A project of the Galen Institute

Issue: "States"

Tom Schatz: More investigations into ObamaCare state exchanges are needed

The Hill
Fri, 2015-04-17
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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Peter Sullivan: Florida to sue feds over ObamaCare dispute

The Hill
Fri, 2015-04-17
Florida Gov. Rick Scott (R) announced Thursday he is suing the Obama administration as part of an escalating dispute over whether the state will expand Medicaid under ObamaCare. “It is appalling that President Obama would cut off federal healthcare dollars to Florida in an effort to force our state further into ObamaCare,” Scott said in a statement Thursday announcing the lawsuit. Scott is objecting to the Obama administration linking the extension of separate federal money to help hospitals in the state care for the uninsured, known as the Low Income Pool (LIP), to the state’s decision on whether to expand Medicaid under the Affordable Care Act. The Obama administration says the LIP funding will not be renewed in its current form after June. It says that the future of the program is "linked" to the decision to expand Medicaid, though it stops short of saying it is entirely dependent on it.
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Nevada’s health-insurance exchange: A colossal failure

Sparks Tribune
Wed, 2015-04-15
Thumbs Down, way down, to everyone responsible for the fiasco known as Nevada Health Link, the state exchange for purchasing health insurance online. As the deadline to file tax returns arrives tomorrow, we suspect plenty of taxpayers have discovered that Nevada Health Link and Xerox, hired to run the online system but since fired, created an accounting nightmare and cost some exchange customers a chunk of change. What’s worse, those responsible for this nightmare don’t appear to care one bit about the mess they created. In accordance with the Affordable Care Act, those who purchased insurance through the exchange in 2014 have to report on their tax returns what they paid for premiums and how much they received in tax credits or subsidies for that coverage. The figures are reported in a federal tax form known as a 1095-A. The form is prepared and distributed by the exchange.
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Cathy Bussewitz: Hawaii health exchange faces federal pressure over finances

SF Gate
Mon, 2015-04-13
HONOLULU (AP) — Hawaii officials are scrambling to provide information to the federal government to satisfy concerns about financial problems at the state's health exchange. All state-run insurance exchanges that are part of President Barack Obama's Affordable Care Act are supposed to be financially sustainable this year. But without an infusion of cash, the Hawaii Health Connector won't have enough money for its operations. The Legislature hasn't yet approved the organization's request to issue $28 million in bonds or loans. Without a solid path to sustainability in place, the federal government is telling the state it may have to eventually move some technology functions to a federal system, said Jeff Kissel, CEO of the Hawaii Health Connector. "This is a contingency that is being imposed on any state-based exchange that doesn't have a funded sustainability plan in play," Kissel said.
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Sarah Hurtubise: New York Legislature Turns Down Tax On Obamacare Policies

The Daily Caller
Wed, 2015-04-01
The New York legislature voted down Gov. Andrew Cuomo’s proposal to tax health insurance policies to fund the state’s Obamacare exchange, calling the fees system used by the Obama administration and other states counterintuitive. The shrinking number of state-run Obamacare exchanges are facing a new problem this year — how to fund their ongoing operations now that start-up grants from the federal government are running out. In New York, like many other states, Cuomo proposed a tax on health insurance premiums to fund the state-run exchange’s operations. That tactic comes with its own concerns: some states, such as Hawaii, have smaller-than-expected enrollment and the per-policy fees aren’t bringing in enough money. Rhode Island is considering adopting a tax itself, but due to small enrollment in the tiny state, fees per Obamacare enrollee would likely climb higher than $30 every month, according to Modern Healthcare.

Grace-Marie Turner: Oregon's Failed ObamaCare Exchange Is A Warning For Other States

Forbes
Wed, 2015-04-01
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.

David Schwartz: Arizona governor signs bill blocking abortion coverage through Obamacare

Reuters
Tue, 2015-03-31
(Reuters) - Arizona Republican Governor Doug Ducey signed a law on Monday that requires doctors to tell women that drug-induced abortions can be reversed and that blocks the purchase of insurance on the Obamacare health exchange that includes abortion coverage. The requirement that patients be told that the effects of abortion pills may be undone by using high doses of a hormone was the most hotly contested provision during legislative debate. Supporters said there was ample evidence the reversal was possible if acted upon quickly, although they provided no peer-reviewed studies in support of their position.

Ryan: GOP will have 'immediate response' for ObamaCare court ruling

The Hill
Mon, 2015-03-30
When the Supreme Court drops its big ObamaCare ruling this summer, Republican leaders say they will be fully ready to step in — even if it won’t be the party’s official replacement plan. “We have to be prepared, by the time the ruling comes, to have something. Not months later,” House Ways and Means Committee Chairman Paul Ryan (R-Wis.) told reporters this week. Ryan said he plans to have a bill ready — and priced by the Congressional Budget Office — by late June when a ruling for King v. Burwell is expected.

Health Insurance Exchanges: State of the States

McKenna Long & Aldridge
Mon, 2015-03-30
Breaking with normal tradition, we’re going to open this week’s update with national trends before moving into updates at the federal and state levels. This week there was an interesting report from the Kaiser Family Foundation that estimated that 50 percent of households receiving financial assistance to purchase private health insurance on the Marketplaces will have to return a portion of that subsidy when they file their tax returns as part of the tax credit reconciliation process. Repayments will, in most cases, be deducted from an enrollee’s refund check and the Kaiser report estimates that the average repayment will be $794. Roughly seven percent of enrollees could owe a repayment of between $2,000 and $5,000 and two percent could have to repay more than $5,000. A slightly smaller percentage of households, 45 percent, are estimated to receive additional money with their tax refund because they received underpayments in tax credits, with the average refund estimated to be $773.
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Obamacare, at 5, still a problem child

The Orange County Register
Tue, 2015-03-24
During a 2014 Valentine’s Day meet-up with House Democrats, President Obama thanked them for their unstinting support of the Patient Protection and Affordable Care Act. “I think,” he said, “10 years, five years from now, we’re going to look back and say this was a monumental achievement.” Well, the president’s health care law marks its fifth anniversary this week. And most Americans are not, in fact, looking back and saying the law enacted in 2010 – with not one Republican vote in either the House or Senate – was a monumental achievement. Indeed, in an NBC News/Wall Street Journal poll this month, a 44-34 plurality of respondents thought Obamacare a “bad idea.” And a 62-22 percent majority said that what they had seen, read or heard in recent weeks about the Affordable Care Act had made them “less confident” about the law. Some suggest the public’s misgivings about Obamacare are almost entirely attributable to GOP opposition to the law.

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