is getting a makeover., health insurance exchange, Obama administration, Affordable Care Act, health plans, Shaun Greene, Arches Health Plan, Centers for Medicare and Medicaid Services, ACA, CVS Caremark, Larry Merlo, Detroit Economic Club

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Inside This Issue - News

Overhaul set for

June 16th, 2014

WASHINGTON – is getting a makeover.

The Obama administration is eliminating major parts of the online health insurance exchange to avoid a repeat of the problems that marked its launch last October, the Wall Street Journal reported, citing presentations to insurers and interviews with government officials and ­contractors.

The overhaul and its tight schedule are raising alarms that consumers could face more difficulties this fall when they return to the website to select health plans under the Affordable Care Act. Some significant back-end functions, including automation of payments to insurers, are behind schedule, the newspaper said.

And the work is being complicated by a shift to new contractors for management of basic functions. Federal officials said some new functions will need to be tested with insurers before open enrollment begins on ­November 15.

“We’re all going to be nervous until November 15,” Shaun Greene, chief operating officer of Utah-based Arches Health Plan, was quoted by the Journal. “There is no wiggle room.”
Greene and other industry executives said they are worried about plan renewals through the website. “The re-enrollment process is what scares me,” he said.

Officials with the Centers for Medicare and Medicaid Services characterized the changes as adjustments as opposed to a reinvention. They said they expect some modifications to begin to be tested over the summer but that others will probably be assessed closer to the new enrollment season.

Enhancements already made to include increased capacity, which helped 5.4 million users choose plans for this year. Another 2.6 million people enrolled in plans through state-run exchanges. State exchanges have had their share of problems, and the Journal reported that five states project spending up to $240 million in repairs or to switch to ­

Polls have continued to reveal dissatisfaction with the ACA, with an Associated Press-GfK survey finding 43% of people opposing the law and 28% supporting it.
Another poll found that the majority of Americans say they have been unaffected by the statute. Sixty percent said neither they nor their families had felt any effects.

In a positive development for the law, a number of insurers that sat out of or minimally participated in the 2013 enrollment said they would join exchanges in the coming year. UnitedHealth Group and Cigna, which were wary of the exchanges last year, are expected to step up their involvement. United is one of four insurers that have told Washington state regulators they are interested in joining its roll of plan providers.

Nonetheless, Republican House members are said to be coming up with alternative health care legislation, with changes in health plans’ ­taxation.

CVS Caremark Corp. president and chief executive officer Larry Merlo commented on the ACA at a meeting of the Detroit Economic Club: “It’s a tall ask to make the assumption that we’ll get it right on the first pass. So I personally believe that there’s going to be a lot that is going to have to be done to get the Affordable Care Act to the right place over time.”