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Aetna Health Reform Weekly - 9/9/13

Story Content Provided by Aetna on 9/14/13

Two new studies released last week examine prices consumers can expect to pay in the new health care exchanges across the country starting in 2014. A Kaiser Family Foundation analysis looks at insurance premiums in 17 states and the District of Columbia for three age groups – showing a wide range of prices from state to state. A separate study by Avelere Health averages the sticker prices of policies at different coverage levels. Before factoring in tax credits, an average 21-year-old buying a mid-range "silver" policy can expect to pay about $270 a month, a 40-year-old will pay close to $330 a month, and a 60-year-old will pay about $615 a month. Avelere representatives noted, however, that there will be big price differences among age groups, states and even within some states. Many consumers are likely to feel good about their new options, while many others are likely to find that the cost of coverage remains a stretch.


Leaders of the House Ways and Means Committee and the House Energy and Commerce Committee have released a paper that outlines suggested areas of focus for Medicare reform. Called "Modernizing Medicare for the 21st Century", the paper focuses on the cost-sharing framework under traditional Medicare and recommends establishing: a single combined annual deductible for Medicare Parts A and B; a simplified coinsurance rate that is applicable to spending above the combined deductible; and a defined and "reasonable" catastrophic limit to shield beneficiaries from high out-of-pocket costs. The paper stipulates that future proposals to reform Medicare must consider the impact of existing supplemental coverage trends on overall Medicare costs and also encourage beneficiary engagement and accountability in the selection of Medigap and other supplemental coverage. The paper is expected to be the first in a series focused on modernizing Medicare.


CALIFORNIA: Covered California, the state's health insurance exchange, began its $80 million, 15-month long exchange marketing campaign on Labor Day. The launch began with a month-long trial of radio and television commercials in three cities: San Diego, Sacramento and Chico-Redding. The exchange will spend $45 million on media through the end of open enrollment in March, and an additional $35 million between April and December 2014.

OKLAHOMA: The state learned last week that the U.S. Department of Health and Human Services has agreed to a one-year extension of the popular Insure Oklahoma program. The extension means that a group of the poorest residents who were in jeopardy of losing health care on Dec. 31, 2013 now get to get to keep that coverage for at least one more year. Insure Oklahoma subsidizes private health insurance for nearly 30,000 low-income workers. Insure Oklahoma currently covers individuals and employees at or below 200 percent of the federal poverty level, just under $24,000 per year. The Obama administration told state officials this spring that it would not renew the Medicaid waiver authorizing federal funds in the program because Insure Oklahoma did not meet ACA requirements. Without a waiver extension, Insure Oklahoma was to expire at the end of the year.

WASHINGTON: Community Health Plan of Washington and Kaiser Foundation Health Plan of the Northwest have won their appeals of Commissioner Mike Kreidler's recent decision denying them approval to participate on the exchange. Community and Kaiser are now allowed to sell their 10 plans on the Washington State health benefits exchange in 2014. Two other health plans, Molina and Centene, also won their appeals before the same administrative law judge hearing and are expected to be certified by the state exchange this week.


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