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Posts Tagged ‘health’
November 20th, 2014 at 7:49 pm
HHS Caught Padding ObamaCare Enrollment Numbers

Is anything the Obama administration says about ObamaCare worth believing?

“The Obama administration said it erroneously calculated the number of people with health coverage under [ObamaCare], incorrectly adding 380,000 dental subscribers to raise the total above 7 million,” reports Bloomberg.

The revelation came to light thanks to diligent work by House Oversight Committee investigators.

Bloomberg quotes Health and Human Services Secretary Sylvia Mathews Burwell as saying, “The mistake we made is unacceptable,” but the news agency goes on to report HHS may have been intentionally misleading in its counts in the run-up to the midterm elections.

“Federal officials said in September they had 7.3 million people enrolled in coverage through new government-run insurance exchanges. They didn’t distinguish between medical and dental plans, breaking from previous practice without notice.” (Emphasis mine)

Along with the Grubergate deceptions, it’s hard to believe that HHS did anything other the deliberately fudge the numbers to help ObamaCare (barely) meet a previous CBO projection. Falling below that threshold would surely have been an embarrassment to the Obama administration, so someone at HHS just changed the rules so the home team could win.

Sounds similar to the president’s approach to immigration, doesn’t it?

November 18th, 2014 at 6:10 pm
Ahead of SCOTUS Challenge, HHS Murky on State-Based Exchange Definition

With its surprising decision to hear oral argument on an ObamaCare subsidy challenge next spring, the Supreme Court of the United States is causing a flurry of activity as some states try to shore up their status ahead of a potentially costly decision.

“The consulting firm Avalere Health estimates that nearly 5 million people would see their premiums spike 76 percent, on average, if the Supreme Court strikes down subsidies in states that don’t operate their own exchanges,” reports Governing. “That estimate assumes a greater number of exchanges are considered federal, not state-based, but the question of what exactly constitutes a ‘state-based’ health exchange is murky.”

How murky?

“States have the option of running their own exchange completely (a state-based exchange), managing aspects of plan design or consumer outreach (a partnership exchange) or leaving everything to the federal government (a federally facilitated exchange),” according to the website.

Predictably, the federal Department of Health and Human Services isn’t divulging its exact criteria for categorizing an exchange, a stance that leaves states without a clear picture of how to prepare for a possible elimination of subsidies to residents.

Some states, like Nevada and Oregon that switched to Healthcare.gov – the federal website – are still considered to have state-based exchanges because they retain control over functions like plan approval, data collection and quality reporting. Others, like Utah and Mississippi, also fall into the state-based category because they host small business exchanges (but not individual exchanges).

So, the bottom line appears to be this: If the Supreme Court axes ObamaCare subsidies per the law’s text and intent, there’s a good chance President Barack Obama’s political appointees will engage in verbal gymnastics to find ways to define “state-based exchanges” in whatever manner best suits them.

No matter. Getting something fundamentally better than ObamaCare isn’t the Supreme Court’s job anyway. Best to pocket the subsidy win if it comes and work toward a policy consensus among the political branches that delivers real reform.

November 17th, 2014 at 3:42 pm
Gallup: New High in Public Disapproval of ObamaCare

Fifty-six percent of Americans disapprove of ObamaCare, the highest number disapproving of the controversial health care law since Gallup began asking the question.

Approval of ObamaCare peaked just before the 2012 presidential election, but has cratered since then.

The culprit is reality.

The beginning of ObamaCare’s nosedive in popularity “occurred in early November 2013”, according to Gallup’s analysis, “shortly after millions of Americans received notices that their current policies were being canceled, which was at odds with President Barack Obama’s pledge that those who liked their plans could keep them. The president later said, by way of clarification, that Americans could keep their plans if those plans didn’t change after [ObamaCare] was passed.”

In other words, the law has continued to grow less popular with each new revelation that it was sold on a pack of lies.

Though completely repealing the entire law seems unlikely because the new Republican Senate majority is less than the number needed to overcome a certain Obama veto, the increasing levels of voter disapproval could convince some Senate Democrats to join Republicans in dismantling large parts.

Unless, that is, they want to risk involuntary retirement when their next election arrives.

