U.S. Territories, Including Puerto Rico, Exempted From Obamacare

The administration waives the law's requirements for insurers selling policies in the U.S. territories since it does not require residents there to get coverage or provide subsidies. Other stories look at pressure on the administration to issue guidance on the employer mandate and the need to educate newly insured consumers about their coverage.

The Washington Post's Wonkblog: The Administration Just Took Obamacare Away From The Territories
Looking for a place where Obamacare doesn't exist? Try moving to the U.S. Territories, where the Obama administration just provided a pretty big waiver from the law's major coverage provisions. The Affordable Care Act's design dealt a pretty big problem to the territories. It required insurers there to comply with the law's major market reforms — guaranteed coverage, mandated benefits, limits on profits, etc. — without requiring residents to get coverage or providing subsidies to help them afford coverage. The territories — Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam and the Northern Mariana Islands — have been warning for years that would destroy their insurance markets (Millman, 7/17).

The Hill: Pressure Builds On Obama For Decision On Employer Mandate
With the [employer] mandate set to take effect in January, businesses are awaiting final world from the administration on whether they will be required to track and report how many of their employees are receiving coverage. Federal officials are late in delivering the final forms and technical guidance necessary for firms to comply, raising suspicions that the mandate could once again be delayed (Viebeck and Goad, 7/18).

The Washington Post: New Challenge For Obamacare: Enrollees Who Don't Understand Their Insurance
Nine months after Americans began signing up for health insurance under the Affordable Care Act, a challenging new phase is emerging as confused enrollees clamor for help in understanding their coverage. Nonprofit organizations across the country are being swamped by consumers with questions. Many are low-income, have never had insurance and have little knowledge of the health-care system. The rampant confusion poses a potential hurdle for the success of the health law: If many Americans don't understand how health insurance works, that could hurt their ability to use their benefits — or to keep their coverage altogether (Sun, 7/16).

Modern Healthcare: Insurers, Providers May Need to Work Harder To Educate ACA's Newly Covered
Millions of Americans gained health insurance coverage under the Patient Protection and Affordable Care Act this year, but the influx apparently has not yet translated into patients packing doctors' offices. That may reflect a lack of understanding about how and where to seek care—and a lack of outreach by their new plans and providers.  "If coverage expansion is allowing patients to establish new relationships with physicians, we would expect to see physicians devote a greater share of their calendars and work effort to caring for new patients," wrote the authors of a report released this week by the Robert Wood Johnson Foundation and Athenahealth, a company that sells cloud-based health information and practice management technology. But that is not what they found. Though it may seem counterintuitive, the organizations discovered that during the first five months of 2014, all specialties—with the exception of pediatrics—experienced lower rates of new-patient visits than they had in the year-ago period (Landen, 7/17).

Meanwhile, an analysis looks at the impact on Florida should a legal challenge to the law's insurance subsidies in federal markets prevail -

Health News Florida: $4.8B In Florida Subsidies At Stake
A court case challenging the Affordable Care Act's subsidies for plans sold on the federal marketplace could have an outsize effect on Florida, according to a new analysis. A ruling is expected any day on Halbig v Burwell from a three-judge panel of the U.S. Court of Appeals in Washington, D.C. If the government loses and further legal maneuvers fail, the 34 states that rely on the federal exchange would see a $36-billion loss of subsidies, three Urban Institute researchers project. The effects in Florida would be huge, says the study, sponsored by the Robert Wood Johnson Foundation and released on Thursday.  Here, 931,000 people would lose a total of $4.8 billion in subsidies for health insurance. The researchers say most of those people would find premiums unaffordable without subsidies and would become uninsured. That would lead to a collapse of the federal marketplace (Gentry, 7/17).

And in health law news from Capitol Hill -

Politico: Democrats Seek Cost Estimate Of Barack Obama Suit
Democrats on the House committee tasked with overseeing a Republican lawsuit against President Barack Obama are asking the panel’s chairman to detail how much the suit will cost. The four Democrats on the Rules Committee, led by New York Democrat Louise Slaughter, sent a letter on Thursday to Committee Chairman Pete Sessions (R-Texas) asking for the total expected bill for the lawsuit and how the House plans to pay for the cost (French, 7/17).

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