axpayers who do not have minimum essential coverage (through an employer, a government program, or individual insurance) or qualify for an exemption must pay an individual responsibility tax. The tax is calculated on a monthly basis and is the greater of either a fixed dollar amount or 2.5 percent of household income above the tax filing limit, up to the the national average premium for a bronze (60 percent actuarial value) health plan.
The IRS has announced that for the 2016 tax filing season the average bronze plan premium used for calculating the maximum penalty will be $232 for each member of a tax household up to $1,360 for five or more members.
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“Medicaid for All” has suddenly become the darling of the health reform crowd. Nevada almost became the first state in the nation to adopt Medicaid for All this year — until Gov. Brian Sandoval vetoed the plan in June. Other states, including Massachusetts and Minnesota, are looking into it.
These Medicaid-for-All plans would let anyone “buy into” the program. Middle-class families could pay government-set premiums for Medicaid coverage. They would get guaranteed health benefits at government-subsidized prices. And given that the program pays healthcare providers less than private insurance, Medicaid for All might even rein in health spending — or so the thinking goes.
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Suppose you wanted to sabotage Obamacare and could not get Congress to help. Short of repeal legislation, the next best strategy would be to cut off funds to health insurers—in other words, starve the beast. That should work, right?
Surprisingly not, according to a new report from the Congressional Budget Office (CBO). Responding to a request from House Democrats, CBO considered what could happen to health coverage, insurance premiums, and taxpayer cost if the federal government stopped paying insurers for cost-sharing reductions (CSRs). Under CBO’s scenario, the federal government would stop making payments to insurers totaling $118 billion between 2018 and 2026. As a result, the federal deficit would rise (not fall) by $194 billion, low-income individuals would pay about the same (not more) for coverage, and more people (not fewer) would be insured.
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Sen. Lamar Alexander will hold bipartisan hearings in early September in a last minute attempt to assure insurers of the federal government’s commitment to the individual market, and pave the way for states to ask for flexibility on insurance benefits.
Alexander, R-Tenn., is looking to drum up support for a “bipartisan way to get a limited result that actually helps people” after tumultuous months of heated debate over whether to repeal-and-replace the Affordable Care Act that ultimately handed the Republicans a defeat.
Alexander wants to extend cost-sharing reduction payments through 2018, and change a section of the ACA to give states more flexibility.
The timing will be difficult, he said, but necessary.
He preferred a repeal, but now wants to make sure that insurers don’t have a reason to decide last minute to pull out of the exchange
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A bipartisan Senate health panel is set to meet on Obamacare in September, but lawmakers disagree on funding for insurer payments that would otherwise lead to more exits from health insurance companies and higher premiums for people who don’t receive subsidies.
Members of the Senate Health, Education, Labor, and Pensions Committee are holding hearings Sept. 6-7 to discuss how to keep premiums from rising much more than they are, particularly if the payments, called cost-sharing reduction subsidies, or CSRs, are not funded. If cut off, a Congressional Budget Office analysis found, premiums would rise by an average of 20 percent next year.
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Health insurer CareSource will offer Affordable Care Act exchange plans in Ohio’s Paulding County, leaving no place in the U.S. currently known to be at risk of lacking marketplace offerings under the law next year.
The decision by CareSource, a nonprofit that focuses largely on Medicaid, caps a triumph for state regulators around the country, who have fought hard to fill potential bare patches in their coverage maps after insurers announced pullbacks over the past several months amid uncertainty about the law’s future.
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Under the ACA, insurance companies must sell polices to people with chronic diseases and charge the same premiums paid by healthy people. But patients with pre-existing conditions in fact are being denied coverage when their insurance plans don’t cover medically-recommended treatments or when they place significant obstacles in the way. Many plans impose “utilization management” rules restricting access to drugs. Dr. Blinderman suggests a “preauthorized trial period” for all medications. Following this trial period, physicians could be asked to justify continuation of the therapy. Doing this would relieve patient suffering due to delays or disruptions in the amelioration of symptoms, reducing health-care costs in the process.
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Ohio Gov. John Kasich (R) and Colorado Gov. John Hickenlooper (D) are working on a bipartisan proposal to stabilize ObamaCare that they say could be unveiled as soon as a week from now.
“We’re getting very close,” Kasich said in a joint interview with Hickenlooper on Colorado Public Radio. “I just talked to my guys today, and men and women who are working on this with John’s people, and we think we’ll have some specifics here. John, I actually think we could have it within a week.”
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Democrats are ready to go on the health care offensive. And Sen. Brian Schatz (D-HI) may have a new plan for them to do it.
In an interview with Vox, Schatz revealed that he’s preparing a new bill that could grant more Americans the opportunity to enroll in Medicaid by giving states the option to offer a “buy-in” to the government program on Obamacare’s exchanges.
His proposal would expand the public health insurance program from one that covers only low-income Americans to one open to anyone seeking coverage, depending on what each state does.
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Andy Thorburn, a health insurance executive who is plugging $2 million into a bid to replace Rep. Edward R. Royce (R-Calif.), is the latest Democrat pushing the party to embrace single-payer health care — even in swing districts. In a video announcement, Thorburn paints the contest as a referendum on health care, between a Republican who voted for the repeal of the Affordable Care Act and a Democrat who wants to move, eventually, to “Medicare for all.”
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