High Court Allows Employers to Opt Out of ACA’s Mandate on Birth Control Coverage

July 8, 2020

The Supreme Court Wednesday settled — at least for now — a decade’s worth of litigation over the women’s health provisions of the Affordable Care Act, ruling 7-2 that employers with a “religious or moral objection” to providing contraceptive coverage to their employees may opt out without penalty.

The Trump administration was within its rights to exempt religious nonprofit agencies, like the lead plaintiff in the case — the Roman Catholic order Little Sisters of the Poor — from having to facilitate in any way contraceptive coverage for their employees. Wrote Justice Clarence Thomas in the majority opinion: “We hold today that the [government] had the statutory authority to craft that exemption, as well as the contemporaneously issued moral exemption.”

The Supreme Court Wednesday settled — at least for now — a decade’s worth of litigation over the women’s health provisions of the Affordable Care Act, ruling 7-2 that employers with a “religious or moral objection” to providing contraceptive coverage to their employees may opt out without penalty.

The Trump administration was within its rights to exempt religious nonprofit agencies, like the lead plaintiff in the case — the Roman Catholic order Little Sisters of the Poor — from having to facilitate in any way contraceptive coverage for their employees. Wrote Justice Clarence Thomas in the majority opinion: “We hold today that the [government] had the statutory authority to craft that exemption, as well as the contemporaneously issued moral exemption.”

But the decision did more than settle a long-standing dispute over how the birth control requirement should affect religious nonprofit organizations. It also provided an exemption for any employer with a “moral” objection, potentially dramatically expanding the universe of women who would be on their own to find and fund birth control….

Read the full Kaiser Health News article

Why the U.S. Is Falling Behind in COVID-19 Fight

July 8, 2020

The United States is falling further behind the rest of the world in fighting the coronavirus as cases set new domestic records.

New daily cases in the U.S. have spiked to a high of around 50,000, a glaring contrast with the European Union, where new case growth has largely been flattened and suppressed. The EU is averaging around 4,000 new cases per day, according to Our World in Data, less than a tenth of the new cases in the U.S., despite having about 100 million more people.

The United States is falling further behind the rest of the world in fighting the coronavirus as cases set new domestic records.

New daily cases in the U.S. have spiked to a high of around 50,000, a glaring contrast with the European Union, where new case growth has largely been flattened and suppressed. The EU is averaging around 4,000 new cases per day, according to Our World in Data, less than a tenth of the new cases in the U.S., despite having about 100 million more people.

Anthony Fauci, the nation’s top infectious disease expert, was the latest authority to point to the contrast on Monday….

Read the full The Hill article

Datapoint: Molina Completes YourCare Health Plan Deal

July 8, 2020

Molina Healthcare last week completed its $40 million acquisition of certain assets of YourCare Health Plan, most notably its New York Medicaid plan, which currently serves 40,715 members. The deal brings a 59.7% enrollment boost to Molina’s New York Medicaid products. YourCare’s parent company, Monroe Plan for Medical Care, will shift its focus to providing integrated care for its members and providers, as well as administrative services.

Molina Healthcare last week completed its $40 million acquisition of certain assets of YourCare Health Plan, most notably its New York Medicaid plan, which currently serves 40,715 members. The deal brings a 59.7% enrollment boost to Molina’s New York Medicaid products. YourCare’s parent company, Monroe Plan for Medical Care, will shift its focus to providing integrated care for its members and providers, as well as administrative services.

Source: AIS’s Directory of Health Plans

House Committee Report Takes Aim at Short-Term Plans

July 8, 2020

More than a year after they began probing health insurers and brokers for information to fuel an investigation of short-term, limited-duration insurance (STLDI) plans, Democratic leaders of the House Energy & Commerce Committee released a report concluding that this market’s growth has come at the expense of consumers who are often duped into purchasing bare-bones coverage.

Policy experts, however, disagree about what conclusions can actually be drawn from the latest salvo in an ongoing debate over alternatives to Affordable Care Act (ACA) exchange plans.

By Leslie Small

More than a year after they began probing health insurers and brokers for information to fuel an investigation of short-term, limited-duration insurance (STLDI) plans, Democratic leaders of the House Energy & Commerce Committee released a report concluding that this market’s growth has come at the expense of consumers who are often duped into purchasing bare-bones coverage.

Policy experts, however, disagree about what conclusions can actually be drawn from the latest salvo in an ongoing debate over alternatives to Affordable Care Act (ACA) exchange plans.

“The nutshell of the report is it confirms everything that these sort of smaller studies that have been highly imperfect have showed about this market,” says Katie Keith, an attorney, research professor at Georgetown University’s Center on Health Insurance Reforms. That includes misleading marketing, various benefit gaps, the use of pre-existing condition exclusions and plan rescissions, she adds.

To Keith, the most striking aspect of the report was how many STLDI plans are being sold through associations, which makes it more difficult for individual states to regulate them.

But Chris Pope, a senior fellow at the right-leaning Manhattan Institute, says “it’s of limited value to have an analysis that’s kind of saying, ‘Well, what is the worst thing that we can find about this market and judge a market by the worst possible thing that’s out there.’”

In Pope’s view, the most interesting finding was the fact that 3 million people were enrolled in STLDI plans in 2019. “It’s somewhat toward the top end of estimates that had been put out previously — clearly a lot of people do value these plans,” says Pope, who authored a report in 2019 for the Manhattan Institute that argued the merits of STLDI plans.

The House committee report calls for federal legislation that subjects STLDI plans to all of the ACA’s protections. In the absence of that, it recommends that states limit STLDI plan duration to 90 days, prohibit renewability, ban the sale of STLDI plans during ACA open enrollment, require such plans to be sold only in person to stymie aggressive marketing tactics, and comply with the ACA’s consumer protection provisions.

Datapoint: Bright Health Plots 2021 Expansion

July 7, 2020

Startup insurer Bright Health last week unveiled its 2021 market expansion plans. For the first time, the insurer will offer products to employer groups, including fully insured small group plans in Denver, Nashville, Memphis and Nebraska. In addition, the insurer will bring its individual and family plans to new markets in Florida and North Carolina, and expand to the Chicago area in Illinois. On the Medicare Advantage side, Bright Health will expand its Florida offerings to Fort Lauderdale. Bright Health currently enrolls 158,698 people in its individual commercial products, and 5,118 Medicare Advantage members.

Startup insurer Bright Health last week unveiled its 2021 market expansion plans. For the first time, the insurer will offer products to employer groups, including fully insured small group plans in Denver, Nashville, Memphis and Nebraska. In addition, the insurer will bring its individual and family plans to new markets in Florida and North Carolina, and expand to the Chicago area in Illinois. On the Medicare Advantage side, Bright Health will expand its Florida offerings to Fort Lauderdale. Bright Health currently enrolls 158,698 people in its individual commercial products, and 5,118 Medicare Advantage members.

Source: AIS’s Directory of Health Plans