ObamaCare getaway: 5 US territories released from health care law
July 24, 2014
The Obama administration is coming under fire for once again making a unilateral change to ObamaCare -- this time, quietly exempting the five U.S. territories and their more than 4 million residents from virtually all major provisions of the health care law. The decision was made a week ago, and was a long time coming. For months, the territories have been complaining that the law was implemented so poorly in their regions that it destabilized their insurance markets. Until now, the Department of Health and Human Services claimed its hands were tied. But last Wednesday, the department reversed course. The about-face has some questioning the department's authority to suddenly grant 4.1 million Americans an out from ObamaCare. It follows a cascade of prior unilateral actions delaying and nixing parts of the law for certain groups -- actions which in part prompted House Republicans to launch a lawsuit against President Obama challenging his use of executive power.
Warner lays ground for delay of employer mandate - HHS announces $9 billion in premium savings since 2011 - NEJM study: 10.3 million gained coverage
July 24, 2014
Virginia Sen. Mark Warner asked the Obama administration Wednesday to either quickly make ACA regulations on employers less burdensome or postpone the employer mandate for another year. In a letter to Treasury Secretary Jack Lew, Warner said that the department hasn’t yet given businesses all the information they need to comply and that he's especially worried smaller businesses don’t realize the “magnitude” of new information they must collect and report to the IRS. He said the employer regulations released in March don’t fully address the problems. If the agency can’t lessen the reporting requirements, it should just delay the mandate for another year, he said.
Rep. Dan Maffei's bill takes away health insurance subsidies for members of Congress
July 24, 2014
U.S. Rep. Dan Maffei introduced a bill today that won't help him win any popularity contests in the halls of Congress.Maffei, D-Syracuse, wants to eliminate the federal subsidy that all 435 House members and 100 Senators are eligible to receive for their health insurance plans. His bill would require members of Congress to buy their plans in their home states, taking away their option to enroll in the District of Columbia health insurance exchange set up under the Affordable Care Act. Maffei's bill, the "Members Play by the Same Rules Act," would affect only members of Congress -- not their staff members. Both members and staff received federal employer-subsidized health insurance long before Obamacare. An Affordable Care Act rule allowed those subsidies to continue when members were required to buy their insurance on the government health exchanges. Maffei's bill will likely face a tough battle in the House, where a previous amendment to stop the subsidy went down to defeat. He started seeking co-sponsors this week, and so far he has two --- Rep. Ron Barber, a Democrat from Arizona, and Rep. John Barrow, D-Ga. "Members of Congress should play by the same rules as the people they represent," Maffei said today as he introduced his bill. "That means no taxpayer-funded subsidy to cover the cost of their health insurance and no exemption for members to get insurance through an exchange that is not available to their constituents."
Burwell appoints new counselor from Wal-Mart
July 24, 2014
Health and Human Services (HHS) Secretary Sylvia Burwell continued her management shake-up Wednesday by naming a former vice president at Wal-Mart as senior adviser. The move to bring Leslie Dach to HHS reveals Burwell's interest in heading off problems during ObamaCare's second enrollment period, due to start in November. The new HHS secretary also wants to add professionals with significant private sector experience to her inner circle. "Leslie’s experience, which spans the business, government, and civil society sectors, will further enhance our ability to deliver impact for the American people," Burwell said in a statement. "We want to not only retain, but also recruit, talented individuals to our mission of ensuring every American has access to the building blocks of a healthy, productive life." Dach will focus on ObamaCare's second enrollment period as well as projects across the department, according to a press memo. He served as Wal-Mart's executive vice president for corporate affairs between 2006 and 2013, where he brokered the company's partnership with first lady Michelle Obama on childhood fitness and nutrition.
Consumers have saved a total of $9 billion on premiums
July 24, 2014
Health care law will return to families an average refund of $80 each this year. Health and Human Services Secretary Sylvia M. Burwell announced today that consumers have saved a total of $9 billion on their health insurance premiums since 2011 as a result of the Affordable Care Act. Created through the law, the 80/20 rule, also known as the Medical Loss Ratio (MLR) rule, requires insurers to spend at least 80 percent of premium dollars on patient care and quality improvement activities. If insurers spend an excessive amount on profits and red tape, they owe a refund back to consumers.“We are pleased that the Affordable Care Act continues to provide Americans better value for their premium dollars,” said Secretary Burwell. “We are continuing our work on building a sustainable long-term system, and provisions such as the 80/20 rule are providing Americans with immediate savings and helping to bring transparency and accountability to the insurance market over the long term.” An HHS report released today shows that last year alone, consumers nationwide saved $3.8 billion up front on their premiums as insurance companies operated more efficiently. Additionally, consumers nationwide will save $330 million in refunds, with 6.8 million consumers due to receive an average refund benefit of $80 per family. This standard and other Affordable Care Act standards contributed to consumers saving approximately $4.1 billion on premiums in 2013, for a total of $9 billion in savings since the MLR program’s inception.
