The Health 202: Obamacare marketplaces survived Trump’s term better than expected

“The overall impact of the Trump administration’s policies towards the marketplaces have probably been more muted than most expected — at least so far,” said Adam Gaffney, a professor at Harvard Medical School and president of Physicians for a National Health Program.

Enrollment in Healthcare.gov and the state-based marketplaces is open through Dec. 15.

People can shop for private plans, and qualify for federal subsidies if their income is between 133 percent and 400 percent of the federal poverty level.

To the concern of health-care advocates, enrollment has ticked down over the past four years, contributing to the nation’s worsening uninsured rate amid the coronavirus pandemic and fueling a growing sense among Democrats that further health restructuring is needed.

Yet by some measures, the marketplaces look healthier than ever.

Individual insurance premiums and choices have steadily improved over the past four years, despite Democrats’ insistence that the administration’s policies would destroy the marketplaces. That trend will continue in the 2021 enrollment season.

“One thing the marketplaces proved is how resilient they actually are,” said Andy Slavitt, former administrator of the Centers for Medicare and Medicaid Services under President Barack Obama.

Still, there’s a clear difference in how a Joe Biden administration would approach the ACA.

It certainly would invest more in boosting marketplace enrollment, advisers say. The Democratic nominee, if he wins tomorrow’s election, is expected to restore funds Trump scrapped to advertise the law and may push Congress to pass legislation increasing the income-based subsidies available to people. 

A Democrat-led administration may also reverse some of the changes President Trump made to the marketplaces — although Trump’s record on them is more nuanced than either party claims.

“The truth is somewhere in middle between what Republicans say and what Democrats say,” said Larry Levitt, a vice president for the Kaiser Family Foundation.

The average Obamacare customer can choose from plans offered by four to five issuers.

That’s up from an average of three to four issuers in 2020, according to data from the Centers for Medicare and Medicaid Services. Four percent of enrollees will have access to plans from just one issuer, up from 12 percent of enrollees this year.

And premiums are declining for the third straight year. The average premiums for the second-lowest-cost “silver”-level plan will be 2 percent lower next year. Average premiums for these “benchmark” plans have declined 8 percent since 2018.

“Despite the uncertainty of the pandemic and concerns about the future of the ACA, the marketplaces are strong and healthy, and premiums for high-quality, comprehensive coverage remain very affordable,” said Joshua Peck, co-founder of Get America Covered — a nonpartisan group that has worked to spread the word about the marketplaces even as the administration has cut advertising for it.

It’s a distinct shift from how things looked during the Obama administration. The first few years of the marketplaces were marked by double-digit premium increases and a steady stream of exits by insurers, as they struggled with how to price and sell insurance

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5 factors make it more likely you’ll suffer long term

Blood collection specialist Niilo Juntunen removes the IV from recovered coronavirus patient Monica Jacobs as she finishes donating convalescent plasma at the Central Seattle Donor Center of Bloodworks Northwest during the coronavirus disease (COVID-19) global outbreak, in Seattle, Washington, September 2, 2020.

Lindsey Wasson | Reuters

A new study has identified the main factors that make it more likely that patients will suffer long term from the coronavirus.

“Long Covid” is the term given to people who recover from coronavirus but continue to suffer from a wide range of symptoms, such as shortness of breath, migraines and chronic fatigue.

A new analysis by researchers at King’s College London, using data from the COVID Symptom Study app, shows that 1 in 20 people with Covid-19 are likely to suffer symptoms for at least eight weeks.  

The study, published Wednesday, looked at data from 4,182 users of the COVID Symptom Study app who had tested positive for the virus and had been consistently logging their health.

The team found that older or overweight people, women, those with asthma and those with a greater number of different symptoms in the first week of their illness were more likely to develop “long Covid.”

Risk factors

Delving into the risk factors more closely, the study by King’s researchers found that long Covid affects around 10% of 18-49 year olds who become unwell with Covid-19, with the percentage of people affected rising to 22% for the over-70s.

Weight also plays a role, with it affecting people with a slightly higher average BMI (body mass index).

Women were much more likely to suffer from long Covid than men (14.5% compared with 9.5%), but only in the younger age group.

The researchers also found that people reporting a wide range of initial symptoms were more likely to develop long Covid, as were people with asthma, although there were no clear links to any other underlying health conditions.

As for the commonly reported symptoms of long Covid, the research identified two main symptom groupings; One was dominated by respiratory symptoms such as a cough and shortness of breath, fatigue and headaches.

The second grouping “was clearly multi-system, affecting many parts of the body, including the brain, gut and heart,” King’s noted.

Predictive model

The researchers have now used these findings, which are due to be published as a pre-print on Medrxiv (distributes unpublished eprints about health sciences) and have not yet been peer-reviewed, to develop a model that can predict who is most at risk of long Covid by looking at an individual’s age, gender, and count of early symptoms.

