Tag Archives: insurance

Blues dropping ObamaCare in much of TN

BlueCross BlueShield of Tennessee will not sell insurance plans on the Obamacare exchange in the state’s three largest metro areas next year, reports The Tennessean.

The insurer made “an extremely difficult but necessary decision” to leave the Nashville, Memphis and Knoxville markets as it tries to manage its number of members to hit a break-even point amid three years of losses, said Roy Vaughn, chief communications officer of BCBST.

“It’s not something we want to do but we believe we must look out for the health care and financial security for all the members that we serve,” Vaughn said in an interview with The Tennessean.

(The Times-Free Press reports the total of 214,000 Tennesseans impacted is more than half of those enrolled through BCBS statewide.)

The company formally made the change to its 2017 plans in a Friday filing with the U.S. Department of Health and Human Services — roughly a month after it raised the possibility of scaling back. Earlier this summer, BCBST requested — and was granted — state approval for an average 62-percent premium increase. The rate hike is still pending federal approval.
By the end of 2016, BCBST anticipates losses from three years selling on the exchange established by the Affordable Care Act will approach $500 million.

…The Chattanooga-based insurer, which was the only insurer that originally planned to sell statewide, expects to shed about 112,000 people from its rolls under the change and keep about 80,000 primarily in rural areas. Shoppers in the three metro areas will not be able to buy either on-exchange plans, where tax credits may be used, or off-exchange plans, which are not eligible for tax credits.

The decision will reshape open enrollment, which begins Nov. 1, for people who buy individual plans in the state’s three largest markets — and where Cigna or Humana, or both, are expected to sell plans. According to BCBST, 52,000 people in Nashville, 31,000 in Knoxville, and 29,000 in Memphis, will have to look to another insurer for coverage in 2017.

Vaughn said the structure of its 2017 footprint was designed to make sure there was at least one insurer in every part of the state. The 95 counties are divided among eight regions. In 2016, BCBST and UnitedHealthcare were the only two insurers to sell statewide.

BCBST’s decision increases the number of counties in which people may choose from a single company to 73 counties — up from 57.

(Note: A BCBS map showing county coverage in 2017 is HERE.)

Alexander, other GOP senators, propose Obamacare ‘options’

News release from Sen. Lamar Alexander’s office
WASHINGTON, Sept. 14—A group of eight United States Senators today introduced emergency, one-year legislation that would give states the authority to allow Americans who rely on Obamacare subsidies to have more options to buy health insurance unavailable on the failing Obamacare exchanges, and waive any penalty if they do not find a plan that suits their or their family’s needs.

Senate health committee chairman Lamar Alexander (R-Tenn.) said: “If you aren’t on Medicare or Medicaid and don’t obtain your health insurance through your employer, you are probably one of the nearly 11 million Americans who purchase their insurance on their own through the Obamacare exchange in your state.

“And you’ve probably read in the news that rates may be 60 percent higher next year than they were this year for the same insurance policy. And come November, nearly a third of the nation’s counties will have only one insurer for you to choose from when you have to buy health insurance on the regional Obamacare exchange as the market collapses and insurance companies are leaving the Obamacare exchanges in droves. This legislation would allow your state to give you the option of buying health insurance wherever you can find it whether on or off the Obamacare exchange.”

“This one-year solution is not a substitute for the long-term need to repeal and replace Obamacare with step-by-step reforms that transform the health care delivery system by putting patients in charge, giving them more choices and reducing the cost of health care so that more people can afford it,” he continued. “That would require a Republican president next year, but it gives Americans a real solution for next year and lets them know that we are on their side. Even if we have a Democratic president next year, we cannot continue without making big, structural changes soon to avoid a collapse of our nation’s health insurance markets.

Sen. Kelly Ayotte (R-N.H.) said: “More than 11,000 people in my home state recently learned that they would have to find a new health care plan after an insurer announced that it would be leaving the New Hampshire partnership exchange next year. Higher premiums and fewer choices are impacting real people today, and hardworking Granite Staters can’t afford to keep taking these hits. Our legislation would provide a temporary means to lessen the burdens of ObamaCare on New Hampshire families and individuals by allowing eligible individuals to use a subsidy to purchase health insurance outside of the exchanges, which may offer less expensive options than plans available through the exchanges.  This bill will help bring back some much-needed flexibility and choice in the health insurance marketplace, both of which ObamaCare has limited.”

