Category: Implementation

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.

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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:

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.

Hundreds of thousands of people lose subsidies under the health law, or even their policies, when they get tangled in a web of paperwork problems involving income, citizenship and taxes. Some are dealing with serious illnesses like cancer. Advocates fear the problems, if left unresolved, could undermine the nation’s historic gains in health insurance.

Coverage disruptions due to complex paperwork requirements seem commonplace in the health law’s system of subsidized private insurance, which currently covers about 12.7 million people.

The government says about 470,000 people had coverage terminated through Sept. 30 last year because of unresolved documentation issues involving citizenship and immigration. During the same time, more than 1 million households had their financial assistance “adjusted” because of income discrepancies. Advocates say “adjusted” usually means the subsidies get eliminated.

The death of U.S. Supreme Court Justice Antonin Scalia, who famously said the Affordable Care Act should be called “SCOTUScare,” leaves in limbo a number of health care-related cases. The news also quickly sparked a debate over who would replace him amid the presidential campaign.

The Supreme Court justices are considering a number of important health care cases focusing on topics including abortion and the ACA’s contraception mandate.

The court is also weighing a case about data sharing with potential implications for insurers and state health care reform efforts and another case with the potential to reduce—or increase—the number of False Claims Act suits brought against health care providers and other companies.

Some people may not receive the necessary ObamaCare forms, 1095-B or 1095-C, until shortly before the April 15 tax filing deadline because the IRS has pushed back the due date from Jan. 31 to March 31 for employers and others that provide insurance.

What’s a consumer to do? File anyway, even without the form, the IRS says. If people make a mistake on their return because they didn’t have the 1095-B or 1095-C forms and relied on information from their employer or other coverage providers instead, they won’t have to amend their return, the IRS said.