Later this month, the Supreme Court will likely announce its decision on King v. Burwell, the lawsuit which asserts tax credits currently being paid to health insurers in 34 to 37 states that use the federal health insurance exchange are illegal. If the Supreme Court stops these tax credits, over six million people will be required to pay the full premiums for their Obamacare policies. This will cause a crisis, which will demand a response by Congress and the president.

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King v. Burwell and three other cases before the Supreme Court concern whether individuals purchasing health insurance under the Affordable Care Act in states with no state insurance exchange should receive subsidies from the federal government.
If the Supreme Court overturns the subsidies, Congress will be under pressure to protect Americans who signed up for coverage on the assumption that it would be subsidized from the cost increases associated with this withdrawal of the federal funds.
Congress should enact a short-term subsidy plan to ease the transition and solve the problems created under the ACA by granting states the ability to opt into a better approach to reform.

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“I just love nuns generally. I’m just saying.” – President Obama, June 9.
And nuns just love him too. At least nuns who run hospitals seem to. And with good reason: the President advocates policies that enable hospitals like those operated by the Daughters of Charity to provide less charity.

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This article will assess the legality of executive actions that the Administration may take after King v. Burwell to continue paying subsidies in these thirty-four states. I will not discuss the merits of the case, predict how the Court should construe the statute or IRS rule, or propose congressional modifications to the ACA. Rather, this analysis is premised on potential administrative fixes HHS could employ following an adverse ruling in King v. Burwell.

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We’ve famously been told that the Department of Health & Human Services has no Plan B. But what if the Supreme Court forces the executive branch’s hand? Yes, there’ll be plenty of finger-pointing and demagoguery as a high-stakes game of chicken unfolds among the White House, Congress, and various state governments. But what could Obama/HHS do? Remember, this is the president who has a pen and a phone, and “if Congress won’t act, I will.”

The running joke is that HHS/IRS will simply promulgate another rule deeming all federal exchanges to be state exchanges. But that couldn’t possibly be the answer, could it?

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Although Obamacare’s initial rollout problems have been resolved, the administration is still running into problems implementing the law. But this time it’s not the website, it’s the IRS.

The Internal Revenue Service is responsible for enforcing major provisions of the health care law—including administering subsidies to people who enrolled on the state and federal exchanges, as well as enforcing mandates by issuing tax penalties to those who don’t have health coverage.

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The U.S. Census Bureau has published new estimates of health spending based on their somewhat obscure but important Quarterly Services Survey. Analysis of the survey data shows that health spending was 7.3% higher in the first quarter of 2015 than in the first quarter of last year. Hospital spending increased 9.2%.

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Maybe the pending King v. Burwell decision will finally put Obamacare out of its misery. No matter what President Obama or Health and Human Services secretary Sylvia Burwell say, the truth is Obamacare is just limping along as another misguided, over-priced and underperforming government program.

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Many consumers with health coverage through the Affordable Care Act are facing unexpected medical bills that in some cases greatly exceed the law’s caps on out-of-pocket expenses.

The law’s limits don’t apply to charges from out-of-network providers, and many insurance plans sold on ACA exchanges have limited networks—amplifying the risk of surprise bills.

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Leading Republicans are charging that the Obama administration is illegally funding yet another part of Obamacare, in addition to the part of the healthcare law over which House Republicans are already suing.

Their latest criticism centers on the Affordable Care Act’s basic health program, an optional program for states that started this year, in which low-income residents can get subsidized, state-contracted health plans instead of buying them through the new online marketplaces.

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