Articles on the implementation of ObamaCare.
Consumers who try to sign up for insurance after the Obamacare open enrollment period will soon need to submit proof that they are eligible for most special enrollment periods, federal health officials announced Wednesday.
This new confirmation process, which is expected to start in the next few months, will only affect those living in the 38 states that use the federal Healthcare.gov site.
It addresses complaints from insurance companies that the Centers for Medicare and Medicaid Services was allowing too many people to buy insurance after the open enrollment deadline passed. This, insurers said, left them with many consumers who waited until they were sick to sign up and then dropped coverage after they received treatment. And the companies claim that created a sicker-than-expected pool of customers that was contributing to the losses on Affordable Care Act exchange plans.
Leaders of some health cooperatives set up under the Affordable Care Act said it would be hard for the Obama administration to recoup more than $1 billion in federal loans made to some of the organizations that are now defunct, because most of the money has been spent.
A group representing existing co-ops, as well as leaders of some of the organizations, said there is little of the federal loan money remaining and some of what is left is needed to pay providers whose bills have yet to be paid. Obama administration officials have said they plan to use every available tool to recoup the federal loans, including legal action.
Thousands of doctors, hospitals and other providers in some states still haven’t been paid for health services they provided to members insured by the co-ops, which are organizations set up under the health law to offer health insurance to consumers and cut costs by giving established insurers more competition.
A response to questions from Senator John Cornyn (R-TX) about federal spending on state-based ObamaCare exchanges reveals the improper spending of one million dollars in Arkansas. The states setting up their own exchanges have spent more than $3.2 billion in federal funds, and many of those states have presided over failed exchanges and have opted to have their citizens routed to the federal healthcare.gov ObamaCare exchange.
Responding to Sen. Cornyn, Centers of Medicare and Medicaid Services Acting Administration Andrew Slavitt wrote, “as part of CMS’s routine federal oversight of (exchanges), CMS found that the Arkansas SBM spent approximately $1 million of the state’s federal grant funding for activities that are not allowed under regulations.”
In a recent letter addressed to Senator John Cornyn (R-Texas), ObamaCare chief Andy Slavitt said the federal government will “recover its fair portion” of funds in the event a failed ObamaCare state exchange reaches a settlement with contractors.
Given that the federal government funded the overwhelming majority of state exchange projects with $5.5 billion in taxpayer funds, “fair portion” should be close to 100 percent.
Recently, Maryland reached a $45 million settlement with a contractor stemming from its state exchange debacle. But despite financing the Maryland exchange to the tune of nearly $200 million the federal government will receive only 70 percent of funds from the settlement.
Funding a problem doesn’t solve a problem. There are ways to make health care more affordable and accessible with less government dependence. For starters, Congress should seriously reconsider the way the program is financially structured so states can be granted more flexibility to devise ways that can improve the value Medicaid brings to its beneficiaries.
The other component involves reducing regulation to make medical care more affordable, like repealing Certificate of Need, permitting mid-level providers to practice within their full scope of authority, exercising right-to-try laws, reducing the number of health insurance benefit mandates, or changing the federal tax code to allow the direct primary care market to expand.
For tax year 2015, millions of Americans will be getting a new tax form related to health care reform measures.
Will you know what to do with yours when it arrives?
The Affordable Health Care Act mandated three new tax forms to be used as a kind of proof of insurance so taxpayers may avoid paying a penalty for failure to be covered. They are:
- Form 1095-A, sent to those who purchase health insurance on government marketplaces.
- Form 1095-B, sent to employees of businesses with fewer than 50 full-time employees
- Form 1095-C, sent to employees of businesses with more than 50 full-time employees
Since the Affordable Care Act was signed into law on March 2010, the Obama administration has changed the law 43 times without Congressional approval. The Galen Institute has been keeping track of these administrative changes, which you can find here.
Apparently another illegal administrative action, which will cost the U.S. Treasury $3.5 billion, can be added to the list. Late last Friday, and conveniently before a long weekend, the Centers for Medicare and Medicaid Services announced in a guidance document it would have $7.7 billion in reinsurance payments to cover the losses Exchange plan insurers incurred in 2015. But CMS is not entitled to $3.5 of the $7.7 billion it is giving away.
A federal appeals court in Atlanta on Thursday upheld a contraceptive mandate included in the president’s health care law but is delaying the implementation of its ruling until the U.S. Supreme Court can weigh in on the issue.
A three-judge panel of the 11th U.S. Circuit Court of Appeals ruled 2-1 to reject challenges to the mandate in a single opinion addressing two separate cases, one filed by nonprofit organizations affiliated with the Catholic Church in Georgia and the other by Catholic broadcaster Eternal Word Television Network in Alabama.
The organizations had argued the mandate and a related rule against those entities would violate the Religious Freedom Restoration Act of 1993, which prohibits the government from imposing a substantial burden on a person’s religious practice.
The Department of Health and Human Services announced Friday night that it was in the process of shorting the U.S. Treasury $3.5 billion.
Well, they didn’t exactly announce it. You had to read between the lines.
The theft of $3.5 billion will help prop up insurers that have agreed to sell ObamaCare policies in the individual market. Behind all the happy talk from Administration officials about the program’s success lies an unpleasant truth: insurers that participate in ObamaCare exchanges are bleeding money.
Those losses are coming despite billions of dollars in handouts the government is providing the industry. Some of those handouts are entirely lawful; others, not so much.
The so-called “reinsurance” program falls into the latter category.
There’s not much more time to speculate about how the Supreme Court will handle health care-related cases without the late Justice Antonin Scalia. A number of them are fast approaching on the court’s calendar, including one scheduled for arguments Tuesday.
Legal experts say they expect the court will go ahead and hear those cases and others despite the conservative justice’s unexpected death late last week.
The case set to be argued Feb. 23 involves the penalties companies face for patent infringement and could have a significant impact on the medical device industry. And in two weeks, the court is scheduled to hear a major case over whether Texas has gone too far in regulating abortions.