Today's News and Commentary

After yesterday, today was a light healthcare news day.

About insurance

Azar touts funding HSAs with Obamacare subsidies: HHS Secretary Azar gave a talk about the options opening up for health insurance. They include: funding Health Savings Accounts (HSAs) with ACA premium subsidies for those enrolling in the individual market; expanding plan coverage (such as for essential medications) before patients need to use HSA money; eliminating rebates to the PBMs in the Medicare Part D market; and expanding “association health plans.”

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Read another article covering a different slant on the speech

Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–September 2018: The National Center for Health Statistics released its most recent health insurance coverage report.The overall findings: “In the first 9 months of 2018, 29.7 million persons of all ages (9.2%) were uninsured at the time of interview—not significantly different from 2017, but 18.9 million fewer persons than in 2010.” The coverage varied by age: of adults aged 18–64, 13.0% were uninsured; among children aged 0–17 years, 4.9% were uninsured.

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Claims Denials and Appeals in ACA Marketplace Plans: This study by the Kaiser family foundation found that: “across issuers with complete data, 19% of in-network claims were denied by issuers in 2017, with denial rates for specific issuers varying significantly around this average, from less than 1% to more than 40%. We also find that consumers rarely appeal claims denials to their issuers, and when they do, issuers typically uphold their original decision. consumers appealed less than one-half of one percent of denied claims, and issuers overturned 14% of appealed denials.” Claims denials also varied by state. For example, in Kentucky the rate was 40.7% while in Oregon it was 7.6%. The research speculates on the possible reasons for these denials but is not clear.

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