Sunday, December 04, 2011

Weekend Update

We are entering the last full week of the Federal Benefits Open Season which ends on December 12. reports that "As the end of open season for changing health insurance elections draws near, the refrain among health care specialists boils down to: Look into changing your plan now, before it's too late."

The article also reports opinions that the Affordable Care Act won't significantly impact the FEHBP when the health insurance exchanges take effect in 2014.The FEHBlog has a different perspective.

In 2014, the Affordable Care Act begins to impose a health insurance tax on the Blue Cross FEP, the HMOs participating in the FEHBP, and oddly enough the qualified health insurance plans operating in the health insurance exchanges. This tax and other Affordable Care Act taxes such as those on medical devices will increase plan premiums. Also in 2014, plans will be prevented from imposing lifetime and annual dollar limits on essential health benefits as defined by the HHS Secretary. Although the Institute of Medicine gave the Secretary very sound advice to take the cost of health care into account when establishing the essential health benefits, Health Care Finance News reports that the medical community and interest groups are pushing the Secretary the other way. Finally the tax on high cost plans (a/k/a the Cadillac tax) which takes effect in 2018 has the potential for disrupting the FEHBP.

While on the topic of the Affordable Care Care Act, the Department of Health and Human Services finalized on Friday the rule governing the minimum loss ratio imposed on insurers including those operating in the FEHBP. Modern Healthcare adds "A final regulation issued Friday to implement a federal medical-loss-ratio standard (PDF) rejected most changes requested by insurers to an interim version issued last December." However, America's Health Insurance Plans had a measured reaction:
HHS has conducted a thorough and balanced process in crafting this final regulation. Today’s announcement takes important steps to make the regulation more workable. The regulation also ensures that some of the costs associated with modernizing the medical claims coding system are appropriately recognized as activities that improve health care quality. We believe health plans’ programs to prevent and combat health care fraud should be given similar consideration and that additional steps should be taken to ensure that consumers and small employers do not lose access to the guidance of a trusted health benefits advisor between now and 2014.  We will continue to work with the Department on these important issues.
The continuing resolution funding the federal government, including the FEHBP, expires on December 16. The Hill reports 
House Majority Leader Eric Cantor (R-Va.) said Friday afternoon that House Republicans are hoping to finish work on a complete 2012 spending agreement by mid-December, which would let Congress avoid the need for another continuing spending resolution.
That strikes the FEHBlog as a heavy lift, but let's keep hope alive.

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