The Department of Health & Human Services’ Office of the Inspector General found that the Centers for Medicare & Medicaid Services (CMS):
• Did not have an effective process in place to ensure that advance premium tax credit (APTC) payments were made only for enrollees who had paid their monthly premiums; instead, CMS relied on each qualified health plan (QHP) issuer to verify that enrollees paid their monthly premiums and to attest that APTC payment information that the issuer reported on its template was accurate; and
• Had sole responsibility for ensuring that APTC payments were made only for confirmed enrollees and did not share these data for enrollees with the IRS when making payments.
The OIG determined that CMS’s processes limited its ability to ensure that APTC payments made to QHP issuers were only for enrollees who had made their premium payments.
Today, the House will pass a budget-reconciliation bill that repeals ObamaCare and stops taxpayer funding to abortion providers. After more than 50 House votes to repeal ObamaCare in part and in full, and after the conscience of our nation was awakened again to the great evil of the abortion industry, we will put this bill on the president’s desk.
Unfortunately, we know and have known for a while that President Obama will veto any bill that repeals ObamaCare or defunds Planned Parenthood. That isn’t news. But with this bill, Republicans show that we have listened to the American people and can use reconciliation to pass substantive policies despite opposition from congressional Democrats and the constant threat of filibuster. That means we can repeat this same process with a Republican in the White House, overcome obstruction from congressional Democrats, and accomplish our greatest priorities.
Congress returns to work this week, and for once those words shouldn’t trigger a panic attack. As early as Wednesday the House will vote to send a bill repealing most of ObamaCare to President Obama, and this may become a consequential moment, assuming Republicans are prepared to make an argument.
The task now is to leverage Mr. Obama’s veto to hold Democrats accountable for their votes and the consequences. Liberal spin can’t disguise that the law is failing on every level other than expanding coverage—as if anyone ever argued that a new entitlement couldn’t reduce the uninsured rate.
For the first time, Congress is passing a bill to gut ObamaCare and sending it to President Barack Obama’s desk. That vote occurs Wednesday in the House, after the Senate passed the package last month.
The bill awaits a veto, as both parties have always known. Even so, the final Affordable Care Act repeal package reflects the results of a long, careful drafting process that, for Republicans, undoes as much of ObamaCare as possible.
Republicans tout the bill as a concrete example of what would be accomplished under a Republican president, acknowledging that Obama will never sign a repeal of his signature domestic policy. This bill, they say, paves a path forward to a life without the ACA in 2017.
Most discussions about insurance costs center around premium increases, or (less often) deductibles. Less often do we here them discussed together. Yet, the combination is a critical factor in determining how illnesses affect the financial well-being of families.
An insured family has to pay its premium regardless of whether or not any claims are made. In addition, a family has to meet its annual deductible before receiving any benefits for treatment of illnesses or injuries. That means a family has to pay the total of the premium plus the deductible before any benefits are payable.
According to the Department of Health and Human Services, half the uninsured who are eligible for subsidized coverage through the exchanges have refused to purchase it. As a result, those remaining in the insurance pool have tended to be sicker and older — and they’ve used more health services than insurers expected.
How much more? According to the consulting firm McKinsey & Co., insurers collectively swallowed $2.5 billion in unexpected medical expenses from exchange enrollees in 2014.
The health insurance industry will be watching and waiting to see if antitrust regulators approve several big insurance mergers, whether the Affordable Care Act’s exchange market grows more sustainable, and whether states adopt new regulations governing provider network adequacy.
Looming above all those issues is the possibility of the election of a Republican president who would seek to jettison the ACA framework and replace it with an entirely different healthcare financing framework.
December’s omnibus budget package contained a measure to delay a provision of the Affordable Care Act by two years is giving finance chiefs some extra time to prepare.
The tax on high-cost employee health plans, or “Cadillac” tax, puts employers on the hook for a 40% levy on any excess cost of health plans above certain thresholds. Even before the delay, many companies and municipalities had already begun to assess whether their plans would trigger additional payments and make preemptive changes to avoid it.
Poor planning and a “lack of effective leadership” within the state Department of Human Services prevented the department’s $155 million computer system from meeting the goals of the federal Affordable Care Act, according to a report released today by the Hawaii State Auditor.
The system has not been able to meet federal goals of creating a simple, real-time process for enrolling and determining eligibility for coverage, according to the auditor.
The U.S. Treasury and Internal Revenue Service said they are extending some Affordable Care Act reporting deadlines to help companies meet the requirements. Employers will have two more months past Feb. 1 to give individuals forms for reporting on offers of health coverage and the coverage provided.
he deadlines to report this information to the IRS are extended by three months past the previous Feb. 29 due date for paper filings and the March 31 date for electronic returns, the Treasury said in a statement Monday.