November 14th, 2014 at 1:32 pm
Ponnuru: What to Do If SCOTUS Strikes Down ObamaCare Subsidies

With ObamaCare architect Jonathan Gruber’s admissions that the controversial health law was sold on a pack of lies, the probability is rising that the Supreme Court will interpret the law as written and eliminate subsidies for millions of people.

If that happens, will Republicans in Congress be ready?

In order to lay the groundwork for an ObamaCare alternative that covers as many or more people than the current law, and costs less, Republicans in Congress could unite behind a framework proposed by conservative health experts James Capretta and Yuval Levin. Similar ideas have been endorsed by Senator Orrin Hatch (R-UT), the incoming-chairman of the Senate Finance Committee, and Rep. Paul Ryan (R-WI), the likely next chairman of the House Ways and Means Committee.

If the Supreme Court does strike down the subsidies, President Barack Obama won’t have much leverage since, “Much of ObamaCare would have just self-destructed due to its own design flaws and lack of public support, and Republicans would be offering a way to advance the law’s stated goal of assuring coverage – if not in the highly prescriptive and centralized manner the White House prefers”, writes Ramesh Ponnuru. “Democrats’ favored lines of attack on Republicans over health care – that they have no alternative, that they would take people off the insurance rolls – would have been neutralized.”

Sounds like a strategy worth pursuing.

November 12th, 2014 at 6:20 pm
ObamaCare’s 2015 Tax Bite

Too bad the incoming Republican majority in Congress probably can’t repeal ObamaCare’s individual mandate before next April, because it looks like millions of middle-income Americans will see their tax refund cut by one-third.

“The financial penalty for skipping out on health insurance coverage [i.e. not complying with the individual mandate] will more than triple to $325 per person in 2015, or 2 percent of income, depending on whichever is higher,” reports CBS News. “Children will be fined at half the adult rate, or $162.50 for those under 18 years old.”

“Based on the flat-rate method, the maximum dollar amount an uninsured family could be fined is $975,” says the news outlet.

To put this into perspective, the average annual American tax refund is about $3,000, meaning that a $975 IRS penalty would reduce the value by one-third.

This is likely to hit middle-income Americans particularly hard since many may be earning too much in wages or salary to qualify for an ObamaCare subsidy. The Catch-22 facing these families is cutting back on other spending to pay high monthly premiums, or foregoing insurance and waiting to see how much the IRS will confiscate. Either way, the predicament facing millions of middle-income Americans is likely to make them even more hostile toward a law billed as the “Affordable Care Act.”

November 10th, 2014 at 7:07 pm
HHS Reduces ObamaCare 2015 Enrollment Prediction by 30%

On Monday, the Obama administration threw out a Congressional Budget Office (CBO) estimate that ObamaCare would have 13 million enrollees by February 15, 2015. It also discarded a CBO forecast that the controversial health law would have 25 million enrollees by 2017.

Instead, the federal department of Health and Human Services (HHS) said a more likely scenario would be between 9 and 9.9 million by mid-February – a reduction of 30% from CBO’s calculations. As for 2017 totals, HHS will not commit to any numbers.

“The reduced projection is due to recent data showing ‘mixed evidence’ about how quickly – and how dramatically – people will shift from employer-sponsored health insurance and non-ObamaCare plans into insurance plans sold on government-run marketplaces such as HealthCare.gov,” reports CNBC.

What HHS isn’t saying is how the Obama administration playing politics with statutorily mandated deadlines has fouled up ObamaCare’s implementation timetable. Originally, CBO and others could reasonably anticipate quick and dramatic shifts onto ObamaCare plans because the employer mandate made it financially smart to dump workers onto the exchanges and pay a relatively small fine.

But fearing a voter backlash at such a quick and dramatic change, the Obama administration has delayed implementing the employer mandate at least three times. It now isn’t scheduled to go into effect until 2017 – the first year after President Barack Obama is out of office.

According to an HHS report, “there is considerable uncertainty that a large shift will occur over the new two years”, which, “contributes to an analysis that the ramp up to 25 million will take more than three years.”

In other words, thanks to politically motivated regulators, no one knows when, or if, ObamaCare will meet its most important benchmark – sustainable enrollment.

