Republicans in Congress are plotting ways to block the Obama administration from paying insurance companies hundreds of millions of dollars as part of an ObamaCare program.
GOP lawmakers say they are looking at “a dozen” options — including a possible provision in the year-end spending bill — to prevent the administration from using an obscure fund within the Treasury Department to pay out massive settlements to insurers.
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The Obama administration is seeking to toss out a pair of high-profile healthcare lawsuits in which insurers claim they are owed millions of dollars under the Affordable Care Act.
The two insurers, Moda Healthcare and BlueCross BlueShield of North Carolina, have sued the federal government over a combined $338 million in ObamaCare payments they argue are overdue.
The Justice Department filed motions to dismiss both lawsuits on Friday, arguing that the federal government isn’t responsible for those payments at all.
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Republican senators are pressing the Obama administration for information on what they say could be a “bailout” of insurance companies under ObamaCare.
Sens. Marco Rubio (Fla.), Mike Lee (Utah), Ben Sasse (Neb.) and John Barrasso (Wyo.) wrote a letter to the administration warning against financial settlements with insurance companies. Those companies have sued over a shortfall in an ObamaCare program known as risk corridors.
“We write to express our grave concerns regarding the potential participation of your departments in a multibillion dollar bailout of select health insurance companies through the Affordable Care Act’s Risk Corridors Program,” the senators wrote.
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The House on Tuesday passed a bill that would allow people who enrolled in failed health insurance “co-ops” under the Affordable Care Act to skip this year’s penalty for not having coverage. The Republican-backed bill passed on a mostly party-line vote of 258-165, but 16 Democrats broke with their party to support the measure. “It’s just wrong, it’s wrong, to hold these working families financially responsible for a co-op’s failure because it went under due to factors beyond their control,” said Rep. Charles Boustany Jr. (R-LA). President Obama says he will veto the bill if it reaches his desk.
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Blue Cross Blue Shield of Nebraska announced Friday that is pulling out of the ObamaCare marketplace in the state, becoming the latest insurer to cite financial losses when reducing participation in the healthcare law.
The move is especially significant given that it is a Blue Cross plan, which form the backbone of the ObamaCare marketplaces. In a few states, the Blue Cross plan will be the only one available on the marketplace next year.
Nebraska, though, will still have two insurers, Aetna and Medica, on its marketplace next year.
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As ObamaCare’s troubles mount, I’ve heard my patients and my peers in healthcare ask: How could the law’s authors not have seen this coming?
For my part, I think a different question needs to be asked: What if they did? What if ObamaCare was purposely designed to fail?
Every day, it seems like there are a dozen new headlines about the crisis facing ObamaCare. Premiums are rising faster than ever. Meanwhile, health insurance companies are abandoning the law’s exchanges left and right, unable to compete in the top-down, regulation-driven environment created by the law. Less than three years into its implementation, the law has never looked so precarious.
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The premium-stabilization programs of the Affordable Care Act (ACA) will expire this year, and even insurers like Blue Cross Blue Shield — once considered the companies of last resort — are considering leaving the exchanges.
While many Blues plans continue to assert their commitment to the ACA market, successive rate hikes and insurer withdrawals from the exchanges temper their assurances.
“These Blue Cross plans will stay longer, but they can’t stay forever,” said Robert -Laszewski, president of Health Policy and Strategy Associates and former insurance executive. Laszewski, a consultant for the plans, added that Blue Cross Blue Shield of Texas lost 40 percent of its reserves in the first two years of ObamaCare. “They can’t continue losing surplus forever.”
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Some of the nation’s largest companies are already taking steps to avoid ObamaCare’s “Cadillac tax,” according to a business survey released Wednesday.
About 12 percent of companies said they have taken steps to avoid being hit by the much-maligned tax on high-priced health insurance plans, which goes into effect in 2020.
Employers say they have either shifted more costs to workers, dropped their pricier options or picked plans with fewer providers, according to the annual employer benefits survey by the Kaiser Family Foundation and the Health Research & Educational Trust.
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A top Obama administration health official indicated Wednesday that there are discussions underway about a settlement with insurance companies over Obamacare payments. This possibility has drawn alarm from Republican lawmakers, who warn that the administration is seeking to get around limitations set by Congress. Several insurers have sued the administration for funds they are owed under an Obamacare program called risk corridors, which is meant to protect insurers from heavy losses in the early years of the health law. A shortfall in funds has limited payouts. Congress enacted a provision preventing the administration from shifting funds into the program in 2014 but warn that judicial settlements now could be a way around that prohibition, for what they term to be a “bailout” of insurers.
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