White House revises contraception opt out
July 24, 2014
The Obama administration announced revisions to the Obamacare contraception mandate so that nonprofit religious organizations can opt out of signing a release form to avoid covering birth control and workers for those nonprofits are able to obtain separate contraception coverage without a copay."This is part of ensuring that all women have access to contraception coverage," said a senior administration official.Earlier this month the Supreme Court issued a temporary order that allows Wheaton College to avoid covering birth control without filing a religious exemption form with its insurer. The new revisions to the Obamacare mandate reveal that the White House is anticipating the U.S. Supreme Court's finalization of the temporary injunction in the coming months.
Two competing Obamacare Rulings
Wall Street Daily
July 24, 2014
First, the D.C. Circuit Court of Appeals handed down a ruling in Halbig v. Burwell that struck a massive blow to the healthcare law. A three-judge panel ruled 2-1 that the government can’t provide subsidies to states that participated in the federal exchange, Healthcare.gov, because of the Affordable Care Act’s specific wording. If upheld, the ruling would make it nearly impossible for Obamacare to work as intended. But just hours later, the Fourth Circuit Court of Appeals in Richmond handed down an opposite ruling in another case, King v. Burwell. So what’s going on? Is Obamacare finally on the way out, or did the Richmond court just give the ACA ultimate protection?
GOP: Ruling an Obamacare ‘repudiation’
July 23, 2014
Congressional Republicans on Tuesday praised the federal appeals court decision limited subsidies for the Affordable Care Act, calling it further evidence that Obamacare is unconstitutional and wrong for America. Sen. Ted Cruz praised the federal appeals court ruling limiting subsidies for the Affordable Care Act, calling it a “repudiation of Obamacare.” “The D.C. Circuit’s decision today in Halbig v. Burwell is a repudiation of Obamacare and all the lawlessness that has come with it,” the Texas Republican said in a statement. “This decision restores power to Congress and to the people and if properly enforced, should shield citizens from Obamacare’s insidious penalties, mandates, and subsidies,” he continued. “This is a significant victory for the American people and the rule of law, but we must not rest.” Cruz also accused the administration of executive overreach by trying to administer subsidies in the states.
Investigators obtain ObamaCare coverage, subsidies using fake identities
July 23, 2014
Undercover government investigators were able to obtain thousands of dollars in taxpayer subsidies under ObamaCare using fake identities, according to findings presented to Congress on Wednesday. The probe by the Government Accountability Office has raised fresh concerns about the ability of the sprawling health care program to prevent or intercept costly fraud schemes. In the case of the GAO investigation, 11 out of 12 applications submitted using "fictitious identities" were accepted, resulting in subsidized health coverage. "For each of our 11 approved applications, we paid the required premiums to put policies into force, and are continuing to pay the premiums. For the 11 applications that were approved for coverage, we obtained the advance premium tax credit in all cases," the report said.
Judges in Health Care Rulings Vote Party Line
July 23, 2014
In rapid succession, six federal judges on two appeals courts weighed in on a key component of President Barack Obama's health care law. Their votes lined up precisely with the party of the president who appointed them. It was the latest illustration that presidents help shape their legacies by stocking the federal bench with judges whose views are more likely to align with their own. The legal drama played out Tuesday in Washington, D.C., and Richmond, Virginia, on two appeals courts that Obama has transformed through 10 appointments in 5½ years.
In the first ruling, a divided three-judge panel of the U.S. Circuit Court of Appeals for the District of Columbia called into question the subsidies that help millions of low- and middle-income people afford their health care premiums, saying financial aid can be provided only in states that have set up their own insurance markets, or exchanges. Two judges nominated by Republican presidents formed the majority over a dissent from a Democratic appointee.
Obamacare: Anger over narrow networks
July 22, 2014
Anger over limited choice of doctors and hospitals in Obamacare plans is prompting some states to require broader networks — and boiling up as yet another election year headache for the health law. Americans for Prosperity is hitting on these “narrow networks” against Democrats such as Sen. Jeanne Shaheen of New Hampshire, whose GOP opponent Scott Brown has made the health law a centerpiece of his campaign to unseat her. And Republicans have highlighted access challenges as another broken promise from a president who assured Americans they could keep their doctor.
