Gap on ACA Views Smallest in Two Years

On the five year anniversary of the Affordable Care Act (ACA), the March 2015 Kaiser Health Tracking Poll finds the gap between those who view the law favorably and those with an unfavorable point of view has narrowed to its lowest level. The latest poll finds 43 percent of Americans view the law negatively, while 41 percent view it more positively.

Most Americans continue to say the health reform law has not had a direct impact on them or their families, but 19 percent of the public says the law has helped their families and 22 percent say the ACA has hurt them. Republican respondents are more likely to report being adversely affected by the law, while Democrats are more likely to report being helped – both statistics consistent with previous Kaiser tracking polls.

The U.S. Supreme Court heard oral arguments in a challenge to the health care law on March 4. The King v. Burwell case centers on whether or not the ACA bars financial assistance to low- and moderate income residents of states that rely on the federal health insurance marketplace, healthcare.gov, rather than a state-run marketplace.

As previously reported, a Kaiser Family Foundation poll after the Supreme Court hearings this month found more than half of those surveyed were not at all aware of the case, while 25 percent were somewhat aware. About one in five (22 percent) told the foundation they have heard at least something about the case. That number was up more than 50 percent from January.

With some Americans unaware of the need to report their health insurance on their 2014 federal taxes, the U.S. Department of Health & Human Services and the Centers for Medicare & Medicaid Services announced a special enrollment period during tax season this year. The special enrollment, which extends through April 30, 2015, allows people who owe a tax penalty for not having health coverage in 2014 to buy coverage for 2015.

Cyberattack at Insurer Exposes Info for 11 Million

Premera Blue Cross, a health insurance plan serving the Pacific Northwest, acknowledged last week that it was hit by a cyberattack in May 2014, and the breach affects more than 11 million customers. Premera learned of the attack in late January, the same day that Anthem discovered its data breach that could potentially affect nearly 80 million customers and employees nationwide.

Health and insurance industry trade media have reported the Premera breach could actually be more devastating than the Anthem cyberattack because of the information exposed in the hack of the Washington and Alaska health insurer’s systems.

“Our investigation determined that the attackers may have gained unauthorized access to applicants’ and members’ information, which could include member name, date of birth, email address, address, telephone number, Social Security number, member identification numbers, bank account information, and claims information, including clinical information,” Premera said in a statement.

Federal authorities and cybersecurity experts are working with Premera to investigate the breach. “The security of Premera’s members’ personal information remains a top priority. We at Premera take this issue seriously and sincerely regret the concern it may cause,” Premera CEO Jeff Rose said. “As much as possible, we want to make this event our burden, not that of the affected individuals, by making services available to help protect people’s information.”

Like Anthem, Premera is offering two years of free credit monitoring and identity theft protection. Premera has also hired Experian to help protect members’ clinical information from fraudulent use.

Many Unaware ACA Subsidies Are at Risk

In spite of widespread news coverage concerning the legal challenge to the Affordable Care Act (ACA), and oral arguments before the U.S. Supreme Court earlier this month, a new poll released by the Kaiser Family Foundation finds many are unaware health insurance premium subsidies are at risk for millions of America’s newly insured.

Fifty-three percent of respondents to the foundation’s survey said they have never heard of the King v. Burwell case, while another 25 percent said they had heard just a little. The challenge to the ACA centers on whether it allows the Internal Revenue Service to provide premium subsidies to citizens of states that choose not to set up a state health insurance exchange. Thirteen states created and are running their own online insurance exchanges, including California; millions of residents in other states are using the federal exchange, healthcare.gov.

When offered details about a potential ruling by the Supreme Court, two-thirds said if the court strikes down the premium subsidies, Congress or state officials should take steps to restore them. A majority of Democrats (81 percent) and independents (67 percent) support action by Congress, as compared to more than half of Republicans (56 percent) who prefer Congress not act on the issue. Thirty-nine percent of GOP respondents support congressional action.

The Kaiser Family Foundation poll echoes results of an NBC News/Wall Street Journal poll of 800 registered voters conducted in February. Fifty-four percent of respondents to that survey believe the U.S. House of Representatives and U.S. Senate should act to ensure people in all states be able to receive federal premium assistance if they qualify.

A formal ruling from the U.S. Supreme Court is expected in June.

Oregon Pulls the Plug on State Exchange

New legislation dissolving Cover Oregon, the Beaver State’s public health insurance exchange, has been signed by Governor Kate Brown, who took office only last month following the resignation of John Kitzhaber.

