Health Reform Weekly

A weekly compilation from Aetna of health care-related developments in Washington, D.C. and state legislatures across the country.


Week of August 26, 2013

The new 2013 Employer Health Benefits Survey released last week shows that premiums for employer-sponsored family health coverage rose only moderately from last year but at a rate still well in excess of wage increases and the general inflation rate. The Kaiser Family Foundation/Health Research & Educational Trust survey found that premiums for family coverage rose 4 percent from last year to $16,351, with workers on average paying $4,565 toward the cost of coverage. During this same period, wages rose 1.8 percent while the general rate of inflation was up 1.1 percent. The survey also found that 78 percent of all covered workers this year pay an annual deductible, up from 72 percent in 2012.

In other news, the U.S. Department of the Treasury last week released a proposed rule 
on the tax credit available under the Affordable Care Act (ACA) to certain small employers that offer health insurance coverage to their employees.


CALIFORNIA: The Assembly Committee on Health has approved a bill designed to offset Medi-Cal costs for hospitals by extending the Quality Assurance Fee for another two years. The bill would create a fee program that would provide supplemental Medi-Cal payments to hospitals. The payments would help reduce the annual loss of about $5 billion a year attributed to treating Medi-Cal patients.  The measure passed with broad bipartisan support. 

CONNECTICUT: The Department of Public Health (DPH) is leading a diverse coalition of stakeholders in developing a plan to help state residents become healthier by 2020.  DPH is holding a series of public forums throughout the state in September and October to share information about the state’s overall health.  More information is available on the DPH website

MASSACHUSETTS: The Center for Health Information and Analysis (CHIA) published its first Annual Report on the Massachusetts Health Care Market, which includes information on health care costs and quality and an analysis of premiums, coverage and spending in the commercial health care market. CHIA found that 80 percent of the enrollment in the commercial market is concentrated with three carriers and that 80 percent of the spending for acute care hospitals and physician services was concentrated among higher-priced providers.  Of the payments made to acute care hospitals by commercial payers, nearly one-third went to one system alone.  In 2012, 39 percent of total commercial payments were made within a global payment model through HMOs, yet enrollment in HMOs declined 4 percent from the previous year.  The full report is available on the CHIA website

NEW HAMPSHIRE: Lawmakers this summer are debating how to improve health pricing transparency, and a House subcommittee convened a public forum recently to discuss health price transparency legislation. New Hampshire has developed a price transparency site for consumers and employers, action that was authorized by a 2003 state law allowing the Insurance Department to collect and analyze billing data – absent patient identification information – from hospitals and insurers. The website’s cost predictions are based on past billing information, calculations that can be done only after the department collects enough bills in each category. Under a federal grant program, the state could be eligible to receive as much as $1.5 million over the next 18 to 24 months to add more procedures and possibly give providers the capability to update their information more frequently. The subcommittee will continue to meet and anticipates developing new draft legislation to forward to the full committee.

NEW YORK: The executive director of the state exchange has announced a new brand for the exchange, New York State of Health. Also announced was a list of health plan offerings by county, available through the exchange in both the individual and small group markets.  The list of participating insurers remained largely the same as announced initially by the state in mid-July, with 20 health plans participating statewide.  The new website, nystateofhealth, has also posted its premium estimator/tax credit calculator. The tool allows consumers to estimate their potential premium subsidies and to compare plans and premiums by county.

UTAH: The Department of Insurance announced the carriers participating in the exchange and provided the first glimpse of exchange rates at a meeting of the Legislative Health Reform Task Force. Six insurers have submitted a total of 99 plans on the individual exchange, and three have submitted 70 plans on Avenue H, the state’s small employer exchange. While the Department is not expected to release approved rates until shortly before open enrollment on October 1, it did provide a sample of low and high rates for a 27-year-old and 40-year-old individual at the silver level. In Salt Lake County, the largest in the state, the monthly premiums ranged from $162 to $255 for the 27-year-old and from $623 to $978 for 40-year-old parents with three or more children under 21.

WASHINGTON: The state’s exchange board delayed certifying plans already approved for the new exchange to help give insurers rejected by the commissioner more time to show they can offer acceptable plans.  Commissioner Mike Kreidler advised the board not to delay certification because the unapproved plans were rejected for substantial reasons. The rejected carriers are Kaiser Foundation Health Plan of the Northwest, Moda Health Plan (formerly ODS Health), and three Medicaid plans: Coordinated Care Health, a subsidiary of Centene Corp.; Molina Healthcare of Washington; and Community Health Plan of Washington.



Health Reform Connection
America's Health Insurance Plans
Aetna 2011 Annual Report 


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