A project of the Galen Institute

Issue: "Medicare"

Get Ready for Health-Insurance Enrollment

Avery Johnson, Wall Street Journal
Tue, 2014-09-02
"If you get health insurance through your workplace, you'll probably have a chance this fall to make important decisions about your coverage and costs. Because many corporate health plans hold their annual open-enrollment periods in October and November, many employees can expect to get a packet of benefits, or instructions for making elections online, as well as updates on changes to their plans required by the Affordable Care Act. Some 55% of Americans have employer-based coverage, according to Mercer, a human-resources consultant.

Consumers Will Owe Uncle Sam If They Got Health Insurance Subsidies Mistakenly

Julie Appleby, Kaiser Health News
Tue, 2014-09-02
"Consumers getting government subsidies for health insurance who are later found ineligible for those payments will owe the government, but not necessarily the full amount, according to the Treasury Department. The clarified rule could affect some of the 300,000 people facing a Sept. 5 deadline to submit additional documents to confirm their citizenship or immigration status, and also apply broadly to anyone ultimately deemed ineligible for subsidies. First reported by the newsletter Inside Health Policy on Thursday, the clarification worries immigration advocates, who say many residents are facing website difficulties and other barriers to meeting the deadline to submit additional details. Those who don’t know about the deadline, or can’t meet it because of glitches, could be deemed ineligible for subsidies and lose their coverage.

States To Help Pay Obamacare Tax On Insurers

Phil Galewitz, Kaiser Health News
Tue, 2014-09-02
"When Congress passed the Affordable Care Act, it required health insurers, hospitals, device makers and pharmaceutical companies to share in the cost because they would get a windfall of new, paying customers. But with an $8 billion tax on insurers due Sept. 30 -- the first time the new tax is being collected -- the industry is getting help from an unlikely source: taxpayers. States and the federal government will spend at least $700 million this year to pay the tax for their Medicaid health plans. The three dozen states that use Medicaid managed care plans will give those insurers more money to cover the new expense. Many of those states – such as Florida, Louisiana and Tennessee – did not expand Medicaid as the law allows, and in the process turned down billions in new federal dollars. Other insurers are getting some help paying the tax as well. Private insurers are passing the tax onto policyholders in the form of higher premiums.

23 states still haven’t expanded Medicaid. Which could be next?

Jason Millman
The Washington Post
Tue, 2014-09-02
"Thursday's announcement that Pennsylvania will expand its Medicaid program brings the country one state closer to the original expansion outlined under Obamacare. But because of the Supreme Court's 2012 decision making the expansion a voluntary program, there are still 23 states that haven't expanded public health insurance to all of their low-income residents. The expansion in Pennsylvania will add about 500,000 low-income to adults to the Medicaid rolls. According to numbers from the Kaiser Family Foundation, about 281,000 of those people were falling into what's known as the "coverage gap"— people who don't qualify for Medicaid but also don't get subsidies for purchasing insurance on their own, either. About 4.5 million people across the country fall into this coverage gap, according to Kaiser."

Is the Republican fight against Medicaid expansion over?

Justin Green
The Examiner
Tue, 2014-09-02
"The Republican fight against Medicaid expansion is far from over, but there are fewer opponents than there used to be. The expansion of the government health insurance program was originally supposed to be mandatory under the Affordable Care Act, but the Supreme Court made it optional as part of a landmark decision on the law in June of 2012. In the wake of the decision, Republican governors flocked to announce they were declining to expand coverage. As of 2014, 19 states — 18 of which are led by Republican governors — have declined outright to expand coverage, but some former holdouts are beginning to come to terms with expansion. This week, Pennsylvania formally agreed to terms with federal regulators, raising the number of states that have expanded coverage for low-income residents under Obamacare to 27. Pennsylvania is the ninth state led by a Republican governor to expand Medicaid.:"

U.S. officials reach deal with Pennsylvania on Medicaid

Hilary Russ and David Morgan, Reuters
Fri, 2014-08-29
"Federal officials have reached an agreement with Pennsylvania Gov. Tom Corbett over his plan to use federal funds to pay for private health insurance coverage for up to 600,000 residents, the governor said on Thursday. The deal highlights a growing number of Republican governors who are finding ways to accept money under President Barack Obama's Affordable Care Act, despite political opposition that has so far prevented nearly half of U.S. states from moving forward with the Medicaid expansion plan. Corbett sought a waiver in February to use those expansion funds to instead subsidize private health insurance for low-income residents."

