth
registration, permanent residence registration, and issuance of health
insurance cards for children under six years old; the interconnection of death
registration, cancellation of permanent residence registration, and funeral
allowance.

As of April 12, 2022, the VSS has successfully coordinated
with the necessary departments to integrate the public service

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How employer-sponsored health insurance can widen economic inequality

What is behind the widening gap in the job market between those with college diplomas and those without them?

Scholars have offered several different explanations, including technological change, globalization, and the decline in private sector unions. A recent study looked at the role of health insurance that often comes with a job.

For more on this Marketplace’s David Brancaccio spoke with our senior economics contributor Chris Farrell. The following is an edited transcript of their conversation.

David Brancaccio: I mean the data are clear college grads, you know, get better jobs, tend to be paid more than those who have a high school diploma or less. Harder to prove cause and effect. But let’s first get this baseline, college degree does help you in the job market?

Chris Farrell: Oh, absolutely. I mean, the wages of college graduates, I mean, they’re nearly twice as high as non-college educated workers. And, you know, as you know, David, college educated workers they enjoy higher employment rates and they’re more likely to get jobs that come with benefits, such as health insurance.

Brancaccio: We do live at a time of enormously quick technological change. And it may be that to deal with that you need the skills that you tend to acquire in college. But you mentioned employer sponsored health insurance. How does that play out here?

Farrell: OK, let me give you three key pieces of information. First, about half the population and all those with private health insurance get it through their employer or a family member’s employer and that is unique to the U.S. Now second, any contributions employers make to their employees health insurance premiums, that’s excluded from employees taxable income, and by the way, the tax exclusion is the single largest federal tax expenditure,

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Shapiro signs first bill, expands Pa. health insurance coverage for breast cancer screenings

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HARRISBURG — Insurers must cover the costs of breast cancer screenings for people at high risk of developing the disease under a new law Pennsylvania Gov. Josh Shapiro signed Monday.

“This is just the start. We have a lot more work to do, and this spirit of goodwill and compromise needs to continue,” Shapiro said at a signing ceremony in the Capitol, flanked by lawmakers from both major parties.

Advocates for health care access said the law — the first Shapiro signed since taking office in January — is a positive, though limited, step toward making crucial medical tests more affordable. They urged further action in this vein, something that typically requires lawmakers to negotiate with the commonwealth’s powerful health insurance industry.

The new law will allow people at higher risk of breast cancer to receive further genetic counseling, ultrasounds, and MRIs among other treatments without paying out-of-pocket costs. State-regulated insurers were already required to cover, but not entirely pay for, MRIs and ultrasounds under a 2020 law.

The coverage requirement only applies to private, state-regulated health insurance plans, though the state’s Medical Assistance program already has similar coverage.

According to the Susan G. Komen Center for Public Policy, 11 other states have passed laws removing copays or deductibles for imaging, while two more are poised to join that list soon.

However, no other state has mandated coverage of genetic testing for the BRCA genes, which indicate a higher chance of developing breast, ovarian, pancreatic, and prostate cancers.

The underlying bill was sponsored by state Senate President Pro Tempore Kim Ward (R., Westmoreland), a breast cancer survivor, and

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Report eyes path to aid those without health insurance

BOSTON — Thousands of Massachusetts residents from marginalized backgrounds could gain health insurance coverage should policymakers move to expand eligibility criteria for state-subsidized plans and remove administrative hurdles, a report released April 27 found.

Massachusetts boasts the highest insurance rate in the country, with about 2% to 3% lacking coverage at any point in time. But those roughly 200,000 uninsured individuals are disproportionately people of color or immigrants, and about one-third have limited English language skills that make it difficult to use the state’s insurance marketplace, according to the report from the Blue Cross Blue Shield of Massachusetts Foundation.

“Massachusetts pioneered a system of near-universal health care coverage that was later adopted nationally in the Affordable Care Act. We have a lot to be proud of, but our work is not finished,” Audrey Shelto, president and CEO of the foundation, said in a statement. “Our research shows there is an opportunity to build on our legacy by tackling the coverage disparities that persist in our system through further action on the policy front.”

The report pointed to another statistic to put the state of the uninsured in perspective. The state’s overall low uninsured rate climbed above 7% — encompassing about 503,000 people — in a 2019 state survey that probed how many individuals didn’t have coverage over a 12-month period, the report noted.

The new report comes as hundreds of thousands of people stand to lose MassHealth insurance coverage as program administrators redetermine eligibility for 2.3 million members. Some of those people remain eligible for certain subsidized plans, the foundation said.

