health insurance

Alix Mattingly

Gov. Matt Bevin said Monday despite praise for Kentucky’s embrace of the Affordable Care Act in recent years, the initiative has been an “abject failure” in the state.

“Kentucky, which has long been vaunted as an example of the opposite, I’m telling you as a matter of fact has been an unmitigated disaster,” Bevin said at a news conference after governors attended an event with President Trump.

Bevin has long opposed the Affordable Care Act, which made more people eligible for Medicaid in Kentucky and created a state exchange, Kynect, for people to purchase health insurance.

Stephen George

Health insurance companies Aetna and Humana have called off their planned merger, citing a federal court ruling last month that blocked the deal.

"While we continue to believe that a combined company would create greater value for health care consumers through improved affordability and quality, the current environment makes it too challenging to continue pursuing the transaction," Aetna CEO Mark Bertolini said in a statement.

Aetna announced it would pay Humana a $1 billion fee for backing out of the agreement. Humana announced about $370 million of that would be paid as taxes.

In January, a federal judge ruled against Aetna's proposed acquisition of Humana in a victory for former President Obama's Justice Department, which sued Aetna last year.

Kentucky Spent $3.7M On Gunshot Victim Care In 2014

Feb 1, 2017
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The average cost of a gunshot victim’s emergency room or hospital stay in Kentucky was $10,000 in 2014. That’s according to a report out from the Urban Institute.

The total costs of these stays was $3.7 million, with the majority coming from inpatient stays.

And most of that care was provided by a government program. In 2014, the majority of gunshot victims in Kentucky hospitals — 68 percent — had their care paid for by public insurance like Medicaid. In 2010, 54 percent of gunshot victims had no insurance at all. Kentucky expanded its Medicaid program to childless adults in 2014 as part of the Affordable Care Act.

J. Tyler Franklin

Kentucky Sen. Rand Paul introduced a bill to repeal and replace the Affordable Care Act on Wednesday that would do away with the law’s major reforms, including the requirement to have health insurance or pay a penalty and the ban on insurers refusing coverage for those with pre-existing conditions.

Under the proposal, people wouldn’t be required to get health insurance, nor would employers be required to offer it. Instead, groups of people and small employers could come together to form “independent health pools” to negotiate rates.

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Whether health insurers Aetna and Humana can merge will likely soon be decided, and the outcome might just have an impact on the price you pay at the doctor’s office.

A new study from researchers at Harvard shows what could happen to the amount policyholders have to pay for a doctor’s visit.

The findings, published in Health Affairs, show that the lower prices consumers pay shopping wholesale — for example, at Costco — also apply to health care. Insurance companies with more buying power – through having more policyholders – pay lower prices for health care services. For instance, insurers with more than 15 percent of a market population paid the least amount for an office visit: $70. That increased to $88 for an insurer with less than 5 percent of marketshare.

Lisa Gillespie

Vickie Sheehan is one of the lucky ones.

She gained health insurance in 2013 through the Affordable Care Act, buying coverage on the health exchange. Since then, Sheehan has undergone treatment for anal cancer.

“Everyone complained about Obamacare… to me, it saved my life,” Sheehan said.

She still feels that way. But this year, for the first time since the ACA, or Obamacare, was implemented, there are fewer choices for Sheehan and the more than 82,000 Kentuckians who get their insurance on the exchange. Fewer companies are selling insurance to these customers, and the lack of options means higher prices and fewer benefits.

Healthcare.gov Enrollment Deadline Extended To Dec. 19

Dec 16, 2016
healthcare.gov

The deadline to sign up for Healthcare.gov coverage has been extended to Monday, Dec. 19 at 11:59 p.m. The federal government made the announcement Thursday night, citing a high volume of people who have left requests to get enrolled.

The deadline is for coverage starting Jan. 1. The final deadline is March 1 for coverage starting April 1. The Affordable Care Act allows for a two-month grace period that consumers can go without health insurance and not receive a tax penalty.

Mark Wilson/Getty Images

Republicans in Congress say they'll vote to repeal much of the Affordable Care Act early next year — even though they don't yet have a plan to replace it.

But they also insist that they don't want to harm any of the millions of people who got their health insurance under the law.

The lawmakers' strategy? Vote to repeal, and fulfill their top campaign pledge. But delay the changes, and keep running Obamacare for as long as two years while they figure out how to fill the hole they'll create in the insurance market.

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Consumer advocates are advising people to not buy into the name “multi-state” plan when shopping for individual market health insurance for next year because the plans don’t necessarily offer coverage across state lines.

