The Affordable Care Act exchange, which begins its second open enrollment period this Saturday, will offer many Georgians lower prices this time around.
Bill Custer, a health insurance expert at Georgia State University, said Thursday that the average premium statewide for a 40-year-old nonsmoker for the second-lowest “silver” plan will rise by 2 percent from the 2014 figure.
But in some Georgia regions, the premium for that plan will drop by double-digit rates, he said.
Still, people looking for a second year of coverage in the exchange – or to get a policy for the first time – need to pay attention to many factors besides premiums. Deductibles, co-insurance, prescription drug coverage, and whether specific hospitals and physicians are in a network are among the major considerations.
One thing is almost certain: Healthcare.gov, the federal enrollment website, will work more smoothly during this enrollment period. Last year, the site was plagued with massive technical problems – so much so the federal government extended the open enrollment window. full story
My recent sinus infection came on suddenly and painfully. After diagnosing it, my physician e-prescribed me an antibiotic.
This is tricky territory for me. I’m sensitive to some antibiotics. Years ago, I took a couple of varieties to treat similar infections, and wound up with oral thrush in one case and C. difficile in another. Both were 100 times worse than the original ailment.
My physician knew this history. He prescribed a two-week supply of doxycyline hyclate, a dependable antibiotic that he felt I could tolerate well, partly because I had handled it well in the past.
So I headed to my pharmacy to pick up the “doxy.”
“It’s one seventeen,’’ said the clerk, in an oddly sheepish way.
I pulled a dollar from my wallet and extracted some change from my pants pocket.
She looked at the money and said, “No. It’s a hundred and seventeen dollars.’’
“Whoa,’’ I said. “$117?” full story
The state insurance department is looking at possible ways to strengthen a Georgia law that requires health insurers’ networks to give consumers adequate access to doctors and hospitals.
“Georgia is not alone: The feds and all the states are looking at the issue,’’ Trey Sivley, director of the Division of Insurance and Financial Oversight for the Georgia agency, told GHN recently.
The National Association of Insurance Commissioners is working on a redraft of its model for a network adequacy law. Georgia is studying the NAIC proposals, Sivley said. But he added that the state’s interest in the details “doesn’t mean that we’re going to adopt” the national group’s plan.
Such regulatory changes, if enacted, would coincide with an accelerating trend of health insurers offering consumers more limited choices of medical providers. The resulting health plans have become known generally as “narrow networks.” full story
A new poll finds 60 percent of Georgians disagree with the state’s decision not to expand the state’s Medicaid program, a key provision of the Affordable Care Act.
The health reform law overall, though, fares less well in popularity. According to the survey, conducted by the Schapiro Group in August and sponsored by Healthcare Georgia Foundation, 42 percent of Georgians approve of the ACA and 46 percent disapprove.
The survey also found that the cost of care continues to be an important factor in whether consumers receive health care. Forty-two percent of Georgians said they wanted to seek care at some point, but chose not to do so, up from 33 percent the year before. Cost was the most cited reason for that decision.
And 40 percent of the 400 respondents said they think they have paid more for care over the past year.
“As the troubling trend of increased health care costs continues, Georgians who cannot afford health insurance are simply unable to seek or choosing not to seek the medical care they need,” said Gary Nelson, president of Healthcare Georgia Foundation. full story
The Federal Trade Commission announced Friday that it has rejected a proposed settlement agreement with Phoebe Putney Health System over the latter’s 2011 merger with a rival Albany hospital.
The FTC and Phoebe tentatively reached the agreement last year, appearing to put an end to what was already a long-running, complicated legal dispute. But the federal agency has been signaling for months that it might not take the deal after all.
Phoebe Putney Memorial Hospital
The agency’s decision to reject the settlement revives the high-profile regulatory fight between Phoebe Putney and the FTC. The matter will now return to an administrative court, where a hearing is expected over the feds’ antitrust allegations against Phoebe.
The federal agency has contended for three years that Phoebe’s acquisition of Palmyra Medical Center violated antitrust laws, reducing competition and potentially raising prices for consumers.
“We’ve argued all along that this merger would create a monopoly in Albany that would harm consumers and employers in the region,” Deborah Feinstein, director of the FTC’s Bureau of Competition, said in a statement Friday. “Meaningful structural relief is needed to restore competition to this marketplace.”
Phoebe Putney officials called the FTC’s rejection of the deal disappointing. full story