This email contains the latest from Kaiser Health News about insurance, coverage and health care costs. To view all KHN resources on these topics, visit the Insurance or Health Costs news pages. Long-Term Care Insurance: Less Bang, More Buck By Barbara Feder Ostrov Seniors slammed with big premium increases face tough choices. FAQ: What Are The Penalties For Not Getting Insurance? By Michelle Andrews A consumer’s guide to the tax penalties for not having insurance. N.H., Calif. Seek To Help Consumers Get Details On Health Care Prices By Jordan Rau New Hampshire is expanding its website that lists the cost of specific medical procedures to include dental treatments and 65 prescription drugs. California is expanding its report cards on large medical groups to include cost of medical services by an average patient. Consumer Choices Have Limited Impact On U.S. Health Care Spending: Study By Michelle Andrews An analysis from the Health Care Cost Institute finds that less than half of health care costs are for services considered “shoppable,” and consumers’ out-of-pocket spending on that is just 7 percent of all spending. California Marketplace May Require Insurers To Pay Agent Commission By Chad Terhune Covered California’s Executive Director Peter Lee said the measure is needed to keep insurers from slicing commissions to avoid enrolling the sickest patients. Insurers And Medicare Agree On Measures Tracking Doctors’ Quality By Jordan Rau The first set of measures focus on seven types of care, including for hearts and cancer. The metrics will be integrated into formulas that determine physicians’ pay. Top Hospitals Likely Are Available On A Marketplace Plan, Study Finds By Michelle Andrews Many of the hospitals can be found in network on at least one plan, but fewer are participating in more than that, according to the analysis. Licking Wounds, Insurers Accelerate Moves To Limit Health-Law Enrollment By Jay Hancock Major changes in broker compensation are designed to discourage enrollment of the sickest, say consumer advocates. Surprise! Here’s Another Bill For That ‘Paramedic Response’ By Anna Gorman California cities increasingly are billing patients for paramedic services that they say were not covered by insurers. One 85-year-old woman took on city hall. N.Y., Minn. Opt For Low-Cost Plans To Help Some Residents Afford Coverage By Michelle Andrews Both states are offering “basic health programs” that provide policies to consumers with low monthly premiums and copayments, and low or no deductibles. Insurer’s Approval Of Genetic Testing For Some Cancers Raises Questions By Julie Appleby The decision by Independence Blue Cross of Pennsylvania to pay for whole genome sequencing for some cancer patients adds to the debate about how to handle these expensive tests. Short-Term Health Plans: The Pros And Cons By Emily Bazar Columnist Emily Bazar answers a consumer’s question: “You could get one of these plans, pay the uninsured tax penalty and still pay less.” Consumers Cut Costs By Combining Limited Coverage Health Plans, Despite Penalty Risks By Michelle Andrews People sometimes put together a variety of policies, such as short-term and critical illness plans, instead of buying more expensive comprehensive health coverage. But they likely will face federal health law penalties. Check The Fine Print: Some Work-Based Health Plans Exclude Outpatient Surgeries By Jay Hancock This new generation of so-called “skinny plans” can save employers money, but it’s not yet clear if they will meet regulatory scrutiny. New Federal Standards For Marketplace Plans May Reduce Out-Of-Pocket Spending By Michelle Andrews Officials have proposed establishing six options for the exchange plans that would set standard deductibles and maximum out-of-pocket spending limits, among other things. Even With ‘Skin In The Game,’ Health Care Shoppers Are Not More Savvy By Shefali Luthra High-deductible health plans don’t necessarily trigger comparison shopping or informed health care choices by consumers, according to a survey published in JAMA Internal Medicine. Determining Whether A Marketplace Plan Covers Abortion Is Still Difficult By Michelle Andrews Many insurers leave out information about abortion coverage on the summary of benefits and coverage. Hispanic Children’s Uninsured Rate Hits Record Low, Study Finds By Lisa Gillespie About 300,000 Hispanic children gained insurance in 2014 from 2013, dropping the number of uninsured to 1.7 million, researchers said, and two-thirds of 1.7 million uninsured Hispanic kids live in five states. Study: Some Marketplace Customers Spend 25 Percent Of Income On Health Expenses By Michelle Andrews Urban Institute researchers found that premiums and out-of-pocket costs are still a major concern for people seeking coverage on the health care marketplaces. Slipping Between Medicaid And Marketplace Coverage Can Leave Consumers Confused By Michelle Andrews KHN’s consumer columnist answers questions about how people can handle moving between the government health plan for low-income residents and the private plans offered on the federal health law’s exchanges. More Employers Offer Plans That Provide Lump Sums For Critical Illnesses By Michelle Andrews The plans can help workers cover their high deductibles, but the policies also have limitations. Obamacare Insurers Sweeten Plans With Free Doctor Visits By Phil Galewitz Some insurers are betting that lowering the barrier to seeing a doctor will encourage people to get needed care sooner. If it works, the health plans could save more than they spend on the benefit. ER Doctors Say Federal Rules Could Raise Patients’ Out-Of-Network Bills By Michelle Andrews Two physician groups say the government’s regulations for out-of-network emergency care payments will cost consumers more because insurers will pay less. Health Plans’ Coverage Of Some Drugs Can Be A Source Of Consumer Confusion By Julie Appleby Some medicines, particularly intravenous treatments, are not listed in plans’ pharmacy benefit section and, therefore, it’s difficult to confirm coverage specifics. Despite Hopes Of Health Law Advocates, ‘Multi-State’ Health Plans Unavailable In Many States By Michelle Andrews The authors of the law mandated the program to try to generate more competition in areas where few plans were available. But the effort has stalled. As HMOs Dominate, Alternatives Become More Expensive By Julie Appleby and Jordan Rau A KHN analysis finds a sharp difference in premium prices between plans that offer out-of-network care and those that do not. |