Articles on the implementation of ObamaCare.

“DEARBORN, Mich.–Signing people up for health insurance is the easy part of Rawha Abouarabi’s job ministering to immigrants and Arab Americans in this manufacturing hub along the Rouge River.
Nagat Sahouba, a medical assistant for the Arab Community Center for Economic and Social Services, takes down a client’s information for an appointment in the center’s clinic in Dearborn, Mich. on Aug. 7, 2014 (Photo by Marissa Evans/KHN).
But many of those she’s enrolled are surprised and indignant when they go to the doctor and are asked to a pay a bill— perhaps a copayment. They insist they’ve already paid their monthly insurance premium.
“They call us and say, ‘it’s a scam’,” says Abouarabi, an insurance navigator for the Arab Community Center for Economic & Social Services (ACCESS), a nonprofit agency that specializes in helping the largest Arab-American population in any U.S. city.
That’s just one example of the confusion immigrants face as they try to navigate the U.S. health care system. Even after signing up for insurance through the Affordable Care Act, advocates find that explaining to clients that they will still have to pay out of their own pockets each time they go to the doctor or get lab tests requires more than translating words like “premium” and “deductible” for non-English speakers.
“This whole concept of insurance doesn’t exist in the Eastern world,” said Madiha Tariq, public health manager for ACCESS. “People are always confused about the health care system when they come to this country.””

“If you get health insurance through your workplace, you’ll probably have a chance this fall to make important decisions about your coverage and costs.
Because many corporate health plans hold their annual open-enrollment periods in October and November, many employees can expect to get a packet of benefits, or instructions for making elections online, as well as updates on changes to their plans required by the Affordable Care Act. Some 55% of Americans have employer-based coverage, according to Mercer, a human-resources consultant.
“From the employee perspective, if there is any year to pay attention to the information, this is the year,” says Brian Marcotte, president and chief executive of the National Business Group on Health, a nonprofit representing large employers.
Starting next year, one change could be an ACA provision requiring some large employers—generally those with 50 or more full-time or equivalent workers—to offer affordable, adequate coverage to employees working more than 30 hours a week.”

” If you got health coverage through President Barack Obama’s law this year, you’ll need a new form from your insurance exchange before you can file your tax return next spring.
Some tax professionals are worried that federal and state insurance marketplaces won’t be able to get those forms out in time, creating the risk of delayed tax refunds for millions of consumers.
The same federal agency that had trouble launching HealthCare.gov last fall is facing the heaviest lift.
The Health and Human Services Department must send out millions of the forms, which are like W-2s for people getting tax credits to help pay health insurance premiums.
The form is called a 1095-A, and it lists who in each household has health coverage and how much the government paid each month to subsidize their premiums. Nearly 5 million people have gotten subsidies through HealthCare.gov.”

“Consumers getting government subsidies for health insurance who are later found ineligible for those payments will owe the government, but not necessarily the full amount, according to the Treasury Department.
The clarified rule could affect some of the 300,000 people facing a Sept. 5 deadline to submit additional documents to confirm their citizenship or immigration status, and also apply broadly to anyone ultimately deemed ineligible for subsidies.
First reported by the newsletter Inside Health Policy on Thursday, the clarification worries immigration advocates, who say many residents are facing website difficulties and other barriers to meeting the deadline to submit additional details. Those who don’t know about the deadline, or can’t meet it because of glitches, could be deemed ineligible for subsidies and lose their coverage.
“We’re very concerned about the implications of this on hundreds of thousands of low-income individuals who are likely eligible, but have encountered significant difficulties with the website, uploading or sending documents,” said Mara Youdelman, managing attorney at the National Health Law Program.
If found ineligible, residents could owe thousands of dollars.”

“Internal Revenue Service officials must enforce a new Obamacare tax designed to collect money from medical device manufacturers, but they’re losing money because they don’t know which companies even qualify for the tax, a new audit shows.
On top of that, the IRS wrongly penalized more than 200 of these companies for not paying their taxes when, in fact, they did pay, the audit from the Treasury Inspector General for Tax Administration reports.
Why doesn’t the IRS know whom to tax?
Medical device manufacturers have to register their products with the Food and Drug Administration.
But the FDA’s registration requirements for medical device manufacturers never quite matched that of the IRS.”

