“We all know Obamacare is a pretty big law, with plenty of obscure provisions that don’t get much attention. For one, the law targets big executive pay packages at health insurance companies — and based on data released Wednesday, the provision is already going a long way.
Companies have long been able to deduct salaries to top executives from their federal tax bills, although since the early 1990s — in an effort to reduce excessive pay — the government has limited the amount to $1 million.
Starting last year, a piece of the Affordable Care Act lowered the limit to $500,000 for health insurers (although the $1 million limit still applies to the rest of corporate America). It also eliminates the tax carve out for what tends to be much more lucrative performance pay, like stock options, for health insurers. Finally, the cap applies to all health insurance employees, no longer just a firm’s four highest-paid executives.
This obscure provision resulted in a $72 million infusion to the Treasury last year from just the 10 largest publicly traded health insurers, according to an analysis from the left-leaning Institute for Policy Studies. The actual tax tab is probably higher when accounting for smaller insurers. And the Joint Committee on Taxation in 2009, a few months before the ACA became law, projected the provision would mean $100 million in revenue each year.”

“Hundreds of thousands of people risk losing their new health insurance policies if they don’t resubmit citizenship or immigration information to the government by the end of next week — but the federal Healthcare.gov site remains so glitchy that they are having a tough time complying.
Consumers are being forced to send their information multiple times, and many can’t access their accounts at all, immigration law experts and insurance agents say.
The Centers for Medicare and Medicaid Services sent letters to about 310,000 consumers two weeks ago, telling them they need to submit proof of their citizenship or immigration status by Sept. 5 or their insurance will be canceled at the end of the month.
CMS spokesman Aaron Albright says letters were sent only to people for whom the government has no citizenship or immigration documentation. Yet agents and others who assisted immigrants with applications say they know documentation was sent during enrollment.
Marielena Hincapie, executive director of the National Immigration Law Center, says the problems don’t lie with the consumers. The federal databases for the Department of Homeland Security and the Social Security Administration are outdated, have mismatched Social Security numbers and names, and often transpose names for those from other countries, especially refugees from Africa, she says.”

“Insurers can no longer reject customers with expensive medical conditions thanks to the health care overhaul. But consumer advocates warn that companies are still using wiggle room to discourage the sickest — and costliest — patients from enrolling.
Some insurers are excluding well-known cancer centers from the list of providers they cover under a plan; requiring patients to make large, initial payments for HIV medications; or delaying participation in public insurance exchanges created by the overhaul.
Advocates and industry insiders say these practices may dissuade the neediest from signing up and make it likelier that the customers these insurers do serve will be healthier — and less expensive.
“It’s the same insurance companies that are up to the same strategies: Take in as much premium as possible and pay out as little as possible,” said Jerry Flanagan, an attorney with the advocacy group Consumer Watchdog.”

“Ascension Health, one of the nation’s largest hospital owners, is expanding rapidly with a string of announced deals that its CEO says will grow its reach beyond hospitals to keep pace with rapid Obamacare-induced changes in the marketplace.
But notably, Ascension is not on an acquisition spree. Its latest deals—in Illinois, Michigan, Arizona and Wisconsin—are not outright purchases, but rather agreements with regional rivals and other national players to jointly own, operate or contract for hospitals and insurance companies.
The deals pair Ascension with well-established players in each market and allow the system to avoid costly competition or wasteful duplication by capitalizing on partners’ resources that Ascension lacks, said Robert Henkel, Ascension Health’s chief executive. The strategy also will allow Ascension to jointly develop broader services to care for patients at home, in nursing homes and other locations outside of hospitals. “There are times we don’t have all the pieces,” he said.
The shift by healthcare systems away from providing care in hospitals has accelerated since the 2010 health reform law, as Medicare and Medicaid introduced new financial incentives for lower-cost care under reform and commercial health plans followed. An explosion of dealmaking across healthcare has followed as hospitals, medical groups, insurance companies and drug and devicemakers consolidated or diversified, depending on strategy.”

“Bill Jacobs spent four nights in a hospital in Florida battling pneumonia. His kids visited each day, fluffed his pillows, brought his favorite Sudoku puzzles and got regular updates from his nurses and doctors. Imagine their surprise when they found out that their 86-year-old father was never actually admitted; instead, he was treated as an outpatient under what Medicare refers to as “observation status.”
What difference does that make? Actually, more than you might think. If your parents are on Medicare, the difference between being considered an inpatient or an observation patient could be thousands of dollars out of their pocket, if not more.
First, Medicare Part A will cover all hospital services, less the deductible, but only if you’re admitted to the hospital as an inpatient. The one-time deductible covers all hospital services for the first 60 days in the hospital. Doctors’ charges are covered under Medicare Part B. After you meet the deductible for Part B, you’ll then owe 20 percent of the Medicare-approved amount for doctor services, according to the Centers for Medicare and Medicaid Services’ Are You A Hospital Inpatient Or Outpatient?”