Obamacare Ruling by the Numbers: 4.7 Million People Could Lose Subsidies
July 22, 14
A federal appeals court panel ruled on Tuesday that the Affordable Care Act doesn’t allow the U.S. government to help people buy insurance; only states can do that. “We conclude that the ACA unambiguously restricts [subsidies] to insurance purchased on Exchanges ‘established by the State,’” the judges wrote (PDF). Since 36 states decided not to establish Obamacare marketplaces, residents in those places will lose the federal help they expect to get if the ruling stands. The case, Halbig v. Burwell, is headed to appeal and could end up before the Supreme Court. If Tuesday’s ruling is upheld, however, the scope of disruption will be staggering. It would gut Obamacare in states that chose not to participate.
GOP Lawsuit Over Obamacare ‘Loophole’ for Congress Dismissed
July 22, 2014
A Republican senator’s challenge to the part of President Barack Obama’s healthcare law involving members of Congress and their staffs was dismissed Monday by a federal judge. Sen. Ron Johnson (R—Wisc.) filed the suit related to the Affordable Care Act (ACA) provision that members of Congress and their staff may only receive health plans created under the healthcare law, or offered through a online exchange established under the law. The lawsuit claimed that the federal Office of Personnel Management “created a loophole that allowed congressional staff an exemption from the ACA’s provisions,” according to the decision. The so-called loophole allowed some junior staffers not considered part of the official office of a member of Congress to continue receiving employee benefits, rather than having to buy insurance under the law.
In response to court ruling, administration works to ensure contraceptive coverage
The Washington Post
July 22, 2014
The Obama administration said Tuesday that it is coming up with a work-around to ensure that employees of certain charities, hospitals and colleges whose leaders have religious objections to contraceptives can still get birth control through their employee health insurance plans. The administration made its plans known in a legal brief filed with the U.S. Court of Appeals for the 10th Circuit in Denver. The alternative plan, which is still being developed, is in response to a recent Supreme Court order questioning the government’s current process for allowing nonprofit organizations to opt out of a requirement that their health plans cover all contraceptives that have been approved by the Food and Drug Administration. The current process involves asking nonprofits to fill out a form directing a third party to provide the contraceptive coverage. But many organizations had argued that filling out the form, in itself, violated their religious beliefs.
White House to change process for opting out of birth-control mandate
July 22, 2014
The White House is developing a workaround to let religious nonprofits opt out of ObamaCare's contraception mandate without filing a form they say violates their religious beliefs, according to a senior administration official.Religious nonprofits that do not want to provide free contraception to their workers can now opt out by submitting a Form 700 stating their religious objection to contraception. Insurance companies can then use the form to provide free contraception to workers and get tax credits from the government in return.However, some religious organizations have objected to filling out the form because they argue it amounts to participation in providing birth control. On Tuesday, a senior administration official said they are working on an alternative option for religious nonprofits that do not want to fill out the document and will issue a federal regulation in the next month.
Federal appeals courts issue contradictory rulings on health-law subsidies
The Washington Post
July 22, 2014
A panel of the U.S. Court of Appeals for the District of Columbia Circuit struck down a major part of the federal health-care law Tuesday, ruling that the insurance subsidies that help millions of Americans pay for coverage are illegal in three dozen states. Less than two hours later, a panel of the U.S. Court of Appeals for the 4th Circuit, based in Richmond, handed down a contradictory ruling on the issue in a separate case, raising the possibility of yet another high-stakes battle over the law playing out before the Supreme Court. The conflicting rulings give traction to the most serious current threat to the Affordable Care Act, which has been battered by a series of legal challenges since it was enacted four years ago. The dispute centers on whether the subsidies may be awarded in states that chose not to set up their own insurance marketplaces and instead left the task to the federal government.
Judge throws out senator's Obamacare lawsuit
July 22, 2014
A federal judge in Green Bay has thrown out Wisconsin Sen. Ron Johnson's lawsuit challenging Obamacare. U.S. District Judge William Griesbach ruled Monday that the Republican lawmaker lacks standing to sue because he did not prove he was harmed by regulations under the law that granted members of Congress and their staff members subsidies to pay for health insurance. Johnson had alleged that such subsidies amounted to special treatment and that he was harmed because the regulations forced him to participate in something he believed was illegal. The judge noted that the legality of the regulation has not been determined and so Johnson's argument "puts the cart before the horse.""If standing to sue were conditioned on a plaintiff's own subjective views about a regulation, there would be no principled way to limit access to the courts and the judiciary would become the kind of super-legislature specifically rejected by the Founders," he wrote in his decision.
