When preventive services are not free

Politico takes a look at the difficulties of carrying out the overhaul's mandate to provide free preventive services, while Kaiser Health News examines a study detailing how limited insurer competition increased consumer premiums. The Fiscal Times reports on a study projecting that high deductibles are likely to keep the premiums of exchange plans in check.

Politico: Free Preventive Care Can Still Cost
"Free" preventive health care is one of Obamacare's chief selling points. But as millions of newly covered people begin to seek that benefit, some are still getting stuck with bills. The Affordable Care Act requires insurers to pay the full cost of services like cholesterol checks, women's birth control, immunizations, colonoscopy screenings and a host of other items. It also covers "well visits" for children and adults -; periodic checkups not triggered by a particular health complaint. But does a free colonoscopy cover just the screening or the immediate removal of polyps, too? ... And exactly when does a routine checkup become an ailment-specific appointment and leave patients on the financial hook (Norman, 5/19).

Kaiser Health News: Capsules: Study: Limited Competition Raised Obamacare Prices
Many insurers only dipped a toe into the Affordable Care Act's online marketplaces for their first year. Cigna, one of the country's largest insurers, offered 2014 plans to individuals in fewer than half a dozen states. Humana is only in a little more than a dozen states. The biggest health insurer, UnitedHealthcare, didn't offer any policies through the federally run online portal and only a few elsewhere. The result: substantially higher premiums than otherwise would have been the case, according to a new paper (Hancock, 5/19).

The Fiscal Times: High Deductibles Keep Obamacare Premiums In Check
Obamacare premiums might not soar sky high after all. Despite some insurers' dire warnings that premiums would significantly increase next year under the president's health care law, a new study suggests that 2015 rates are only going to increase moderately -; as they have in the past. The Urban Institute and the Robert Wood Johnson Foundation released a joint analysis examining 2014 premiums for exchange policies in eight states. They found that each state had lower prices this year compared to similar products sold before the exchanges were implemented (Ehley, 5/20).

Meanwhile, House Republicans react to press reports about incorrect subsidy payments -

CQ Healthbeat: Income Verification Woes Could Fuel New Attacks on Health Law
A report that the Department of Health and Human Services is months away from completing an income verification mechanism to assure the accurate payout of insurance subsidies under the health law is creating a fresh opportunity for Republicans to attack the overhaul and put the White House back on the defensive after its recent enrollment successes. Citing internal documents, the Washington Post reported that health law payouts may be wrong for about 1 million of the 8 million people who signed up for coverage in insurance marketplaces during the recently completed open enrollment period (Reichard, 5/19).

CQ Healthbeat: Republicans Seize On Report Of Possible Health Subsidy Glitches
Republican leaders of the House Energy and Commerce Committee asked the Department of Health and Human Services and three federal contractors Monday for information about subsidies paid out under the health care law after a report that more than 1 million Americans may be receiving incorrect payments. The lawmakers want the individuals within HHS and at Serco Inc., Accenture and CGI who are working on the subsidy issue to provide committee staff with a briefing and a wide range of documents by June 2. In separate letters to the department and each contractor, the Republicans noted that the issue exists because the part of the federal health insurance exchange needed to address the problems is not yet built (Attias, 5/20).