The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers
Two Republican committee chairmen are pressing the Obama administration to improve its oversight of how state-run ObamaCare marketplaces use federal dollars, citing an inspector general report on potential violations of law.
Sens. Orrin Hatch (R-Utah) and Chuck Grassley (R-Iowa) wrote to the head of the Centers for Medicare and Medicaid Services (CMS) on Monday asking for the agency to issue clarifying guidance on how the federal dollars can be spent.
State-run ObamaCare marketplaces received federal funds to help set themselves up, but after Jan. 1 of this year, they marketplaces are supposed to be self-sustaining. They are now prohibited by law from using federal funds for “operating expenses.” They can only use the money for “design, development, and implementation.”
The problem is that the definition of these two categories can be unclear, as noted by an HHS Inspector General report late last month. The senators want clearer definitions from CMS.
State-based marketplaces (SBMs) “cannot be allowed to use hard-earned taxpayer dollars for expenses that are statutorily prohibited,” the senators write.
This tax season, millions of Americans are feeling the impact of the ACA on their tax return for the first time. Those who failed to obtain minimum essential health insurance coverage last year will have had to send the Internal Revenue Service (IRS) a check for $1,130, on average.1 Setting aside the impact on these millions of people’s wallets, this figure is also worth noting because it highlights the ineffectiveness of the individual mandate. Yes, the estimated 6.3 million people paying the penalty didn’t buy health insurance, but neither did the more than 30 million who qualified for an exemption from the mandate.2 If the mandate were 100 percent effective, everyone would have health insurance. However, there were still tens of millions of people uninsured in the U.S in 2014.
Sen. David Vitter (R-La.) has a simple question: How and why did Congress qualify as a “small business” eligible for special taxpayer subsidies under the Affordable Care Act (ACA)? For anyone in a real small business — private employers who get no such subsidies — the very idea is absurd. But getting a straight answer is as difficult as getting Lois Lerner’s IRS emails.
In search of answers, Vitter proposed subpoenaing documents from the District of Columbia Health Benefits Exchange Authority. But his colleagues on the Small Business and Entrepreneurship Committee recently voted (14 to five) to block the effort. They’ve tried to justify their lack of curiosity by calling the proposed subpoena an unnecessary “distraction” or an invitation to a “protracted” legal fight. But these are rather obviously lame excuses.
With Milwaukee-based Assurant Health continuing to bleed red ink, its parent company announced in a Tuesday news release it will either sell the health insurer or exit the health insurance business.
Assurant Health’s product lines include Time Insurance and John Alden. The company has more than 1,000 employees at its downtown Milwaukee offices, 501 W. Michigan St.
The impact on those employees will depend on whether the company is sold and the business strategy of a buyer.
“It’s premature for us to comment on possible outcomes,” said Assurant Inc. spokeswoman Vera Carley of impact on employees.
Republicans are being ridiculed by the right and the left for weighing ideas that would rescue ObamaCare health insurance policies for people in 37 states if the petitioners prevail in King v Burwell.
“Republicans Are Now Trying To Pass Obamacare Extension To Save Their Own Asses,” writes Allen Clifton in Forward Progressives. “GOP Gets Ready to Save the Day If the Court Strikes Down Obamacare Subsidies,” says Rush Limbaugh.
If the Supreme Court decides against the Obama administration in the case, leaders in Congress are indeed determined to pass legislation to protect coverage for an estimated six million people. ObamaCare has so distorted the market for individually-purchased and small group health insurance that Congress has little choice but to throw them a safety net.
As the state struggled under the national spotlight to fix its deeply flawed online health insurance marketplace last year, officials awarded more than $84 million in contracts without competition, about a third of the money spent on the troubled website. About 15 companies benefited from the “sole-source” and “emergency” contracts that did not use competitive bidding, according to documents obtained by The Baltimore Sun through public information requests. The Maryland Health Benefit Exchange’s lack of transparency has been criticized by government watchdogs and state officials, including Gov. Larry Hogan during his successful campaign, but the amount of the noncompetitive awards is now raising eyebrows among government procurement experts and prompting pledges from the administration to curtail the practice.
– See more at: http://www.capitalgazette.com/bs-hs-exchange-contracting-20150417,0,807245,full.story#sthash.q5qkVCoy.dpuf
Despite being designed to help the poor, certain aspects of Obamacare are holding millions of individuals back who fall into what is being called the “coverage gap.”
Reverend Vann R. Ellison, the president of the Florida based St. Matthew’s House, is trying to bring attention to the issue which he says affects people that fall between the $10,000 and $12,000 a year income range. St. Matthew’s House, which takes care of roughly 1,500 people, provides food and shelter to those individuals trying to work their way out of poverty.
“We generally deal with lower income people trying to get their lives together,” Ellison told The Daily Caller News Foundation. “These are people that can’t afford their own apartments.”
Those in that income range make too much to qualify for assistance under Obamacare but often times make too little to actually afford coverage or the fee that comes with not being covered. It’s an issue that impacts many of the lower income people Ellison is trying to help.
Although the Affordable Care Act (ACA) was enacted 5 years ago, 2014 was the first year of implementation for most of the health law’s major provisions. In fact, it turned out to be a glitch machine. Defying the expectations of even the law’s most ardent critics, Obamacare’s rollout of the federal online health exchange was a disaster, combined with the cancellation of millions of private health insurance policies (if you “liked” your plan, too bad), a delay in reporting requirements of the employer mandate, and new administrative exemptions from the individual mandate penalty.
Nonetheless, the Obama administration’s allies insist that the law is “working” and that it will even become popular with the majority of Americans with the passage of time. The law’s congressional supporters, they hope, will reap political benefits rather than political retribution.
King vs. Burwell is on the horizon. If the plaintiffs are successful, so goes the theory, subsidies end in 37 exchanges operated by the Department of Health and Human Services and serviced by HealthCare.gov. Coverage gets more expensive, and people won’t be able to afford their policies.
But, this outcome was foretold all the way back in the Senate mark-up of the proposed ACA legislation. Purposely requiring subsidies in state-run exchanges remains the incentive for states to set them up. The administration did not expect so many states elected not to set up their own exchanges, and it is now a big problem. As was noted in 2009 by critics of the bill, if states don’t hand out subsidies, people won’t be able to afford to buy coverage.
In the health savings account industry, the problem is compounded. The ACA law also created a perpetual rule change engine. For example, every year HHS issues what’s called the Letter to Issuers letter to Federal-facilitated Marketplaces (FFMs), in which it discusses all of the fixes that need to be made to exchange operations. This year, HHS has proclaimed that we would all be better off if out-of-pocket maximums (OOPM) for “other than self-only coverage” were restricted to the OOPM for individuals or $6,850 for 2016.
During the 2008 financial crisis, “too big to fail” became a familiar phrase in the U.S. financial system. Now the U.S. health-care system is heading down the same path with a record number of hospital mergers and acquisitions—95 last year—some creating regional monopolies that, as in all monopolies, will likely result in higher prices from decreased competition.