“States have developed various ways to avoid paying their fair share of Medicaid expenses over the years, in some cases costing the federal government hundreds of millions of dollars in extra funding for the program.
The Department of Health and Human Services, which runs Medicaid through its Centers for Medicare and Medicaid Services (CMS), has known about the issue for more than a decade, but states still find ways to game the system. The agency’s inspector general this year listed the issue among 25 key problems the agency needs to address.”

“We did not see big changes in employer-based coverage in the Kaiser-HRET annual Employer Health Benefit Survey released last week. Mostly this is good news, particularly on the cost side where premiums increased just 3%.
But one long-term trend that is not so good is how this market works for firms with relatively large shares of lower-wage workers (which we define as firms where at least 35% of employees earn less than $23,000). These low-wage firms often do not offer health benefits at all. And, as the chart below shows, when they do offer coverage, it has lower premiums on average (likely meaning skimpier coverage) and requires workers to pay more for it. Workers in low-wage firms pay an average of $6,472 for family coverage, compared with $4,693 for workers in higher wage firms.”

“BOSTON — When it comes to the president’s health care law, there’s very little that Republicans and Democrats agree on—but one idea that seems to unite analysts, experts and lawmakers across the political spectrum is that Obamacare has done very little to actually improve health care.
“The U.S. healthcare system was always dysfunctional. The Affordable Care Act has just provided more access to that dysfunctional system,” iVantage chief Donald Bialek said during an ACA debate at The Economist’s health care forum in Boston on Wednesday. Bialek, for his part, was on the side defending the health care law.”

“Lawmakers told officials with the Department of Health and Hospitals on Wednesday they needed to provide more complete information going forward about Bayou Health, Gov. Bobby Jindal’s Medicaid privatization program.
The Legislative Audit Advisory Council heard testimony from DHH and the Legislative Auditor’s Office about an audit that raised a number of questions about the program. Auditors testified 74 percent of the transparency report was based on self-reported data with no corroborating documentation.”

“RICHMOND — Republican leaders of Virginia’s House of Delegates, who have staunchly opposed Medicaid expansion all year, plan to put the question to a floor vote as early as Thursday in a special legislative session.
The GOP-dominated chamber is widely expected to shoot down the proposed $2 billion-a-year expansion, although a few conservative legislators have expressed fears that the measure might defy expectations and pass — just as a then-record tax hike did when Democrat Mark R. Warner was governor a decade ago.”

“Very few industries in bed with Obamacare come off smelling like a rose. But if one had to pick a bad actor above all others, it would probably be Big Health Insurance.
America’s largest and most influential health insurance companies actively supported passage of Obamacare in Congress, and continue to do so today. That’s not surprising, since the heart of Obamacare is a mandate on Americans to purchase the product the health insurance companies are selling (the individual mandate). The “essential minimum coverage” on “qualified health insurance plans” as dictated by the Department of Health and Human Services tend to emphasize first dollar insurance coverage whenever possible, which increases insurance company profits. Worst of all, insurance companies are the beneficiaries of a giant taxpayer bailout that makes their Obamacare participation a “heads they win, tails taxpayers lose” kind of scenario.”

“If you are looking for information on how Americans are engaging with the Affordable Care Act, the Census Bureau’s recently released latest annual estimates of health insurance coverage is probably not the place to look—at least for now.
The Census Bureau, which derives its information on healthcare from the Annual Social and Economic Supplement—the same survey where it asks how many toilets, computers, microwaves, etc., people have in their homes—does provide some useful insights.
It catalogues the demographic characteristics of the population based on participation in different types of health insurance coverage—government health care programs, private employer and individual plans, and the uninsured. It tells us young adults make up a disproportionate share of the uninsured and provides useful information on the relative availability of employer-sponsored coverage by industry and firm size.
But its hard numbers on enrollment and enrollment trends are not reliable for drawing “big picture” conclusions, especially regarding the ACA. Indeed, that unreliability is why this year the Census Bureau started using a new set of health coverage questions in the ASEC.”

“Since the Affordable Care Act’s (ACA) passage, a number of lawsuits have been filed challenging various provisions of the law. The Supreme Court has decided cases about the constitutionality of the ACA’s individual mandate and Medicaid expansion as well as the applicability of the contraceptive coverage requirement to closely held for-profit corporations with religious objections. In addition, several cases challenging the availability of premium subsidies in the Federally-Facilitated Marketplace (FFM) are currently progressing through the federal courts. All of this litigation has altered, or has the potential to alter, the way in which the ACA is implemented and consequently could affect the achievement of the law’s policy goals. This issue brief examines the federal courts’ role to date in interpreting and affecting implementation of the ACA, with a focus on the provisions that seek to expand access to affordable coverage.
Court decisions about how to interpret the ACA will continue to affect the number of people who ultimately obtain affordable coverage. At present, access to Medicaid up to 138% FPL is dependent upon where people live because the Supreme Court held that implementation of the ACA’s Medicaid expansion is effectively a state option. This has resulted in a coverage gap for just over 4.5 million people with incomes too high to qualify for Medicaid but too low to qualify for Marketplace subsidies in the states that have not implemented the ACA’s Medicaid expansion to date.”

“States have developed various ways to avoid paying their fair share of Medicaid expenses over the years, in some cases costing the federal government hundreds of millions of dollars in extra funding for the program.
The Department of Health and Human Services, which runs Medicaid through its Centers for Medicare and Medicaid Services (CMS), has known about the issue for more than a decade, but states still find ways to game the system. The agency’s inspector general this year listed the issue among 25 key problems the agency needs to address.”

“Obamacare created a new entitlement through its exchange subsidies and vastly expanded another one, Medicaid. The Congressional Budget Office expects these two pieces of the law to cost over $1.8 trillion over the next decade.
To offset some of this new spending, the law includes 18 new or increased taxes and fees that are estimated to bring in nearly $800 billion in new revenue from 2013-2022. Many of Obamacare’s taxes fall directly on the middle class, breaking the president’s promise to the contrary, while others will affect taxpayers indirectly through increased costs for goods, higher insurance premiums or lost wages.”