“Get ready to be inundated with a fresh round of Obamacare propaganda. President Obama’s health care law will be back in the news next month when open enrollment begins Nov. 15. The government is already gearing up to recruit more enrollees.
But based on what we know already, the Affordable Care Act isn’t panning out exactly as expected. That’s because the vast majority—an estimated 71 percent—of people who gained coverage under Obamacare between January and June did so by qualifying under Medicaid’s loosened eligibility requirements.”
“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.”
“U.S. small businesses are dropping health insurance for their workers, as Obamacare lets them send employees to new marketplaces where they can often get subsidies from the government to buy coverage.
WellPoint Inc. (WLP)’s small business insurance products lost 300,000 people this year, the company said today. Business owners are dropping coverage they previously bought through WellPoint and other insurers, and instead sending employees to shop for it on the government exchanges created under the Patient Protection and Affordable Care Act known as Obamacare.”
“A caucus of seven nervous Democratic senators, led by Mark Begich of Alaska, has been pushing a plan to “reform” the Affordable Care Act by allowing insurers to offer an even skimpier insurance plan than the skimpiest permitted now. .
The idea of their “Expanded Consumer Choice Act” is to create a new “copper” tier of health plan permitted in the individual and small-business markets under the ACA. The copper tier would undercut the current tiers of health plans by covering only 50% of expected health costs. Under the current law, the stingiest “bronze” tier covers 60% of costs.”
“A key provision of the Affordable Care Act (ACA) is the requirement that private insurance plans cover recommended preventive services without any patient cost-sharing.1 Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they develop into more complicated, debilitating conditions, and that some services are also cost-effective.2 However, costs do prevent some individuals from obtaining preventive services (Figure 1). The coverage requirement aims to remove cost barriers.”
“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.””
“If you bought health insurance on HealthCare.gov for this year, you could be in for a few surprises when open enrollment begins next month.
It’s possible, for example, that you could end up being billed for two different plans. The reason, insurers say, is because the federal government hasn’t addressed a key communications issue with the website.
And if you haven’t updated your financial information on the online insurance marketplace, you could face higher premiums and get less of a subsidy than you deserve.”
“Hanging around actuaries as long as I have one of the old sayings I picked up was, “Figures don’t lie, but liars figure.”
I have read one story after another this summer and fall about the modest Obamacare rates increases––or decreases––for 2015.
On this blog you have also seen me write about the complex way the 2015 Obamacare rates will hit people particularly because of the impact the changes in the so called second lowest cost Silver plan will have on so many people’s final subsidy. You have also seen me write about the fact that we really won’t know what Obamacare costs people until the now unlimited Obamacare reinsurance program stops subsidizing insurance rates in 2017.”
“Americans love Obamacare, the New York Times propagandizes today. It’s not the only media outfit running with this story today, suggesting a coordinated campaign effort a week before the election.
According to the New York Times, it is too soon to tell if Obamacare is working, except with the young. There, Obamacare seems to be working. But, here’s the kicker. With the Obama Administration claiming Obamacare would reduce costs, the New York Times finds it only has at the margins.”