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Posts Tagged ‘health’
April 10th, 2015 at 2:57 pm
Beware ObamaCare as Tax Day Approaches

Nearly every American that received an ObamaCare subsidy to help pay for health insurance last year got the wrong amount.

“Only 4 percent of the people who signed up for ObamaCare got the correct subsidy, so a whopping 96 percent will see their tax bill adjusted, some up and others down,” writes Betsy McCaughey. “Who would design a system that’s right only 4 percent of the time?”

The main reason for the discrepancy is that a person must estimate – i.e. guess – their entire taxable income for the next year in order to find out how much of a subsidy they qualify for under ObamaCare during enrollment season. A raise or switch to a higher paying job could be zeroed out because the government gets to “clawback” the difference. Losing a job means a fatter refund.

You can see which direction ObamaCare’s incentives point to, which provides a partial answer to McCaughey’s rhetorical question – people who penalize moving up the income ladder.

April 6th, 2015 at 7:25 pm
Tax Filing Deadline Extended 6 Months for 800,000 ObamaCare Users

If you are one of the estimated 800,000 Americans who purchased an ObamaCare-compliant health insurance policy for the 2014 enrollment year through Healthcare.gov – the federal exchange portal – and received the wrong tax reporting form, you now have until October 15 to file your taxes.

The Treasury Department announcement came last Friday, less than two weeks before the traditional tax filing deadline.

Credit where it’s due – this is the right call by the Obama Administration since it was the government – not taxpayers – that fouled up the process by mailing error-laden reporting forms. The six month extension relieves the pressure on taxpayers and their accountants and hopefully gives the bureaucracy enough time to fix the problem.

Nevertheless, like all of the other unilateral delays and waivers granted under ObamaCare, this development is yet another indication that the federal government bit off more than it can chew and the number one casualty is the rule of law.

April 2nd, 2015 at 5:58 pm
ObamaCare’s Subsidy “Clawback” Feature Explained

Daniel Payne at The Federalist has a must-read article explaining the perverse and punitive feature of ObamaCare that allows the federal government to “clawback” subsidy amounts from eligible recipients.

“If you’re flat broke at the beginning of the year and accept tax credits from ObamaCare for several months, then find a high-paying job with health insurance halfway through the year and make enough money to put yourself over the subsidy threshold, you’ll owe back every penny of those subsidies you received come tax season, even though you had no money when you received them,” writes Payne.

ObamaCare’s critics have warned that the law would discourage people from getting better paying jobs for fear of losing their health insurance subsidy. In practice, it looks like the penalty on work could be even worse.

April 1st, 2015 at 6:01 pm
Reuters Runs Hit Job on Anti-ObamaCare GOP Governors

Today, Reuters ran the following headline claiming that Republican governors opposed to ObamaCare are really just a bunch of hypocrites: “Exclusive: Republican White House hopefuls attack Obamacare but take money”.

The evidence offered is a combined $352 million in federal grants that GOP governors Rick Perry (TX), Scott Walker (WI), Bobby Jindal (LA), and Chris Christie (NJ) applied for and won under the terms of ObamaCare. Lest any reader miss the theme of the article, the author writes, “Aides [to each governor] told Reuters they saw no contradiction in applying for these grants while criticizing the law as a whole.”

The aides – and by extension, the governors – are absolutely correct. According to the Reuters report, many of the grant programs predate the passage of ObamaCare, and the ones that originated with the controversial health care law are not connected to either the excessively expensive health insurance exchanges or the Medicaid expansion – the two policy devices loathed by fiscal conservatives. As a matter of policy then, there is nothing inconsistent about wanting to repeal a law to get rid of its bad elements while supporting parts that have no connection to them.

As if to walk back from its misleading headline, the Reuters piece says that “It’s not clear whether the Republican governors now considering running for the White House would protect these programs if they won the November 2016 presidential election.” Except that it is clear. So far, none of these governors have indicated that in repealing ObamaCare they would refuse to reinstate the non-controversial grant programs. Therefore, it’s reasonable to assume that these programs are safe.