November 7th, 2014 at 5:45 pm
Supreme Court to Hear ObamaCare Subsidy Challenge

In a surprise move, the United States Supreme Court announced today it will hear a third challenge to ObamaCare in as many years.

The case, King v. Burwell, is one of many lawsuits challenging a controversial IRS decision to extend federal subsidies to any person eligible to buy insurance on an ObamaCare exchange. The legal fight is over whether the text of ObamaCare permits subsidies to be given to citizens purchasing health insurance through Healthcare.gov, the federal exchange, when the law clearly says they cannot.

Supporters of ObamaCare say the disputed statutory language amounts to typos inconsistent with the spirit and purpose of the law. Opponents insist that the plain meaning of the words be honored, or risk the rule of law taking a back seat to bureaucratic whim.

The timing of the Supreme Court’s decision means that oral arguments will be held sometime in the spring with a final decision likely next summer. If the challengers are successful, King v. Burwell may go down in history as the lawsuit that signaled the beginning of the end of ObamaCare.

November 5th, 2014 at 3:08 pm
Can Congressional GOP Hang Together on ObamaCare?

Conservative health policy experts Avik Roy and Gracie-Marie Turner both have interesting long reads on what the new Republican majority in Congress should do to transition away from ObamaCare towards a more market friendly alternative.

Both call for a unified strategy focused on repealing ObamaCare’s most unpopular elements and daring President Barack Obama to veto. Importantly, both want the GOP to leave the door open for a truly patient-centered alternative that reduces the government’s role while increasing access to quality health care. It’s a tall order with little consensus.

Roy and Turner each have specific pathways for achieving their goals, and it’s worth reading their articles to get a sense of where conservative health policy may be heading. However, the success of a conservative ObamaCare alternative ultimately comes down to whether House Speaker John Boehner (R-OH) and new Senate Majority Leader Mitch McConnell (R-KY) can corral enough of their members around a unified endpoint. That job is made trickier by the fact that the 2016 presidential campaign will soon be underway, with lots of Republican candidates keeping the specifics of their own ObamaCare alternatives close to the vest.

Going forward, the real goal for Boehner and McConnell is to get rid of what they can, minimize what they can’t and leave enough room for the 2016 presidential nominee to maneuver toward an alternative the public will support.

Easy? No. The price of leadership? You betcha.

November 3rd, 2014 at 5:09 pm
Fed Court Blocks Contraception Mandate Reporting Requirements

With its newest batch of regulations, the federal Department of Health and Human Services (HHS) essentially is telling non-profit religious employers that they can claim an exemption from ObamaCare’s contraception mandate, so long as they provide all the information necessary to violate the deeply held beliefs that justify the exemption.

As Lyle Denniston of SCOTUS Blog explains, the rules “also required the organization to tell the government what its health coverage plan for its employees was by name and type, and to provide contact information to the insurer operating the plan.

“The added information was designed to enable HHS to then take the initiative to arrange for the religious organization’s female employees to have contraceptive coverage at no cost, and with no cost to the organization itself.”

The controversial HHS rules came to light because of a legal challenge filed by a Catholic university in Florida. A federal judge blocked enforcement of the rules pending the outcome of the lawsuit.

A couple of observations immediately come to mind. First, there is no such thing as free contraception. If the insurance company must provide it “free” to some customers, it will then pass on the cost to others (e.g. higher premiums). Even the manpower at HHS spent on coordinating this run-around the First Amendment costs taxpayers money.

This brings up another point. How can it be that the federal agency charged with implementing ObamaCare has the resources and personnel available to investigate, negotiate and procure “free” contraception to the thousands (and more) employees working at exempt religious employers?

It’s not like there’s a public health crisis over lack of access to contraception. If HHS has so many extra people and dollars laying around, it should funnel them to real priorities like fighting Ebola, or perhaps, finishing ObamaCare’s main insurance portal before the second enrollment period begins in a matter of days.

Instead we get demands for information in order to make religious objectors participate in the very activity they cannot abide.

