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Tag: ACA (page 1 of 6)

CMS signals support for Medicaid work requirements

Sean Kirschner

Sean is a Business Analyst at Softheon. His objective is to provide insight into the current state of the healthcare landscape through research on both business and policy. He is also responsible for assisting the research team through creating and maintaining research briefings on various industry topics. He earned his bachelor’s degree in economics from Boston College.

Latest posts by Sean Kirschner (see all)

Earlier this month, the head of the Centers for Medicare and Medicaid Services (CMS), Seema Verma, made an announcement conveying that CMS would approve waiver applications from states that would require Medicaid enrollees to participate in “community engagement” activities, otherwise known as work requirements. This follows a letter co-authored by Verma that encouraged state Medicaid directors to use these waivers to modify their Medicaid programs to empower consumers. To advocates, work requirements are a way to empower Medicaid enrollees by encouraging them to be independent, self-sufficient consumers of healthcare.

Here’s what you should know about the proposed work requirements for Medicaid:

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What can healthcare payers learn from consumer retail?

Matt Cummings

Solutions Architect at Softheon
Matthew is a Solutions Architect at Softheon. He works closely with Product and Development teams to design products and solutions to help Health Plans and other entities to excel in the marketplace. He received his bachelor's degree in Applied Psychology and Business Management from Stony Brook University in Stony Brook, New York.

The Commerce Department announced last week that U.S. retail sales have surged 0.8% for the month of November, which was more than double the rate economists had predicted. As consumers flock to retailers like Amazon and Walmart this holiday season, here are 5 takeaways healthcare Payers can learn from them:

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Major changes to 1332 waivers could be coming

Sean Kirschner

Sean is a Business Analyst at Softheon. His objective is to provide insight into the current state of the healthcare landscape through research on both business and policy. He is also responsible for assisting the research team through creating and maintaining research briefings on various industry topics. He earned his bachelor’s degree in economics from Boston College.

Latest posts by Sean Kirschner (see all)

1332 waivers, or state innovation waivers, allow states to apply to the federal government to waive certain provisions of the Affordable Care Act (ACA) and pursue innovative strategies for providing residents with access to quality, affordable insurance while retaining the law’s basic protections. However, there are two developments currently in motion that could make significant changes to these waivers.

One is the Alexander-Murray bill, which is indirectly connected to the Congressional tax bill currently in the process of reconciliation between the Senate and the House. The other is a bill currently being drafted by Senators Orrin Hatch (R-UT) and Mike Crapo (R-ID) that would overhaul the 1332 process, altering many of the original stipulations laid out by the ACA.

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Repealing individual mandate: not as bad as once feared?

Matt Cummings

Solutions Architect at Softheon
Matthew is a Solutions Architect at Softheon. He works closely with Product and Development teams to design products and solutions to help Health Plans and other entities to excel in the marketplace. He received his bachelor's degree in Applied Psychology and Business Management from Stony Brook University in Stony Brook, New York.

Background

On Wednesday, December 13th, leaders from both the House and Senate will meet in Washington to finalize the Tax Cuts and Jobs Bill. If they decide to include removing the individual mandate, this will undoubtedly have an impact on healthcare in America – but it may be not as extreme as originally thought.

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Tax bill takes toll on individual mandate

Matt Cummings

Solutions Architect at Softheon
Matthew is a Solutions Architect at Softheon. He works closely with Product and Development teams to design products and solutions to help Health Plans and other entities to excel in the marketplace. He received his bachelor's degree in Applied Psychology and Business Management from Stony Brook University in Stony Brook, New York.

Background

On Saturday, December 2nd, the U.S. Senate passed The Tax Cuts and Jobs Act, which was drafted in a Republican effort to reform the U.S. tax code. This follows the passage of Congress’ version of the bill, which took place on November 16th. One of the key differences between the two bills is that the Senate’s version includes a provision that effectively removes the Affordable Care Act’s individual mandate, which requires all individuals to purchase health insurance.

As leaders from the Senate and Congress meet to discuss how to reconcile the two versions of the bill, the healthcare industry is waiting to see if the mandate will be removed and what some of the ramifications could be.

