A project of the Galen Institute
The Washington Times
05/22/15
Though supporters of President Obama's healthcare program tout its success in providing insurance to millions of Americans, recent rate filings from large insurers have revealed that the law is built on a shaky foundation. In recent weeks, large insurers selling coverage through Obamacare have proposed massive rate increases for 2016 – even exceeding 40 percent – because they haven't been able to sign up enough young and healthy customers.
The Tennessean
05/22/15
Community Health Alliance, a Knoxville-based health insurance cooperative, is looking to increase monthly premiums by double digits in 2016 for those who enroll in plans on the federally run exchange as the newly established company tries to find an equilibrium. The co-op's plans — ranging from $68.22 to $1,062.05 per month — were the least expensive while they were available for purchase on the exchange. The co-op is asking the Tennessee Department of Commerce and Insurance for an average 32.6 percent increase for 2016 plans. The minimum a plan will increase is 16.2 percent, while the maximum increase is 65.2 percent.
The Washington Post
05/21/15
The Internal Revenue Service (IRS) is charged with administering many key provisions of the Patient Protection and Affordable Care Act (PPACA). One might expect the IRS to follow the law when doing so. In drafting regulations to implement the PPACA’s tax credit provisions, however, the IRS seems to have a habit of ignoring the statutory text where the IRS does not like the result. University of Iowa law professor Andy Grewal has found multiple instances of the IRS expanding tax credit eligibility beyond that provided for by the text of the PPACA and, in the process, increasing potential employer exposure to penalties under the Act. I discussed two of professor Grewal’s finds in a prior post. (See also this forthcoming article.) In a new post on the Yale Journal on Regulation blog, “Notice & Comment,” professor Grewal identifies another IRS departure from the statutory text.
Tacoma Weekly
05/19/15
Federal programs rarely come in under budget. Consider Medicare, which will soon celebrate its 50th anniversary. In 1967, lawmakers projected annual spending in the program would reach $12 billion in 1990. The actual tab that year? A cool $110 billion. A new report from the Congressional Budget Office says that Obamacare will buck the trend. The CBO has lowered its projections for the cost of the president's healthcare law by $142 billion over the coming decade, from $1.35 trillion to $1.2 trillion. Obamacare may cost the feds less than anticipated, but it's extracting far more from consumers' wallets than they bargained for. Consequently, Obamacare has put insurance out of reach for many Americans – breaking its promise to make health care more affordable. The decline in Obamacare's cost is not as impressive as it seems. The total price tag is still some $250 billion higher than the president promised when he signed Obamacare in March 2010.
Yale Journal
05/19/15
I might be accused of picking at low-hanging fruit, but I’d nonetheless like to devote another blog post to more IRS regulations that expand and contradict Section 36B. My prior blog posts, which I’ve adapted into an essay upcoming in Bloomberg BNA, discuss regulations that improperly extend ACA premium tax credits to persons in the Medicare coverage gap and to some unlawful aliens. In this post, I want to highlight regulations that improperly penalize employers and that give credits to taxpayers already enrolled in employer-sponsored minimum essential coverage. Broadly speaking, Section 36B offers premium tax credits, on a month-by-month basis, to taxpayers who purchase Exchange policies only when they can’t otherwise obtain minimum essential coverage. However, the mere offering of minimum essential coverage by an employer to a taxpayer will not disqualify her from tax credits. Instead, the employer coverage must be affordable and provide minimum value.
Harvard Law Center for Health Law and Policy Innovation
05/19/15
On April 20, 2015, the American Constitution Society held a panel on the King v Burwell case that is before the Supreme Court. CHLPI’s Director and HLS Professor, Robert Greenwald, served as the moderator for panelists Yaakov Roth, Matthew Hellman, and Rachel Gargiulo, all lawyers involved in the case. Each panelist provided a very different perspective on this historical case. Yaakov Roth, one of the lawyers for the plaintiffs, was involved in the case from the very beginning of its path to the Supreme Court. He spoke about his experience and rationale to file the case as quickly as possible, which was based on the belief that the challenge to the Affordable Care Act (ACA) would have to be decided by the Supreme Court. When Jones Day filed the first motion in district court in Washington, D.C., the slow pace of the judge’s decision led to the filing of a second motion. Both motions were denied and Jones Day filed appeals to both decision.
Forbes
05/18/15
ObamaCare supporters have produced study after study warning of the devastation to come if the Supreme Court decides the IRS did in fact illegally extend health insurance subsidies to people in states operating under federal exchanges. But the American Action Forum (AAF), a dynamic think tank led by former CBO director Douglas Holtz-Eakin, has produced new research that provides balance to what has been a one-sided debate. He shows how people in 37 states will be helped if the petitioners prevail in King v Burwell. AAF estimates that more than 11 million people would be liberated from having to purchase expensive ObamaCare insurance and freed from the onerous penalties of the individual mandate, which cost those who don’t comply an average of $1,200 in fines this year. The study also finds that workers could earn nearly $1,000 more, and 1.2 million more people would join the workforce in federal exchange states if King prevails in the lawsuit.
Washington Examiner
05/15/15
Nearly a quarter of all people who bought Obamacare health plans still cannot afford the care they need, a leading advocate for President Obama's healthcare law says. Families USA, a group that often proposes improvements to the law, says high deductibles make healthcare unaffordable for many people, even though they now have insurance. A survey released by the group Thursday found that nearly one in four adults shopping in the new insurance marketplaces bought plans with deductibles of $3,000 or more and 42 percent enrolled in plans with at least a $1,500 deductible. It means many customers are forgoing needed health services because they cannot foot the bill. "They could not afford tests or they could not afford various treatments or they could not afford the cost of medicines," said Families USA President Ron Pollack. "The key culprit [is] high deductibles."
American Enterprise Institute
05/15/15
In March, the Supreme Court heard oral arguments in King v. Burwell, the case that will decide whether the language of the Affordable Care Act (ACA) allows only those who purchase health insurance through state-established exchanges—not federal health exchanges—to qualify for federal subsidies. Justices Sonia Sotomayor and Anthony Kennedy suggested that they may be forced to allow the subsidies for federal exchanges because limiting subsidies to state exchanges might unconstitutionally intrude on the federal-state relationship by coercing states into forming their own health-insurance exchanges. This federalism argument, however, is based on speculation leading to flawed legal reasoning. It shouldn’t determine the outcome the case. The ACA’s statutory language seems to limit federal subsidies to people enrolled “through an Exchange established by the State under section 1311,” the ACA section directing states to establish health exchanges.
American Action Forum
05/14/15
The Supreme Court’s pending decision in King v. Burwell could upend the way premium subsidies are distributed through the Federal health insurance exchanges in as many as 37 states. The impacted states are those that declined or failed to establish their own exchanges under the Affordable Care Act (ACA). Examining the insurance market effects we find that:

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