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Re: ''Affordable'' Care Act plans bring hefty fees for certain vital drugs

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Re: ''Affordable'' Care Act plans bring hefty fees for certain vital drugs

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Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage

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Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage

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Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage

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Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage

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Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage

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Re: Ezekiel Emanuel (ACA ''architect''): Vast majority of employers will drop healthcare coverage

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AP/GfK poll: Public support for ACA at lowest level yet (26%)

Posted by Olog-hai on Fri Mar 28 03:37:27 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Mar 28, 2014 3:09 AM EDT

Poll: Obama health care law fails to gain support

By Ricardo Alonso-Zaldivar and Dennis Junius
Associated Press

Public support for President Barack Obama's health care law is languishing at its lowest level since passage of the landmark legislation four years ago, according to a new poll.

The Associated Press-GfK survey finds that 26 percent of Americans support the Affordable Care Act. Yet even fewer — 13 percent — think it will be completely repealed. A narrow majority expects the law to be further implemented with minor changes, or as passed.

"To get something repealed that has been passed is pretty impossible," said Gwen Sliger of Dallas. "At this point, I don't see that happening."

Sliger illustrates the prevailing national mood. Although a Democrat, she's strongly opposed to Obama's signature legislation. But she thinks "Obamacare" is here to stay.

"I like the idea that if you have a pre-existing condition you can't be turned down, but I don't like the idea that if you don't have health insurance you'll be fined," said Sliger.

The poll was taken before Thursday's announcement by the White House that new health insurance markets have surpassed the goal of 6 million sign-ups, so it did not register any of the potential impact of that news on public opinion. Open enrollment season began with a dysfunctional HealthCare.gov website last Oct. 1 but will end Monday on what looks to be a more positive note.

Impressions of the health care rollout while low, have improved slightly.

While only 5 percent of Americans say the launch of the insurance exchanges has gone very or extremely well, the number who think it has gone at least somewhat well has improved from 12 percent in December to 26 percent now. The exchanges offer subsidized private coverage to people without a plan on the job.

Of those who said they or someone in their household tried signing up for coverage, 59 percent said there were problems.

Repealing the health care law is the rallying cry of Republicans running to capture control of the Senate in the fall congressional elections. The Republican-led House has already voted more than 50 times to repeal, defund or scale back "Obamacare," but has been stymied in its crusade by Democrats running the Senate.

Thursday, five Democratic senators and one independent — three facing re-election — introduced a package of changes to the law that seems calibrated to public sentiment. One of their major proposals would spare companies with fewer than 100 employees from a requirement to provide coverage to their workers. The current cutoff is 50.

The poll found that 7 in 10 Americans believe the law will be implemented with changes.

Forty-two percent think those changes will be minor, and 30 percent say they think major changes are in store.

Combining the 42 percent who see minor changes coming and 12 percent who say they think the law will be implemented as passed, a narrow majority of 54 percent see either tweaks in store, or no changes at all.

Larry Carroll, 64, a church deacon from Cameron, W.Va., says he would like to see major changes — but he doesn't have high hopes.

"I think it's much too big a thing for the country to be taking on," said Cameron, who's strongly opposed to the overhaul.

"I don't see repeal," he added. "The federal bureaucracy simply seems to be too strong. The federal bureaucracy is like an anaconda."

Teresa Stevens, a factory supervisor from Jacksonville, Fla., said her two adult sons shopped for coverage on the health insurance exchanges and found it too expensive.

"There are so many different things they say about (the law) that are not true," she said. "It's not affordable."

A supporter of former Democratic President Bill Clinton, Stevens said the economy has soured for working people under Obama. "Everything is so expensive, not just health care," she said.

The poll found that much of the slippage for the health care law over the last four years has come from a drop in support, not an increase in opposition.

In April of 2010, soon after the law passed, 50 percent of Americans said they were opposed to it, while 39 percent were in favor. Ten percent were on the fence.

Now, just 26 percent say they are in favor, a drop of 13 percentage points. Forty-three percent say they are opposed, a drop of 7 percentage points since that poll four years ago. But the number who neither support nor oppose the law has tripled, to 30 percent.

The 26 percent in favor in the AP-GfK poll is not significantly different from the 27 percent registered in January and December.

The AP-GfK Poll was conducted March 20-24 using KnowledgePanel, GfK's probability-based online panel designed to be representative of the U.S. population. It involved online interviews with 1,012 adults and has a margin of sampling error of plus or minus 3.4 percentage points for all respondents.

