Deluged with catastrophes, court challenges and criticism, Obamacare (ACA) has had a controversial life to date. Yet it is ready to enter a completely new phase where the implementation gets shifted to the Internal Revenue Service – America’s favorite three words. If you liked the health care plan up to now, you ain’t seen nothing yet.
Services to taxpayers are likely to drop to their worst levels since 2001, when the Internal Revenue Service first started measuring its performance, the agency’s taxpayer advocate said in her annual report released on Wednesday.
Five years of budget-cutting have “brought about a devastating erosion of taxpayer service, harming taxpayers individually and collectively,” wrote Nina E. Olson, who leads the Taxpayer Advocate Service, an independent office within the I.R.S.
In the next few days, consumers who enrolled in qualified health plans through the marketplaces in 2014 will begin receiving IRS form 1095-As from the marketplaces, be they the federally facilitated marketplaces (FFMs) or state-operated marketplaces. The form 1095-A is the form that provides individuals who have enrolled in qualified health plans through the marketplaces the information they need to fill out form 8962, which in turn is the form enrollees will need to reconcile the advance premium tax credits (APTC) they received in 2014 with the premium tax credits they were actually entitled to. The marketplace also reports the information on the 1095-A to the IRS.
By Kimberly Leonard
Grace Brewer says she never thought she would be without health insurance at this stage of her life. “I’m a casualty of Obamacare,” says Brewer, 60, a self-employed chiropractor in the Kansas City, Kansas, area.
She wanted to keep the catastrophic health insurance plan she once had, which she says fit her needs. But under the Affordable Care Act, the government’s health care reform law, the plan was discontinued because it did not comply with the law’s requirements, and her bills doubled to more than $400 a month. “I wanted a minimal plan and I’m not allowed to have it,” she says. “That seems like an encroachment on my freedom.”
Here is something few pundits predicted.
Poor, long-uninsured patients are getting Medicaid through Obamacare and finally going to the doctor’s office for care. But middle-class patients are increasingly staying away.
Take Praveen Arla, who helps his father run a family practice in Hillview, Kentucky. The Arlas’ patient load used to be 45% commercially insured and 25% Medicaid. Those percentages are now reversed, report Laura Ungar and Jayne O’Donnell in USA Today.
The Department of Health and Human Services (HHS) is looking for vendors to run its “National Data Warehouse,” a database for “capturing, aggregating, and analyzing information” related to beneficiary and customer experiences with Medicare and the federal Obamacare marketplaces. Although the database primarily consists of quality control metrics related to individuals’ interactions with customer service, potential contractors are to “[d]emonstrate … experience with scalability and security in protecting data and information with customer, person-sensitive information including Personal Health Information and Personally Identifiable information (personal health records, etc.).” Vendors are also instructed that one of the requirements of a possible future contract would be “[e]nsuring that all products developed and delivered adhere to Health Insurance Portability and Accountability Act (HIPAA) compliance standards.”
Over the past year, the ranks of people working part-time jobs by choice — as opposed to business-driven factors — has grown by more than one million, the fastest pace in at least two decades.
The timing with ObamaCare’s first year of subsidies to buy health insurance is likely more than coincidental. While analysts on the left and right have sparred over whether businesses have shifted to part-time jobs to limit liability under ObamaCare, no one disputes that the law will lead more people to choose to work part-time. Any disagreement is over whether the law should get credit for making less work possible or blame for making work less financially rewarding.
Casey Mulligan, a professor of economics at the University of Chicago and author of “Side Effects: The Economic Consequences of the Health Reform,” recently gave a speech in which he essentially explains in easily understood terms how the Affordable Care Act is a tax on full-time work, and a huge downer on our economy.
By Scott Gottlieb Dec. 7, 2014 5:12 p.m. ET
Here’s a dirty little secret about recent attempts to fix ObamaCare. The “reforms,” approved by Senate and House leaders this summer and set to advance in the next Congress, adopt many of the Medicare payment reforms already in the Affordable Care Act. Both favor the consolidation of previously independent doctors into salaried roles inside larger institutions, usually tied to a central hospital, in effect ending independent medical practices.
The case for single payer – Medicare for All
By Jeoffry B. Gordon, M.D., M.P.H.
December 3, 2014
The Patient Protection and Affordable Care Act (ACA) has as its main and overriding purpose the expansion and subsidization of health insurance coverage for many (usually poor and uninsured) Americans who were previously unable to reliably access medical services. Under its auspices, the federal law has provided for health insurance enrollment for 1 million to 3 million additional 19- to 26-year-olds; 6 million new, expanded Medicaid enrollees; and 7.2 million commercial Qualified Health Plan enrollees. Of the latter, about 80 percent qualify for financial subsidy. Taking into account additional factors, e.g. the fact that some of the new enrollees were previously insured, there has been a net gain of about 10 million people who have coverage. Yet even at full expansion, it is estimated that the ACA will not insure another 30 million U.S. residents.