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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.

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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.

The percentage of Kentucky workers enrolled in high-deductible health insurance plans increased by nearly six times between 2006 and 2014.  A report released by the Foundation for a Healthy Kentucky shows the growth of those plans is nationwide. 

Foundation CEO Susan Zepeda says consumers typically choose high-deductible plans in exchange for lower monthly premiums.

"When people are having to pay those first dollars before their health plans kick in, it does make them more prudent consumers when they have a choice in the health care that they seek out," Zepada told WKU Public Radio.

Zepeda says consumers on high-deductible plans also tend to use fewer preventive services such as vaccinations and screenings, which may save money in the long run. 

Most of the state’s nearly 94,000 Kynect enrollees have chosen plans with high-deductibles.  The report did not address what may happen if Kentucky transitions to the federal health care exchange.

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A Western Kentucky University researcher says hospitals now have more incentive than ever before to achieve patient satisfaction.

Neale Chumbler, Dean of the College of Health and Human Services at WKU, says a federal survey of hospital patients is creating a comparison of care providers across the country.

The survey’s official name is Hospital Consumer Assessment of Healthcare Providers and Systems. Its goal is to measure patients’ perspectives on the care they’ve received.

Chumbler says the results are also being scrutinized by insurance companies.

“As a hospital CEO, whether you get more or less reimbursements through insurance, these types of results will bear a lot of important findings.”

Kentucky Cabinet for Health and Family Services

A new, wide-ranging health poll shows that opinion remains split on the Affordable Care Act in Kentucky, with most unfavorable opinions coming from northern and western parts of the state. Those areas also happen to have the highest rates of uninsured in the state.

Susan Zepeda is president of Foundation for a Healthy Kentucky, which conducts the annual poll along with Cincinnati-based Interact for Health.

“Overall, what we’re finding with these reports is that an increasing number of Kentuckians have health insurance, but many are still delaying or simply can’t afford necessary health care,” Zepeda said.

The Kentucky Health Issues Poll showed that just 41 percent of Kentuckians have a favorable opinion of the Affordable Care Act.

Jacob Ryan, WFPL

Kentucky’s Medicaid commissioner says the state’s plan to scale back the expanded Medicaid system will not require beneficiaries to pay premiums, according to an Associated Press report.

In the report, Commissioner Stephen Miller goes on to say that Medicaid recipients could receive fewer benefits, including reduced vision and dental services.

Late last year, Gov. Matt Bevin announced that he would by 2017 “transform” the state’s expanded Medicaid system into one where recipients have “skin in the game” by paying for benefits.

Doug Hogan, communications director for Kentucky’s Cabinet for Health and Family Services, said that the state couldn’t comment on the proposed changes or negotiations with the Centers for Medicare and Medicaid Services (CMS).

“Everything is on the table and no decisions have been finalized. We are continuing to engage stakeholders and CMS in good faith,” Hogan said.

J. Tyler Franklin, WFPL

The Bevin administration says it has met the June 1 deadline of demonstrating that it’s made adequate progress in Kentucky’s transition from the state health insurance exchange Kynect, to the federal exchange, healthcare.gov.

Doug Hogan, communications director for the Cabinet for Health and Family Services, said the state has “met milestone requirements ahead of schedule,” but refused to comment on details of what criteria the state has accomplished.

According to a March 15 letter sent to state officials by Kevin Counihan with Centers for Medicare and Medicaid Services, the federal government has to “determine whether sufficient progress has been made to proceed with leveraging the federal platform” for the upcoming year.

CMS officials refused to comment on details of Kentucky’s transition to the federal exchange.

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Health insurance companies in Kentucky want to increase rates by an average of 17 percent next year.

The Kentucky Department of Insurance posted rate requests from the state's major insurance carriers on Wednesday. They include plans for individuals and small groups.

These are not premium increases. The base rate is one of several factors used to determine a person's premium, including age, sex and where a person lives. Individual premiums will vary.

State officials blame some of the increases on the failure of the Kentucky Health Cooperative. Many of the company's high-risk customers were picked up by other companies, leading to higher rates.

The rate requests cover plans sold on and off kynect, the state's health insurance exchange. Republican Gov. Matt Bevin plans to dismantle kynect by the end of this year.

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More Kentuckians are gaining health insurance coverage, a trend that has continued since the Affordable Care Act was implemented in 2014, according to a report released Wednesday by the Foundation for a Healthy Kentucky.

The fourth quarter 2015 snapshot of the impact of the ACA in Kentucky indicates that the rate of uninsurance was 7.5 percent as of December 2015, down from 9 percent in June 2015.

Nationally, 11.7 percent lacked health insurance as of December; the rate was 10.2 percent for the eight states surrounding Kentucky.

“Lack of insurance is a significant barrier to getting necessary health care and preventive services timely,” said Susan Zepeda, President/CEO of the Foundation for a Healthy Kentucky.

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A recent report by Kaiser Family Foundation says Kentucky has one of the most successful implementations of the Affordable Care Act in the U.S.

The report cites the “single, integrated eligibility system [Kentucky] built for Kynect and Medicaid” as one of the most pivotal components to its success.

The foundation also concludes that the state’s leadership and collaboration, outreach and marketing efforts, and diverse network of enrollment assistance were also contributing factors to its success.

In a statement from Saving KY Healthcare, former Gov. Steve Beshear — a principal with the nonprofit — said Kynect and Medicaid expansion had a big impact.

“The successful rollout was largely due to thorough coordination by officials throughout the state, and a comprehensive effort to ensure that all aspects of Kynect and the expansion were ready to launch on day one,” he said.

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