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A Victory for Maine Medicaid Could Be an Inspiration to Others

Sean Kirschner

Sean is a Business Analyst at Softheon. His objective is to provide insight into the current state of the healthcare landscape through research on both business and policy. He is also responsible for assisting the research team through creating and maintaining research briefings on various industry topics. He earned his bachelor’s degree in economics from Boston College.

Latest posts by Sean Kirschner (see all)

What happened?

In a first-of-its-kind vote, Maine residents elected to expand the state’s Medicaid program through a state-wide referendum on Tuesday, November 7.

The expansion easily passed with 59% of voters in favor. These results place a majority of Maine residents in opposition to the stance of their Governor, Paul LePage, who has vetoed five bills to expand Medicaid.

Maine was one of 19 states that did not initially expand Medicaid in reaction to the Patient Protection and Affordable Care Act (ACA) in 2010. The state previously expanded the program in 2003, increasing the eligible population and subsidizing private coverage, but LePage dismantled much of this framework when he took office in 2011.

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AHIP Illustrates the Big Picture on AHCA, our Evolving Health Care System

Yvonne Villante
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Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
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We are on the cusp of a major transformation. As the healthcare market moves to strengthen the individual channel and expand employer sponsored health insurance (ESI), it will not only impact Millions of Americans, but also how people access care and how it is administered.

Held just days following the release of the long-awaited American Health Care Act (AHCA), it was undeniable that some uncertainties still reside. The theme of “change” was at the forefront at the recently held AHIP National Health Policy Conference and National Conference. A dominant pattern among sessions included talks on the impact of AHCA provisions, as well as debates on what will be needed to make the individual market viable moving forward.

The notion of shifting coverage and costs between the Affordable Care Act and the AHCA was especially compelling. The discussion, which was led by industry expert and NAIC consumer liaison, Timothy Stoltzfus Jost, JD, focused on the AHCA’s financial impact and the influence on both the uninsured and insured populations.

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President Trump’s Executive Order on PPACA: 5 Things You Should Know

Yvonne Villante
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Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
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President Trump signed an executive order on January 20, 2017 to lessen the economic burden of the Patient Protection and Affordable Care Act (PPACA).

Highlighting the Administration’s desire for a prompt repeal of the health law, the executive order outlined several actions that minimize both “unwarranted” economic and regulatory burdens, provide more flexibility to states, and establish a healthcare market that is more free and open.

While lawmakers work on a repeal and replacement plan, here are 5 things you should know. The executive order will:

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Behind the Numbers: Assessing ACA Marketplace Enrollment

Yvonne Villante
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Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
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Even as a repeal moves forward, newly released data from the Centers for Medicare and Medicaid Services (CMS) open enrollment period (OEP). The report, which was released on January 10, 2017, covers enrollment from November 1 to December 24, 2016, for both state-run and federally-facilitated marketplaces. The national data provided in this report are based on the performance of 12 state based marketplaces, 5 marketplaces that are utilizing the state based marketplace-federal platform, and 6 state partnership marketplaces. The remaining 28 states are utilizing the federal platform (healthcare.gov).

Offering evidence that enrollment numbers remain solid, the report highlights that 11.5 million people have signed up for coverage. This total includes 8.9 million returning and 2.6 million new consumers, and according to the CMS data, suggests a 2.5 percent or 286,000 increase compared to this time last year. It is also noteworthy that more than 9.3 million people, or 81 percent of the consumers that signed up for coverage this plan year, will receive premium tax credits, which average $386 per member per month.

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15 Big Changes Under Tom Price’s ACA Replacement Proposal

Yvonne Villante
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Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
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On January 20, Tom Price (R-GA) is set to be confirmed by Congress for the role of Secretary of the Department of Health and Human Services (HHS).

In March 2015, Rep. Tom Price (R-GA) introduced a 242-page detailed proposal, known as Empowering Patients First, or H.R. 2300. Outlining his plan to reform the current healthcare system and replace the Patient Protection and Affordable Care Act (PPACA), the proposed bill would repeal PPACA – in its entirety – in addition to provisions of the Health Care and Education Reconciliation Act (HCERA) of 2010.

Here’s what you need to know about Price’s Proposal for expanding access to coverage. It would:

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