October 22nd, 2014 at 2:43 pm
Insurance Companies Got CMS Okay to Cancel Policies If ObamaCare Subsidies Invalidated

“Amy Lotven of the trade publication Inside Health Reform reports that before insurers agreed to sell coverage through the Patient Protection and Affordable Care Act’s health insurance Exchanges in 2015, they demanded that the federal Centers for Medicare and Medicaid Services explicitly agree to let them cancel policies if any of the Halbig cases succeed in blocking the subsidies that carriers had been receiving in the 36 states whose ObamaCare Exchanges were not, as [ObamaCare] requires before subsidies can flow, ‘established by the State’”, writes Michael Cannon.

You’ll recall that there is a big fight over whether the Obama administration is blatantly violating its own law by making subsidies available to people who don’t qualify under the statute. And, as Cannon points out, making illegal subsidies available also subjects up to 57 million individuals and employers to illegal penalties under ObamaCare’s individual and employer mandates.

That insurance companies demanded the right to cancel policies relying on subsidies shows how concerned the industry is at being blamed for high-cost coverage when and if the government’s policy is ruled illegal. That the Obama administration agreed indicates the strength of the argument that even the executive branch should follow the law.

October 21st, 2014 at 1:50 pm
Report: Without Subsidies, ObamaCare Enrollment in Death Spiral

“Without [ObamaCare’s] premium support, premiums rise by nearly 45 percent, and enrollment falls by nearly 70 percent,” says a report by RAND Health.

The analysis is part of an evaluation commissioned by the federal Department of Health and Human Services (HHS), the agency in charge of ObamaCare implementation.

The report’s publication follows on news that a federal district judge in Oklahoma ruled ObamaCare’s premium support (i.e. subsidies) mechanism is not available in states that use Healthcare.gov, the federal ObamaCare exchange. According to the text of the law, eligibility for subsidies depends on a citizen’s state operating its own exchange. If the law’s plain meaning is followed, RAND’s analysis will apply to citizens in more than half of the states.

The RAND Health report confirms a simple truth about ObamaCare – if people must pay the full freight of its “affordable” insurance, they will refuse.

H/T: The Daily Caller

October 14th, 2014 at 12:06 pm
ObamaCare: Welcome to Politicized Medicine

Next year’s ObamaCare premiums won’t be available through Healthcare.gov – the federal insurance portal servicing 26 states – until the week after the November 4th midterm elections.

“Insurers say one big challenge for next year will involve millions of returning customers,” the AP reports. “It’s not really a technology issue, but a time crunch that also coincides with the Thanksgiving and Christmas holidays.”

In this case, it’s not the health insurance companies who are to blame, but rather the Obama administration. Late last year when Healthcare.gov was glitching its way into infamy, news leaked that the enrollment period for 2015 would be pushed back a month – from October 15 to November 15. Everybody who could read a political calendar knew the primary motivation was to hide the true cost of ObamaCare’s second year premiums from voters before going to the polls.

This is just one more reason why it’s a bad idea to have the government in control of health care pricing – those responsible will never allow the public to hold them accountable.

H/T: Townhall Tipsheet

September 30th, 2014 at 7:25 pm
HHS’ Burwell Caught Low-Balling Congress on Cost of Healthcare.gov

A new report by Bloomberg Government indicates that Sylvia Burwell, the Secretary of Health and Human Services (HHS), gave a potentially misleading answer when she told Congress that Healthcare.gov – the federal government’s ObamaCare portal – cost taxpayers $834 million to build.

Nicole Kaeding at the CATO Institute teases out some of the unstated, but related, costs that balloon the overall price tag to $2.14 billion, far north of Burwell’s testimony.

I’ve summarized them here as bullet points:

  • $300 million contract to process paper applications to serve as backups to electronic files
  • $387 million for real-time interfacing between the IRS and Healthcare.gov to verify income and family size for insurance subsidy calculations
  • $400 million in accounting tricks HHS used to pay for creating Healthcare.gov when 26 states refused to take federal start-up grants to build their own. Congress made no appropriations to build Healthcare.gov, so HHS shifted money from other units to fund the project.
  • $255 million in spending between February 2014 – the end of Burwell’s timeline – and August 20, 2014, the most recent information available. Bloomberg also included projected spending at current levels through September 30, 2014, the end of the fiscal year.