Susan McConkey, a health insurance broker, said many consumers assume “multi-state” means coverage across state lines at in-network prices. But that isn’t true in most states, including Kentucky.

“They think they can use it in any state, and that’s not the case,” McConkey said.

The Office of Personnel Management in Washington, D.C. was assigned the task of getting insurers to offer these plans because of the agency’s experience managing federal employee health insurance.

Beth Hadley is in charge of multi-state plans at OPM. She acknowledged that the name is misleading, and said the agency is considering changing the name.

healthcare.gov

Sharon Bush spent 30 minutes on Tuesday helping a client sign up for an email account. The email address is a necessary step in signing up for health insurance through Healthcare.gov.

Bush didn’t realized that the email requirement for the federal exchange would take up so much time.

“In southeastern Kentucky, there are a lot of people who don’t have and/or use technology,” Bush said. “[The client] is a grandmother in her early 60s, and she just said, ‘I have two granddaughters and they use it a lot.’”

Bush works in Manchester, Kentucky, at Grace Community Health Center, where she helps people sign up for health insurance. She’s a former Kynector, a person paid by the state to assist people with enrollment. She helped people last year find health insurance through Kynect and is now helping people sign up on the federal exchange at Healthcare.gov.

In early October, Gov. Matt Bevin was given approval by the federal Centers for Medicare and Medicaid Services to dismantle the state-based insurance portal, Kynect, leaving Kentuckians searching for insurance to go through the federal portal, Healthcare.gov.

Kentuckians in more than half of all counties who buy insurance through HealthCare.gov next year will have a much more limited choice of doctors and hospitals.

That’s because the only insurer left in Kentucky offering exchange plans in all 120 counties — Anthem Blue Cross Blue Shield — will only offer an HMO plan in 74 of those counties starting Jan. 1.

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A new study shows fewer Kentucky adults are delaying or skipping medical care because of cost concerns.

The report from the Foundation for a Healthy Kentucky says a little more than 20 percent of Kentuckians who are 18 and older put off treatment this year because they couldn’t afford it.

That’s a big improvement over the 32 percent who skipped or delayed medical care in 2009.

“It’s still too high a figure, and we’re still higher than the national average,” said Foundation President and CEO Ben Chandler. “But it’s certainly better than what it was, and it’s a good sign and a step in the right direction.”

Chandler says the increasing number of Kentuckians who have health coverage under the Affordable Care Act has made a big difference. He points out income level is also a big predictor of whether Kentuckians had to put off getting medical care.

Kentucky Cabinet for Health and Family Services

Kentuckians who’ve purchased health insurance via Kynect will have to re-enroll on the federal exchange starting Nov. 1.

The Centers for Medicare and Medicaid Services on Tuesday told Gov. Matt Bevin that all major milestones for the switch had been met. As of this year, 74,640 people were enrolled via the state health care exchange, Kynect.

This means if you currently have coverage that was acquired on the state exchange, you will have to re-enroll on the federal exchange at healthcare.gov. Officials said that’s due to consumer information not being transferred from Kynect. 

Adam Meier, Bevin’s chief of staff for policy, said people can be screened for Medicaid eligibility or a plan on the federal exchange via the Benefind website, which operates as the umbrella portal for Kentuckians to apply for nearly all entitlement services.

Baptist Health Plan To Stop Selling Insurance In Kentucky

Oct 3, 2016
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Baptist Health Plan says it will not sell policies in Kentucky next year, meaning about 7,000 people will have to find a new insurance provider.

Kentucky’s fourth-largest insurer notified state officials in a letter. In a news release, state officials say company President James S. Fritz said Baptist Health Plan had enrolled more people than it planned and said federal risk assessments imposed by the federal Affordable Care Act are “unsustainable.”

The company’s insurance plans sold on the state’s health exchange will be good through Dec. 31. Plans sold off the exchange will expire March 31, 2017.

The news means next year people in 59 counties will have one insurance provider selling plans on the state health exchange. Off the exchange, most counties will have two options, state officials said.

Aetna will pull out of the ten counties in Kentucky where it offers exchange coverage, starting in 2017.

The company said Monday that it lost $430 million since January 2014, when Kentucky and many other states started offering plans on their state exchanges.

The departure leaves Boone, Campbell, Owen and Kenton counties with only two exchange plans. The other affected counties are Fayette, Jefferson, Madison, Henry, Oldham and Trimble. Aetna will continue to offer small group and an off-exchange individual coverage for 2017.

Aetna spokesman Rohan Hutchings says the company will notify customers before open enrollment in November about their options. But they’re likely to lose some current benefits.

The departure means consumers will have fewer insurance choices. They may already face dramatically increased premiums.

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