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. See Sections 36B(c)(2)(C)(i) & (ii).
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. The CBO’s projection came down primarily because the agency decided that the law would be less effective at expanding access to insurance coverage than previously thought. An earlier estimate held that Obamacare would increase the number of insured Americans by 27 million in 2023. The new estimate is 25 million.
This year was supposed to be the first wherein Obamacare’s state-based insurance exchanges would be self-sufficient. By now, the law’s architects assured, the exchanges would be thriving, competitive marketplaces, where all Americans could secure affordable coverage.
It hasn’t worked out that way.
Two of the original 17 state exchanges have failed. Half of those that remain are struggling financially.
After getting $5 billion in federal grants, most of the state exchanges have turned out to be a disastrous mix of runaway spending on technology, lower-than-expected enrollment, huge overhead costs, and looming bankruptcy.
Gallup Poll– PRINCETON, N.J. — Americans’ views about the Affordable Care Act are more positive now than they were last fall, although overall attitudes remain more negative than positive. Half of Americans now disapprove of the 2010 law, while 44% approve — the narrowest gap since October 2013. By comparison, last November, just after the strong Republican showing in the midterm elections, 56% of Americans disapproved and 37% approved.
Following close to two years of reports of cost overruns on HealthCare.gov, increased premium prices and lost work hours since the implementation of the Affordable Care Act, Rep. Peter Roskam, R-Ill., is introducing legislation to appoint a watchdog to oversee the health care law and ensure the protection of taxpayer dollars.
The legislation calls for the creation of a special inspector general for monitoring the Affordable Care Act, or SIGMA.
“The false, rosy claims of Obamacare have largely been debunked, and there’s a level of dissatisfaction all around,” Roskam said in an interview with The Daily Signal. “More time and more attention is in the oversight function. [The legislation] doesn’t reinvent the wheel in that it doesn’t use the same legislative architecture, but what will do is force disclosure, and the public then has choices about how it wants to move forward.”
Republican chairmen of four House subcommittees—Tim Murphy of Pennsylvania, Tom Cole of Oklahoma, Tom Marino of Pennsylvania and Jim Jordan of Ohio—as well as Republican Sen. Rob Portman of Ohio, chairman of the Permanent Subcommittee on Investigations, and Rep. Bill Flores of Texas, chairman of the Republican Study Committee, support the bill.
One primary goal of the Affordable Care Act (ACA) was to expand access to affordable health care. However, in the five years since the ACA’s passage, we have found that while more people have health insurance, they do not necessarily have access to affordable health care.
In order to pay for the subsidies that have facilitated the expansion of health insurance coverage, many recipients of federal funds were forced to accept payment reductions. Hospitals were faced with cuts of $260 billion over ten years.[1] These reductions came in the form of delayed payment updates for Medicare hospital services and reduced Disproportionate Share Hospital (DSH) payments meant to compensate hospitals for treating a high percentage of patients for whom the hospital is often inadequately reimbursed. The justification for the cuts to hospital payments was based on assumptions that, by increasing insurance coverage to millions of people, fewer individuals would go to the emergency room (ER) to receive care—where they would potentially be treated for free subject to the Emergency Medical Treatment and Labor Act (EMTALA)[2]—and instead could seek care in non-hospital settings such as physician offices, outpatient clinics, urgent care centers, etc.