Health Care Delivery

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.

Project ECHO, which helps specialists disseminate knowledge to primary care providers, was created on the idea that patients should not be dying from curable diseases because they don’t have access to the right providers, said Sanjeev Arora, MD, FACG, MACP, director and founder of Project ECHO and a professor of medicine at University of New Mexico.

Open enrollment for the sixth season under the Affordable Care Act (ACA) begins today and lasts until December 15, and organizations like The Commonwealth Fund are highlighting resources to alert consumers to the differences between the various health insurance plans now available on the individual marketplaces.

The Trump administration Monday moved to drastically overhaul section 1332 waivers under the Affordable Care Act (ACA), including giving governors the ability to seek more flexibility without legislative approval, and to encourage people to sign up for plans that are not ACA-compliant.

The midterm election is less than a month away, and a new poll tracking how Americans view healthcare issues finds that a majority of voters in 2 bellwether states—Nevada and Florida—prefer a candidate who supports keeping the Affordable Care Act (ACA)'s protections for people with pre-existing conditions.

The National Comprehensive Cancer Network (NCCN) in collaboration with Avalere Health present survey results examining the experiences National Cancer Institute (NCI)-designated cancer centers have had with the marketplaces, the implications for patients' access to cancer care, and proposed policy solutions.

CMS said Thursday that the average 2019 premium charged for the silver level of health insurance in the exchanges set up by the Affordable Care Act (ACA) dropped slightly for the first time since 2014, and Seema Verma, who heads CMS, credited the actions of the Trump administration for the lower premiums.

Senate Democrats were 1 vote short of overturning the Trump administration's expansion of short-term health plans; Celltrion’s CT-P10, a biosimilar to cancer drug Rituxan, received the unanimous support of an FDA advisory panel; Centene will enter 4 new states—North Carolina, Pennsylvania, South Carolina, and Tennessee—and expand offerings in 10 markets in 2019.

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

A survey has revealed gaps in HIV providers’ knowledge of the Affordable Care Act. However, despite these gaps, the majority of surveyed providers expressed belief that Medicaid expansion would improve both HIV outcomes and general outcomes for patients with the disease.

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.

This week, the top managed care news included medical groups asking CMS to halt or slow down its plans to cut physician reimbursement for evaluation and management services; the Senate weighs a package of bills to combat the opioid epidemic; new research shows the Affordable Care Act pushed the uninsured rate down to 10%.

Health insurance coverage gains created by the Affordable Care Act (ACA) caused the number of the uninsured in the United States to fall from 17% in 2013 to 10% in 2016, according to a new analysis from the Urban Institute. The report said the reductions were even more striking in states that expanded Medicaid.

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.

This week, the top managed care stories included a study on the impact physician burnout is having on care quality; the latest Affordable Care Act showdown took place in a Texas courtroom; the share of employers offering health coverage increased for the first time since 2008.

A hearing in a federal court in Fort Worth, Texas regarding the Affordable Care Act (ACA) ended Wednesday, with the attorney general for the Lone Star State leading 19 other like-minded Republican states in trying to convince a judge that a preliminary injunction to put the ACA on hold should be granted. Later, Senate Democrats tied the hearing to the Supreme Court nomination hearing for Judge Brett Kavanaugh, who, if confirmed, will likely have to consider the case, Texas v Azar.