Healthcare Reform

TIPPING POINT FOR OBAMACARE?

Sure As Heck Looks Like It.

What we’ve been sensing lately here in the Florida healthcare trenches, is now being amplified in the national press — newspapers, trade publications and leading industry blogs.

First, before talking about today’s headlines, here are a few examples of what we’ve been seeing as the 4th quarter unfolds and as 2016 fast approaches:

King v. Burwell: With Decision Imminent It’s Still Anybody’s Guess How Court Will Decide

As the Supreme Court decision on subsidies looms, many are wondering:  which way is the court leaning?  Most experts agree it’s way too close to a call.

Wondering where things stand as we wait for the high court to announce its decision?

Here’s a good, plain speaking synopsis of why it’s too close to call.  It was reported by Amy Howe at SCOTUS Blog back in March right after the case was argued before the Supreme Court:

Quietly Lurking: 2017 Obamacare Waiver Could Open the Door for States to Do Their Own Thing

We’re keeping an eye on it; and, apparently so are many of the states. The healthcare reform law includes a waiver that, starting in 2017, would let states take federal dollars now invested in the implementation of the Affordable Care Act and redirect them and redesign their own health care systems.

Some elements of the law could not be repealed, such as the requirement that insurance companies provide coverage regardless of pre-existing health problems. But they could replace the law’s unpopular mandate that requires virtually everyone in the country to have health insurance, provided the alternative worked reasonably well.

Costs For Routine Colonoscopies and Who Pays? It Can Be A Real Pain… In the Pocketbook.

We’ve seen quite a spike recently in the number of claims issues clients’ employees are reporting related to the coverage of colonoscopies.  The problem almost always centers on billing for the service and payment of the claim.  Many employees report that they are being forced to pay out-of-pocket for colonoscopies that they believe should be fully covered under preventive care benefits.

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