Articles on the implementation of ObamaCare.
“New language in contracts between the CMS and insurers operating on HealthCare.gov is grabbing attention, with some calling it an admission by the government that it might lose upcoming court battles dealing with insurance subsidies on the health portal and others saying the new wording is just a practical precaution.
The new language appears to allow insurers to stop offering their plans should federal premium subsidies disappear. A number of cases regarding the legality of the subsidies in states without their own exchanges are now working their way through the courts.
The language says, “CMS acknowledges that (the insurer) has developed its products for the (federal exchange) based on the assumption that (advance payments of the premium tax credit) and (cost-sharing reductions) will be available to qualifying enrollees. In the event that this assumption ceases to be valid during the term of this agreement, CMS acknowledges that issuer could have cause to terminate this agreement subject to applicable state and federal law.””
“The millions of health insurance cancellations caused by Obamacare don’t mean people are “losing insurance,” according to a top Health and Human Services official — they just mean people are being invited to join an Obamacare exchange.
HHS regional director Joanne Grossie spoke to the Virginia legislature about widespread cancellations. At least 250,000 Virginians will be losing their health insurance Jan. 1 because they don’t meet Obamacare regulations.
Republican state Sen. Jeff McWaters asked Grossie whether HHS knows how many people are going to lose coverage, but Grossie took issue with the idea that customers are even losing insurance.”
“Leo Boudreau of Massachusetts was thrilled to find a psychologist in his insurance network to treat his teenage daughter for emotional stress related to a medical condition. The therapist worked out of a local hospital.
But he was surprised when the bill for each visit contained two charges: the approximately $100 he expected to see for the therapist — and a similar fee for the room, which was not covered.
“How could it be that the doctor was in network and the hospital was in network, but I had to pay separately for the room?” Mr. Boudreau said.”
“WASHINGTON — With health insurance marketplaces about to open for 2015 enrollment, the Obama administration has told insurance companies that it will delay requirements for them to disclose data on the number of people enrolled, the number of claims denied and the costs to consumers for specific services.
For months, insurers have been asking the administration if they had to comply with two sections of the Affordable Care Act that require “transparency in coverage.””
“If you bought health insurance on HealthCare.gov for this year, you could be in for a few surprises when open enrollment begins next month.
It’s possible, for example, that you could end up being billed for two different plans. The reason, insurers say, is because the federal government hasn’t addressed a key communications issue with the website.
And if you haven’t updated your financial information on the online insurance marketplace, you could face higher premiums and get less of a subsidy than you deserve.”
“Hanging around actuaries as long as I have one of the old sayings I picked up was, “Figures don’t lie, but liars figure.”
I have read one story after another this summer and fall about the modest Obamacare rates increases––or decreases––for 2015.
On this blog you have also seen me write about the complex way the 2015 Obamacare rates will hit people particularly because of the impact the changes in the so called second lowest cost Silver plan will have on so many people’s final subsidy. You have also seen me write about the fact that we really won’t know what Obamacare costs people until the now unlimited Obamacare reinsurance program stops subsidizing insurance rates in 2017.”
“Americans love Obamacare, the New York Times propagandizes today. It’s not the only media outfit running with this story today, suggesting a coordinated campaign effort a week before the election.
According to the New York Times, it is too soon to tell if Obamacare is working, except with the young. There, Obamacare seems to be working. But, here’s the kicker. With the Obama Administration claiming Obamacare would reduce costs, the New York Times finds it only has at the margins.”
“After the worst transition to Obamacare in the country, Massachusetts is still without a functional exchange website and just 769 people have enrolled in Obamacare-subsidized plans.
To avoid accountability and political repercussions, Massachusetts Gov. Deval Patrick is about to cut two special deals with the federal government: the “Commonwealth Kickback” which grants Massachusetts the most generous taxpayer-funded premium subsidies in the entire country, while the “Bay State Bailout” gives 300,000+ MA residents “temporary” Medicaid coverage in 2014, without any verification of their eligibility.
These deals are reminiscent of the controversial ACA-related “Cornhusker Kickback” and “Louisiana Purchase,” but they also can be added to the growing list of special deals cut for Massachusetts as the state struggles to transition to the ACA.”
“As President Barack Obama’s administration gears up for its second open enrollment period next month, the president’s health care overhaul is now facing two new threats. Either piece of news, on its own, should warrant concern from the law’s most ardent supporters for the program’s long-term prospects.
The first threat is a group of legal challenges to the law that are making their way through the courts. At issue is what the plain text of Section 1401 of the Affordable Care Act means. Even though the text of the law states that the subsidies are available “through an Exchange established by the State under 1311 of the Patient Protection and Affordable Care Act,” the Internal Revenue Service (IRS), without congressional authorization, allowed federal subsidies to flow into states participating in the federal exchange when it implemented the law.”
“ObamaCare rate increases are coming to some key battleground states, fueling Republican attacks ahead of next month’s midterm elections.
“It looks like we’re going to have double-digit premium increases in places like Alaska, and Iowa and Louisiana,” said health economist John Goodman. “Where we’ve got very close races for Senate, and Republican candidates are making a big deal over this.””