Wisconsin Senator’s Obamacare Subsidy Suit Thrown Out
July 22, 2014
U.S. Senator Ron Johnson’s lawsuit challenging an Obamacare provision subsidizing health insurance for members of Congress and their aides was dismissed by a judge who found the lawmaker failed to show he’d been harmed. U.S. District Judge William Griesbach in Green Bay, Wisconsin, threw out the senator’s case, ruling yesterday that without a “concrete injury” that can be remedied by the court, the dispute ought to be resolved politically. Johnson, a first-term Republican from Wisconsin, sued President Barack Obama’s administration this year. He argued the subsidy treats legislators and their employees better than most Americans working for private employers, violating the U.S. Constitution’s guarantee of equal protection.
Krugman: Affordable Care Act coming in 'ahead of expectations'
July 21, 2014
There were a bunch of things that Obamacare was supposed to do in its first year. It was supposed to sign up a lot of people through the exchanges, through people buying, essentially, private insurance, but through the government-run exchanges. It was supposed to insure a bunch of additional people through Medicaid. It was supposed to do this without causing a spike in health care costs. It was supposed to substantially reduce the number of people who are uninsured. All of those things have happened. If you put just about any of the numerical targets for the first year, it's done better than that. It's the most amazing thing that people don't know that, but, you know, after the big problems last fall, everyone was assuming that year one would come in short of expectations. In fact, it's come in ahead of expectations. And it looks very clear that this is a workable policy.
Obamacare Oversight Picks Up for Elections: Health Week Ahead
July 21, 2014
House Republicans are picking up the pace of their Obamacare investigations, reversing a lull after the president’s administration took a victory lap upon signing up about 8 million Americans for the health program. The Republican-controlled House Ways and Means Committee will hold hearings July 23 and 24 on the Patient Protection and Affordable Care Act’s coverage subsidies and on its payment cuts to health insurers participating in the private sector version of the U.S. health program for the elderly, called Medicare Advantage. The renewed focus on oversight comes as Congress gears up for the November midterm elections, and as independent investigators give critics new ammunition. The Health and Human Services Department’s inspector general reported July 1 that the government found 2.9 million “inconsistencies” in information provided by Obamacare applicants.
A Lawsuit Could Destroy Obamacare In These 36 States
July 20, 2014
A lawsuit challenging Obamacare subsidies has the potential to skyrocket the health insurance costs of 5.4 million Americans. The decision lies on the shoulders of three federal judges, who will decide the legality of subsidies served through the federal health insurance marketplaces, a decision that impacts residents of 36 states. The decision could come as early as July 15. The Affordable Care Act, colloquially called Obamacare, established what are known as health insurance marketplaces or exchanges, where consumers can buy health insurance plans. So far around 8 million people have signed up. Sixteen states operate their own marketplaces, and the remaining two-thirds of states use the federal marketplace, Healthcare.gov. Under the ACA, Individuals who make less than $46,075 are eligible to receive subsidies, or tax credits, towards their premiums, which means they do not pay the full monthly cost of their health insurance. Without these subsidies their costs would quadruple.
Obamacare in Kentucky: The luxury of seeing a doctor
July 20, 2014
Healthcare reform is President Obama's signature piece of domestic legislation, and also his most controversial, with strong political opposition and continuing legal challenges. But millions have signed up for "Obamacare" in its first year, gaining access to medical care they previously could not afford. Liberty Sizemore leans back in her chair and beams. The 26-year-old filling station cashier has just been told her enrolment in Obamacare is complete. Now she can have her first routine doctor's appointment for seven years
UnitedHealth To Expand On Obamacare Exchanges In 2015 'And Beyond'
July 18, 2014
UnitedHealth Group UNH +1.2% said this morning it would expand private health plan products on government exchanges under the Affordable Care Act “to as many as two dozen” states for next year, chief executive officer Stephen J. Hemsley said this morning.
The nation’s largest health insurance company, which raised its revenue forecast for this year by more than $1 billion to $130 billion thanks in part to strong growth in the “public and senior sector” said it will broaden its participation in public exchanges. Hemsley made his comments during a 70-minute call discussing the company’s second-quarter earnings report that unveiled a 2 percent decline in net earnings on increased taxes and other expenses in part related to the health law.
Obamacare Isn't What's Slowing Costs
July 18, 2013
Health-care cost growth is slowing, and the Congressional Budget Office expects this to continue. Is this good news? To many people, that question may seem crazy. Every other week seems to bring another lurid graph showing that if you project out health-care costs for the next 40 years, 100 percent of our income will be devoted to hip implants and cardiac stents. What’s not to like about slower growth in a major expenditure? Well, much depends on why it’s slowing. If health-care cost growth is slowing down because we’re working a lot of inefficiency out of the system, then the slowdown is obviously a big win for everyone except health-care providers and their shareholders. This explanation is a big favorite with the Barack Obama administration, which likes to credit the Affordable Care Act and related policies for the slowdown.
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