These are the kinds of expenses that Members of Congress would expect the HHS Secretary to include when testifying about full cost of a program. The fact that Burwell gave a low-ball estimate when these figures were easily accessible to her or her staff weakens her credibility as an honest broker of information. As her departing colleague Eric Holder knows, once Congress loses its ability to trust a Cabinet official, the gloves come off.

September 29th, 2014 at 5:07 pm
California’s ObamaCare Exchange Can’t Match Doctors to Plans

If you purchase an ObamaCare plan in California, good luck trying to find a directory that matches your insurance policy with a specific doctor.

“Altogether, the 10 insurers in Covered California have contracted with an estimated 75% of California’s licensed physicians, or nearly 90% of those considered active in the state,” reports the Los Angeles Times. “However, many of those doctors are available in just one or two health plans.”

That is, if you can find them.

“There’s no timetable for a state provider directory after the exchange scrapped an initial version that was riddled with errors. Instead, Covered California refers people to insurance company websites that vary in usefulness,” says the paper.

The resulting anger and confusion has spawned almost 300 complaints to state regulators and two consumer lawsuits against some of the biggest insurance companies in California.

Doctors are getting hosed too, according to the report. “Insurers say they can pass along savings by paying doctors less and rewarding that select group with higher patient volume. It’s also hoped those doctors will take on a bigger role coordinating patient care.”

To clarify, in return for getting paid less doctors that accept ObamaCare-compliant plans are getting more patients and more exposure to medical malpractice lawsuits.

No wonder there’s no directory matching providers to plans. The docs want to hide!

September 24th, 2014 at 3:05 pm
ObamaCare’s Coverage Gaps Will Kill Good Health Insurance

If you’ve tried to buy insurance on an ObamaCare exchange, you’re familiar with the four levels of coverage available: Bronze, Silver, Gold and Platinum. Each level covers a set percentage of costs should you incur health-related expenses.

For example, a Bronze plan covers 58-62 percent, a Silver plan 68-72 percent, Gold 78-82 percent and Platinum 88-92 percent.

Notice, however, that there are gaps between the coverage levels.

Recall as well that ObamaCare’s coverage requirements get tweaked from year-to-year, changing the actuarial value – i.e. the percentage of covered benefits the insurance company is expected to pay – each year.

Here’s the problem.

“Suppose you are in a Bronze plan with an actuarial value of 58 percent. Then, a year from now, because of price changes, technology changes, or some other kind of change, your plan suddenly covers 64 percent of expected expenses. That’s good for you, right? Wrong. Because your plan no longer fits into one of the metallic corridors, it’s no longer a valid plan – despite the fact that it has become a better plan,” explains John C. Goodman, a conservative health policy expert.

The same is true at the other end of the coverage spectrum.

“Now let’s suppose you have a really good plan – a plan that pays 98% of expected health care costs,” writes Goodman. “Given the large number of Democrats who believe that health insurance should pay almost every medical bill, you would think that the law passed by a Democratic Congress without a single Republican vote would strongly encourage such a plan. If you’re inclined to think that, you are mistaken, however.

“Any plan that pays more than 92% of expected health care costs for the average enrollee is illegal under Obamacare.”

Get ready to change your health insurance more often than you change your auto insurance.

September 23rd, 2014 at 5:24 pm
New ObamaCare Glitch Could Cost Doctors Millions

Doctors who spent heavily trying to comply with ObamaCare’s electronic health records mandate could still be hit with costly penalties.

ObamaCare gives doctors until October 1, 2014, to switch from paper-based to electronic health records. Failure to comply results in losing 1 percent of federal reimbursements for treating Medicare patients.

Here’s the rub.

“[P]hysicians who went electronic for the first time this year are discovering that [the Centers for Medicare and Medicaid Services, or CMS] won’t be ready to officially register the evidence of their work until mid-October. That means they will miss the Oct. 1 deadline, and CMS will withhold 1 percent of their 2015 Medicare payments,” reports Politico.

That means that a doctors’ group like Morganton Eye Physicians in North Carolina spent $1.3 million to buy and implement new software – and added $250,000 to its annual operating budget – only to be threatened with a $65,000 penalty because the federal government can’t meet its own compliance deadline.

One would think CMS has a moral obligation to waive compliance until the agency is able to do its job, but so far it’s requiring doctors to submit to a cumbersome hardship process. How does a business politely explain that the hardship exists completely because of government ineptitude?

