Earlier this week, news surfaced that some HealthCare.gov users may have received an incorrect subsidy or Medicaid eligibility determination from the Marketplace. According to reports, HealthCare.gov has been counting Social Security income received by children when calculating the Modified Adjusted Gross Income (MAGI) for a household. Once calculated, MAGI is then used to help determine a household’s eligibility for Medicaid or subsidized private insurance. By including a child’s Social Security Income in a household’s income, the Federally-facilitated Marketplace (FFM) likely increased the overall household income, which could have resulted in some persons either not qualifying for Medicaid or an inaccurate tax credit determination. While CMS has acknowledged the error, the agency has so far not given an indication of how many households may be impacted.Details
The Obama administration is dialing up the pressure on a handful of states that have resisted expanding Medicaid coverage for their low-income residents under the federal health care overhaul.
The leverage comes from a little-known federal fund that helps states and hospitals recoup some of the cost of caring for uninsured patients. The administration says states can just expand Medicaid, as the health care law provides, and then they wouldn’t need as much extra help with costs for the uninsured.
Two top targets so far are Florida and Texas, with large numbers of uninsured residents. Both have received several billion dollars in recent years from Washington under the so-called low income pool, also known as LIP.
Florida’s hospital funding is the first of the nine states — which include Tennessee, California, Massachusetts, Arizona, Hawaii, Kansas and New Mexico — to expire on June 30.Details
As the state struggled under the national spotlight to fix its deeply flawed online health insurance marketplace last year, officials awarded more than $84 million in contracts without competition, about a third of the money spent on the troubled website. About 15 companies benefited from the “sole-source” and “emergency” contracts that did not use competitive bidding, according to documents obtained by The Baltimore Sun through public information requests. The Maryland Health Benefit Exchange’s lack of transparency has been criticized by government watchdogs and state officials, including Gov. Larry Hogan during his successful campaign, but the amount of the noncompetitive awards is now raising eyebrows among government procurement experts and prompting pledges from the administration to curtail the practice.
– See more at: http://www.capitalgazette.com/bs-hs-exchange-contracting-20150417,0,807245,full.story#sthash.q5qkVCoy.dpuf
There are three simple numbers Republicans in Congress need to keep their eyes on in the aftermath of the Supreme Court’s forthcoming decision in King v. Burwell, no matter what the outcome: 28, 60 and 67.
28: The number of GOP governors in states with a federal health insurance exchange where a combined total of 6.5 million subsidy-eligible residents are at risk of losing those subsidies and their insurance if the plaintiffs win in King. The Department of Health and Human Service will offer these governors a quick fix: Simply deem the federal exchanges an “exchange established by the state” for the purpose of receiving federal subsidies.
Despite being designed to help the poor, certain aspects of Obamacare are holding millions of individuals back who fall into what is being called the “coverage gap.”
Reverend Vann R. Ellison, the president of the Florida based St. Matthew’s House, is trying to bring attention to the issue which he says affects people that fall between the $10,000 and $12,000 a year income range. St. Matthew’s House, which takes care of roughly 1,500 people, provides food and shelter to those individuals trying to work their way out of poverty.
“We generally deal with lower income people trying to get their lives together,” Ellison told The Daily Caller News Foundation. “These are people that can’t afford their own apartments.”
Those in that income range make too much to qualify for assistance under Obamacare but often times make too little to actually afford coverage or the fee that comes with not being covered.Details
A new analysis from Avalere finds that the penalties associated with the individual mandate, which grow in 2015, might be too low to attract enrollment, particularly among middle-income, healthy individuals.
Earlier this week, the Department of Health and Human Services (HHS) announced that 68,000 people enrolled in exchange coverage through HealthCare.gov as part of a special enrollment period for individuals paying the individual mandate penalty on their 2014 tax filings. That lackluster uptake of the special enrollment period is driven, in part, because for most people individual mandate penalties are much lower than actual costs of coverage.Details
Some consumers are willing to pay the penalty for not having health insurance because it is cheaper than getting coverage, according to a new analysis.
The analysis from research firm Avalere Health details one reason why the administration has done so poorly in a special enrollment period for Obamacare. So far only 68,000 people have signed up for the period that ends April 30.
This is the period set aside for people who are getting hit by the law’s new tax on Americans who do not have health insurance packages. Affected taxpayers must still pay the 2014 penalty but could avoid the higher 2015 penalty by getting coverage by the deadline.
But it turns out many uninsured workers would rather pay the tax, because it will cost less than buying insurance.Details
The IRS shifted around substantial resources and manpower to implement the Affordable Care Act while its overall operations and taxpayer assistance suffered, according to a Republican staff report released by the House Ways and Means committee.
The findings, released Wednesday (April 22), follow a stressful tax season for the Treasury Department, as it handled nearly 1 million people who received incorrect 1095-A forms that used the wrong data to calculate health insurance exchange enrollees’ subsidies due to a technological code glitch. Taxpayers were told they owed or were owed the wrong amount for their tax return; the IRS said those affected did not have to refile if they had already done so.
“To date, the IRS has spent over $1.2 billion on implementation of the ACA,” the report says. “In fiscal year 2014, the IRS spent $386.6 million on the ACA, including $12.1 million from the taxpayer-services account and $185.7 million from its user-fee account.”Details
Oregon and Washington state strongly embraced Obamacare and opened their own health insurance exchanges. The states are similar, not just geographically but politically, economically and demographically. As the first enrollment season winds down, Washington has some of the best results in the country. Next door, Oregon’s exchange website is still broken.
SALEM, Ore. — Oregon had all the right ingredients for a sparkling Obamacare success story: a Democratic doctor as governor, an eager Legislature and a history of health care innovation.Details
It has been five years since the Affordable Care Act, better known as ObamaCare, was signed into law. The disastrous rollout of the federal marketplace website, Healthcare.gov, is well-known. According to a Bloomberg Government analysis released in September 2014, the cost of Healthcare.gov was more than $2 billion, more than twice the Obama administration’s estimates. Appropriately, the federal marketplace has been a subject of numerous congressional hearings.
But state-run websites have also squandered hundreds of millions of federal tax dollars. While the House Committee on Oversight and Government Reform has been investigating some of the problems with state-run websites, much more can and should be done. Every House and Senate committee that oversees healthcare issues should carefully examine the roles played by the Centers for Medicare and Medicaid Services (CMS), state officials and contractors in the design and implementation of the websites.Details