Bruce Shutan

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.

After two years of health plan enrollments in the emerging online marketplace, it’s possible that public and private exchanges are finally converging.

Health care consumers in some parts of the U.S. may face higher premiums next year if some insurers struggle to cover their costs and Congress continues to require that the risk-corridors program established under the ACA be self-sustaining.

Covered California’s Small Employer Health Options Program (SHOP) is growing, but a private-sector competitor to the state-run HIX is growing even faster.

What happens if the U.S. Supreme Court decides next month to eliminate federal subsidies for as many as 10 million consumers in 37 states and carriers are unable to cover claims based on rates they've already submitted to Healthcare.gov?

Highlights of the expected legislation include limiting tax exclusions on employer-provided health insurance to $12,000 for individual coverage and $30,000 for family coverage and dismantling Medicaid expansion under the Affordable Care Act in favor of state grants.

A new $250,000 national advertising campaign running on several popular political TV programs casts the Affordable Care Act as a positive force that is saving lives. It also seeks to counteract continued threats of repeal or scaling back the landmark legislation.