Attention-grabbing headlines are necessary in the news business, but only if they’re true. The next time Reuters wants to ding GOP politicians for hypocrisy, it needs to bring much better evidence than this.

March 30th, 2015 at 7:23 pm
Supreme Court Declines Challenge to ObamaCare’s IPAB

The Obama administration got a rare piece of good news today when the U.S. Supreme Court declined to overturn a Ninth Circuit Court of Appeals decision upholding part of ObamaCare.

The case, Coons v. Lew, is an Arizona-based challenge to the Independent Payment Advisory Board (IPAB), the 15-member group of experts empowered to reduce Medicare spending below a certain threshold.

In declining the plaintiffs’ appeal, the Supremes did not in any way indicate that this case is without merit. Rather, it may have been filed too early. Courts are typically loathe to strike down parts of laws that have yet to go into effect. IPAB won’t be making any decisions until 2019 at the earliest.

As usual, the issue is whether IPAB is constitutional. “Its decisions cannot be overridden by Congress without a super-majority and cannot be challenged in court,” explains a report in Politico. If that sounds like near monarchial power for an unelected bunch of experts, well, this is the Obama administration after all.

For now, IPAB is a dormant legal issue. Time will tell if it becomes a political rallying cry in next year’s presidential election.

March 10th, 2015 at 5:33 pm
Lessons from Britain in Repealing ObamaCare

Daniel Hannan, a British conservative serving in the European Parliament, warns Americans about the danger of propping up ObamaCare long enough for it to get entrenched in everyday life.

“ObamaCare isn’t a precise copy of the British health system. But there is one parallel on which its exponents are relying, namely the conflation of their healthcare model with the people who work in it,” writes Hannan. “The chairman of the body in charge of overseeing care quality in Britain recently put his finger on the problem: ‘The NHS became too powerful to criticize. When things were going wrong, people didn’t say anything. If you criticized the NHS – the attitude was how dare you?’”

Something similar seems to be happening now. Some states are getting ready to install ObamaCare exchanges if the Supreme Court strikes down the IRS subsidies as unlawfully distributed to people using the federal Healthcare.gov website.

Others are suggesting the creation of an “off-ramp” from ObamaCare that would keep the subsidies flowing until the 2016 presidential election, but would also extend the health law’s life span.

These kinds of half-measures do nothing to help move health reform in a more sustainable, market-oriented direction. All they do is put a bipartisan face on ObamaCare, albeit in an altered form.

Part of what makes repealing ObamaCare a realistic option is the steadfast resistance from state and federal Republicans in implementing it. If even a significant minority of GOP leaders start to go along with saving ObamaCare – in whatever form – then the United States runs the risk that Hannan in Britain knows all too well.

Socialized medicine will be here to stay.

March 10th, 2015 at 2:49 pm
States Should Resist Push to Start Exchanges, Save ObamaCare

If the U.S. Supreme Court (correctly) interprets the health care law as disallowing insurance subsidies for citizens using the federal Healthcare.gov website, some states are preparing to fast-track the process for creating their own ObamaCare exchanges.

That process won’t be easy.

“The first step would be enactment of a law authorizing a state agency, nonprofit or public-private entity to run the exchange. Next, the state would have to build or acquire a website to enroll residents, take over contracts with insurance carriers, develop a consumer assistance program and create a bureaucracy to operate the exchange,” says a summary published by the Pew Charitable Trusts.

Nor will it be cheap. States that opted to build their own exchanges had almost three years to get them up-and-running, and there were still a number of expensive failures. Trying to accelerate the process into a matter of months will only invite more wasted taxpayer money.

States that refused to sink money into an ObamaCare exchange were right to resist adding another layer to their health care bureaucracies. Citizens don’t need another government program with costly administrators. We need a simplified system of health care delivery that frees up more money for treatment and prevention.

February 26th, 2015 at 8:23 pm
Treasury Dept. Approves $3 Billion Transfer to Insurance Companies that Congress Denied

A letter from House Ways and Means Chairman Paul Ryan (R-WI) demands an explanation from the Treasury Department on why it allowed $3 billion in payments to ObamaCare insurance companies that Congress never approved.

In a well-documented piece, Philip Klein gives a disturbing summary of the Obama administration deliberately refusing to follow the law.

“At issue are payments to insurers known as cost-sharing subsidies,” writes Klein. “These payments come about because President Obama’s healthcare law forces insurers to limit out-of-pocket costs for certain low income individuals by capping consumer expenses, such as deductibles and co-payments, in insurance plans. In exchange for capping these charges, insurers are supposed to receive compensation.”

Here’s the rub.

“What’s tricky is that Congress never authorized any money to make such payments to insurers in its annual appropriations, but the Department of Health and Human Services, with the cooperation of the U.S. Treasury, made them anyway,” says Klein.

As proof, Klein cites a $4 billion funding request for the cost-sharing subsidies program in 2014 that was not fulfilled by Congress. It’s now 2015, the bills are coming due, and the Obama administration effectively said, “Never mind.”

Whether the domain is immigration or ObamaCare, the default setting for this administration seems to be that if it can’t get what it wants the legal way, it’s just as good to go around the law.

February 20th, 2015 at 2:36 pm
Feds Send Out 800,000 Incorrect ObamaCare Tax Forms

First Uncle Bear, now Uncle Sam.

“The Obama administration says it sent about 800,000 HealthCare.gov customers the wrong tax information, and officials are asking those consumers to delay filing their 2014 taxes,” reports CNBC.

The massive blunder comes on the heels of a similar admission by California officials that the state sent out approximately 100,000 error-laden tax forms to residents using the state’s ObamaCare exchange, Covered California.

No timeline was apparent on when revised forms would be sent out, or whether early tax filers would be penalized by the Internal Revenue Service for submitting unknowingly false information.

Another item in the CNBC report may foreshadow the next move. Due to concerns that some people will be angered for being penalized for not buying insurance to comply with ObamaCare’s coverage mandate, the Obama administration is creating another sign-up extension.

Perhaps the IRS will get similar instructions from on high and bump back the filing deadline.

If so, expect to hear the millions of non-ObamaCare customers clamor, “Me too!”

February 17th, 2015 at 7:58 pm
California ObamaCare Exchange Sends Out Nearly 100,000 Error-Laden Tax Forms

The CBS affiliate in San Francisco is reporting on a massive failure by the state’s ObamaCare exchange to correctly reconcile information on customers with health insurance providers.

“About 100,000 or 12 percent of the forms generated by Covered California have inaccuracies,” says the report. The forms are needed by California ObamaCare users to claim tax refunds and verify subsidy amounts with the IRS.

A spokesperson for Covered California said the inaccuracies are due in large part to discrepancies between the state’s records and what the insurance companies have. Despite this, the exchange sent out the forms anyway to beat the February 2 deadline.

Corrected forms are scheduled to go out later this month, but it’s unclear whether all of the 100,000 or so recipients of the inaccurate forms know they are bad. If not, they could be submitting false information to the IRS, an issue that could cause considerable problems down the road.

Expect this to add to the ire already forming ahead of Tax Day.

February 17th, 2015 at 12:53 pm
Congressional Democrats Want to Delay ObamaCare Penalties

It looks like having the courage of one’s convictions about the imperative of ObamaCare doesn’t include making good on the Democrats’ promise to “pay-as-you-go.”

Once upon a time when Rep. Nancy Pelosi (D-CA) was Speaker of the House, Democrats in Congress made a lot of noise about PAYGO, the fiscal policy that essentially requires new spending to be paid for with spending cuts, tax increases, or some combination of the two.

But now that ObamaCare’s IRS-imposed penalties are coming due, those same Democrats are singing a different tune.

“Three senior House members told the Associated Press that they plan to strongly urge the administration to grant a special sign-up opportunity for uninsured taxpayers who will be facing fines under the law for the first time this year,” the AP reports.

Interestingly, the three House members – Michigan’s Sander Levin, Washington’s Jim McDermott and Texas’ Lloyd Dogget – “[a]ll worked to help steer Obama’s law through rancorous congressional debates from 2009-2010.”

And now that the price of non-compliance with ObamaCare’s tax-raising mandates is becoming obvious, all three want to avoid a predictable constituent backlash.

Sorry fellas, if spending at least $684 million annually to educate the public about ObamaCare isn’t enough to adequately inoculate against angry voters, perhaps there’s a fatal flaw in the law.

At any rate, it’s time the American public got the version of health reform you voted for.

February 13th, 2015 at 6:05 pm
The ObamaCare Tax Even Democrats Want to Repeal

Nice things cost money, and so too does so-called affordable health insurance.

“More than one-third of all House members have signed onto legislation that would repeal ObamaCare’s tax on insurance companies, which even some Democrats agree is leading to high insurance costs for millions of American families,” reports The Blaze.

People familiar with the logic of doing business understand that private firms don’t pay taxes, people do. So when ObamaCare imposes a tax on health insurance providers, that amount gets passed on to consumers as higher premiums.

With ObamaCare’s second enrollment cycle about to end, many people are experiencing this economic rule up-close-and-personal.

“I hear every day from individuals, families, and businesses in Arizona about the cost of health care,” Rep. Kyrsten Sinema (D-AZ) is quoted as saying. “This common sense fix [i.e. repeal] will help lower out of pocket costs for hardworking Arizonans. By working together, we can provide relief for individuals, families, and employers while increasing access to quality affordable health care.”

That’s highly unlikely because ObamaCare’s regulations increase the cost of providing health care, and its complex web of subsidies is designed to hide some of that increase. Repealing a source for subsidies without also repealing the regulations that make them necessary leaves the elevated cost without a means to pay for it.

Still, it’s good to see at least some Democrats in Congress supporting the repeal of at least some part of ObamaCare. Remove enough supports, and eventually the whole architecture crumbles.

February 12th, 2015 at 6:36 pm
GOP Senators: Obama Admin Officials “Evading” Whether Backup Plan Exists If Supremes Strike Down Subsidies

Does the Obama administration have a backup plan if the Supreme Court interprets ObamaCare according to its terms and prohibits federal subsidies to Americans in 36 states?

If so, top administrators at Health and Human Services, the Internal Revenue Service and Treasury aren’t sharing.

That lack of transparency – and the havoc it could wreck on millions of mandatory ObamaCare users – angers a group of powerful Senate Republicans.

“I want to make certain that the government has notified people who have signed up through the HHS insurance exchange – including the thousands of Georgians who were forced to enroll after ObamaCare cancelled their health plans – of the potential consequences of the Court ruling against the government, especially given the fact that the cost of the program could be significantly increased,” Senator Johnny Isakson (R-GA) said in a statement.

“The Obama administration needs to be forthcoming about its backup plans so my constituents can make their own backup plans.”

Isakson and other Republicans serving on the Senate Finance Committee sent a strongly worded letter to several government agencies demanding details of any contingency plans. In it they charge HHS Secretary Sylvia Mathews Burwell, Treasury Secretary Jacob Lew, and IRS Commissioner John Koskinen with “lack of candor” and “evad[ing] the issue when it was raised at hearings before the Committee this week.”

Consider this another unfulfilled promise of “the most transparent administration in history.

February 11th, 2015 at 7:55 pm
Big Insurance Lines Up Behind ObamaCare

If you can’t beat ‘em, join ‘em, and then fight like hell to save them.

That’s essentially the health insurance industry’s strategy when it comes to ObamaCare.

Unable to derail the Democrats’ health reform train in 2009 and 2010, most of the biggest players in the health insurance industry agreed to make peace with the Obama administration.

For their troubles the insurance companies won policy concessions like the individual mandate to ensure a captive market for their products, and a complicated bailout scheme to subsidize losses.

Then along came King v. Burwell, one of the cases challenging the legality of federal subsidies necessary to make ObamaCare plans affordable. (Necessary, but not, according to ObamaCare’s text, permitted in states that rely on the federal government’s insurance portal.)

The Supreme Court is set to hear oral arguments this spring, and many entities have submitted amicus or friend-of-the-court briefs to persuade the justices their way.

“Among those filing amicus briefs defending health reform are HCA, the American Hospital Association, America’s Health Insurance Plans, the National Alliance of State Health Co-ops, the Catholic Health Association of the United States, the American Cancer Society, and the National Association of Community Health Centers,” reports Bloomberg Business. “The insurance and medical industries share the administration’s goal of seeing millions more people covered because that translates into millions more customers seeking the services of carriers, hospitals, and doctors.”

If given a choice, many established businesses would prefer a guaranteed arrangement with the government rather than rely exclusively on the volatility of the market. It’s easy to see why. But discomfort to the health insurance industry should not trump the rule of law. If the IRS can rewrite ObamaCare to make money available where it has been prohibited, then perhaps another agency hence can also decide to cancel spending that is legally required.

No businessman wants to be on the wrong side of a one-way contract. Yet that’s precisely what will happen if the federal bureaucracy gets to change the terms of ObamaCare whenever it sees fit.

February 6th, 2015 at 4:43 pm
Avik Roy Weighs In on the GOP’s Patient CARE Act

Avik Roy, a conservative health policy expert, penned a very helpful primer on the latest GOP ObamaCare alternative.

The plan – the Patient CARE Act – is an updated version of similar reform concepts presented last year by three leading Republican members of Congress.

Along with other intriguing ideas, the Patient CARE Act replaces ObamaCare’s restrictive subsidy system – i.e. the money can only be spent on federally-approved insurance plans – with “a means-tested tax credit that individuals could use to buy a far broader range of insurance products, or deposit the funds in a health savings account.”

As a tremendous service to readers, Roy also summarizes how the Patient CARE Act compares to other conservative health reform alternatives: his Transcending ObamaCare and one championed by the 2017 Project. All three are serious proposals and deserve attention.

More on these and other ObamaCare alternatives as they develop…

February 5th, 2015 at 8:27 pm
New GOP ObamaCare Alternative

Here’s a look at the newest Republican alternative to ObamaCare.

According to the plan’s authors – Rep. Fred Upton of Michigan, plus Senators Richard Burr of North Carolina and Orrin Hatch of Utah – the plan would rein in Medicaid’s burgeoning costs by turning it into a block grant.

That’s not all.

Among other things, the Patient CARE Act would:

  • Enact medical malpractice reforms to reduce frivolous lawsuits
  • Require basic price transparency to inform and empower patients
  • Cap the exclusion of an employee’s employer-provided health coverage
  • Create a targeted tax credit to help buy health care

Billed as a “Bicameral Republican Blueprint,” this proposal has support from three powerful members of the GOP in Congress. Once they produce more details, then we’ll see how many votes they can muster.

February 4th, 2015 at 1:11 pm
IRS Delays Enforcement of ObamaCare “Clawback”

Ladies and gentlemen, please welcome another politically-motivated ObamaCare delay to the stage!

Megan McArdle sums up the IRS’ decision to let those who received too much in ObamaCare subsidies last year get extra time to pay back the difference (called the law’s “clawback” provision).

“It’s not relieving you of the obligation to repay; it’s just saying that you won’t be liable for a penalty if you don’t repay by the deadline,” explains McArdle. “Interest will continue to accrue, but the interest rates that the IRS charges are actually pretty reasonable (and probably much better than what your credit card company charges). It’s the failure-to-pay penalties it layers on top – half a percentage point a month, with even stiffer penalties for failing to file – that really make your tax bill add up fast.”

That is, if the Obama IRS ever gets around to enforcing the parts of laws it doesn’t like. McArdle writes, “The IRS emphasizes that this is a one-time deal, just for 2014. But I’m not sure if you should believe it. This emphasizes one of the problems we’ve spoken about a lot in this space: The political will to impose the costs of the Affordable Care Act is a lot less strong than the will to distribute the benefits.”

The Republican establishment was once derided as the tax collector for the welfare state. If Obama and the Democratic Party can’t be bothered to administer both the costs and the benefits of their so-called health reform law, the GOP shouldn’t shoulder the burden of balancing its books.

Every politically-motivated delay in enforcing an aspect of ObamaCare is a tacit admission by its supporters that the law is unworkable in practice. Republicans should acknowledge the obvious and start afresh.

January 29th, 2015 at 8:13 pm
Disgraced ObamaCare Contractor Now Working for the IRS

CGI Federal was the primary contractor responsible for building Healthcare.gov – the federal ObamaCare website that glitched its way into bureaucratic infamy.

In the aftermath, CGI was fired by the Department of Health and Human Services and a number of states holding similar contracts.

But like a vampire rising from the dead, CGI Federal is back in the ObamaCare game, and just in time for tax season!

That’s right, a Republican-led House subcommittee discovered that the IRS has hired CGI Federal to a $4.46 million contract. Recall that, under ObamaCare, the IRS must administer a complex income-reporting system to verify which taxpayers received too generous a subsidy.

This news was too much for the Wall Street Journal editorial page, which opined that, “Perhaps CGI is still able to obtain federal business because no one has ever been punished for the worst government technology failures since the Challenger explosion. The political class would prefer to forget, but a new audit from HHS Inspector General Daniel Levinson probes what he delicately calls ObamaCare’s ‘inadequacies in contract planning and procurement.’”

“According to the report,” the Journal continues, “HHS rarely obeyed the laws that govern outside hiring, such as competitive bidding and due diligence of past performance. The 33 contractors that contributed to the $800 million website reported to multiple managers and no one at HHS devised an ‘acquisition strategy’ – also required by statute – to integrate the various pieces.”

So if you are confused, frustrated or inappropriately fined by the IRS this tax season, rest assured that CGI Federal is somehow probably responsible – and making millions.

January 27th, 2015 at 6:41 pm
GOP Congress Working on ObamaCare Alternative If Subsidies Struck Down

Republicans on both sides of Capitol Hill are busy strategizing for ways to minimize the political fallout if the Supreme Court invalidates health insurance subsidies for millions of people currently receiving them under ObamaCare.

The case, King v. Burwell, challenges the IRS’ decision to make insurance premium subsidies available to citizens of 34 states that do not have a state-run ObamaCare exchange. The policy is in direct conflict with ObamaCare’s text, providing the justices with a clear opportunity to hold the Obama administration to the letter of the law.

The Hill is reporting that Republican members of the House and Senate are discussing ways to be ready when and if an estimated 5 to 6 million Americans suddenly can’t afford to purchase mandated health insurance.

So far, no details have emerged regarding specifics. There is a lot to consider since any change in the law will require President Barack Obama’s signature. A complicating factor may be this president’s willingness to let the media portray Republicans and the Court as heartless conservatives, even though all that’s being asked for is the Obama administration to implement its own law as written.

Nothing new here.

On the flip side, it’s encouraging to hear that Republicans in Congress are trying to get in front of a potentially damaging issue by coalescing around an alternative they can sell to the public.

Hopefully this is the start of a welcome trend.

January 22nd, 2015 at 8:50 pm
Doctor Pay Raise Increases Medicaid Access

Think rationing health care spending has an effect of which patients doctors see?

A new study released by the New England Journal of Medicine found that Medicaid beneficiaries enjoyed a 7.7 percent bump in the number of appointments doctors scheduled with them when government reimbursement rates increased.

Unfortunately for the poor who use Medicaid, once ObamaCare’s temporary subsidy phased out, states didn’t have the extra money to continue the higher reimbursements to doctors.

And so, it’s likely that doctors will respond to the new (lower) price signal and cut back on the number of Medicaid patients they schedule.

From a policy perspective this study confirms that doctors respond to economic incentives, and that if we as a society are going to help the poorest of the poor get adequate health care Congress and the president need to start prioritizing federal spending so that there’s more money available to help those who need it.

If the folks in Washington, D.C. are looking for a place to start trimming, former U.S. Senator Tom Coburn’s (R-OK) “Wastebook 2014” is a good place to start.