The lead researchers, Dr. Claire Steves and Professor Tim Spector, said the research could be used to help target early interventions and research aimed at preventing and treating long Covid.

“It’s important we use the knowledge we have gained from the first wave in the pandemic to reduce the long-term impact of the second,” Steves, a clinical academic and senior author of the study, noted.

“This research could already

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Trump plays down virus as he steps up pitch for second term

WASHINGTON (AP) — Gone are the days when President Donald Trump held forth daily at the White House podium flanked by members of his coronavirus task force. And the days when Vice President Mike Pence and other task force officials would head to Trump’s office to brief him immediately after their meetings.

The White House won’t say when Trump last met with the task force.

In the week since he emerged from coronavirus isolation, Trump has demonstrated new determination to minimize the threat of the virus that has killed more than 215,000 Americans and complicated his chances of winning another four years in the White House.

“The light at the end of the tunnel is near. We are rounding the turn,” Trump told supporters Friday at an event in Fort Myers, Florida, one of many moments during a week of campaigning in which the president tried to play down the virus threat. “Don’t listen to the cynics and angry partisans and pessimists.”

In word and action, he is pushing an optimistic outlook at a moment when coronavirus infections are spiking in Europe and public health officials are raising alarm that the infection rate in the U.S. is climbing toward a new peak.

In the past week he has spread misinformation about the virus, undercut the nation’s leading infectious disease expert and kept up his practice of shunning mask use. The effort to diminish the virus has gone into overdrive as Democrats try to frame the race for the White House as a referendum on Trump’s handling of the worst U.S. public health crisis in over a century.

The U.S. economy is still roughly 11 million jobs short of recovering all 22 million jobs that were lost when the pandemic struck in early spring. The nation averaged more than 50,000 new coronavirus cases per day over the past week. National and battleground public opinion polls suggest that Trump faces stiff headwinds in his bid for a second term.

Olivia Troye, a former aide to the task force who has emerged as a harsh Trump critic, says that early in the crisis Trump was “asking the right questions” when doctors spoke to him about their concerns that the country could face a surge of cases in the fall and winter.

“That’s why it so completely reckless of him, after having COVID himself, to turn around this week and double down on taking the mask off and parading around like it’s not a necessary thing, calling himself immune,” she said. “He’s doubling down on misinformation that has been coming out of his mouth for the entire tenure of this pandemic.”

At his NBC News town hall on Thursday night, Trump was asked whether he should have known better than to announce his nomination of Judge Amy Coney Barrett to the Supreme Court with a Rose Garden ceremony and indoor reception where few guests wore masks and social distancing was nonexistent.

He responded by incorrectly citing a Centers for Disease Control and

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Non-Obamacare Short Term Health Plans On The Rise

American’s are looking for lower cost alternatives when it comes to their healthcare needs. Those who do not need a huge demand for medical services to be covered have other options. Even those with some medical requirements on a monthly or quarterly basis are OK with little less coverage if they are saving enough on premiums. The good news is alternative plans are here, and they will continue to grow in demand as 2018 continues.

The Trump Administration signed off on an executive order in the fall of 2017 requiring that short-term health care plans be extended from the current 90-day restriction to the full 365 days as it once was. These types of policies are not there to replace the ACA plans, but to provide individuals and families with more choices for their healthcare needs.

This is great news for millions of Americans who do not qualify for the federal health subsidies and really cannot afford the premiums for the ACA plans. By freeing up some of their hard-earned dollars, they can put it back into the economy, retirement, college or whatever they need.

Short-term plans are non-ACA qualified health plans that are not required to cover preexisting conditions or certain ACA (Obamacare) mandated Essential Health Benefits (EHB), that are covered by ACA-qualified plans.

These benefits include:

  • Maternity and newborn care
  • Mental health and substance use disorder services
  • Specific preventive care benefits such as routine exams, mammograms, cancer screenings, etc
  • Pediatric services (oral care and vision)

The short-term plans are a great option without the above coverages in the policy. Insurance is supposed to be for sudden, expensive things that you usually could not afford on your own. Look at your homeowners and auto insurance. They provide coverage for the unforeseen, costly risks that you cannot afford to take on yourself. The short-term medical plans do just that.

The short-term medical plan extension from the current 90-day maximum to 365-day maximum takes effect May 1st. After that date, you can apply with an insurance company that offers the short-term plan that does not have the 90-day maximum limit.

One other drawback for 2018 is the individual mandate. The short-term medical plan is not an ACA-compliant plan according to the IRS and will be subject to the tax penalty when you file your taxes in 2018. There are other ways around this. You will need to seek out a professional in the field to get more information. For the tax year 2019, this tax penalty goes away.

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