“Legal challenges to various aspects of Obamacare (aka the Affordable Care Act) keep traveling on a rollercoaster. Today’s episode of the law’s continuing courtroom soap opera involves a ruling by a federal district court in Oklahoma, which overturned a 2012 IRS rule authorizing premium assistance tax credits in federal exchanges (since rebranded as “federally facilitated marketplaces”). The decision improves the likelihood that the Supreme Court ultimately will consider this issue on appeal; either in the spring of 2015 or during its next 2015-2016 term.
Judge Ronald White ruled in State of Oklahoma v. Burwell that the IRS rule is “arbitrary, capricious, an abuse of discretion not in accordance with law, pursuant to 5 U.S.C. section 706(2)(A), in excess of statutory jurisdiction, authority, or limitations, or short of statutory right, pursuant to 5 U.S.C. section 706(2)(C), or otherwise is an invalid implementation of the ACA, and is hereby vacated.”
In other words, it was not just a “bad idea,” but an illegal one, too.”
“In a legal setback for the Obama administration, a federal judge in Oklahoma ruled Tuesday that people in states that rely on the federal insurance exchange are not eligible for Obamacare premium subsidies to help them pay for coverage.
Judge Ronald White, a George W. Bush appointee, invalidated an Internal Revenue Service rule interpreting the Patient Protection and Affordable Care Act to allow the premium tax credits in states that have not established their own exchange. “The court holds that the IRS Rule is arbitrary, capricious, an abuse of discretion or otherwise not in accordance with law,” White wrote.
In his ruling, White rejected the argument that striking down the subsidies would cripple the entire healthcare reform law. “Congress is free to amend the ACA to provide for tax credits in both state and federal exchanges, if that is the legislative will,” he wrote.”
“The second Obamacare enrollment season could go negative — but not because of the health care law’s critics.
Obama administration allies are weighing a focus on the loathsome individual mandate and the penalties that millions of Americans could face if they don’t get covered. It would be a calculated approach to prompt sign-ups, a task that the law’s supporters expect to be more difficult, or at least more complex, than in its coverage’s inaugural year.
There are several challenges: The 2015 enrollment period is shorter, the most motivated Americans are probably already enrolled and the law is still politically unpopular. That means that even if HealthCare.gov works well — and it couldn’t be worse than last October’s meltdown — proponents are confronting a tough messaging landscape.”
“CMS decided not to include some payments disputed by doctors and teaching hospitals in the Open Payments database published Tuesday (Sept. 30) in order to give physicians and hospitals more time to review the information, but the highly anticipated database includes de-identified data in cases where it was unclear exactly to which physician the payments should have been linked.
The Open Payments site will include 4.4 million payments valued at almost $3.5 billion, according to CMS. Payments from drug and device makers, as well as group purchasing organizations, which were disputed by physicians or hospitals and not corrected before the end of the review and dispute period (Sept. 11) were not included in the most recent batch of Open Payments data because of timing issues, CMS officials said on a call.”
“The federal exchange is set to cut thousands of individuals from its coverage rolls this week because of unresolved inconsistencies related to immigration status, with HHS saying 115,000 will lose coverage as of Tuesday (Sept. 30). Tuesday is also the deadline for about 279,000 households to submit current income information to the exchange or risk seeing changes in their tax credits and cost-sharing subsidies that could result in higher costs for enrollees.
Furthering the saga on coverage data matching issues, the National Immigration Law Center has filed an administrative complaint under the ACA’s anti-discrimination section due to HHS’ failure to communicate with consumers in languages other than English and Spanish. The center also filed a Freedom of Information Act request in order to glean more insight into why that decision was made.”
“Gov. Bobby Jindal has been viewed as a health care policy wonk, and he’s tried to build on that image ahead of a likely 2016 presidential campaign, positioning himself as the candidate with substantive ideas.
But his administration’s handling of health care matters at home could undermine his bonafides in the subject area and threaten his efforts to sell himself as a health care expert.”
“After the rocky rollout last fall of the ObamaCare website, the administration wants to re-enroll those already in the system in hopes of avoiding another technological embarrassment.
But analysts warn that just blindly re-enrolling could mean trouble for consumers.
“This notion of just sit back and re-enroll is really misleading and I think could cause a lot of harm to people,” said Bob Laszewski of Health Policy and Strategy Associates.
“The automatic renewal, it’s easy, it will keep people getting ObamaCare,” added Rosemary Gibson of the Hastings Center. “But you have to trust but verify. You have to go look. You just can’t be on automatic pilot for health insurance.””
“When Fabrizio Mancinelli applied for health insurance through California’s online marketplace nine months ago, he ran into a frustrating snag.
An Italian composer and self-described computer geek, Mancinelli said he was surprised to find there wasn’t a clear way to upload a copy of his O-1 visa. The document, which grants temporary residency status to people with extraordinary talents in the sciences and arts, was part of his proof to the government to that he was eligible for coverage.
So, the 35 year-old Sherman Oaks resident wrote in his application that he’d be happy to send along any further documentation.
Months went by without word from the state. Then last week he came home from vacation to find a notice telling him he was at risk of losing the Anthem Blue Cross plan he’d purchased.”
“Three Blue Cross Blue Shield plans operated by Health Care Service Corporation have decided to discontinue their “transitional” non-ACA compliant plans at the end of this year and cancellation notices will be sent to affected policyholders “shortly,” a company spokesperson tells Inside Health Policy. HCSC says the decision was made to help keep premiums for ACA plans affordable, because moving those enrollees into compliant plans will result in a more balanced mix of individuals.
Transitional plans that were on the market this year from Blue Cross Blue Shield of Texas, Blue Cross Blue Shield of New Mexico and Blue Cross Blue Shield of Oklahoma will be discontinued effective Jan. 1. One source tracking state developments said the Blues appear to be discontinuing the plans on its own volition. The Blues participated aggressively in the exchanges in the first year while many other carriers remained cautious about entering the new markets, though that is beginning to change for 2015. All of the aforementioned states are using the federal exchange for 2015 open enrollment for individual plans.”
“New survey data show that companies are passing on to their employees additional costs they have incurred as a result of the Affordable Care Act, according to a management professor at the University of South Carolina’s Moore School of Business.
And that means employees who get their health insurance through work are bearing the cost of subsidizing people newly covered under President Obama’s healthcare reform law, said Professor Patrick M. Wright.”