Respondents were first selected randomly using phone or mail survey methods and were later interviewed online. People selected for KnowledgePanel who didn't otherwise have access to the Internet were provided with the ability to access the Internet at no cost to them.

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%)

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%) WAIT

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%)

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%) WAIT

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%) WAIT

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%) WAIT

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%) WAIT

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%) WAIT

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%)

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%)

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%)

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%)

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%)

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%)

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Re: AP/GfK poll: Public support for ACA at lowest level yet (26%)

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Missed open enrollment? Might be shut out of getting health insurance—thanks to ACA

Posted by Olog-hai on Fri Apr 4 11:22:31 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Health insurance isn't a year-round thing anymore

By Connie Cass
Apr 4, 2014 3:54 AM EDT

Here's more fallout from the health care law: Until now, customers could walk into an insurance office or go online to buy standard health care coverage any time of year. Not anymore.

Many people who didn't sign up during the government's open enrollment period that ended Monday will soon find it difficult or impossible to get insured this year, even if they go directly to a private company and money is no object. For some it's already too late.

With limited exceptions, insurers are refusing to sell to individuals after the enrollment period for HealthCare.gov and the state marketplaces. They will lock out the young and healthy as well as the sick or injured. Those who want to switch plans also are affected. The next wide-open chance to enroll comes in November for coverage in 2015.

It's a little-noted consequence of President Barack Obama's health care overhaul, which requires nearly all Americans to be insured or pay a fine and requires insurers to accept people with health problems.

"I have people that can buy insurance, but the companies shut them down. They won't take the applications," insurance broker Steve Bobiak of Frackville, Pa., said. "We're a free country. You should be able to buy anything anytime you want."

Those who act now may still be able to get in, depending on where they live. Following the lead of the government marketplaces, some companies are extending off-marketplace sales for a week or a month to help people who hit snags trying to enroll by this week's deadline. Rules vary from state to state.

After those extensions, eligibility for coverage during 2014 is guaranteed only for people who experience certain qualifying life events, such as losing a job that provided insurance, moving to a new state, getting married, having a baby or losing coverage under a parent's health plan.

The federal law doesn't prevent companies from selling policies to everyone all year. But insurers consider it too risky now that the law prohibits them from rejecting people in poor health.

"If you didn't have an open enrollment period, you would have people who would potentially enroll when they get sick and dis-enroll when they get better," said Chris Stenrud, spokesman for insurer Kaiser Permanente. "The only insured people would be sick people, which would make insurance unaffordable for everyone."

Bobiak, whose NICA Benefits company helps people buy insurance in New Jersey, Ohio and Pennsylvania, said he learned only a couple of weeks ago that insurers were cutting off new policies.

"It's lousy communication out there," he said. "If we don't know, my God, how do they expect other people to know? It's terrible."

A survey by the Kaiser Family Foundation in mid-March found that 6 out of 10 people without insurance weren't aware of the marketplace deadline on March 31. The Obama administration, insurance companies and nonprofit groups scrambled to spread the word, often with messages that focused on the cost savings available to many people through the government marketplaces.

There wasn't much public discussion about people who prefer to buy policies outside the marketplaces, sometimes finding better deals or options more to their liking.

Health and Human Services spokesman Aaron Albright pointed to a cryptic note on the HealthCare.gov website: It says "in some limited cases some insurance companies may sell private health plans outside the marketplace and outside open enrollment" that satisfy the law's coverage mandate. It doesn't say how to find any companies doing that. Albright had no further comment.

Gary Claxton, a health law expert at the Kaiser Family Foundation, said it's "highly unlikely" that companies will offer such coverage after the deadline window fully closes. Some do still offer temporary plans, lasting from a month to a year. But those plans don't cover pre-existing conditions and don't get buyers off the hook for the law's tax penalty.

Nate Purpura, spokesman for eHealthInsurance.com, which sells policies from 200 companies across the nation, said at this point he knows of none planning to offer major medical insurance after this month, except to people with qualifying life events.

For people trying to get an off-marketplace plan through an open enrollment extension, some insurers are selling them through April 15, and others through the end of the month. Purpura said eHealth will offer such plans in at least some areas of these states: Arizona, California, Georgia, Hawaii, Louisiana, Maryland, Michigan, Nevada, New Mexico, Ohio, Oregon, Utah, Virginia and Washington state.

Kaiser Permanente will offer extensions that mirror the state or federal marketplace in the area where a plan is sold, Stenrud said. The federal marketplace extension for online enrollment is April 15. But Oregon, for example, is giving marketplace buyers until April 30.

