A project of the Galen Institute
The Washington Times
The IRS cannot be sure that Americans who lacked health insurance last year have complied with Obamacare’s “individual mandate” penalty this tax season, according to an inspector general report Friday that pointed to a decision to delay proof-of-coverage forms from insurers and employers until 2016. Agency managers told the Treasury’s Inspector General for Tax Administration that a “business decision was made to not develop processes and procedures” to ensure compliance after it decided in 2013 to delay the pair of forms. The documents are sent to both filers and the IRS, allowing the federal government to cross-check what filers say on their returns. “The transition relief was intended to give the insurer time to adapt its health coverage and reporting systems to comply with the [Affordable Care Act],” the IG report said.
Florida Watchdog
Trying to force Obamacare expansion onto Florida by cutting funding for an existing Medicaid program has backfired on President Obama. Florida Gov. Rick Scott, a Republican, is suing Obama’s Department of Health and Human Services over plans to stop funding the state’s Low Income Pool program, which compensates hospitals for seeing uninsured patients. Almost immediately, Republican Texas Gov. Greg Abbott and Republican Kansas Gov. Sam Brownback announced they would join the suit against HHS. Christie Herrera, senior fellow at Florida’s free-market Foundation for Government Accountability, told Watchdog.org the Obama administration has “awakened a sleeping giant.” “They’ve raised the ire of all these other states that are in Florida’s exact position, and that’s why you’ve seen Kansas and Texas filing amicus briefs in the lawsuit,” Herrera said during a phone interview.
Investor's Business Daily
If ObamaCare were working as well as supporters claim, would New York state have just decided to steer more than half of its subsidized exchange enrollees to a public managed-care plan? New York is the second state after Minnesota to adopt a Basic Health Program for households up to 200% of the poverty level. It's a government-managed health care option included in the 2010 reform law. Following Minnesota is a curious move. Minnesota has signed up just 22% of those eligible for exchange coverage, 48th among all states and barely half the U.S. average of 42%, according to the Kaiser Family Foundation. The MNsure exchange also ranks near the bottom in its share of young-adult enrollees (24.2%) and near the top in its share of adults age 55 and up (33%). To top it off, PreferredOne quit the Minnesota exchange despite being its dominant insurer in 2014, hardly a vote of confidence.
a Brief Case
In the 34 states that did not establish Obamacare exchanges, Governors nervously await a Supreme Court ruling that could throw their health insurance markets into chaos. Meanwhile, many of the Governors who did establish exchanges are regretting their decision. More than five years after its enactment, Obamacare has proven a bitter brew for many states. Nowhere is this more evident than in health care exchanges. Exchanges began as a figment of Washington’s imagination.
The Washington Post
Nearly half of the 17 insurance marketplaces set up by the states and the District under President Obama’s health law are struggling financially, presenting state officials with an unexpected and serious challenge five years after the passage of the landmark Affordable Care Act. Many of the online exchanges are wrestling with surging costs, especially for balky technology and expensive customer-call centers — and tepid enrollment numbers. To ease the fiscal distress, officials are considering raising fees on insurers, sharing costs with other states and pressing state lawmakers for cash infusions. Some are weighing turning over part or all of their troubled marketplaces to the federal exchange, HealthCare.gov, which is now working smoothly.
Ohio Watchdog
Americans’ tax burden is already $3 billion heavier because of Ohio Gov. John Kasich’s expansion of Medicaid under Obamacare. By putting more able-bodied, working-age childless adults on Medicaid than Kasich projected, Obamacare expansion is reducing incentives to work and threatening traditional Medicaid recipients’ access to care faster and at greater cost than anticipated. After Kasich expanded Medicaid unilaterally, a state panel approved $2.56 billion in Obamacare spending for the expansion’s first 18 months. The money was meant to last until July, but it ran out in February. Kasich’s Obamacare expansion cost $323 million in March — 84 percent greater than estimates revised just six months earlier.
Michigan Capitol Confidential
The Foundation for Government Accountability has just published a report on state enrollments under the Obamacare Medicaid expansion. Here’s what the authors say about Michigan: When Republican Governor Rick Snyder lobbied the Michigan legislature to adopt his Obamacare Medicaid expansion plan, he too sold it on the promise of low and predictable enrollment. His office predicted no more than 477,000 able-bodied adults would ever sign up, with 323,000 signing up in the first year. But more able-bodied adults enrolled in ObamaCare expansion in the first three months than the state thought would sign up during the entire year. Despite the fact that Michigan did not expand Medicaid eligibility until April, nearly 508,000 adults signed up by the end of 2014, far more than the state thought would ever enroll. Enrollment continues to climb, with nearly 582,000 able-bodied adults signing up by April 2015.
McKenna Long & Aldridge LLP
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.
Other states experienced their own particular brand of exchange fiascos. Add Hawaii, Minnesota, New Mexico, Idaho, and Vermont to the list. The Obama administration says it does not have contingency plans should the Supreme Court decide the IRS acted illegally and the subsidies must stop. But Chairman Joe Pitts (R-PA) of the House Energy and Commerce Health Subcommittee has information that suggests otherwise. He said during a recent congressional hearing that he has learned of a 100-page document showing the Obama administration is preparing contingency plans should the Supreme Court invalidate the federal subsidies in King v Burwell. HHS Secretary Sylvia Burwell repeatedly denied the existence of such a document, and says she has no legal way around the Supreme Court. “That’s why you’re not hearing plans” from the administration, Burwell told Pitts.
The Hill
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.

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