What about the working class and middle class?

Robert Laszewski, Health Care Policy and Marketplace Review

Robert Laszewski's picture

Perhaps the biggest consumer problem Obamacare has is that the plans with high premiums even after the subsidy, big deductibles, and narrow networks are not attractive to working class and middle class families and individuals who don't qualify for the biggest tax credits.

Lessons learned from consumerism

Tom Paul, chief consumer officer, UnitedHealthcare

In recent years, there has been an incredible transformation in the healthcare industry, especially in the role of consumers. A decade ago, health plans worked with employers to manage almost all health benefit decisions, leaving consumers relatively unaware of the costs associated with their healthcare needs. Not so today.

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President Obama acknowledges the technical issues with HealthCare.gov, pledging his Administration will resolve them soon and asserting that the distressed web portal is not the only way to shop for affordable health insurance available through the ACA.


Three years after launching a 750-patient Medicare Advantage collaborative care pilot, Portland, Maine-based independent physician practice NovaHealth and insurer Aetna have shown concrete results in improving care quality and reducing costs. Technology and provider-payer cooperation played a large part in the program's success.

As payers and employers put pressure on providers to assume more financial risk, providers are struggling to assess the impact of the risk they have already assumed.

Lawmakers, taxpayers and health organizations concerned about Medicare's sustainability can breathe a small sigh of relief, if not hold their breath.

Incorporating federal sequestration into Medicare Advantage provider reimbursement has spurred a new lawsuit, and one that could spell trouble for other plans.

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While some state exchange executives exited their exchanges amid foundering technology and low public esteem, the director of one successful state HIX has landed in the growing private exchange unit of a large national insurer.

Ahead of the next open enrollment period, federal regulators are trying to clarify rules for member non-payment and grace periods, but insurers and providers may still have lingering concerns about getting paid.

Americans across the country may be pleasantly surprised to get a small check from their health plans this summer, but insurers may need to plan better if they want avoid an administrative hassle.

At a time when states are both reforming Medicaid and expanding managed care, insurers have a lot of opportunities but also face many financial pressures.


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