After that, Stenrud said, without a qualifying life event, the door closes until Nov. 15.

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ACA forces cancellation of New Jersey's FamilyCare Advantage (for kids)

Posted by Olog-hai on Sun Apr 6 16:08:00 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Obamacare eclipses low-cost NJ health plan for middle-class kids

By Susan K. Livio/The Star-Ledger
on April 06, 2014 at 7:30 AM, updated April 06, 2014 at 7:34 AM

While the federal government was trumpeting the benefits of Obamacare to boost enrollment earlier this year, about 1,800 families in New Jersey were receiving letters telling them their children would be losing their health coverage last week.

The Affordable Care Act — the federal law that mandates everyone have insurance — effectively killed FamilyCare Advantage, a low-cost option for kids in New Jersey created six years ago for parents who earned too much to qualify for Medicaid and other subsidized programs but too little to buy on a policy on their own. The state program was the first of its kind in the nation.

Horizon Blue Cross Blue Shield of New Jersey was the only insurance carrier that agreed to offer the FamilyCare Advantage plan, which covered most medical, dental and vision needs for the relative bargain of $144 a month per child.

But it didn’t offer mental health treatment and several other services Obamacare requires, and that was the fatal flaw, said Sen. Joseph Vitale (D-Middlesex), who sponsored the law creating the program.

Vitale said he tried for several months to broker a deal between Horizon and the U.S. Centers for Medicare and Medicaid Services, but neither side could agree on how to make it affordable and legal. The program ended last week.

People who tried to buy a plan on the health exchange would have been hit with sticker shock, Vitale said. FamilyCare Advantage had no deductible, compared with the less generous Horizon plan on the exchange that has a minimum deductible of $1,500. And most people would not have qualified for subsidies through the exchange because they earned too much money, he said.

“This is enormously disappointing. New Jersey was always ahead of the nation on health coverage for children and parents,” said Vitale. “It was $5 for doctor visits, $1 for pharmacy and no deductible or cost sharing.”

Vitale noted the irony that the program created to extend universal health care access to all New Jersey’s uninsured children was done in by federal health care reform.

FamilyCare Advantage “was a great deal,” but with little marketing it never caught on, Vitale said. “It’s New Jersey’s best-kept secret.”

Surprised

Bob Miotla of Gloucester Township, who signed up his son, Robert, for the coverage after his wife’s company stopped offering family coverage about four years ago, said the letter from Horizon in January “took us by surprise.”

“Without having that safety net, if an illness arises, we will probably take him to the ER,” said Miotla, who is disabled and gets Medicare.

The news made him “extremely angry” with both the federal government and Horizon, Miotla said.

“Obamacare did snuff it out, but it also looks like Horizon was looking for a reason to end it. With all of the federal mandates (for employers to offer insurance) delayed, they didn’t need to do anything right now.”

This is not the only instance of the Affordable Care Act clashing with existing health policies.

About 800,000 people who bought their coverage through the state-regulated small-employer and individual market programs were informed last fall their plans did not contain all of what the federal law requires: hospitalization, lab services, rehab services and devices, outpatient services, emergency care, prescription drugs, maternity care, preventive services, mental health and substance abuse treatment, and pediatric services, including oral and vision care. Insurance policies also could no longer contain lifetime caps on benefits.

As millions across the nation started losing their coverage for the same reason, President Obama asked governors and state insurance commissioners to preserve these policies for a year.

Gov. Chris Christie let the insurance companies decide, and they declined, saying the federal government still required no lifetime cap on benefits, which would make the policies much more expensive.

The same reckoning played out with the FamilyCare Advantage plan.

“The NJ FamilyCare Advantage plan does not meet all ACA requirements and would have had to be significantly changed. This would have increased considerably the premiums for the plan,” Horizon spokesman Tom Vincz said.

Disagreeing

Danielle Liss, spokeswoman for the federal Medicaid program, disagreed with Horizon’s assessment. “Horizon had the option to extend any non-ACA compliant plans for another year even without changing benefits to meet the ACA requirements said,” she said.

Vitale said that in the end, the Obama administration would not allow the Advantage plan to be offered to just the original customers without it being an option for everyone.

“Now people will have to go on the exchange, where the premiums are reasonable but the deductibles are enormous,” he said. “The Affordable Care Act is costing families a lot more than it should.”

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Re: Missed open enrollment? Might be shut out of getting health insurance—thanks to ACA

Posted by Olog-hai on Sun Apr 6 16:09:41 2014, in response to Missed open enrollment? Might be shut out of getting health insurance—thanks to ACA, posted by Olog-hai on Fri Apr 4 11:22:31 2014.