Sen. John Barrasso (R-Wyo.) said: “In more than half of all counties in America, there will be only be two or fewer carriers offering coverage on the Obamacare exchange. Hard-working families facing higher premiums because of Obamacare deserve relief.  This legislation will give families more choices in 2017, as Republicans work to replace this failed law with real reforms that will make health care more affordable for all Americans.”

Sen. Thad Cochran (R-Miss.) said: “Time has shown that Obamacare is resulting in fewer and more expensive choices for the American people.  This legislation would increase options for families in Mississippi and elsewhere to obtain health insurance without being locked into troubled Obamacare exchanges,”
Sen. Ron Johnson (R-Wisc.) said: “I have worked for years to limit the damage and harm done to real people by Obamacare, a partisan policy that promised marketplace competition and higher quality health plans at lower costs and instead delivered the exact opposite. This bill would provide necessary relief to Wisconsinites who, under Obamacare, would be penalized for not purchasing a product that they cannot afford or does not meet their needs. It will allow the state to provide Wisconsinites receiving subsidies more options that just those offered on the Obamacare exchanges for 2017.”

Sen. Rob Portman (R-Ohio) said: “Ohioans need immediate relief from the skyrocketing cost of Obamacare. Premiums have increased in Ohio more than 90% since the President’s health care law went into place. This bill would provide individuals who have suffered under the high costs and fewer choices of Obamacare more options to receive coverage—which means more competition which in turn brings down costs. After eight years of stagnating wages, slow economic growth, and a rising cost of living, Ohioans deserve the relief this legislation would provide, not a health care system they can’t afford.”                                                             
The legislation, introduced by U.S. Sens. Lamar Alexander (R-Tenn.), Kelly Ayotte (R-N.H.), John Barrasso (R-Wyo.), Thad Cochran (R-Miss.), Ron Johnson (R-Wisc.), Mark Kirk (R-Ill.), David Perdue (R-Ga.), and Rob Portman (R-Ohio), would:

        Give states with a failing Obamacare exchange the authority to allow residents to use their Obamacare subsidy to purchase any health plan of their choice, even those off the exchange, for the 2017 plan year.

        If the state chooses to use this authority to allow residents to use subsidies outside of the exchange, the legislation will waive the Obamacare law’s requirement that you must buy a specific health care plan or pay a fine of as much as $2,000 for a family of four next year.

A summary of the State Flexibility to Provide Affordable Health Options Act is available online HERE.

TN regulators OK big Obamacare insurance hikes

Tennessee regulators have approved the full amount of the rate increases requested by the three health insurers still offering exchange plans under ObamaCare, pushing up rates by the biggest amount since the program began three years ago, reports the Times-Free Press.

BlueCross BlueShield of Tennessee, the state’s biggest health insurer, will raise individual rates by 62 percent in 2017, or nearly double the 36 percent rate increase adopted this year by BlueCross. Small group rates in the marketplace exchange will rise by only 6.5 percent, however.

Cigna got state approval to raise its individual rates for its ObamaCare plans by 46.3 percent, while Humana got the OK for a 44.3 percent jump in premiums for individual plans next year.

The increases for the marketplace plans were the biggest of the rate increases approved by the Tennessee Department of Commerce and Insurance, according to an announcement released this morning.

U.S. Sen. Lamar Alexander, R-Tenn., the chairman of the Senate health committee, said the increases prove that ObamaCare is not working. Alexander said the record increases under the program for 2017 are “only the most recent proof that Obamacare is spiraling out of control. Continue reading

AG joins lawsuit against insurance company merger

News release from Tennessee Attorney General’s Office
Attorney General Herbert H. Slatery III today announced that Tennessee has joined the U.S. Department of Justice and attorneys general from 11 states and the District of Columbia in litigation to block the merger between health insurance companies Anthem and Cigna, alleging that the transaction would increase concentration and harm competition in Tennessee and across the country.

The Justice Department and state attorneys general filed the merger challenge in the U.S. District Court for the District of Columbia. The complaint alleges that the merger, valued at $54 billion, would harm seniors, working families and individuals, employers, and doctors and other healthcare providers by limiting price competition, reducing benefits, decreasing incentives to provide innovative wellness programs, and lowering the quality of care.

“In what instance would Tennesseans want 4 instead of 5 competitors from which to choose insurance products or negotiate services? That is the question raised by the merger, whether one is a national employer comparing benefits and premiums, a health care provider like a hospital or physician practice, or an individual selecting a policy on an exchange. There are too many unanswered questions and too much at stake in reducing competition for Tennessee to support this merger,” Attorney General Slatery said.

