Health Care Delivery

Consumers shopping for insurance online last fall were most often directed to websites that promote individual health plans that didn’t meet consumer protections of the Affordable Care Act (ACA).

Voters in the red states of Utah and Idaho voted to expand Medicaid under the Affordable Care Act last fall, but Republican legislatures in both those states are seeking ways to roll back those expansions; women sought out long-acting reversible contraception after the election of President Trump; a California coalition of health, labor, and education leaders cited a dearth of healthcare workers in recommending a workforce investment plan calling for spending up to $3 billion over 10 years to address the shortfall.

While President Trump's State of the Union address is not finalized, he may plan to unveil a promise to end HIV transmission in America by 2030; a federal judge dismissed a lawsuit brought by Maryland that claimed the Trump administration is failing to enforce the Affordable Care Act; new cystic fibrosis (CF) treatments targeting the genetic mutations that cause the disease help about 90% of patients, meaning that 10% are still waiting for a cutting-edge therapy.

A recent report from the Government Accountability Office (GAO) found that claims costs and federal and state policies largely influenced insurer participation in exchanges during the early years of the Affordable Care Act (ACA).

President Trump’s latest healthcare proposal could have the effect of raising out-of-pocket drug costs for some while lowering them for others; FDA Commissioner Scott Gottlieb said it is shocking to him that the rate of young people addicted to using e-cigarettes, or vaping, had reached levels at which FDA-approved methods for quitting e-cigarettes could be necessary; "Medicare for More,” not Medicare for All, is likely to emerge as Democrats jockey for 2020 with a watered-down version of universal health care.

CMS is proposing more changes to the Affordable Care Act (ACA), including ways to seek to end the practice of silver loading, end automatic re-enrollment in individual exchange plans, and raise premiums by 1%, it said in its proposed 2020 Payment Notice.

As expected, California and 16 other states defending the Affordable Care Act (ACA) in a federal lawsuit announced they will appeal last month’s ruling by a Texas judge that declared the ACA unconstitutional.

The federal judge who ruled last month that the Affordable Care Act (ACA) was invalid issued an order over the weekend that the law will remain in effect pending appeal; pharmacies and businesses with pharmacies in New York City will no longer be allowed to sell cigarettes and other tobacco products; a federal judge has blocked the administration's cut to the 340B program.

Here are the top 5 articles for the month of December.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

A federal judge in Texas ruled that the Affordable Care Act's individual coverage mandate is unconstitutional and that the rest of the law must also fall, likely setting up a fight in the Supreme Court and throwing into question the idea that consumers should have protection against discrimination by insurers for having pre-existing health conditions.

This week, the top managed care news included a report that found uninsured rates were on the rise in 2017; an analysis of rising health insurance costs for families; predictions for cardiology trends in 2019.

Days before open enrollment for health insurance in the individual market for 2019 sold through the Affordable Care Act (ACA) exchanges comes to a close, a new report found health insurance coverage gained between 2013 and 2017 under the ACA is slipping.

A new Gallup poll finds a split in beliefs in how Americans think about healthcare. The majority of respondents think the federal government should be responsible for ensuring that all Americans have health insurance, but at the same time, a majority is opposed to the notion of a “government-run” healthcare system.

While a full repeal of the Affordable Care Act (ACA) in Congress failed last year, the Trump administration, in the courts and through regulation, has managed to get closer and closer to its goal as a matter of practicality. As health policy watchers wait for an impending decision to drop in Texas v Azar, the case about the constitutionality of the ACA, here is a look back at the healthcare actions taken during the first 2 years of the Trump administration.

With health policy increasingly transferring to the state level, what’s the most effective way for states to cover the majority of their population through affordable health insurance leveraging public funds? On a day when the Trump administration unveiled 4 ways states can request Section 1332 waivers, some of which are aimed at avoiding key parts of the Affordable Care Act (ACA), an advocacy organization released its own proposal to cover more of the uninsured and lower health insurance costs.

CMS Administrator Seema Verma announced consumers buying health insurance through the exchanges set up by the Affordable Care Act (ACA) would be allowed to have heath savings accounts, and the agency will allow states to set their own subsidies and decide what type of health plan is eligible for subsidies. In addition, waivers would be evaluated against the Hyde amendment.

America's Health Insurance Plans (AHIP) released what it said are 12 proposals to help increase affordability for people who buy insurance on the individual market who do not qualify for subsidies. Meanwhile, CMS said 1.2 million people signed up for health insurance during the first 10 days of open enrollment for the individual marketplaces.

The move comes more than 10 months after the state's governor first called for selling non-compliant plans.