ACA Plans Denied 19% Of In-Network Claims In 2024: Report

Health insurance exchange carriers rejected nearly one-in-five in-network claims in 2024. That’s according to federal health insurance exchange claims data analyzed by the health policy research institute KFF. The 19% denial rate is tied with 2023 for the highest since the Affordable Care Act of 2010 marketplaces debuted in 2015. Oscar Health, Molina Healthcare, Florida Blue, Community ...

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Obamacare Customers Paying $6,000 a Year Doubled in 2026

The share of Affordable Care Act insurance customers in plans that cost more than $6,000 a year doubled, a sign of the squeeze on household budgets after Congress let Covid-era assistance expire. The US Centers for Medicare and Medicaid Services posted data late Friday on ACA plans, also called Obamacare, that showed total enrollment this year dipping ...

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States Pay Deloitte, Others Millions To Comply With Trump Law To Cut Medicaid Rolls

States are paying contractors such as Deloitte, Accenture, and Optum millions of dollars to help them comply with the One Big Beautiful Bill Act — a law that will strip safety-net health and food benefits from millions. State governments rely on such companies to design and operate computer systems that assess whether low-income people qualify ...

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Some 2027 ACA Exchange Plans Could Ditch Provider Networks

The regulators who oversee the Affordable Care Act public exchange system are wondering whether to treat “non-network plans” as major medical insurance coverage and let the plans use ACA premium tax credit subsidies. The Centers for Medicare & Medicaid Services — the arm of the U.S. Department of Health and Human Services that oversees HealthCare.gov ...

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Aetna, Elevance, Humana Medicare Marketing Lawsuit Moves Forward

CVS Health subsidiary Aetna, Elevance Health and Humana must face a civil lawsuit alleging they paid kickbacks to online brokerages for Medicare Advantage enrollments, a federal court ruled Wednesday. A whistleblower initiated the case in 2021, which the U.S. District Court for the District of Massachusetts unsealed last year after the Justice Department intervened. According to the ...

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Medi-Cal Faces Funding Emergency From State Miscalculations, Federal Budget Cuts

“This story was originally published by CalMatters. Sign up for their newsletters.” Gavin Newsom loves to brag about his accomplishments as governor — a syndrome that sometimes backfires when reality raises its ugly head. So it was in January 2022 when he proposed extending health care coverage to everyone in the state, including undocumented immigrants. “I campaigned ...

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