Weekend Update

Wow. Not only did Congress reach a compromise to avoid a government shutdown (at least for a few months), but the budget deal also will repeal one of the most potentially disruptive provisions in the Affordable Care Act, the so-called free choice voucher provision, according to a Wall Street Journal report.

Here's how the free choice voucher would have worked. Under § 10108 of the Affordable Care Act, employees whose income is at or below 400% of the federal poverty line (approximately $45,000 for an individual and $90,000 for a family of four this year) would have received beginning in 2014 a “free choice voucher” if the employee contribution toward his or her employer sponsored coverage represented from 8% to 9.8% of his or her household income. The free choice voucher would have given the employee the value of the employer contribution that employee could have used to purchase stated based health insurance exchange coverage. If the exchange plan's premium is less than the value of the free choice voucher, the employee would have received the balance of the free choice voucher in cash. The portion of the voucher used to purchase Exchange coverage would have been tax free.

What's so bad about that? The free choice voucher had the potential to shred the risk pools in employer based plans, including the FEHBP.  For example, the younger employees, who weren't covered under their parents' coverage, could have opted into a young invincible plan in the exchange. FEHBP enrollees in living in lower cost states may have found lower cost plans in their state exchanges. (Fee for service plans in the FEHBP must offer nationwide premium rates.) In both cases, the enrollee would pocket any resulting savings which potentially could have cost employers, including the federal government, a lot of money. There will be enough changes in 2014 without this additional disruption.  

Following up on the release of an HHS strategy to reduce health disparities, AHIP's coverage blog discusses the steps that health plans are taking to reduce health disparities -- an objective that OPM shares according to its 2012 call letter.

Finally, although the FEHBlog was aware of CMS's Hospital Compare and Nursing Home Compare websites, I just ran across this healthcare.gov website that consolidates links to all four CMS provider comparison website. There's also a home health compare and a dialysis provider compare website. What is really cool about these very helpful websites is that the quality information reflects the entire patient base at the facility, not just the Medicare patient base.