“The fate of President Barack Obama’s health-care law is again in the hands of the U.S. Supreme Court.
Two years after upholding the law by a single vote, the justices are weighing whether to hear a Republican-backed appeal that would block people in 36 states from getting tax subsidies to buy insurance. The justices are scheduled to discuss the matter tomorrow, with an announcement coming as soon as Nov. 3.
The tax credits have implications well beyond the 4.6 million people who receive them in those states. A high court decision against the administration would have ripple effects, undercutting other parts of the Affordable Care Act and potentially destabilizing insurance markets across the nation.”
“NEW YORK — The federal government has sued New York City, saying it ripped off Medicaid for millions of dollars by submitting tens of thousands of false claims.
A civil lawsuit seeking unspecified damages was filed Monday in Manhattan federal court.
The lawsuit says the city and a computer company used computer programs to dodge a requirement that Medicaid be billed only after private insurance coverage is exhausted. The lawsuit says false diagnosis codes were submitted to Medicaid.”
“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.””
“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.””
“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.”
“Using data on household income and health insurance coverage maintained by the Census Bureau and McKinsey estimates on previously uninsured households enrolled through the Health Insurance Marketplace, the American Action Forum was able to construct state-level estimates of individual mandate payments. After accounting for exemptions, AAF estimates that 5.2 million people will be subject to the individual mandate penalty for being uninsured in 2014 and will pay a total of $5.8 billion in additional taxes. The AAF estimates include the exemptions for unauthorized immigrants, households that do not file income taxes, households that earn less than 138 percent of the federal poverty level, and households that cannot purchase a Bronze plan with 8 percent of household income, but do not attempt to project how many households may apply for one of the many hardship exemptions.”
“Last spring, John* purchased health insurance through the Washington State healthcare exchange. He was surprised when, last month, he received an email from the exchange at the address he’d provided when he signed up. The email was entitled, “Voter Registration Information.”
It read, in part:
“ARE YOU REGISTERED TO VOTE? If you would like to register to vote or
update your information, visit the Washington Secretary of State
website at https://weiapplets.sos.wa.gov/myvote?Org=confidHBE&language=en”
“I did think it was an effort to [register voters] for the Democrat party,” says John, a union member for the better part of four decades.
He wasn’t the only healthcare exchange customer to get the voter registration email.”
“The Obama administration has funded a new study by top consulting firm RAND Health that startlingly finds that if taxpayer subsidies are eliminated, Obamacare exchanges will fall into a “death spiral.”
The study comes in the wake of a number of lawsuits which are challenging the Obama administration’s implementation of Obamacare subsidies. Three lawsuits have made it to U.S. Circuit Courts, just one step from the Supreme Court, arguing that the text of the Affordable Care Act allows premium subsidies for state-run exchanges only. (RELATED: Second Court Strikes Down Obamacare Subsidies In Federal Exchanges)”
“Republican gubernatorial candidate Larry Hogan criticized the O’Malley administration Monday over its decision to delay a lawsuit against the contractor it has blamed for the failed launch of the state’s health exchange web site. .
Hogan, locked in a battle with Democratic Lt. Gov. Anthony G. Brown with two weeks to go before Election Day, accused the administration of putting politics ahead of the taxpayers by delaying court action against Noridian Healthcare Solutions.”
“Developments in the last ten days make it more likely that the entire U.S. Court of Appeals for the D.C. Circuit will agree to hear the leading challenge of the Pacific Legal Foundation (PLF) to the Obamacare individual-mandate penalty — and whoever does not prevail at this level will have a compelling case to take to the Supreme Court. An order from the D.C. Circuit last week, instructing the Obama administration to respond to PLF’s petition for rehearing, and an impressive set of amicus briefs supporting PLF’s petition filed yesterday confirm that this is no ordinary litigation.
Readers will recall that Chief Justice John Roberts joined four justices in 2012 to hold that the individual mandate was not authorized by the Commerce Clause or other congressional power, but he sided with four other justices in holding that the penalty for not buying insurance could be read as a tax, pursuant to Congress’s taxing power. No judge below had accepted the tax theory, so the debate over the tax issue in the Supreme Court briefs was truly brief. The Court was careful to write that Congress still had to comply with all constitutional requirements for the exercise of its taxing power, so the initial Obamacare ruling did not purport to end litigation that raised that and other issues.”