The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers
“House Ways & Means health subcommittee chair Kevin Brady (R-TX) questions HHS’ authority to settle hospitals’ appeals of denied inpatient claims and is urging HHS Secretary Sylvia Burwell to retract what he views as an “ill thought” settlement process. Brady wants Burwell to work with lawmakers to come up with a different “fair, transparent and conclusive settlement process.”
Brady wrote to Burwell Tuesday (Sept. 16) that he is dismayed by HHS’ reluctance to work with the committee on an equitable settlement process that is fully legal, adding that the “lack of engagement makes it challenging for the Congress to solve the current appeals problems and prevent similar problems in the future.”
CMS announced late last month (Aug. 29) that it will pay hospitals 68 percent of denied inpatient status claims in the appeals queue if hospitals take them out of the backlogged appeals process. The agency has been encouraging hospitals to take advantage of the settlement to “alleviate the burden of Medicare appeals on both the hospital and Medicare systems,” according to the CMS website.
Hospitals should decide whether to participate by the end of October, and CMS in a Frequently Asked Questions document released Sept. 9 says that four hospitals have already stepped forward to take the settlement offer. The document also states that this is a one-time offer from CMS.”
“New polling data released from Independent Women’s Voice, conducted by Public Opinion Strategies among 1,000 likely voters in 43 congressional swing districts, is the most comprehensive survey yet on the likely electoral impact of the Affordable Care Act in swing states heading into the November elections.
If the elections were held today, the survey shows that Republican congressional candidates have a built-in advantage (42% – 36%) on the ballot test. Most prevalent in districts that lean Republication (43% – 33%), the GOP lead extends into pure toss-up seats (42% – 35%), and nearly disappears in districts that lean Democrat (40% – 39%).
Voters in key congressional districts are clear in their opposition to the Affordable Care Act. Disapproval of the law remains high with majority (54% – 43%) of voters in swing districts disapproving of the federal health care takeover. Strong opposition (45%) outnumbers strong support (25%) by nearly 2 to 1.
Regardless of seat type (Lean GOP, Pure Toss Up, Lean DEM), majorities of respondents disapprove of the Affordable Care Act.”
“Last year I wrote that Obamacare could leave doctors holding the bag for claims for patients who don’t pay their insurance premiums. That’s because the law includes a three-month grace period during which health insurers must continue to cover patients who sign up, but don’t pay the price of their insurance. If the patients eventually make good, there’s no problem. But if patients don’t pay the owed premiums, the insurance company has to cover the cost of claims filed during the first month. Providers are stuck with the tab for any claims filed during months two and three.
The piece I wrote last July was theoretical. The notification letter I’m holding in my hand, addressed to my wife’s pediatric practice, is reality. And reality costs, in this case, over $600. That’s the outstanding balance owed the practice by a patient insured by BlueCross BlueShield of Arizona. It’s a balance that my wife might have to eat, or else try to collect herself.”
“There are widespread instances of Obamacare insurance plans violating the rigid rules surrounding whether customers can use federal health care subsidies on insurance policies that cover abortion procedures, according to a Government Accountability Office investigation.
The report, commissioned by House Republican leadership and obtained by POLITICO on Monday night, found that 15 insurers in a sample of 18 are selling Obamacare plans that do not segregate funds to cover abortion (except in cases of rape, incest or the mother’s life) from their Obamacare subsidies.
“Three little words is all it takes to change voters’ minds about Medicaid expansion.
Morning Consult polling shows using the term “Affordable Care Act” can make a difference in how a voter feels about expanding Medicaid. When asked if Medicaid should be expanded for low income adults below the federal poverty line, 71 percent of registered voters said yes. When asked if Medicaid should be expanded “as encouraged under the Affordable Care Act”, support dropped nine percentage points.”
“During the 2014 open enrollment for Obamacare coverage, Mary Denson, 21, a student at Columbia (Mo.) College, qualified for a federal premium subsidy that reduced her premium contribution for buying health insurance to less than $20 a month.
But she fears that when she renews her coverage for 2015, she won’t have enough income from her nanny job to reach the subsidy income threshold of 100% of the federal poverty level and continue qualifying for premium tax credits. She isn’t eligible for Medicaid because Missouri hasn’t expanded that program for low-income adults. Denson says she’s considering looking for another job to reach the $11,670 income threshold but worries she may have to drop classes. Without the subsidy, her coverage would cost nearly $400 a month, far more than she can afford.
“I’m just going to have to re-apply and pretty much hope that I make the cut again,” Denson said.”
“Proposition 45 would give California’s elected insurance commissioner the authority to reject excessive health insurance rate hikes, a power the commissioner already wields for auto and homeowners insurance rates.
The campaign against it — for which the insurance industry has so far put up $37.3 million — is now airing a 60-second radio ad narrated by a nurse named Candy Campbell.
What does the ad say?
Campbell says voters have a choice between letting the state’s “new independent commission” negotiate rates and reject expensive plans, or handing that power over to “one politician” who can “take millions in campaign contributions from special interests.”
Is it true?
The “commission” Campbell is referring to is the board of Covered California, the state’s new health insurance exchange created by the Affordable Care Act, commonly called “Obamacare.” Covered California is indeed an independent part of state government. But it’s somewhat misleading to describe the board as “independent.” The board members are appointed by politicians — the governor and the Legislature.”
“States have developed various ways to avoid paying their fair share of Medicaid expenses over the years, in some cases costing the federal government hundreds of millions of dollars in extra funding for the program.
The Department of Health and Human Services, which runs Medicaid through its Centers for Medicare and Medicaid Services (CMS), has known about the issue for more than a decade, but states still find ways to game the system. The agency’s inspector general this year listed the issue among 25 key problems the agency needs to address.”
“When it comes to claims about Medicare, some political talking points just never die.
In Iowa and Virginia, Republicans have accused Democrats of cutting Medicare to pay for Obamacare. In Florida, a Republican was slammed for ending the Medicare “guarantee.” Other Medicare-related attacks have been deployed in Arkansas and Kentucky Senate races. The point of all the attacks is to convince midterm voters that one side or the other won’t protect the program.
Take this one, used in a recent ad aired by the National Republican Senatorial Committee in the hotly contested Iowa Senate race between Democratic Rep. Bruce Braley and Republican state Sen. Joni Ernst:
“Bruce Braley voted to cut $700 billion from Medicare to support Obamacare,” the ad says. “That’s just not fair. We paid in. We paid for it. That should be there for us.””
“A Republican-controlled Senate cannot repeal Obamacare, no matter how fervently GOP candidates pledge to do so on the campaign trail this fall. But if they do win the majority, Senate Republicans could inflict deep and lasting damage to the president’s signature law.
Republicans are quick to say they are not yet measuring the proverbial drapes. But they are taking the political measurements of repealing large parts of the health law, considering which pieces could be repealed with Democratic support, and how to leverage the annual appropriations and budget process to eliminate funding or large pieces of the law.
Initial targets are likely to include the medical device tax, the individual and employer mandates, the 30-hour workweek to qualify for coverage, and spending on a preventive health fund that Republicans call a slush fund.”