New coverage gaps, cost issues spur health law worries

News outlets look at the nuts and bolts of the health law's implementation, including a worry that coverage gaps will persist for some vulnerable people, as well as how the government pays for insurance subsidies and why some premium costs increase under the health law.

The Associated Press/Washington Post: Health Exchange Problems Could Mean Patients With Serious Illness Run Out Of Time To Sign Up
With federal and state online health care marketplaces experiencing glitches a month into implementation, concern is mounting for a vulnerable group of people who were supposed to be among the health law's earliest beneficiaries. Hundreds of thousands of people across the country with pre-existing chronic conditions such as cancer, heart failure or kidney disease who are covered through high risk-insurance pools will see their coverage dissolve by year's end (11/6).

NPR: How The Affordable Care Act Pays For Insurance Subsidies
But the authors of the Affordable Care Act didn't want the subsidies to become a drain on the Treasury and add to the deficits. So they included provisions designed to offset the cost of the subsidies. MIT economist Jonathan Gruber, who helped develop the law, says about half the costs are offset by projected savings in Medicare payments to insurers and hospitals. Another quarter is offset by added taxes on medical-device makers and drug companies (Ydstie, 11/7).

Kaiser Health News: Popular Provision Of Obamacare Is Fueling Sticker Shock For Some Consumers
Kaiser Health News staff writer Julie Appleby reports: "When setting premiums for next year, insurers baked in bigger-than-usual adjustments, driven in large part by a game-changing rule: They can no longer reject people with medical problems. Popular in consumer polls, the provision in the health law transforms the market for the estimated 14 million Americans who buy their own policies because they don't get coverage through their jobs. Barred from denying coverage, insurers also can't demand higher rates from unhealthy people and those deemed high risks because of conditions including obesity, high blood pressure or a previous cancer diagnosis" (Appleby, 11/6).

USA Today: Mental Health Bills May Limit Young American's Clout
High mental health costs for young adults threaten to undermine a key assumption of the Affordable Care Act: that insuring more young people will lower costs because they are healthier and require less expensive care (Kennedy, 11/6).