“Obamacare—or at least the version of it that the president and his advisers currently think they can get away with putting into place—has been upending arrangements and reshuffling the deck in the health system since the beginning of the year. That’s when the new insurance rules, subsidies, and optional state Medicaid expansions went into effect. The law’s defenders say the changes that have been set in motion are irreversible, in large part because several million people are now covered by insurance plans sold through the exchanges, and a few million more are enrolled in Medicaid as a result of Obamacare. President Obama has stated repeatedly that these developments should effectively shut the door on further debate over the matter.
Of course, the president does not get to decide when public debates begin or end, and the public seems to be in no mood to declare the Obamacare case closed. Polling has consistently shown that more Americans oppose the law than support it, and that the opposition is far more intense than the support. The law is built on a foundation of dramatically expanded government power over the nation’s health system, which strikes many voters as a dangerous step toward more bureaucracy, less choice, higher costs, and lower quality care. The beginning of the law’s implementation does not appear to have eased these fears, and in some cases has exacerbated them.”
“Since the Affordable Care Act’s (ACA) passage, a number of lawsuits have been filed challenging various provisions of the law. The Supreme Court has decided cases about the constitutionality of the ACA’s individual mandate and Medicaid expansion as well as the applicability of the contraceptive coverage requirement to closely held for-profit corporations with religious objections. In addition, several cases challenging the availability of premium subsidies in the Federally-Facilitated Marketplace (FFM) are currently progressing through the federal courts. All of this litigation has altered, or has the potential to alter, the way in which the ACA is implemented and consequently could affect the achievement of the law’s policy goals. This issue brief examines the federal courts’ role to date in interpreting and affecting implementation of the ACA, with a focus on the provisions that seek to expand access to affordable coverage.
Court decisions about how to interpret the ACA will continue to affect the number of people who ultimately obtain affordable coverage. At present, access to Medicaid up to 138% FPL is dependent upon where people live because the Supreme Court held that implementation of the ACA’s Medicaid expansion is effectively a state option. This has resulted in a coverage gap for just over 4.5 million people with incomes too high to qualify for Medicaid but too low to qualify for Marketplace subsidies in the states that have not implemented the ACA’s Medicaid expansion to date.”
“House Ways & Means health subcommittee chair Kevin Brady (R-TX) questions HHS’ authority to settle hospitals’ appeals of denied inpatient claims and is urging HHS Secretary Sylvia Burwell to retract what he views as an “ill thought” settlement process. Brady wants Burwell to work with lawmakers to come up with a different “fair, transparent and conclusive settlement process.”
Brady wrote to Burwell Tuesday (Sept. 16) that he is dismayed by HHS’ reluctance to work with the committee on an equitable settlement process that is fully legal, adding that the “lack of engagement makes it challenging for the Congress to solve the current appeals problems and prevent similar problems in the future.”
CMS announced late last month (Aug. 29) that it will pay hospitals 68 percent of denied inpatient status claims in the appeals queue if hospitals take them out of the backlogged appeals process. The agency has been encouraging hospitals to take advantage of the settlement to “alleviate the burden of Medicare appeals on both the hospital and Medicare systems,” according to the CMS website.
Hospitals should decide whether to participate by the end of October, and CMS in a Frequently Asked Questions document released Sept. 9 says that four hospitals have already stepped forward to take the settlement offer. The document also states that this is a one-time offer from CMS.”
“The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of this provision in 2012, some nonprofit and for profit employers with religious objections to contraceptives have brought legal challenges to this rule. For many women today, their contraceptive coverage depends on their employer or when they purchased their individual insurance plan.”
“A federal judge on Thursday struck down Ohio’s law barring people from knowingly or recklessly making false statements about candidates in a case that the United States Supreme Court said needed to be heard. The judge, Timothy Black, said that the answer to false statements in politics is “not to force silence, but to encourage truthful speech in response, and to let the voters, not the government, decide what the political truth is.” The case began in the 2010 congressional race after Steve Driehaus, a congressman at the time, filed a complaint when the Susan B. Anthony List planned to post billboards claiming the Democrat’s support for President Obama’s health care overhaul equated with support for abortion, even though he opposed abortion.”
“CVS Health is investigating a potential glitch in its drug pricing system that appears to have charged women copayments for prescription birth control – though the scope of the error is unclear.
The problem came to the attention of Rep. Jackie Speier, D-Calif., after one of her staffers attempted to buy generic prescription birth control in Washington D.C. and was charged a $20 copay.
The retailer’s error, highlighted in a letter to the company from Speier, runs counter to a provision of the federal health law that mandates insurance coverage of women’s preventive care – a category including generic prescription birth control – without cost sharing.”