Arizona Medicaid appeal to be heard by court

Mary Jo Pitzl, Arizona Republic
Thu, 2014-08-28
"PHOENIX — The Arizona Supreme Court has agreed to hear Gov. Jan Brewer's appeal of an appeals-court decision that could unravel the Medicaid expansion she fought for last year. The high court has not yet set a date, but indicated it will hear Brewer's argument that about three dozen Republican lawmakers don't have the legal standing to challenge the controversial vote. The court's decision, reached in a scheduling conference, comes on the heels of Tuesday's primary election in which every Republican lawmaker who voted to expand the state's Medicaid program won re-election. That means it would be highly unlikely the next Legislature would vote to reverse the 2013 decision, which was a consistent fault line in numerous GOP legislative primaries. The case revolves around whether the Legislature's 2013 vote to impose an assessment on hospitals to help cover the cost of expanding the Arizona Health Care Cost Containment program was a tax.

Talks on Pennsylvania Medicaid plan said to be nearing end

The Associated Press
Thu, 2014-08-28
"An announcement could be made soon on Pennsylvania Gov. Tom Corbett's plan to use billions of federal Medicaid expansion dollars under the 2010 healthcare law to subsidize private health insurance policies, a spokeswoman said Wednesday. Kait Gillis, a state Department of Public Welfare spokeswoman, said negotiations with the federal government are in the final stages, but details remain under wraps. HHS officials did not immediately respond to a request for comment Wednesday, and the federal agency consistently has declined to publicly discuss details of Corbett's plan. The 124-page plan was formally submitted in February, and closed-door negotiations began in April after a public comment period."

Medicare Limbo: A Question Seniors Need To Ask If They're In The Hospital

Northwestern Mutual team
Forbes magazine
Wed, 2014-08-27
"Bill Jacobs spent four nights in a hospital in Florida battling pneumonia. His kids visited each day, fluffed his pillows, brought his favorite Sudoku puzzles and got regular updates from his nurses and doctors. Imagine their surprise when they found out that their 86-year-old father was never actually admitted; instead, he was treated as an outpatient under what Medicare refers to as “observation status.” What difference does that make? Actually, more than you might think. If your parents are on Medicare, the difference between being considered an inpatient or an observation patient could be thousands of dollars out of their pocket, if not more. First, Medicare Part A will cover all hospital services, less the deductible, but only if you’re admitted to the hospital as an inpatient. The one-time deductible covers all hospital services for the first 60 days in the hospital. Doctors’ charges are covered under Medicare Part B.

Cover Oregon: At least 2,000 Oregonians need to change coverage due to health exchange errors

Nick Budnick, The Oregonian
Wed, 2014-08-27
"Cover Oregon will hold a special open enrollment period for 1,400 Oregonians who were incorrectly enrolled into the low-income Oregon Health Plan by the state's troubled health insurance exchange. Starting Aug. 31, the people affected will have no coverage through the OHP, the state's version of Medicaid. However, they will have the option to sign up for coverage from private insurers and to qualify for tax credits through Cover Oregon to bring down premiums. Meanwhile, Cover Oregon is contacting at least 700 people who should have been enrolled in the Oregon Health Plan, but were incorrectly enrolled in a commercial health plan instead. If they were receiving tax credits for private plans, those will go away immediately, though they can keep their plan. Cover Oregon is currently negotiating with the federal government over whether those people will have to refund to the IRS all the tax credits they received incorrectly, said Amy Fauver, Cover Oregon communications director.

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