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November 9, 2012

Obama Administration Extends Deadline For State Exchanges

By Phil Galewitz

KHN Staff Writer

The Obama administration on Friday gave states more time to submit plans to set up state-based health insurance exchanges, a concession to the reality that many states had delayed planning until they saw who won the presidential election.

States will have to tell federal regulators that they plan to go ahead by next Friday, but they will have until Dec. 14 to submit plans for state-based, online markets, according to a letter to governors from Health and Human Services Secretary Kathleen Sebelius. Those who want to partner with the federal government to set up the markets have until Feb. 15.

“This administration is committed to providing significant flexibility for building a marketplace that best meets your state’s needs,” Sebelius wrote. “… we have heard from many states that additional time would allow you to submit a more comprehensive, complete blueprint application for your exchange.”

The exchanges are a key element of the health care law. They are supposed to make it easier to find an affordable plan and to help people in small group and individual insurance market determine if they qualify for new federal subsidies. An estimated 12 million people are expected to get insurance through the exchanges in 2014.

Originally, states had to give federal regulators a plan by Nov. 16 detailing how they would move forward, with enrollment slated to launch next October.

Under the law, the federal government will set up exchanges if states don’t. As of late September, only 19 had begun setting up exchanges or agreed to do so in partnership with the federal government, according to an analysis by the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)

Some experts have raised questions about whether the federal government has the capability to set up and run several dozen markets by January 2014.

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November 15, 2012

Obama Administration Extends Deadline For State Exchanges –Again

By Phil Galewitz
KHN Staff Writer

For the second time in a week, the Obama administration gave states more time to decide whether to build online insurance marketplaces that will help millions of people buy health coverage starting next fall.

“States have and will continue to be partners in implementing the health care law and we are committed to providing states with the flexibility, resources and time they need to deliver the benefits of the health care law to the American people,” Health and Human Services Secretary Kathleen Sebelius wrote late Thursday to the Republican Governors Association. “We will continue to work directly with individual states to address their particular questions and concerns.”

Sebelius said that states may submit both a letter of intent and an application to operate their own exchanges by Dec. 14. The original deadline had been Friday, Nov. 16.

A week ago, Sebelius said states could submit only their letters of intent by Friday but push back sending their detailed plans until Dec. 14. She also gave them until Feb. 15 to elect to partner with the federal government to operate an exchange.

Thursday’s decision came a day after the Republican Governors Association asked the administration to extend the deadline until after HHS publishes rules about how the exchanges would work.

“States are struggling with many unanswered questions and are not able to make comprehensive far-reaching decisions prudently,” said the RGA letter signed by Govs. Bob McDonnell of Virginia and Bobby Jindal of Louisiana.

Just seven states have yet to decide whether to build and run state-based exchanges — Tennessee, Pennsylvania, Idaho, New Jersey, Oklahoma, Arizona and Wisconsin.

Seventeen states and the District of Columbia have committed to running their own exchanges — far fewer than envisioned by the Obama administration when the law was passed in 2010. The rest have not yet responded, or indicated they planned to partner with the federal government or to allow the federal government to run the exchanges.

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December 7, 2012

Q&A: What would it mean to raise Medicare’s eligibility age?

Raising the age for starting Medicare is among the leading proposals to slow the program’s spending — key to a federal budget deal. But how would it work?

By Noam N. Levey, Washington Bureau
December 7, 2012

WASHINGTON — As they debate ways to control the federal deficit, President Obama and congressional Republicans have both acknowledged the need to rein in federal spending on healthcare programs such as Medicare, which provides health insurance to about 50 million elderly and disabled Americans. Among the leading proposals to slow Medicare spending — a key ingredient of a budget deal — is to raise the eligibility age for the program, an option frequently championed by conservatives. Here are answers to some basic questions about the concept and its potential effects:

How would raising the Medicare eligibility age work?

Most proposals envision gradually raising the eligibility age from 65 to 67 over a decade or longer. Lawmakers agreed in the 1980s to a similar phase-in to raise the Social Security eligibility age, a process that is still underway.\

This idea was discussed during the 2011 budget negotiations between the president and congressional Republicans and was championed by former Massachusetts Gov. Mitt Romney, the 2012 GOP presidential nominee.

How much money would that save?

That depends on how the shift is structured. Last year, the nonpartisan Congressional Budget Office estimated that a proposal to phase in the rise in eligibility over 13 years starting in 2014 would save the federal government about $113 billion over the next decade.

That makes the proposal one of the single biggest money savers at a time when Medicare spending is projected to rise from $600 billion a year to more than $1 trillion a year by 2021, driven in large part by retiring baby boomers who will join Medicare in coming years.

Proponents of raising the eligibility age also note that it would encourage more Americans to continue working through their mid- to late 60s, adding to economic growth, though the CBO concluded the effects of this would be modest.

What would happen to these seniors?

If the new healthcare law is fully implemented in 2014, all Americans will be guaranteed health coverage, so seniors who do not qualify for Medicare when they are 65 would still be able to get health insurance.

They would just have to purchase it on their own or get it from an employer, much like younger workers today. The law limits how much more insurers can charge older consumers and prohibits insurance companies from charging more to people with preexisting medical conditions.

Those new protections mark a major change from today, when it can be difficult for consumers in their 60s to get a health insurance plan on their own.

Nonetheless, some seniors would probably end up paying more for health insurance than they do with Medicare, because private health plans are often more expensive, the CBO says. Budget analysts also estimated that about 5% would become uninsured.

What would raising the eligibility age mean for everyone else?

It could mean higher costs.

Younger Medicare beneficiaries are typically healthier and less expensive than older people on the program. That spreads risk and helps control Medicare premiums.

If healthier beneficiaries leave the program as the eligibility age is raised, that would leave a sicker population behind, necessitating higher premiums for beneficiaries to cover the higher medical costs.

Are there other proposals to control Medicare spending?

Yes. Some policymakers favor cutting Medicare payments to hospitals and other providers. Lawmakers have also discussed charging higher premiums to wealthy seniors. And many Republicans would like to overhaul Medicare by giving beneficiaries vouchers to shop for private health insurance.

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Copyright © 2012, Los Angeles Times

December 7, 2012

Obama administration moves forward to implement health care law, ban discrimination against people with pre-existing conditions

The Obama administration moved forward today to implement provisions in the health care law that would make it illegal for insurance companies to discriminate against people with pre-existing conditions. The provisions of the Affordable Care Act also would make it easier for consumers to compare health plans and employers to promote and encourage employee wellness…

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December 7, 2012

What’s at stake if they build state-based exchanges, partner with the federal government — or let federal regulators run everything?

To partner with the federal government or not. That is the question facing many of the nation’s governors as crunch time approaches to carry out the 2010 health care law.

Their decisions about whether to set up state-run online markets to offer health insurance will affect whether millions of individual consumers and small businesses shop for coverage on state or federally operated websites starting in 2014….

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