“The price tag of the Cover Oregon health insurance exchange fiasco continues to grow.
As Clyde Hamstreet, the corporate turnaround expert hired to lead Cover Oregon in April, wraps up his work he leaves behind a stabilized agency – and a hefty bill.
Initially signed to a $100,000 contract, Hamstreet ended up staying longer than expected, with two associates joining him at Cover Oregon after Gov. John Kitzhaber essentially forced out three top officials there in a public display of house-cleaning.
Through July, Hamstreet has billed $598,699 on an amended $750,00 contract. He hasn’t submitted his August invoice. He says the price tag was driven by the exchange’s increasing needs, as his firm stayed longer and did more than initially planned.
“We didn’t do this job to make a lot of money off the state,” he said Thursday. “Our philosophy was to try and help get the boat righted and try to help clean things up and basically help the state. … It turned out to be a bigger engagement than I expected.””

“A lack of transparency in describing and fixing technical problems became an issue in Thursday’s Washington Health Benefit Exchange Board meeting.
Board member Bill Hinkle grew testy at what he said was mutual staff back-patting and excuses for the problems still plaguing thousands of accounts.
“C’mon you guys, let’s quit blowing smoke here,” Hinkle said. “I’m tired of patting people on the back….We’re not doing great yet.”
Board member Teresa Mosqueda pressed staff for numbers of enrollees affected by technical problems.
“We really need to have the data in front of us to manage some of these issues,” she said. “I’m going to ask this question again ­– what is the total number of individuals affected by this, so we have a sense of how well we’re doing?”
The answer appeared to stun some board members: Glitches and technical problems have affected as many as 28,000 people trying to buy health insurance through the Washington Healthplanfinder online marketplace, said associate operations director Brad Finnegan.
In answer to a question, Finnegan conceded that that means one out of every five people has had a problem.”

“An announcement could be made soon on Pennsylvania Gov. Tom Corbett’s plan to use billions of federal Medicaid expansion dollars under the 2010 healthcare law to subsidize private health insurance policies, a spokeswoman said Wednesday.
Kait Gillis, a state Department of Public Welfare spokeswoman, said negotiations with the federal government are in the final stages, but details remain under wraps.
HHS officials did not immediately respond to a request for comment Wednesday, and the federal agency consistently has declined to publicly discuss details of Corbett’s plan. The 124-page plan was formally submitted in February, and closed-door negotiations began in April after a public comment period.”

“Signed into law by President Obama on March 23, 2010, the Affordable Care Act has proven to be its own kind of jobs act, especially when it comes to the Washington-area IT community.
When, in several places, the bill called for the creation of an “Internet website” to allow Americans to find and sign up for new health insurance coverage, it opened the tap on hundreds of millions of dollars that would eventually go to creating HealthCare.gov’s front end and back end, as well as a small universe of accompanying digital sites. On Wednesday, the office of Daniel Levinson, the inspector general of the Department of Health and Human Services, put out a report detailing the dozens of contracts that went into building out the Federal Marketplace project. And a look at each in the disaggregate paints a picture of an effort far more sweeping than even that suggested by the half-billion dollars the federal government has already paid out to implement the digital side of the health insurance law.
So, how do you spend that much money building HealthCare.gov and its companion sites? A few million here, a few hundred thousand there, and eventually it adds up.”

“Hundreds of thousands of people risk losing their new health insurance policies if they don’t resubmit citizenship or immigration information to the government by the end of next week — but the federal Healthcare.gov site remains so glitchy that they are having a tough time complying.
Consumers are being forced to send their information multiple times, and many can’t access their accounts at all, immigration law experts and insurance agents say.
The Centers for Medicare and Medicaid Services sent letters to about 310,000 consumers two weeks ago, telling them they need to submit proof of their citizenship or immigration status by Sept. 5 or their insurance will be canceled at the end of the month.
CMS spokesman Aaron Albright says letters were sent only to people for whom the government has no citizenship or immigration documentation. Yet agents and others who assisted immigrants with applications say they know documentation was sent during enrollment.
Marielena Hincapie, executive director of the National Immigration Law Center, says the problems don’t lie with the consumers. The federal databases for the Department of Homeland Security and the Social Security Administration are outdated, have mismatched Social Security numbers and names, and often transpose names for those from other countries, especially refugees from Africa, she says.”