Articles on the implementation of ObamaCare.
“Obamacare challengers in the Halbig case have asked the D.C. Circuit Court of Appeals not to review a three-judge panel’s ruling against federal exchange subsidies, instead calling for “final resolution by the Supreme Court.”
The backstory: one month ago a divided three-judge panel prohibited Obamacare subsidies for residents buying from the federal exchange. The Obama administration asked the full D.C. Circuit bench to rehear the case, which is reserved for matters of exceptional importance.
The challengers don’t want that, because if they lose at the D.C. Circuit it would make the Supreme Court less likely to take the case.
“There is no doubt that this case is of great national importance. Not due to the legal principles at stake—this is a straightforward statutory construction case under well-established principles—but rather due to its policy implications for ongoing implementation of the Affordable Care Act (‘ACA’). Those implications, however, are precisely why rehearing would not be appropriate here, as Judges of this Court have recognized in many analogous cases,” the plaintiffs wrote in the brief filed Monday.
The Obama administration has an advantage in an en banc — or full bench — ruling: it would feature eight Democratic-appointed judges and five Republican-appointed judges. Now that the 4th Circuit Court of Appeals has ruled in favor of the federal subsidies, the only way the challengers can win is at the Supreme Court. The plaintiffs at the 4th Circuit have already asked the justices to take the case, which the Halbig plaintiffs pointed out.”
“WASHINGTON — Ending insurance discrimination against the sick was a central goal of the nation’s health care overhaul, but leading patient groups say that promise is being undermined by new barriers from insurers.
The insurance industry responds that critics are confusing legitimate cost-control with bias. Some state regulators, however, say there’s reason to be concerned about policies that shift costs to patients and narrow their choices of hospitals and doctors.
With open enrollment for 2015 three months away, the Obama administration is being pressed to enforce the Affordable Care Act’s anti-discrimination provisions. Some regulations have been issued; others are pending after more than four years.
More than 300 patient advocacy groups recently wrote Health and Human Services Secretary Sylvia Mathews Burwell to complain about some insurer tactics that “are highly discriminatory against patients with chronic health conditions and may … violate the (law’s) nondiscrimination provisions.”
Among the groups were the AIDS Institute, the American Lung Association, Easter Seals, the Epilepsy Foundation, the Leukemia & Lymphoma Society, the National Alliance on Mental Illness, the National Kidney Foundation and United Cerebral Palsy. All supported the law.
Coverage of expensive drugs tops their concerns.”
“WASHINGTON — In a policy change, the Obama administration is planning to pay doctors to coordinate the care of Medicare beneficiaries, amid growing evidence that patients with chronic illnesses suffer from disjointed, fragmented care.
Although doctors have often performed such work between office visits by patients, they have historically not been paid for it.
Starting in January, Medicare will pay monthly fees to doctors who manage care for patients with two or more chronic conditions like heart disease, diabetes and depression.
“Paying separately for chronic care management services is a significant policy change,” said Marilyn B. Tavenner, the administrator of the Centers for Medicare and Medicaid Services. Officials said such care coordination could pay for itself by keeping patients healthier and out of hospitals.”
“Congressional Republicans investigating last fall’s botched launch of HealthCare.gov revealed Friday that a top Obamacare official had asked her spokeswoman to delete an email from a senior White House advisor that discussed problems with customer service calls about that website.
Those Republicans now want Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner to explain that deletion request, and to reveal if she has asked staff to “delete or otherwise destroy emails, communications or any other documents relating to HealthCare.gov.” The Republicans said the Obama administration has a “pattern” of being unable to preserve records.
Tavenner’s email asking the subordinate to delete an email was turned over to the House Energy and Commerce Committee last week, just a day after her staff told the committee that some copies of her email communications might have been lost.”
“New information related to physician-industry interaction is scheduled to be released to the public for the first time on September 30. The public database from the Centers for Medicare & Medicaid Services (CMS), which is part of the Sunshine Act implementation, will focus on payments that biopharmaceutical and medical technology companies have made to physicians. Although the release date is less than six weeks away, concerns about what the data will look like and its effect on medical innovation are already being brought to light by stakeholders across the board.