Eleven states – California, Colorado, Connecticut, Georgia, Iowa, Maryland, Maine, New Hampshire, New York, Tennessee, and Virginia – along with the District of Columbia joined the department’s challenge of Anthem’s $54 billion acquisition of Cigna.

The suit against Anthem and Cigna alleges that their merger would substantially reduce competition for millions of consumers who receive commercial health insurance coverage from national employers throughout the United States. The complaint also alleges that the elimination of Cigna threatens competition among commercial insurers for the purchase of healthcare services from hospitals, physicians, and other healthcare providers.

Anthem, Inc. is headquartered in Indianapolis, Indiana. It is the nation’s second-largest health insurer. It operates in every state and the District of Columbia, and provides health insurance to 39 million people. In 2015, Anthem reported over $79 billion in revenues.

Cigna Corp. is headquartered in Hartford, Connecticut. It is the nation’s fourth-largest health insurer. It operates in every state and the District of Columbia, and provides health insurance to 15 million people. In 2015, Cigna reported $38 billion in revenues.

Former GOP leader/lobbyist leads new Insure TN promotional campaign

The Tennessee Hospital Association earlier this year formed a spinoff group – named Tennesseans for a Responsible Future — to promote Gov. Bill Haslam’s Insure Tennessee proposal, a Medicaid expansion move that failed in the 2015 legislative session. Now, the group has chosen Adam Nickas, a former political operative for the state Republican party and more recently a lobbyist, as executive director.

Here’s the press release from Tennesseans for a Responsible Future:
NASHVILLE, Tenn. – Today, Tennesseans for a Responsible Future (TRF) announced Adam Nickas as Executive Director. A Nashville resident and Memphis-area native, Nickas served as Executive Director of the Tennessee Republican Party during the 2012 election cycle and Political Director during the 2010 cycle. TRF was launched in January 2016 with the goal of promoting healthcare policies that benefit Tennesseans.
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Harwellcare task force meets in Memphis; ‘It’s for real’

As the third meeting of House Speaker Beth Harwell’s the task force charged with finding alternatives to Insure Tennessee began breaking up Monday in Memphis, reports the Commercial Appeal, Rep. Steve McManus took hold of the microphone to rebut citizens’ criticism that the panel is a farce.

“We’re for real, and we’re going to work for you,” said McManus, a Cordova Republican who sits on the task force.

Rep. Cameron Sexton, chairman of the “3-Star Healthy Project” task force and a Crossville Republican, said after the meeting — agreeing with McManus — that the goal wasn’t to completely scrap Gov. Bill Haslam’s Insure Tennessee plan, which failed to win legislative approval. Instead, the task force will re-evaluate it to see what parts, if any, the General Assembly can support.

“Insure didn’t have the votes,” he said. “We’re going to look to see if there’s a different approach.”

Summing up his takeaways from the meeting, Sexton said the task force — which includes Rep. Karen Camper, D-Memphis — could try to ease restrictions on faith-based health care organizations like the Church Health Center, which connects patients with volunteer doctors for a flat $35 fee.

Dr. Scott Morris, CEO of Church Health Center, told the task force that state law should be changed to allow citizens to claim health care coverage to satisfy the requirements of the Affordable Care Act and avoid costly fines for being uninsured.

Harwell to study health care via task force; Democrats howl

By Erik Schelzig, Associated Press
NASHVILLE, Tenn. — Republican House Speaker Beth Harwell on Tuesday touted a new initiative to improve health care access in the state, but Democrats quickly derided it as an election-year “charade” to deflect criticism of lawmakers who rejected the governor’s Insure Tennessee proposal.

Harwell said she began talking with health policy experts at Vanderbilt University’s medical school to come up with alternatives last year after lawmakers rejected Republican Gov. Bill Haslam’s proposal to extend health coverage to 280,000 low-income Tennesseans.

Harwell, R-Nashville, has dubbed her initiative the “3-Star Healthy Project,” and said it will tap conservative ideas like encouraging greater responsibility for enrollees; create health savings accounts funded by co-payments; and provide more support for people trying to rejoin the workforce.

She is a creating task force to propose ways to improve access to health care in Tennessee. Harwell said the four Republican House members she has appointed to the task force will work to come up with a specific proposal to make to the federal government as early as June, though the plan could require lawmaker approval next year.

Democrats called the announcement an attempt to give Republicans political cover for rejecting Insure Tennessee.

“This is simply designed to give the false impression that the House Republican leadership is willing to do anything about health care,” said House Democratic Caucus Chairman Mike Stewart of Nashville. “It’s clearly not. This is a charade, it’s an effort to delay, and to not simply pass Gov. Haslam’s Insure Tennessee plan.