“Thought HealthCare.gov had problems?
Another federal government-run website created under ObamaCare is suffering the same symptoms as the troubled federal health care exchange — grappling with delays, data problems and other hiccups as the deadline to take it public nears.
At issue is a database known as the Open Payments website. It was created under the Affordable Care Act to shed light on the financial ties between doctors and pharmaceutical companies as well as device manufacturers.
The transparency initiative is supposed to include detailed information about drug payments made by doctors as well as the value of gifts and services given by drug makers. Such items can include everything from meals to swanky retreats.
The database project, though, is dealing with a minefield of technical problems and confusion over the data. The problems led the Centers for Medicare and Medicaid Services to shut down what is currently a private site for 11 days earlier this month.”

“File this under ‘how ironic.’
Drug makers are asking for more transparency from the government agency that is requiring them to be more transparent about how much they pay doctors.
The Pharmaceutical Research and Manufacturers of America, or PhRMA, is calling on the Centers for Medicare and Medicaid Services to further explain why the agency has removed one-third of the payment information from an online database that is due to be made public by Sept. 30.
Earlier this month, CMS said it would withhold about one-third of the payment data from the so-called “Open Payments” system. The agency also said it would return the records to drug makers because they were “intermingled,” including the erroneous linking of payment information for some doctors to still other doctors with similar names. CMS cited incorrect state medical-license numbers as one reason for the mix-up, among others.
CMS had collected partial-year 2013 payment data from the companies and began allowing doctors to go online for a preview this summer, before the database goes public by Sept. 30, in order to dispute any inaccuracies. But CMS closed the preview function for about 11 days to investigate the data intermingling and re-opened the site nearly two weeks ago. The missing one-third will be put back in the database at a later date, likely next year.”

“While average compensation for top health insurance executives hit $5.4 million each last year, a little-noticed provision in the federal health law sharply reduced insurers’ ability to shield much of that pay from corporate taxes, says a report out today.
As a result, insurers owed at least $72 million more to the U.S. Treasury last year, said the Institute for Policy Studies, a liberal think tank in Washington D.C.
Researchers analyzed the compensation of 57 executives at the 10 largest publicly traded health plans, finding they earned a combined $300 million in 2013. Insurers were able to deduct 27 percent of that from their taxes as a business expense, estimates the report. Before the health law, 96 percent would have been deductible.”

“Middle Tennessee State University (MTSU) is restricting student work because of compliance issues associated with the Affordable Care Act (ACA), commonly known as Obamacare.
In an email last week, MTSU President Sidney McPhee explained that “due to our interpretation of the reporting requirements of ACA,” graduate assistants, adjunct faculty members, and resident assistants are barred from working on-campus jobs that exceed 29 hours of work per week.
“[E]ffective beginning with the fall semester, we will no longer allow part-time employees, or those receiving monthly stipends from the university, to accept multiple work assignments on campus.” Tweet This
Now, they cannot take on multiple campus jobs.
“[E]ffective beginning with the fall semester, we will no longer allow part-time employees, or those receiving monthly stipends from the university, to accept multiple work assignments on campus,” the email stated.
McPhee noted that violations of the law “could add up as high as $6 million” in penalties.”

“Planned Parenthood Action Fund released today a t-shirt designed by actress Scarlett Johansson that targets the Supreme Court’s Hobby Lobby decision.
The front of the pink t-shirt reads “Hey Politicians! The 1950s called…” and the back reads, “They want their sexism back!”
“When I heard that some politicians were cheering the Supreme Court’s decision to give bosses the right to interfere in our access to birth control, I thought I had woken up in another decade,” explained Johansson in a statement.
“Like many of my friends, I was appalled by the thought of men taking away women’s ability to make our own personal health care decisions,” she added.
Um … what?
Let’s look at some facts, beginning with that the Hobby Lobby decision was fairly narrow. As Heritage policy experts Sarah Torre and Elizabeth Slattery explained, the decision didn’t strike down the Department of Health and Human Services Obamacare mandate that forces business to provide insurance coverage for twenty abortion-inducing drugs and birth control devices. “The Court did not strike down the mandate,” write Torre and Slattery, “but said that the government cannot force these two family businesses that object to providing coverage of four potentially life-ending drugs and devices to comply with the mandate.””