S.B. 1, which passed with bipartisan support, moves the functions of the Oregon exchange to the state’s Department of Consumer & Business Services (DCBS), effective June 30. The measure eliminates the board of directors for Cover Oregon and the role of executive director. About 30 new jobs will be established in the DCBS, including short-term roles for 17 employees.

The Oregon exchange was plagued by problems virtually from day one. In the first year of open enrollment under the Affordable Care Act (ACA), the state exchange was unable to take a single application online because of problems with its website. In April 2014, Oregon announced it was moving to the federal exchange, HealthCare.gov, citing the expected high cost of fixing the online state marketplace. To date, more than $300 million in federal funds have been spent on Cover Oregon and the state is out an additional $23 million on failed technology.

Oracle America, Inc. has sued Cover Oregon alleging breach of contract and copyright infringement, and demanding payment for services rendered. In return, the state has counter-sued, accusing the Redwood City, California, firm of failing to deliver under its contract and civil racketeering; the state alleges $240 million in false claims.

Brokers Pushing for Insurance Contract Change

Health insurance brokers in California are working with a Southern California Assembly member to implement a change affecting how health insurers can alter contracts with brokers selling their plans.

A.B. 1163, introduced by Assembly member Freddie Rodriquez, D-Pomona, will require health insurers and health maintenance organizations (HMO) to provide appointed agents and brokers with 120 days notice of any material change in their agency agreement. The new legislation is modeled after the existing property and casualty insurance agent notice requirement.

The proposed bill mandates a delay of any substantive change to a contract by a health insurer or HMO until proper notice is given to the broker. It was introduced in response to a recent action by a health insurance carrier that gave its distributors just 48 hours notice of a planned change.

"Agents understand business necessity can sometimes drive a need for a material change. That is why special language was added to A.B. 1163 to ensure changes that are mutually agreed to, or changes made necessary due to a change in state or federal law, can occur without delay. In all other cases, under A.B. 1163 as introduced, a change desired by the carrier can take effect as soon as proper notice is given under the terms of the bill," said Patrick Burns, president of the California Association of Health Underwriters. "A.B. 1163 levels the playing field and provides for a fair and reasonable notice to licensed agents when their contract is substantially changed."    

The measure is supported by the California Association of Health Underwriters (CAHU), Independent Insurance Agents and Brokers of California (IIABCal), and the National Association of Insurance and Financial Advisors. The bill is awaiting assignment to the appropriate Assembly Committee for consideration.  

Covered California Enrollment Up But Below Target

While Covered California, the Golden State’s public health insurance exchange, drew more enrollees in its second open enrollment period, participation fell short of its goal for 2015. According to numbers released in early March, nearly 500,000 new consumers selected a health plan during open enrollment, which ended February 22, 2015. Another 944,000 renewed their plans for 2015, bringing the total enrollment in the individual marketplace to more 1.4 million. However, the enrollment goal was 1.7 million for the year.

Some additional enrollment could come during the special enrollment period now underway. Covered California announced a few weeks ago it was giving consumers who did know or understand they would be subject to a tax penalty for being uninsured in 2014, or who learned they may face a penalty for 2015, a special enrollment opportunity to enroll through April 30, 2015.

Among enrollees for 2015, nearly nine out of 10 new enrollees qualified for some level of financial assistance. Nationally, more than 85 percent of enrollees qualified for premium subsidies. New enrollments for subsidy-eligible Latinos shot up six percent in California, while African-American enrollees increased by three percent. Enrollment among the state’s young adults, ages 18 to 34, was up five percent.

“New enrollment for 2015 coverage is strong and has brought in consumers who our marketing and outreach targeted,” said Covered California Executive Director Peter V. Lee. “It is clear Latinos, African-Americans, and young adults not only heard, but acted on Covered California’s increased advertising and person-to-person outreach.”

Insurance agents accounted for 43 percent of new enrollments for the state exchange. That was up four percent from last year’s open enrollment. Thirty percent of participants enrolled online on their own and 10 percent turned to a certified enrollment counselor or navigator.

Hawaii Exchange Could Offer Large Group Coverage

New legislation introduced in the Hawaii state senate would allow the state’s public health insurance exchange, the Hawaii Health Connector, to offer large group coverage. Senate Bill 1338, approved by the Aloha State’s Judiciary and Labor and Ways and Means committees on February 27, is now headed to the Hawaii state House of Representatives.

Under the bill, the current definition of a “small employer” would be amended to include a business of up to 100 employees. The theory behind the move is that by broadening the market, the state can attract more insurer participation in the exchange established under the Affordable Care Act (ACA).

Only Kaiser Permanente currently offers small group coverage through the Hawaii Health Connector. The Hawaii Medical Services Association (HMSA) was part of the state exchange in 2014, but announced last August it was exiting the small business market. HMSA does continue to market individual plans in Hawaii.

