PACE Act Passage Elicits Praise and Frustration

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Earlier this month, President Obama signed the bipartisan PACE Act to stop the Affordable Care Act (ACA) from changing rules that apply to employers with between 51 and 99 employees. This is important both as a rare example of bipartisan cooperation to reform Obamacare, as well as a preservation of the status quo for employers in this mid-market segment. The Act has been praised by insurance brokers and business groups, but has ...

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Republicans Unveil ACA Alternatives

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As the Republican presidential primary race is heating up, the candidates’ plans to repeal and replace Obamacare are receiving increased attention.

Wisconsin Governor Scott Walker announced his plan to repeal and replace Obamacare, “The Day One Patient Freedom Plan,” at a factory in Minnesota on Tuesday. His plan includes a number of policy proposals that have long been popular among conservatives, including tort reform, selling health insurance across state lines, and Medicaid block grants for the states. One of ...

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National Uninsured Rate Falls Below 10%

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Two national surveys show that the percentage of people without health insurance has dropped steadily since the Affordable Care Act’s public insurance exchanges launched in 2013. A separate analysis focused on Wisconsin concluded that while the state now has fewer uninsured than it did in 2014 and a lower uninsured rate than the national average, progress has not been as great as hoped. These findings come at a time when all viable legal challenges to the law have been resolved ...

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GAO Probe Focuses on Healthcare.gov Fraud

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The nonpartisan Government Accountability Office (GAO) reported to Congress last Thursday that it has concluded an undercover investigation into the fraud detection capabilities of the federal health exchange website, www.healthcare.gov.

The GAO’s Director of Forensic Audits, Seto Bagdoyan, told the Senate Finance Committee that his investigators submitted applications for eighteen fictitious individuals last year. Of those eighteen, eleven successfully enrolled in a subsidized health insurance plan. And of those eleven, six were flagged as suspicious and terminated ...

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ACA Subsidies Upheld

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This morning, the U.S. Supreme Court issued its opinion in the case King v. Burwell. The Court ruled 6-3 that individuals who purchase health insurance through the federal exchange, www.healthcare.gov, can received subsidies based on their income.

The plaintiffs in the case argued that only individuals who purchased coverage through a state-based exchange should be eligible for subsidies because the text of the Affordable Care Act (ACA) says subsidies are available to people who enroll through an ...

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Arise to offer AboutHealth plans

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AboutHealth, one of two new health system partnerships in Wisconsin, recently announced plans to sell health plans to individuals and employer groups through a co-branding agreement with Arise Health Plan. Early announcements from AboutHealth have focused on efforts to improve clinical integration and cooperation among its members. The agreement with Arise marks the first instance in which AboutHealth member systems have negotiated a single contract with a health insurance company.

Arise Health Plan is a wholly owned subsidiary of ...

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Broker, Insurer Revenues Rise as Uninsured Rate and Wages Fall

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With tax day just one week away, many Americans are being reminded that 2014 was the first year they will have to pay a penalty for not having health insurance. The requirement to get health coverage is leading more and more people to sign up for health insurance and helping to reduce the rate of the uninsured. At the same time, these new customers are helping to bolster profits at the largest brokerages and insurance companies. The cost ...

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Public Exchange enrollment up 59% in Wisconsin

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As of February 22, a total of 207,349 Wisconsinites have enrolled in private health insurance through the public exchange, www.healthcare.gov. This total is up slightly from an estimate released by the U.S. Department of Health and Human Services shortly after the close of the annual open enrollment period in February. The total also represents a 59% increase in enrollment over last year, when approximately 130,000 people in Wisconsin signed up on the public exchange during open enrollment.

Nearly a third ...

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Getting to Know Form 1095-A

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If you enrolled in a Qualified Health Plan (QHP) through the public Health Insurance Marketplace last year, you may have recently received a new document from the Internal Revenue Service (IRS) called Form 1095-A. Form 1095-A is a tax form that is sent by the Marketplace to allow consumers to complete Form 8962, which they will use to calculate their premium tax credit and reconcile it with any advance payments of the premium tax credit they may have received.

If the ...

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2015 Exchange Rates Impact Subsidies

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Public Exchange rate changes in SE WI

With the second season of public exchange open enrollment in full swing, it is now possible to analyze changes in plan costs from year to year. Of all the plans on the public exchange, the one with the biggest effect on the rest ...

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