Welcome to ObamaCare’s bureaucratic hell. More episodes to follow.

September 22nd, 2014 at 6:49 pm
ObamaCare’s 7.3 Million Enrollments May be False

Last week the Obama administration released its first official headcount of ObamaCare enrollments since applauding itself for 8 million initial sign-ups.

The current enrollment is 7.3 million, according to the Centers for Medicare and Medicaid Services (CMS).

But there’s reason to be suspicious.

“Under ObamaCare, after a person has paid their first premium, a health plan can’t cancel anyone until they have gone three months without making a payment,” writes health care policy expert Bob Laszewski.

By saying that the 7.3 million number includes all enrollments that have occurred through mid-August, CMS is “effectively double counting by including the ‘adds’ while also keeping the ‘deletes’.” That means the 7.3 figure “also still includes every person who has failed to make a premium payment in June, July, and August – since the carriers can’t yet knock them off the rolls,” explains Laszewski. “The health plans tell me there is a 2% to 4% monthly attrition rate. That means the 7.3 million could be overstated by 6% to 12% of the total.”

Unfortunately, the most transparent administration in history refuses to release the monthly enrollment numbers since ObamaCare went online. That makes it impossible to verify whether the 7.3 million is accurate.

If the Obama administration is so proud of its new number, why not release the data on which it’s based?

September 16th, 2014 at 7:03 pm
Top Minnesota ObamaCare Insurer Leaving Exchange

The largest player on Minnesota’s ObamaCare exchange is dropping out, and not even the promise of federal subsidies can get it back.

Earlier today PreferredOne – an insurance company that covered 59 percent of Minnesota’s ObamaCare population – announced that it will not offer health care plans next year paid for with ObamaCare subsidies.

Apparently, the decision is being driven by high administrative costs associated with doing business with MNsure. Even after hiring an additional 50 workers to handle the exchange’s post-launch fixes and tweaks, PreferredOne says continuing to participate is financially unsustainable.

The move makes it likely that MNsure’s ObamaCare rates will jump since PreferredOne sold the lowest cost option. Those rates will be released sometime in October – just weeks before the midterm elections.

September 12th, 2014 at 1:31 pm
Workers Paying More for Health Insurance under ObamaCare

As ObamaCare’s next open enrollment period draws near, some of the controversial law’s biggest backers are cheering a seven city survey claiming that health insurance premiums associated with it are dropping.

This leads liberal health policy expert Ezra Klein of Vox to say that “Obama’s signature accomplishment is succeeding beyond all reasonable expectation.”

But not if you get your health insurance from your employer, however.

“Employees are on the hook for more and more of their health care costs. Premiums are increasing so slowly in part because employers are continuing to shift toward higher deductibles, requiring employees to pay more out of their own pockets before their health care plans kick in,” explains Sam Baker in National Journal.

Comparing monthly premium rates year-to-year makes sense if that’s the best single indicator of how ObamaCare is impacting paychecks. But it isn’t. For employees working in the real economy the shift to high deductible plans means more out-of-pocket spending every time they visit the doctor.

Translation: ObamaCare makes health insurance for workers more expensive.

When it comes to measuring ObamaCare’s success, we need to make sure we’re looking at the most relevant data. Otherwise, we risk scoring political points at the expense of the truth.

September 9th, 2014 at 7:51 pm
ObamaCare’s Popularity Dropping Ahead of Midterms

“Just 35 percent of voters now support the Affordable Care Act, down 3 percentage points from May, according to a monthly poll by the Kaiser Health Foundation,” reports The Hill.

Moreover, the poll found that 47 percent of respondents feel negatively about the law, otherwise known as ObamaCare.

The RealClearPolitics average of six national polls is even worse: 53.8 percent say they oppose the law, with only 40.3 percent in favor.

Little wonder that the controversial health law is so unpopular. States are continuing to resist Medicaid expansion under ObamaCare’s terms for fear of a Trojan horse spending spree, and consumers are getting shut out of some of the country’s best hospitals.

All this and it is still almost two months until the midterm elections.

President Barack Obama may not be on the ballot this year, but his eponymous health law surely is.