In other state exchange-related news, Massachusetts Gov. Charlie Baker has removed four members from the Massachusetts Health Connector board of directors. The four include the controversial MIT professor, Jonathan Gruber, who spoke critically last year regarding how the ACA legislation was crafted and passed in 2010. Others who have resigned from the Bay State exchange are John Bertko, an actuarial consult with California’s state health insurance exchange, Rick Jakious, CEO of the Massachusetts Nonprofit Network, and George Gonser, CEO of Spring Insurance Group.

Majority Supports Congressional Action on ACA

A new NBC News/Wall Street Journal poll released last week finds a majority of voters believe the U.S. Congress should move to pass new legislation if the U.S. Supreme Court invalidates the health insurance premium subsidies for individuals using the federal health insurance exchange, Healthcare.gov, to purchase health insurance required under the Affordable Care Act (ACA).

The survey, which was conducted in late February with 800 registered voters, found 54 percent of participants believe the House and Senate should act to ensure eligible people in all states be able to receive federal premium assistance if they qualify. Thirty-five percent of those surveyed oppose such an action.

The U.S. Supreme Court heard oral arguments in the case of King v. Burwell on Wednesday, March 4. The ACA challenge centers on whether the ACA allows the Internal Revenue Service to provide premium subsidies to citizens of states that choose not to set up their own state health insurance exchange. Thirteen states created and are running their own online insurance exchanges, including California; millions of residents in other states are using the federal exchange to purchase ACA-compliant coverage. A formal ruling from the Court is expected in June.

In the NBC/WSJ survey, Republicans were far less likely to support new legislation to “correct” the ACA. Only one in four GOP voters said they want Congress to step in and provide the subsidies in states without their own exchange. That compares to 81 percent of Democratic voters who support Congressional action to keep the subsidies available.

Majority Supports Congressional Action on ACA

A new NBC News/Wall Street Journal poll released last week finds a majority of voters believe the U.S. Congress should move to pass new legislation if the U.S. Supreme Court invalidates the health insurance premium subsidies for individuals using the federal health insurance exchange, Healthcare.gov, to purchase health insurance required under the Affordable Care Act (ACA).

The survey, which was conducted in late February with 800 registered voters, found 54 percent of participants believe the House and Senate should act to ensure eligible people in all states be able to receive federal premium assistance if they qualify. Thirty-five percent of those surveyed oppose such an action.

The U.S. Supreme Court heard oral arguments in the case of King v. Burwell on Wednesday, March 4. The ACA challenge centers on whether the ACA allows the Internal Revenue Service to provide premium subsidies to citizens of states that choose not to set up their own state health insurance exchange. Thirteen states created and are running their own online insurance exchanges, including California; millions of residents in other states are using the federal exchange to purchase ACA-compliant coverage. A formal ruling from the Court is expected in June.

In the NBC/WSJ survey, Republicans were far less likely to support new legislation to “correct” the ACA. Only one in four GOP voters said they want Congress to step in and provide the subsidies in states without their own exchange. That compares to 81 percent of Democratic voters who support Congressional action to keep the subsidies available.

Insurance Commissioners to Investigate Anthem Breach

It’s been a few weeks since Anthem, Inc. disclosed a security breach that potentially could affect nearly 80 million customers and employees, including 13.5 million current and former customers in California. While Anthem continues to work with federal and state authorities to find the persons responsible for the breach, the National Association of Insurance Commissioners has announced which of its members will be leading the multi-state investigation on behalf of the regulatory support organization.

Insurance commissioners from California, Indiana, Maine, Missouri, New Hampshire, North Dakota, and South California have been named to the NAIC task force. The seven lead-state regulators have reserved their right to expand the examination, anticipating a majority of states and territories will want to sign on in the future.

“While the criminal investigation runs its course, we will act now to assist and protect consumers,” said NAIC President Monica Lindeen, who is also the Montana Commissioner of Securities and Insurance. “We’ll work to identify those affected, assure that they receive appropriate protections, and continue our efforts to improve the industry’s cybersecurity.”

Federal health care officials and state regulators are investigating whether Anthem took sufficient security measures to safeguard its database. Anthem is offering people affected by the security breach two years of free identity theft protection and credit monitoring services. Eligible consumers include those doing business with any of Anthem’s businesses nationwide, including Amerigroup, Anthem Blue Cross, Anthem Blue Cross Blue Shield, Empire Blue Cross, Caremore, and Unicare. It also affects those using their Blue Cross and Blue Shield insurance in any of the 14 states where Anthem operates: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin.