Over 214,000 Doctors will not participate in ACA Plans in 2015

Over 214,000 doctors won't participate in the new plans under the Affordable Care Act (ACA,) analysis of a new survey by Medical Group Management Association shows. That number of 214,524, estimated by American Action Forum, is through May 2014, but appears to be growing due to plans that force doctors to take on burdensome costs. It's also about a quarter of the total number of 893,851 active professional physicians reported by the Kaiser Family Foundation. In January, an estimated 70% of California's physicians were not participating in Covered California plans. Here are some of the reasons why: 1. Reimbursements under Obamacare are at bottom-dollar - they are even lower than Medicare reimbursements, which are already significantly below market rates. "It is estimated that where private plans pay $1.00 for a service, Medicare pays $0.80, and ACA exchange plans are now paying about $0.60," a study by the think-tank American Action Forum finds. "For example, Covered California plans are setting their plan fee schedules in line with that of Medi-Cal-California's Medicaid Program-which means exchange plans are cutting provider reimbursement by up to 40 percent." 2. Doctors are expected to take on more patients to make up for the lost revenue, but that's not happening, because primary care doctors already have more patients than they can handle. "Furthermore, physicians are worried that exchange plan patients will be sicker than the average patient because they may have been without insurance for extended periods of time, and therefore will require more of the PCPs time at lower pay," says the study. The study also points to two reasons that doctors might not get paid at all: 3. An MGMA study indicates that 75% of ACA patients that had seen doctors had chosen plans with high deductibles. Given that most of the patients are low-income, doctors are concerned that the patients cannot meet the deductibles and they will get stuck with the bill. 4. HHS requires that insurers cover customers for an additional 90 days after they have stopped paying their premiums: the insurer covers the first 30 - but, it's up to the doctor to recoup payment for the last 60 days. This is the number one reason providers are opting to not participate in the exchange plans. Currently, about a million people have failed to pay their premiums and had their plans canceled. So, Obamacare is asking doctors to take on sicker patients for less money, with the risk of not getting paid at all? No wonder doctors are running from these plans!

Impact of Affordable Care Act: Health Care Costs Down -

"According to the Congressional Budget Office, the Affordable Care Act (ACA), often referred to as "Obamacare," will cut the federal budget deficit by a $100 billion. That despite adding health coverage for about 10 million people, by federal estimates. Paul Van de Water, a senior fellow at the Center on Budget and Policy Priorities, says the reform has been able to do this because it's had real success at one of its key goals: holding down the cost of health care." This statement fails to mention that one of the factors that make up "cost" are the premiums that consumers pay as well as co-pays. Yes, many of the Obamacare plans have lower premiums and have forced insurance companies to keep their premiums artificially lower for the last 2 years. Starting in 2015 we will see the insurance companies defy the Obama administration and raise the rates to reflect the actual market conditions. Premiums reflect the cost of keeping people insured. If more people are insured that would normally not get coverage, due to their condition that the insurers would consider "risky" or "expensive", then rates in a free market would naturally rise to offset this cost. That's what will happen in 2015. So this statement is a bit premature since it only factors in the results of the last 2 years. Let's compare those 2 years to the next 2 years. Premiums will continue to rise as well as deductibles. As subscribers to Obamacare plans learn that more doctors will be refusing to serve them the backlash will be seen more readily.

Questions About Reshopping for Health Insurance During Open Enrollment

Today eHealth, Inc. (NASDAQ: EHTH) (eHealthInsurance.com), the nation's first and largest private online health insurance exchange, released answers to questions commonly asked by subsidy-eligible health insurance consumers who want to maintain coverage for 2015 and avoid the potential loss of any premium subsidies they may be due next year. The Affordable Care Act (ACA), also known as Obamacare, created specific open enrollment periods during which eligible consumers can sign up for individual and family major medical health insurance and apply for subsidy assistance. The first-ever open enrollment period ended March 31, 2014. Since that date, consumers have only been able to enroll in major medical health insurance on their own if they experienced a qualifying life event (like marriage, the birth of a child, a move, etc.). The second nationwide open enrollment period is scheduled to begin November 15, 2014 and continue through February 15, 2015. For many consumers, this may be the only opportunity to enroll in major medical coverage and try to avoid the ACA tax penalty for 2015. In order to help subsidy-eligible consumers better understand how to get the most for their health insurance dollars in 2015, eHealth has released answers to the following common questions. Answers to Consumer Questions About Subsidies and Major Medical Health Insurance Coverage for 2015 Question: How do government health insurance subsidies work? Answer: The ACA provides government-funded subsidies to help reduce monthly health insurance premiums for qualifying persons. Consumers may qualify for subsidies if they have an annual household income between 133% and 400% of the federal poverty level (up to about $46,000 for a single person in the contiguousUnited States, or $95,000 for a family of four). The dollar value of the subsidies you receive will depend on where your income falls within that range and on the cost of "benchmark" health plans in your area. Since subsidies are based on your estimated income for the current year, the amount of subsidies you qualify for may fluctuate depending on changes to your actual income. Any discrepancies in the subsidies you received and the subsidies you were actually due are reconciled when you complete your federal tax return for the year. Question: If I enroll in a new plan during open enrollment, when can my coverage start? Answer: The new open enrollment period is for 2015 health insurance plans only. During open enrollment, coverage under any new plan you select can begin no sooner than January 1, 2015, at the earliest. Question: I already have coverage. Am I required to apply for health insurance again during this open enrollment period? Answer: You are not required to enroll in a new plan for 2015, unless your insurance company or licensed agent tells you otherwise, but reshopping during open enrollment -- especially if you used a government subsidy in 2014 or may qualify for a subsidy in 2015 -- could save you money, and you may find a new plan better suited to your personal coverage needs. Question: Am I going to lose my health insurance subsidies for 2015 if I don't reshop during open enrollment? Answer: The answer depends on your personal circumstances. When you first applied for a subsidy, did you give permission for your tax records to be accessed so that your subsidy could be automatically updated each year? If the answer is yes, and if your income hasn't changed much and plan prices in your area do not change significantly, you'll probably continue to receive the same subsidy as long as you remain in the same plan. If your income has increased to over 500% of the federal poverty level (about $58,000 for a single person in the contiguous United States, or $119,000 for a family of four) your subsidy will end after December 31, 2014 unless you re-apply for a one and enroll in a new plan for 2015. Likewise, if you received a subsidy in 2014 and did not give permission for your tax records to be accessed for the purposes of updating your subsidy, your subsidy will also endDecember 31, 2014, unless you re-enroll. Question: Make it easy for me. Who should shop for health insurance during open enrollment, and who shouldn't? Answer: Here's a simple breakdown of who should shop or reshop for health insurance during open enrollment, and who may not need to. Find the category that best describes your personal situation: "I am currently uninsured:" Don't let open enrollment pass you by! This may be your only chance to get health insurance coverage for yourself and your family for 2015. You may even be eligible for subsidies to make your coverage more affordable. "I am no longer happy with my current health insurance plan:" Anyone no longer happy with their current health insurance plan should take advantage of open enrollment to look at their coverage options. There may be other plans that are better suited to your medical or financial needs or that cover the doctors and hospitals you prefer to see. "I am a subsidy recipient who gave permission for my tax information to be accessed but my income has changed:" When you completed your application last year you may have given permission for your tax information to be accessed for the purpose of updating your subsidy eligibility this year. If that's the case, and if your income has changed, you should reshop and re-enroll in coverage during this open enrollment period. Depending on how your income changed, your subsidies may be scheduled to end after December 31, 2014 unless you take action. It's also possible that you may be due more subsidies in 2015 than you are currently receiving. "I am a subsidy recipient who gave permission for my tax information to be accessed and my income has not changed:" You may still want to reshop during open enrollment because it's possible your coverage options may change even if your personal circumstances haven't. For example, if the "benchmark" health insurance plan in your area has changed, it could alter the value of your subsidy for 2015. And just because your favorite doctor is in your coverage network for 2014 doesn't mean that he or she will also be in-network for 2015. "I am a subsidy recipient who did not give permission for my tax information to be accessed in order to update my subsidies:" Your subsidies will end afterDecember 31, 2014 unless you take action. If you believe you are still entitled to subsidies in 2015, you must reshop, apply for a subsidy again, and enroll in a plan for 2015. "I did not receive subsidies in 2014 but think I may qualify for them in 2015:" If you think you may be eligible for subsidies to help make your monthly premiums more affordable, take advantage of open enrollment to apply for subsidies and enroll in a plan for 2015. "I will not qualify for subsidies in 2015:" If you're happy with your current plan, you shouldn't need to take any action unless advised to do so by your health insurance company or licensed agent. However, there are new plans available in 2015 and it's always a good idea to take a fresh look at your coverage options once per year. Unless you experience a qualifying life event (like a move, marriage, birth of a child, or other event) open enrollment may be your only chance to change your health plan for 2015. Question: Am I going to lose coverage under my current plan if I don't reshop during open enrollment? Answer: No, you should not lose coverage under your current ACA-compliant health insurance plan in 2015, unless your insurance company or licensed agent informs you otherwise. Here's a possible exception: your insurance company may decide to stop offering your plan. If that happens, they will probably advise you of other plans you may wish to consider. You should also work with a licensed online agent like eHealth to review plans from multiple insurers and make sure you find the best match for your needs. Question: Last year I got my health insurance plan and subsidies through the online government exchange. Do I need to reshop through the government exchange again for 2015? Answer: A lot of consumers expressed frustration with their experience of the government-run health insurance exchanges during the last open enrollment period. The good news is that you may have other options, even if you're eligible for subsidies. Licensed private health insurance marketplaces like eHealth can help. At eHealth, consumers from most states can apply for subsidies and enroll in coverage in precisely the same health insurance plans available through their government exchange. Question: Why should I shop for my 2015 health insurance plan through eHealth rather than through the government exchange? Answer: When you shop with eHealth during open enrollment you may benefit in the following ways: eHealth makes it simple to shop for coverage and enroll in the plan of your choice. With more than fifteen years of expertise, eHealth understands how consumers like you want to shop for health insurance. We're always improving our website and shopping tools to make it easier -- and faster -- to find the coverage you need. eHealth offers a broader range of coverage options. The health insurance plans offered through government exchanges may only represent a fraction of the coverage choices available to you. You may have other options that will also meet your coverage requirements under the ACA and protect you from a tax penalty. eHealth is your best source for selection, representing over 200 brand-name insurers nationwide. eHealth may be able to help you apply for government subsidies. Subsidies are available for qualifying shoppers, depending on your income and other criteria. Subsidy-eligible consumers in most states can apply for government help through eHealth and then enroll in the very same health plans (at the same prices) that are offered through government exchanges. eHealth provides personal advice and ongoing advocacy. The customer service representatives available to help you at government exchanges aren't usually licensed agents and probably can't provide you with personal advice about your coverage choices. At eHealth, our unbiased, licensed agents make all the difference when it comes to your long-term satisfaction. Even after you enroll, eHealth can continue to serve as your advocate with the insurance company. eHealth is a total coverage marketplace. There's more to "coverage" than just health insurance -- which is what government exchanges are mostly limited to. By contrast, at eHealth you can also find dental and vision insurance, as well as products like short-term insurance, travel insurance, and accident or critical illness insurance. eHealth has all you need to craft a total coverage package for yourself or your family. Question: What happens if I miss the open enrollment period? Answer: If you miss the ACA open enrollment period for 2015 you may run the risk of going uninsured -- or being stuck in your current plan -- for all of 2015. Outside of open enrollment, you may only be able to enroll in a major medical individual or family plan when you experience a qualifying life event such as marriage, the birth of a child, or a move to a new city or state. So don't let open enrollment pass you by without taking a look at your eligibility for a subsidy and your coverage choices for 2015. You'll be glad you did. For additional information on subsidies, re-enrollment and the Affordable Care Act, consumers can visit eHealth's new Subsidy Help Center, a dedicated consumer resource center providing educational information, videos, and tools designed to help subsidy-eligible consumers navigate open enrollment and get the health insurance subsidies they may be due next year. About eHealth eHealth, Inc. (NASDAQ: EHTH) operates eHealthInsurance.com, the Nation's first and largest private health insurance exchange where individuals, families and small businesses can compare health insurance products from leading insurers side by side and purchase and enroll in coverage online. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 200 of the nation's leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia. eHealth, Inc. also provides powerful online and pharmacy-based tools to help Medicare beneficiaries navigate Medicare health insurance options, choose the right plan and enroll in select plans online through PlanPrescriber.com (www.planprescriber.com) and eHealthMedicare.com (www.eHealthMedicare.com). For more health insurance news and information, visit the eHealth consumer blog:Get Smart - Get Covered or visit eHealth's Affordable Care Act Resource Center atwww.eHealth.com/affordable-care-act. Forward-Looking Statements This press release contains forward-looking statements, including statements regarding the open enrollment period for individual and family health insurance and eHealth's ability to assist consumers in applying for subsidies and health insurance plans during the open enrollment period. These forward-looking statements involve certain risks and uncertainties that could cause actual results to differ materially from those indicated in such forward-looking statements, including, but not limited to, eHealth's ability to maintain its relationships with insurance carriers and its ability to offer qualified health insurance plans; insurance carriers gaining approval to market health plans and providing eHealth permission to display them on eHealth's website; eHealth's ability to obtain health plan information and incorporate it into its web platform; eHealth's ability to enter into and maintain relationships with government exchanges; the Federal government's willingness and capability to resolve issues with eHealth's integration with healthcare.gov; the ability of eHealth's Internet platform and technology to interact with government exchanges; eHealth's ability to successfully integrate with healthcare.gov and other government exchanges; eHealth's ability to timely meet requirements to sell qualified health insurance plans and assist individuals in applying for subsidies; potential changes in laws, regulations and regulatory guidance; and any changes to the Affordable Care Act and related regulations and rules. Other risks and uncertainties that can affect actual results are included under the captions "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" in eHealth's Annual Report on Form 10-K for the year ended December 31, 2013 and most recent Quarterly Report on Form 10-Q, which are on file with the SEC and are available on the investor relations page of eHealth's website athttp://www.ehealthinsurance.com and on the Securities and Exchange Commission's website at www.sec.gov. All information provided in this press release is as of the date of this press release, and we undertake no duty to update this information unless required by law.

Despite being eligible for subsidies from Affordable Care Act's Health Insurance Marketplace, many Texans still believe coverage is too expensive

Half of Texans who are eligible for premium subsidies under the Affordable Care Act (ACA) and who looked for health plans in the ACA's Health Insurance Marketplace said cost was the main reason they didn't enroll in a plan. That's just one of the findings in a report released by Rice University's Baker Institute for Public Policy and the Episcopal Health Foundation. The report specifically looked at lower- to middle-income families in Texas who don't have access to health insurance through an employer and who earn too much to qualify for public programs. That group includes approximately 2 million uninsured Texans and is a key target population of the ACA. The report found that virtually all of the target population knew about the ACA Marketplace and the available subsidies for health insurance premiums. In addition, the report found that one-third of those aware of the marketplace looked for information on health insurance plans. Another one-third planned to look for that information in the future. However, many Texans who looked for plans in the ACA Marketplace still didn't enroll in a health insurance plan. The report found half of those who did not enroll said costs were the main reason - either costs were too high or they didn't have enough money to enroll at that time. The report is the sixth in a series on the implementation of the ACA in Texas. It was co-authored by Elena Marks, the president and CEO of the Episcopal Health Foundation and a health policy scholar at the Baker Institute, and Vivian Ho, the chair in health economics at the Baker Institute, a professor of economics at Rice and a professor of medicine at Baylor College of Medicine. "The affordability of Health Insurance Marketplace plans, even with subsidies, has been an open question from the outset," Marks said. "Perceptions about affordability may be preventing some Texans from enrolling in a plan. The intense, politically charged dialogue around the ACA in the state may have created misconceptions about the costs." Uninsured Texans may also think health coverage is too expensive because the cost is new to them, the report found. Even with subsidies, some families still would pay some amount for coverage - an added expense, regardless of the amount, not previously part of the family budget. Also, the report found there's evidence many uninsured don't value health insurance or believe they can still use charity care programs that offer free or discounted medical care on a pay-as-you-go basis. As the report showed, most of the uninsured knew about the ACA Marketplace and two-thirds looked, or planned to look, for information on health insurance plans. However, the report also discovered 29 percent not only hadn't looked for marketplace information, they also didn't plan to look for information in the future. "Many of those who didn't buy insurance will pay a penalty of $95 or 1 percent of income on their 2014 tax return," Ho said. "That penalty rises to $695 or 2.5 percent of income in 2016, which will likely lead to more people enrolling in coming years." The Health Reform Monitoring Survey (HRMS)-Texas report is based on a national project that provides timely information on implementation issues under the Affordable Care Act and changes in health insurance coverage and related health outcomes. The Episcopal Health Foundation and Baker Institute are partnering to fund studies of and report on key factors about Texans obtained from an expanded representative sample of Texas residents. Today's report contains responses from 1,595 Texans in September 2013 and 1,538 in March 2014. The survey was developed by the Urban Institute, conducted by the company GfK and jointly funded by the Robert Wood Johnson Foundation, the Ford Foundation and the Urban Institute.