“It’s pathetic,” Stewart said.
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Billboards urge Harwell to call vote on Insure TN

A statewide billboard campaign — funded by private citizens, including renowned Nashville philanthropist Martha Ingram — is pushing Harwell to bring Insure Tennessee to the House floor, reports The Tennessean. Harwell says she has no intention of doing so.

In a statement to The Tennessean, Harwell said Gov. Bill Haslam decided “not to pursue the implementation of Insure Tennessee.”

“As Speaker, I cannot unilaterally bring it to a vote,” Harwell said. “All bills go through the committee process, and this has failed to receive the support needed to advance.”

Citizens for Insure Tennessee are paying for 20 billboards in cities across the state, urging people to call on Harwell, R-Nashville, to bring Haslam’s Insure Tennessee to a vote.

“I’m just stunned by the leadership, or the lack of leadership, in the legislature,” said Renee Frazier, retired CEO of Shelby County Common Table Health Alliance, who donated to the campaign.

…Mary Falls and Sally Smallwood paid for three Nashville billboards in February and received feedback from private citizens from across the state who wanted to get involved. Billboards with Harwell’s number are also in Memphis, Knoxville, Chattanooga, the Tri-Cities, Tullahoma and other cities. Plus, The number of billboards in Nashville has increased to six.

“I’m involved in this because I’m so very disappointed by the actions of many members of the Tennessee legislature,” Ingram said. “I honestly don’t know how they sleep at night.”

Donations from more than 70 people across the state range from $10 to $4,200. Billboards can cost from a couple of hundred dollars to a couple of thousand, depending on the market. The cost of the billboards to the private donors is negligible compared to the impact Insure Tennessee would have on the state, Falls said.

Referendum on Insure TN rejected; Democrats blame Durham

NASHVILLE, Tenn. (AP) — A proposal to place Republican Gov. Bill Haslam’s Insure Tennessee proposal before the voters in November has been defeated in a House subcommittee.

The House Insurance and Banking Subcommittee voted Wednesday to study the bill sponsored by Democratic Rep. Craig Fitzhugh of Ripley (HB2545) after the General Assembly adjourns.

Haslam last year proposed extending health coverage to 280,000 low-income Tennesseans. The Tennessee Hospital Association had pledged to cover the entire $74 million state share of the program to draw down $2.8 billion in federal Medicaid funds over two years.

But Republican lawmakers rejected Haslam’s plan last year amid fears that it was too closely linked to President Barack Obama’s signature health care law.

Haslam wants to wait and see who the next president is before deciding how to proceed.

Note: Democrats blame defeat of the bill on Rep. Jeremy Durham, R-Franklin, who is otherwise facing an investigation into alleged sexual harassment. News releases below.
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Cancer survivor Ketron loses effort to help others

Senate Republican Caucus Chairman Bill Ketron, a cancer survivor, has lost an effort to reduce costs to patients for orally administered cancer drugs after two weeks of sometime emotional debate.

Only three members of the Senate Commerce Committee, one a Democrat, ultimately voted for the bill by the Murfreesboro lawmaker, who said he had vowed to help other cancer patients after his own yearlong bout with non-Hodgkin lymphoma. Six fellow Republicans voted no.

“As I lay in the hospital I told God that if he would help me survive I would do everything to help all other cancer patients in the state,” he told the panel at one point.

The bill (SB2091) requires medical insurance policies that cover cancer treatments to set co-pays, deductibles and coinsurance costs for oral drugs – including some that are “off label,” or officially designated for other purposes – at the same level as those that are injected. It was staunchly opposed by lobbyists for the insurance industry while supported by advocates for cancer patients, including the Leukemia and Lymphoma Society of Tennessee.

Some lawmakers, including Senate Commerce Committee Chairman Jack Johnson, R-Franklin, contended the measure would conflict with long-standing conservative sentiment against mandates for insurance coverage.

Johnson last month won Senate passage of a bill intended to make it more difficult to enact insurance mandates in the future. The measure (SB1619) requires that any mandated health benefit will apply equally to TennCare as well as to private insurance companies. In the past, some mandates have excluded TennCare so the bill would not have any cost to state government. Legislation that imposes a new cost on state government without the spending being specifically authorized in the state budget is far more difficult to pass.

The House version of that bill, sponsored by Rep. Roger Kane, R-Knoxville, is scheduled for a House vote Monday and considered likely to win approval.

Note: A press release thanking Ketron for his efforts is below. Continue reading