A $5 billion lawsuit filed by a nonprofit insurer against the Obama administration for a program implemented under Obamacare is raising questions about the use of a fund available for settlements with the government and whether Congress can, and should, intervene.
According to legal experts, if the Obama administration decided to settle its class action lawsuit with Health Republic Insurance of Oregon, one of 23 co-ops started under Obamacare, and other insurers for all or part of the $5 billion it’s seeking, the money would come from the Judgment Fund, an indefinite appropriation created by Congress and administered by the Department of Treasury.
The two principal expenditures of the Affordable Care Act so far include $850 billion for insurance subsidies and a similar outlay for a massive Medicaid expansion. The truth is that Medicaid—a program costing $500 billion a year that rises to $890 billion in 2024—funnels low-income families into substandard coverage. Instead of providing a pathway to excellent health care for poor Americans, ObamaCare’s Medicaid expansion doubles down on their second-class health-care status.
Published studies have shown that pairing HSAs with high-deductible coverage reduceshealth-care costs. Patient spending averages 15% lower in high-deductible plans, with even more savings when paired with HSAs—without any consequent increases in emergency visits or hospitalizations and without a harmful impact on low-income families. Secondarily, wellness programs that HSA holders more commonly use improve chronic illnesses, reduce health claims and save money.
The central feature of the latest plan in Nebraska is to deliver Medicaid expansion benefits through health plans sold on the Obamacare exchange, instead of through the state’s managed care system. But, at the end of the day, this is really just a more expensive way to expand Medicaid under Obamacare.
Nebraska’s own actuaries estimate that using these plans to expand Medicaid would increase per-person costs by 94% next fiscal year. By 2021, the cost difference is expected to reach 150%. Overall, this plan would cost taxpayers billions of dollars more (as if regular Medicaid expansion wasn’t expensive enough) and leave even fewer dollars for the truly needy.
Ask the price of anything and the answer is always the same: What insurance do you have? Patients are blocked from shopping for fair value. The part of the Affordable Care Act which was supposed to control insurance costs, perversely, incentivizes insurers to pay higher, not lower costs. Under the Affordable Care Act, premiums and profits are legally permitted to rise only as health costs rise. In short, when it comes to pricing, nobody is watching the store and citizens cannot shop to protect themselves from medical price gouging.
This former hospital president says that because billing rates are not set, the health industry is able to prey on patients at their most vulnerable. And if you are out of network or uninsured, you pay the highest rates.
A Senate panel found that the government ignored warning signs that Obamacare co-op plans were a bad bet when it doled out $1.2 billion in taxpayer funds to them.
The report from the Senate Permanent Subcommittee on Investigations, released during a hearing Thursday, found that in 2014 the Department of Health and Human Services gave out loans to failed consumer-oriented and operated plans, called co-ops, despite clear warning signs they weren’t reliable.
The co-ops were created to spur more competition on the Obamacare exchanges. However, of the 23 taxpayer-funded co-ops, 12 have shut down.
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Sen. Marco Rubio (R-Fla.) is opening a new front in his attacks on ObamaCare as he campaigns for president.
After trying to bring publicity to his efforts to limit the Affordable Care Act’s “risk corridors” program, Rubio and Sen. Orrin Hatch (R-Utah), the chairman of the Finance Committee and a campaign backer, wrote a letter on Tuesday arguing that the Obama administration is breaking the law with another “bailout” of insurance companies.
Their letter concerns ObamaCare’s “reinsurance” program, designed to protect insurers against high costs for sicker enrollees in the early years of the law. Under the program, the government collects money from insurers and then redistributes it to those with high-cost enrollees.
This one weird trick can help even rich people buy ObamaCare at sharply reduced prices. Really.
A number of wealthy individuals, some of whom were “disgusted” with ObamaCare when it first went into effect, nonetheless are now taking advantage of federal financial aid available under that health-care law to help significantly reduce their monthly insurance premiums.
Carolyn McClanahan, a Jacksonville, Florida-based financial advisor and medical doctor, told CNBC that she’s steered at least five such clients, whose individual net worths range between $1 million and $3 million, toward buying ObamaCare health plans because of the federal subsidies available due to their taxable income levels.
In his final State of the Union address, President Obama spent little time discussing health care programs. In sum, the president made one generic reference to Medicare, made no mention of Medicaid, and spent only about 30 seconds discussing his signature health care legislation—the Affordable Care Act—recapping its main purpose and making three claims about how it is performing.
The president claimed that the purpose of the ACA Is to ensure portability of coverage, that health care inflation has slowed, and that nearly 18 million people have gained coverage so far. He also claimed that businesses have created jobs every single month since the ACA became law. He failed to mention the nation’s greatest fiscal challenge: the unsustainability of entitlement programs.
This piece by Brian Blase aims to fill in some of the gaps.
The Department of Health & Human Services’ Office of the Inspector General found that the Centers for Medicare & Medicaid Services (CMS):
• Did not have an effective process in place to ensure that advance premium tax credit (APTC) payments were made only for enrollees who had paid their monthly premiums; instead, CMS relied on each qualified health plan (QHP) issuer to verify that enrollees paid their monthly premiums and to attest that APTC payment information that the issuer reported on its template was accurate; and
• Had sole responsibility for ensuring that APTC payments were made only for confirmed enrollees and did not share these data for enrollees with the IRS when making payments.
The OIG determined that CMS’s processes limited its ability to ensure that APTC payments made to QHP issuers were only for enrollees who had made their premium payments.
Released on December 22, 2015, the third estimate of Gross Domestic Product (GDP) for the third quarter indicates growth in health services spending is maintaining a disproportionate share of still slow GDP growth.
Spending on health services grew faster (4.8%, annualized, in current dollars) than spending on non-health services (3.9%) The growth in health services spending ($24.8 billion, annualized) accounted for 17% of all GDP growth ($146.5 billion), just under one fifth of personal consumption expenditure ($130.6 billion) ), and 29% of all services spending ($84.7 billion).
The evidence continues to indicate Obamacare is not bending the cost curve.