Bruce Shutan

Proposed rate increases for 2016 health insurance coverage that a dozen carriers will sell on Covered California’s state-run exchange will be just 4% compared to the 4.2% rise approved for 2015.

Public exchange plan participants spent less money on medications in the first quarter of 2015 than the first quarter of 2014 amid changes in the demographic mix of enrollees, according to newly released data from Express Scripts Holding Company.

Connecticut’s AccessHealthCT is poised to become the nation’s first state-run marketplace that will be financially self-sustaining in 2016 when federal grants end for these online marketplaces as stipulated under the Affordable Care Act.

While Montana has one of the nation’s lowest head counts, it ranked a close second behind New Hampshire in terms of the highest rate of 2015 public exchange re-enrollment among 34 states that direct their residents to Healthcare.gov.

Next-generation total compensation statements meet employees’ demands for real-time benefits information and can offer employers a powerful recruiting tool.

As pressure mounts on state-run public health insurance exchanges to be financially self-sufficient in time for 2016, consumer operated and oriented plans created under the Affordable Care Act face the same challenge. And with two recent troubling developments in the CO-OP space, there are renewed questions about the long-term viability of these nonprofit entities.

Narrow networks are more prevalent in public exchanges than the commercial market, and while this trend helps keep costs more manageable, it also significantly restricts any movement for consumers and could undermine network adequacy standards.

After more than 50 votes in Congress and two attempts before the U.S. Supreme Court to mothball the ACA and public exchange marketplace, some Republicans now see the budget reconciliation process as yet another avenue for achieving this long-time goal.

Two Urban Institute reports funded by the Robert Wood Johnson Foundation found that 9.4 million fewer families struggled to pay medical bills in early 2015 than just before the rollout of public exchanges and Medicaid expansion in 2013.

The $34.1 billion blockbuster deal between Aetna Inc. and Humana Inc. is seen as complementary to both health insurers in terms of helping grow their involvement in private and public health insurance exchanges.

Pent-up demand for various medical services has been identified among newer public exchange enrollees who deferred or avoided treatment because of financial constraints resulting from a lack of health insurance, notes the first in a series of research papers on so called preference-sensitive services.

Narrow-network restrictions help health insurance carriers participating in public exchanges limit their exposure to adverse selection and better manage the cost of patient care, but they’re also an annoyance for health care exchange enrollees who want unencumbered access to doctors and hospitals.

Doctors think insurance cards in Texas that identify HIX enrollees could serve as a reminder to pay their monthly premiums and reduce the number of unpaid bills. Critics, however, counter that they are akin to a Scarlet letter and could be used to deny treatment.

As Towers Watson & Co. and Willis Group Holdings Plc head to the altar for an all-stock merger valued at $18 billion, their respective private exchanges could command the roles of best man and bridesmaid.

It turns out that two of the most common consumer complaints about HIX plans mirror longstanding gripes about traditional health insurance, but there’s a movement afoot to ensure provider network directories are accurate and help patients better calculate and budget for out-of-pocket costs in the nascent online marketplace.

Most of the 13 state-run public health insurance have collectively spent $4.8 billion in federal funding during their first 17 months of operations and face serious cash-flow problems.

A legislation proposal by 32 Republicans that would temporarily preserve federal premium subsidies for Healthcare.gov enrollees through August 2017 if the Supreme Court rules them unconstitutional in King v. Burwell would simply bandage a festering wound. That’s the conclusion of a recent American Academy of Actuaries analysis.

The clock is ticking for various state legislatures that are pondering a change in the way their residents enroll in public health insurance exchanges ahead of the widely anticipated June ruling in King v. Burwell on whether federal subsidies will be scrapped in 34 states that rely on Healthcare.gov for signups.

Low-cost lending and credit-establishment services emerge as a new benefit to help employees make better financial decisions.

Nearly half of the 17 state-run public health insurance exchanges are suffering financial difficulties with the chief culprits being high expenses and tepid enrollment, which rose just 12% compared with compared to a 61% increase for Healthcare.gov.