Researchers found that Black residents comprise 7% of the state population, but 11% of Bay Staters who are uninsured. Hispanic residents represent 12% of the state population but 23% of the uninsured population. Meanwhile, just over half of

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Bright Health to sell Medicare Advantage arm, focus on NeueHealth

The last remnant of Bright Health Group’s health insurance operation is up for sale as the company negotiates with lenders to avoid bankruptcy, the company announced Friday.

The insurtech must find a buyer for its California Medicare Advantage business by the end of May to qualify for a credit extension through June, Bright Health notified investors in a filing to the Securities and Exchange Commission. Under the terms of the amended credit facility, the company would have to maintain $50 million in cash, down from $85 million under the current agreement.

Bright Health needs the credit to avoid bankruptcy: The company overdrew its $300 million line of credit last month and had until next Monday to reach the minimum threshold to maintain access to lenders.

Bright Health did not immediately respond to an interview request.

If the company sells its Medicare Advantage line in California, it would mark the end of the insurance company’s insurance business. Bright Health previously participated in the Medicare Advantage, health insurance exchange and employer-sponsored health plan markets in 15 states. The company has 125,000 Medicare-Medicaid dual-eligible members in the Golden State, where it lost $40.8 million last year, according to regulatory filings.

Going forward, Bright Health will focus solely on its NeueHealth primary care business, which comprises 74 clinics in Florida and Texas that serve 375,000 patients, the company said in a news release Friday.

The credit agreement announced Friday requires Bright Health executives to attend weekly meetings with creditors about the Medicare Advantage sale and biweekly meetings about its finances. Bright Health is barred from taking on new debt or investments.

If insurance regulators in Texas or Florida place the company under receivership or under additional supervision, lenders have the right to dissolve the credit agreement. Bright Health reported a $163 million

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Employer-Sponsored Health Insurance: How It Affects Job Change and Job Market

ESI (Employer-sponsored health insurance) is a type of health insurance coverage provided by employers to their employees. It’s an essential component of the United States healthcare system, with approximately 49% of Americans receiving health insurance through their employer.

 

In this article, we will explore the impact of ESI on job change and the job market, highlighting the benefits and challenges of this type of coverage.

 

ESI and Job Change

When employees leave their jobs, they may be able to continue their health insurance coverage through a program called COBRA. COBRA allows individuals to maintain their group health insurance plan for up to 18 months after leaving their job. However, the costs of continuing with COBRA coverage can be significant, as the employee is responsible for paying the full cost of the insurance premium between jobs.

The availability of ESI can have a significant impact on an employee’s decision to change jobs. Employees may choose to stay with their current employer, even if they are unhappy because they do not want to lose their health insurance coverage. Conversely, employees may be more likely to leave a job that does not offer health insurance or offers inadequate coverage.

A recent study found that employees who were offered health insurance by their employer were more likely to stay on the job compared to those who were not. Additionally, employees who were not offered health insurance were more likely to actively search for a new job with better benefits.

 

ESI and the Job Market

ESI can also have a significant impact on the job market. Employers who offer comprehensive health insurance coverage may be more likely to attract and retain top talent, as employees value health benefits highly. A recent survey found that 61% of employees consider health insurance to be

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Health insurance customers in Ireland who took out entry-level plans now paying too much

Up to 50,000 people may now be paying too much as they have failed to review their cover. This is because they took out entry-level plans in 2015 for themselves and their families just to get into the system to avoid future loadings.

Many have not changed health insurance plans since.

Life Community Rating was introduced eight years ago to encourage younger people to take up health insurance early to avoid age loadings.

The rules mean anyone over the age of 34 and who never had health insurance previously is charged a 2pc loading on the gross premium for every year. That means a 44-year-old is 10 years over the threshold and will have a 20pc loading on their gross premium, according to Dermot Goode of TotalHealthCover.ie.

He said that around 100,000 consumers had taken out health insurance just before the deadline of April 30, 2015.

But Mr Goode said half of these had taken out an entry-level plan for themselves and their families just to get into the system.

Many are now due to renew their policies.

How to save money on your health insurance

Mr Goode said: “Because they have not reviewed their cover, they are potentially significantly over-paying as they have auto-renewed their policies since 2015. They mistakenly believe that they still hold the cheapest cover, which is not the case.”

He said some older entry-level plans for public hospital cover had now become very expensive for adults.

He said this was particularly the case with Laya’s Assure Ideal plan – which is €1,191 a year for an adult. By comparison, Laya’s Essential Assist is €931, while its Future Protect Choice is €920.

Irish Life Health’s Select plan costs €660, its Day-to-Day Focus plan is €870, while its Level 1 Hospital plan is €1,085.

He said

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