Articles on the implementation of ObamaCare.
Health insurers that sold plans on the exchanges in 2015 and enrolled droves of high-cost members, could haul away as much as $7.7 billion this year, as part of the healthcare law’s reinsurance program.
The CMS released a memo (PDF) late Friday that said the agency expects its jar of reinsurance money will total $7.7 billion. The payouts, to be issued this year, will reflect data from the 2015 benefit year.
The late Supreme Court Justice Antonin Scalia wasn’t a fan of the Affordable Care Act and opposed it when it came before the nation’s high court every time.
Known for his blunt writings, here are some highlights from a dissenting opinion he wrote, published June 15, 2015, in what was the high court’s second major decision upholding President Obama’s signature legislative achievement. Scalia wrote the following passages in the famous King vs. Burwell case on behalf of a three-vote minority that included Justices Samuel Alito and Clarence Thomas. The entire dissent can be read here.
Click through to read five of the best quotes from Scalia’s dissent.
Tax season has alerted Sen. David Vitter (R-La.) to a new way to investigate a provision of the Affordable Care Act that allows congressional members and staffers to avoid the federal exchanges.
The Internal Revenue Services has sent 1095-C forms to congressional staffers and members in recent weeks stating that Congress is considered a large employer. That statement is at odds with a rule allowing members and their staffs to purchase insurance plans on an exchange for small business with less than 50 employees.
The Louisiana senator sent a letter to the IRS on Wednesday, asking the agency to confirm that Congress is a large employer.
On more than one occasion, President Obama has said that the core idea behind ObamaCare came from the Heritage Foundation and Politifact rates the claim as “mostly true.” More than one left-of-center commentator has made the same charge, often tracing the lineage from the Heritage building in Washington, DC to Mitt Romney’s health reform in Massachusetts to the Obama administration. Most recently, John Aravosis writing at the America Blog claimed that the core idea behind ObamaCare (the individual mandate) comes from a 1989 lecture by Stuart Butler, then a health economist at Heritage. The same notion is almost as common on the right as it is on the left.
There is just one problem. This is all malarkey.
What is ObamaCare? If you sift through the hundreds of pages of legislation, the thousands of pages of regulations and all of the ridiculous complexity you will find that ObamaCare in its essence is a bastardized form of what health economists call “managed competition.”
After most health insurers racked up financial losses on Affordable Care Act plans in 2014, many companies’ results for last year worsened, creating heavy pressure to improve performance this year.
An analysis of filings by not-for-profit Blue Cross and Blue Shield insurers—among the biggest players in the law’s exchanges for buying individual insurance—shows the challenge facing the industry as it seeks a turnaround in the individual business. They paid out more for health care in the first three quarters of 2015 than they took in from premiums on their individual plans.
On Wednesday, Humana Inc. became the latest of the big publicly traded companies to flag problems, saying its losses on individual plans deepened last year. Humana included in its 2015 results $176 million in losses it expects to incur on such plans in 2016.
House Ways and Means Committee Chairman Kevin Brady (R-Texas) on Wednesday gave a nod of approval to a proposal about Obamacare’s Cadillac tax in the White House’s 2017 budget.
“While we will disagree more than we agree today, I do believe that there are some important areas of cooperation. I’m glad that the White House has finally faced reality in one area and agreed that the so-called Cadillac tax is not workable,” Brady said during a hearing on the proposed budget.
Many contractors who provide farm labor and must now offer workers health insurance are complaining loudly about the cost in their already low-margin business.
Some are also concerned that the forms they must file with the federal government under the Affordable Care Act will bring immigration problems to the fore. About half of the farm labor workforce in the U.S. is undocumented.
“There’s definitely going to be some repercussions to it,” said Jesse Sandoval, a farm labor contractor based in Stockton, California. “I think there’s going to be some things that cannot be ignored.”
The Obama administration released its proposed budget for 2017 this week. It includes a host of health care-related proposals, including new initiatives to increase access to mental health care, expand opioid abuse treatment, fight antibiotic resistance, address the Zika virus threat, and fund a “cancer moonshot.”
The budget also contains a number of proposals relevant to Affordable Care Act provisions. It proposes providing 100% federal funding for state Medicaid expansions for three years regardless of when the state decides to expand.
It would also modify the high-cost employer health plan (“Cadillac”) tax to take account of geographic differences in health care costs; specifically, it would set the threshold when the tax begins to apply at the greater of the current statutory dollar threshold or a state’s “gold plan average premium.”
The HHS Budget in Brief includes a request for $2.1 billion to fund the federally facilitated marketplaces and oversight of the state marketplaces.
The budget anticipates the collection of $4.335 billion and expenditure of $4.560 billion in 2017 for the transitional reinsurance program.
The Obama administration is setting up a new ObamaCare sign-up period for people who failed to file 2014 tax returns.
Jan. 31 was the deadline for most people to sign up, but this new period will provide another chance until March 31, for certain people who might have missed out on coverage because of confusion about new ObamaCare requirements regarding taxes and health insurance.
The copay cap on drugs is one way Covered California chose to shape the health insurance marketplace this year. Experts say the California exchange uses more of its powers as an “active purchaser” than any other state. That means it can decide which insurers can join the exchange, what plans and benefits are available and at what price.
The federal government — in pending proposed rules for 2017 — has signaled it too wants to have more of a hand in crafting plans. Though there are no plans to go as far as a monthly drug copay cap, healthcare.gov would be forging ahead on a path California already paved, swapping variety for simplicity in plan design.
“Not letting [health] plans define what’s right for consumers, but defining it on behalf of consumers … is a better model for the market,” said Peter Lee, executive director of Covered California.
“We want to make sure every consumer has good choice but not infinite choice,” said Lee.