One of the primary concerns that PhRMA shares with more than two dozen other patient and industry organizations is that the data needs to include context to explain what the payments represent – collaborations that benefit patient health and innovation. It’s critical to note that the new database will include information on many different types of interactions. For example, the data could reflect an oncologist partnering with a biopharmaceutical company to lead a clinical trial on an innovative cancer treatment or a family practice physician’s attendance at an industry-sponsored speaking event led by a peer to further her education about geriatric care. However, if the data released includes only names and numbers, the public is likely to be confused and the information is left subject to misinterpretation.
Additionally, many physicians are not aware about the Sunshine Act, what it means for them and their ability to be part of this collaborative process. It is important for CMS to provide physicians with more information about their ability to register and review data reported on them.
To compound this lack of information, physicians also face a confusing registration process with a very short timeline. Given how instrumental relationships between companies and physicians are to driving future innovation, we want to ensure that both groups can provide input on the process of Sunshine Act reporting.”
“In 2010, President Obama signed into law the Patient Protection and Affordable Care Act, also known as the “Affordable Care Act,” the “ACA,” or “Obamacare.” The ACA will reduce the number of Americans without health insurance— an important goal—but it will do so by increasing the cost of U.S. health coverage. Increasing the cost of health coverage, in turn, will worsen two of the nation’s most important policy problems.
The first of those problems is the increasing unaffordability of private health insurance, a problem that is straining the budgets of middle-income Americans, and hampering social mobility. The second problem is the nation’s grave long-term fiscal instability, a problem primarily driven by government spending on health insurance and health care.
Indeed, the ACA will especially drive up the cost of private health insurance that individuals purchase directly. The law will dramatically expand Medicaid, a program with the poorest health outcomes of any health insurance system in the industrialized world. And the ACA, despite spending over $2 trillion over the next decade, will leave 23 million lawful U.S. residents without health insurance, according to estimates from the Congressional Budget Office (CBO).
In other words, the U.S. health care system remains in need of substantial reform, in ways that address the ACA’s deficiencies as well as the system’s preexisting flaws.”
“This tax season will be a messy one for most of Obamacare’s 8 million enrollees.
Individuals and families who bought subsidized coverage have been receiving tax credits based on whatever amount they thought they would earn this year. Upon filing taxes, the IRS will reconcile the amount of subsidy received, based on expected income, with the person’s actual income.
That’s where things can get ugly.
If the person underestimated their income for the year — and got a higher subsidy than they actually deserved — they’ll owe the government the difference. But if they overestimated their income, and received too small a subsidy, they’ll see a bigger tax return.”
“State officials offered assurances Wednesday that software fixes to the flawed MNsure health insurance exchange are happening as planned, and that the system should be in good working order by the Nov. 15 start of open enrollment.
Still grappling with consumer fallout and political pressure over last year’s troubled rollout, MNsure officials said changes are being made to the system that will allow more time for testing and that sufficient backup plans are in development if things go wrong.
MNsure is preparing for the “worst case, if that comes about,” interim Chief Operating Officer Wes Kooistra told the agency’s board of directors, but he added that all hands are on deck to ensure an “improved user experience for 2015.”
IBM installed its final software upgrades over the weekend, officials said, a move that should resolve one of several major logjams that have prevented consumers from seamlessly logging onto the MNsure website and enrolling in health insurance coverage.”
“Backers of the health-care law say they are rushing to make sure tens of thousands of people provide more documents to prove they are in the U.S. legally and therefore entitled to the coverage they obtained through HealthCare.gov.
Immigrant advocates say they felt the Obama administration moved hastily in announcing Tuesday it would cut off health insurance for up to 310,000 people who signed up for plans through online exchanges run by the federal government if they don’t send additional information in the next few weeks showing they are U.S. citizens or legal residents.
The federal government is taking the steps to comply with a requirement in the health law that bars unauthorized immigrants from using the online exchanges to shop for coverage, as well as from receiving federal tax credits to offset the cost of premiums.”
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The law’s supporters inserted the provision to try to tamp down controversy over the prospect that it could help people who aren’t legally in the U.S.
“What happens in November will play a major role in shaping President Obama’s final two years in office.
No, it’s not just the 2014 midterm elections that have the White House on edge, but also the return of open enrollment in Obamacare.
After the disastrous rollout of the president’s signature domestic initiative in 2013, the administration needs to avoid the problems that diminished public confidence in the most significant overhaul to the health care system since the creation of Medicare.
The White House believes the technical problems that crashed healthcare.gov will become a distant memory. However, team Obama must worry about much more than just a website.
Here are the top five potential Obamacare headaches looming in November:”