Access To Care

Hackers Strike Health Insurer Anthem

Feb 5, 2015

The country's second-biggest health insurer says cyberattackers infiltrated one of its IT systems and obtained personal information about current and former customers as well as employees covered by the insurer.

"The information accessed includes names, birthdays, social security numbers, street addresses, email addresses and employment information, including income data," wrote Anthem CEO Joe Swedish in a letter to the company's policyholders.

More than 400,000 Medicare beneficiaries who may have been confused or misinformed about the pharmacy details of their 2015 Aetna prescription drug plans have until the end of this month to find participating pharmacies or switch plans, according to the Centers for Medicare & Medicaid Services.

In health insurance prices, as in the weather, Alaska and the Sun Belt are extremes. This year Alaska is the most expensive health insurance market for people who do not get coverage through their employers, while Phoenix, Albuquerque, N.M., and Tucson, Ariz., are among the very cheapest.

In December, the Food and Drug Administration approved a new obesity drug, Saxenda, the fourth prescription medicine the agency has given the green light to fight obesity since 2012. But even though two-thirds of adults are overweight or obese, there's a good chance their insurer won't cover Saxenda or other anti-obesity drugs.

California's health insurance marketplace, Covered California, has supported the development of more than 200 new storefronts at or near shopping centers across the state this year, each tasked with explaining the ins and outs of different health plans to holiday (and everyday) shoppers.

For two decades Atlanta restaurant owner Jim Dunn offered a group health plan to his managers and helped pay for it. That ended Dec. 1, after the Affordable Care Act made him an offer he couldn't refuse.

Subsidies under the health law for workers to buy their own coverage combined with years of rising costs in the company plan made dropping the plan an obvious — though not easy — choice.

Don Benfield of Taylorsville, N.C., makes $11 an hour working for a mobile-home parts business, selling things like replacement doors and windows.

Benfield, 51, doesn't have health insurance.

"I haven't had health care insurance in years, simply because I haven't been able to afford it, especially with food prices, how they went up," he explains.

Benfield's employer does offer health insurance coverage, even though, with fewer than 50 employees, the business is not required to.

About a year ago at a Miami-Dade County school board meeting, superintendent Alberto Carvalho was happy to announce the district and the teacher's union had just ratified a new contract.

"I believe that this contract honors and dignifies what you do every single day," he told the school board members. It included bonuses for most teachers and it settled how to handle health care expenses after yet another year of rising costs.

"We know exactly what the district pays out in terms of claims, because we are the insurance company. There's no profit to be made," he said.

Exactly what would happen to the Affordable Care Act if the Supreme Court invalidates tax credits in three dozen states where the federal government runs the program?

Legal scholars say a decision like that would deal a potentially lethal blow to the law because it would undermine the government-run insurance marketplaces that are its backbone, as well as the mandate requiring most Americans to carry coverage.

As employers try to minimize expenses under the health law, the Obama administration has warned them against paying high-cost workers to leave the company medical plan and buy coverage elsewhere.

Such a move would unlawfully discriminate against employees based on their health status, three federal agencies said in a bulletin issued in early November.

Pages