“Dan wrote up yesterday’s Washington Post/ABC News poll, which was jammed with crooked numbers for President Obama. Most striking was the (30/55) majority deeming Obama’s presidency “a failure,” along with the prevailing opinion that he’s divided the country, and his unsightly leadership score. The survey also included a dreadful (38/56) presidential approval rating on the implementation of Obamacare; support for the law itself was also underwater, with an outright majority opposed, despite this polling series’ silly question wording that omits any mention of ‘Obamacare’ or the ‘Affordable Care Act.’ A new Kaiser Family Foundation poll produces similar findings, with support for the president’s signature domestic accomplishment swamped by opposition. It’s been this way for years, across hundreds of national surveys.
One major reason for the enduring opposition is that the law has violated virtually every major promise erected in dishonest ideologues’ sales pitch. Another is that an ongoing parade of unpleasant developments continues to make headlines, including the recent revelation that Healthcare.gov was hacked last month. Apologists can cherry-pick useful data points to try to convince the public that Obamacare is reducing premium costs and driving down costs, but that’s simply not the case. Individual market premiums exploded in 2014, and are expected to grow by roughly eight percent in 2015 (with many consumers confronting double-digit spikes) — to say nothing of high out-of-pocket costs and narrow coverage networks. Overall health spending continues an upward climb. The law was billed as a dramatic premium reducer that would also bend down the so-called “cost curve.””
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Dan wrote up yesterday’s Washington Post/ABC News poll, which was jammed with crooked numbers for President Obama. Most striking was the (30/55) majority deeming Obama’s presidency “a failure,” along with the prevailing opinion that he’s divided the country, and his unsightly leadership score. The survey also included a dreadful (38/56) presidential approval rating on the implementation of Obamacare; support for the law itself was also underwater, with an outright majority opposed, despite this polling series’ silly question wording that omits any mention of ‘Obamacare’ or the ‘Affordable Care Act.’ A new Kaiser Family Foundation poll produces similar findings, with support for the president’s signature domestic accomplishment swamped by opposition. It’s been this way for years, across hundreds of national surveys.
One major reason for the enduring opposition is that the law has violated virtually every major promise erected in dishonest ideologues’ sales pitch. Another is that an ongoing parade of unpleasant developments continues to make headlines, including the recent revelation that Healthcare.gov was hacked last month. Apologists can cherry-pick useful data points to try to convince the public that Obamacare is reducing premium costs and driving down costs, but that’s simply not the case. Individual market premiums exploded in 2014, and are expected to grow by roughly eight percent in 2015 (with many consumers confronting double-digit spikes) — to say nothing of high out-of-pocket costs and narrow coverage networks. Overall health spending continues an upward climb. The law was billed as a dramatic premium reducer that would also bend down the so-called “cost curve.”
“The Obama administration has decided to continue its legal battle against Little Sisters of the Poor, a Catholic charity that objects to Obamacare’s mandate that employee health plans cover contraceptives and abortion-inducing drugs.
The order of Catholic nuns argues that the rule fashioned by the Department of Health and Human Services requires them to violate their religious beliefs by offering insurance coverage for 20 specific drugs and devices — some of which the nuns believe could destroy what they consider a human life.
If the Little Sisters of the Poor choose not to abide by the HHS mandate, they face devastating fines by the Internal Revenue Service that could result in millions of dollars a year being diverted from their mission of caring for elderly women and men.”
“When Congress returns this week, action in both chambers will mostly be a show for the voters back home ahead of the midterm election. In the House, that will include a vote on a bill to allow insurance companies to continue offering any plan that was sold in the group market in 2013.
Noticeably absent from congressional politicking in the next few weeks is the Affordable Care Act’s risk corridor program, which was, as recently as a few months ago, a major Republican criticism of the law. But that doesn’t mean the “insurer bailout” fight is dead. Republicans in both chambers are quietly working to challenge the legality and projected cost of the program. And that could tee up the issue to become a bargaining chip in the budget fights to come at the end of this year, regardless of who wins the Senate.
The Affordable Care Act’s risk corridor program runs from 2014 through 2016, and was established to encourage insurers to take a chance on covering an unknown population — the Americans who would be purchasing insurance on state and federal exchanges. The program collects funds from qualified health plans that bring in more money than they paid for medical claims, and then pays that money to plans with claims that cost more than they brought it from consumers.
But what happens if there isn’t enough money from well-performing insurers to pay all of the insurers that missed the mark? The federal government is on the hook, but where they find the money to pay those insurers is a question being debated throughout Washington. That’s because the law did not give the federal government a clear appropriation to spend money to make up for losses. And Republicans are, of course, very unlikely to give them one.”