Category: Implementation

Gov. Scott Walker (Wis.), a Republican who has been one of ObamaCare’s most vocal opponents, signed a bill Tuesday that would shore up the law’s insurance markets.

The bill would authorize the state to apply for a federal waiver to offer a reinsurance program covering 80 percent of medical claims costing between $50,000 and $250,000.

The program would cost $200 million, with the federal government paying 75 percent of the costs, and is meant to lower premiums for everyone else by paying for claims filed by the sickest, most expensive patients.

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Over a 6-month period, the OIG found in California:

For our sample of 150 beneficiaries, California made Medicaid payments on behalf of 112 eligible beneficiaries. However, for the remaining 38 beneficiaries, California made payments on behalf of ineligible beneficiaries (e.g., a woman who did not meet eligibility requirements for the newly eligible group because she was pregnant) and potentially ineligible beneficiaries (e.g., a beneficiary who may not have met the residency requirement). On the basis of our sample results, we estimated that California made Medicaid payments of $738.2 million ($628.8 million Federal share) on behalf of 366,078 ineligible beneficiaries and $416.5 million ($402.4 million Federal share) on behalf of 79,055 potentially ineligible beneficiaries. (These estimates represent Medicaid payments for fee-for service, managed-care, the drug treatment program, and mental health services.) These deficiencies occurred because California’s eligibility determination systems lacked the necessary system functionality and eligibility caseworkers made errors. We also identified a weakness in California’s procedures related to determining eligibility of individuals who may not have intended to apply for Medicaid.

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Through its regime of subsidies, penalties, and federal regulations, the Affordable Care Act (ACA) made health insurance affordable to millions of people who were uninsured because they earned too little or had preexisting conditions. But it also made insurance more expensive for millions who used to be able to afford it. Between December 2013 and January 2017, average premiums more than doubled, and individual markets were in turmoil.

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A bipartisan group of governors working to strike compromise on hot-button policy issues will take on the health care question at an event Friday.

Republican Gov. John Kasich, of Ohio, Democratic Gov. John Hickenlooper, of Colorado, and Alaska Gov. Bill Walker, an independent, are among governors scheduled to headline a briefing at the National Press Club in Washington to discuss their latest ideas for improving the nation’s health care system.

Their blueprint, a copy of which was provided to The Associated Press, lays out a host of ideas for improving affordability, restoring stability, promoting flexibility so that states can innovate and eliminating duplicative and burdensome insurance regulations.

The governors urge the federal government to restore insurer subsidies that were stopped by Republican President Donald Trump, triggering sharp increases in premiums this year.
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On February 21, 2018, the District of Columbia (D.C.) moved one step closer toward becoming the second in the nation, behind Massachusetts, to adopt an individual health insurance mandate. The Executive Board of the D.C. Health Benefit Exchange Authority (Authority) approved a resolution recommending the adoption of a District-level mandate as well as a number of other policy proposals. The resolution will have to be approved by the D.C. Council before going into effect.

D.C. would be the first to adopt its own mandate in the wake of repeal of the Affordable Care Act’s (ACA’s) individual mandate, but it joins at least eight states considering or studying their own individual mandate.
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Hundreds of companies face prospective fines for violating Obamacare’s employer mandate by the same Trump administration that has done virtually everything in its power to abolish the federal health care law.

Internal Revenue Service notices recently began arriving in corporate mailboxes, in some cases demanding millions of dollars in fines — an awkward development as the White House touts its business-friendly tax package. The notices will likely spur another legal fight over the health law.
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Kentucky Gov. Matt Bevin (R) is countersuing to stop a lawsuit filed by critics of the state’s plan to institute Medicaid work requirements.

The administration filed a lawsuit in federal district court in Kentucky on Monday seeking a ruling that the state’s Medicaid waiver fully complies with federal law.

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Ohio will soon ask the federal government to waive an Obamacare requirement that nearly everyone in the state get health insurance coverage.

It will also ask permission to make some Medicaid recipients work 20 hours a week, go to school or take on similar activities. The state announced both these actions today, anticipating it will submit separate applications to Washington in about a month, after holding public hearings.
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Alex Azar, the new secretary of health and human services, said Thursday that he would closely scrutinize a plan by Idaho to allow the sale of insurance that does not comply with the Affordable Care Act, an early test of how he will enforce a law he opposes. But he said it was too early to know what action he might take. “We’ll be looking at that very carefully and measure it up against the standards of the law,” Mr. Azar said at a hearing of the Senate Finance Committee. The plan presents Mr. Azar with a choice that he could face frequently in his new job: whether to try to shore up the health law or to “let Obamacare fail.”

Two weeks into his new post, HHS Secretary Alex Azar on Wednesday took another step in the Trump administration’s move toward relaxing the Affordable Care Act’s moratorium on new physician-owned hospitals.

In the HHS budget hearing before the House Ways and Means Committee, Rep. Sam Johnson (R-Texas) asked for Azar to commit the administration to help repeal the ACA’s “ban” on physician-owned hospitals.

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