“Here unedited is what I posted on September 29, 2013:
The Affordable Health Care Act’s Launch On October 1st––So How Did it Go?
Unavoidably, that will be the big question come Tuesday.
But there will be much more to it than that.
A 180-Day Open Enrollment––Not a One-Day Open Enrollment
What happens on the first day, for good or bad, will constitute only a tiny percentage of the open enrollment period. Consumers will likely visit the new websites many times before they make any decisions, and that is exactly as it should be.
Many of the health plans touted as being low-cost plans are going to be very limited access plans. It won’t be easy for consumers to compare one plan’s provider network to the other. In the best of circumstances, consumers will be confused by what is being offered for some time and will have to make a major effort to make sense of it for themselves.”
“Former HHS insurance oversight chief Jay Angoff has filed a lawsuit against the department for not making 2015 rate filings public, arguing the administration is not abiding by its own regulations on disclosing the information.
Responding to the lawsuit, an HHS official said the agency will publish the rate information prior to the beginning of open enrollment. HHS Spokesperson Ben Wakana told Inside Health Policy late Wednesday (Oct. 1): “We are readying the rate change information. The department is committed to providing consumers accurate information so they can make informed decisions, and therefore, before the beginning of Open Enrollment, the agency will publish final insurance rates for all 50 states.””
“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.”