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Re: Missed open enrollment? Might be shut out of getting health insurance—thanks to ACA

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Re: Missed open enrollment? Might be shut out of getting health insurance—thanks to ACA

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Re: Missed open enrollment? Might be shut out of getting health insurance—thanks to ACA

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Too poor for "Universal Health Care" (millions can't get Medicaid and can't get subsidies)

Posted by Olog-hai on Wed Apr 23 06:51:01 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Re: Too poor for ''Universal Health Care'' (millions can't get Medicaid and can't get subsidies)

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Re: Too poor for ''Universal Health Care'' (millions can't get Medicaid and can't get subsidies)

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Re: Too poor for ''Universal Health Care'' (millions can't get Medicaid and can't get subsidies)

Posted by italianstallion on Wed Apr 23 14:48:01 2014, in response to Too poor for "Universal Health Care" (millions can't get Medicaid and can't get subsidies), posted by Olog-hai on Wed Apr 23 06:51:01 2014.

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Re: Too poor for ''Universal Health Care'' (millions can't get Medicaid and can't get subsidies)

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Chatham County GA cuts hours for 100+ PT seasonal workers due to ACA

Posted by Olog-hai on Mon Apr 28 05:17:13 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Chatham County votes to cut part-time seasonal employees' hours

Posted: Apr 25, 2014 4:16 PM EDT
Updated: Apr 25, 2014 10:42 PM EDT
By WTOC Staff

More than 100 part- time seasonal employees will have their hours cut after Chatham County Commissioners voted unanimously to do so on Friday.

They said the cuts were due to new provisions in the Affordable Care Act.

The county does not want to face the liability and cost of providing insurance for anyone working more than 30 hours a week.

"We have to guard the taxpayers' money, and there's no way to pay for full-time work when only part time work is actually needed," said Chatham County Commissioner Dean Kicklighter.

The county will assist them in applying for insurance through the Healthcare Exchange.

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VA governor Terry Tarkin (er, McAuliffe) trying to bypass VA legislature to expand Medicaid

Posted by Olog-hai on Sat May 3 03:12:14 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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McAuliffe explores whether he can expand Medicaid coverage without legislature’s okay

By Laura Vozzella
Published: May 1, 2014

Virginia Gov. Terry McAuliffe is considering expanding health coverage for the poor without the approval of the state legislature, a move that would muscle his top priority past Republican opponents but also throw his young administration into a partisan firestorm and uncertain legal territory.

McAuliffe and his top advisers have consulted lawyers, health-care experts and legislators on how to bypass the GOP-dominated House of Delegates, according to three people familiar with the discussions. A fourth, who like the others spoke on the condition of anonymity because they were not authorized to reveal private strategy, said the office of Attorney General Mark R. Herring (D) has been researching the matter.

The move would allow Virginia to take advantage of a key state option under the Affordable Care Act, and it could help break a budget stalemate and avert a looming government shutdown. But it would be a daring action; only two other governors have done anything similar to bulldoze Medicaid expansion past opponents.

If McAuliffe follows through, he would raise far-reaching constitutional questions about the chief executive’s power and the rule of law — issues cropping up with increasing frequency in the states and in Washington, as governors and President Obama seek to push past adversarial legislatures and Congress.

The action would also surely create a politically toxic environment for McAuliffe, a new governor who just passed the 100-day mark of his term, and it could launch legal challenges that he is by no means assured of defeating.

Legal powers uncertain

“I don’t believe that he has that authority,” said Del. S. Chris Jones (R-Suffolk), chairman of the House Appropriations Committee and a central adversary in the budget stalemate with McAuliffe.

Even nonpartisan observers were uncertain of McAuliffe’s position. “I don’t know what the legal theory would be, frankly,” said A.E. Dick Howard, a University of Virginia legal scholar who was chief draftsman of the state constitution when it was revamped in 1971.

McAuliffe (D) and Herring sidestepped questions this week about the possibility of expanding Medicaid by executive action. Their spokesmen declined to comment Thursday.

Just two governors, in Ohio and Kentucky, have relied on their executive authority to buck reluctant legislatures to expand Medicaid under the Affordable Care Act, according to health-
policy experts. And their examples do not provide a clear path for McAuliffe, because those governors took advantage of legal quirks in those states.

Ohio Gov. John Kasich (R) was able to tap an administrative board that normally oversees state contracting to approve expansion. In Kentucky, Gov. Steve Beshear (D) could authorize ­expansion unilaterally because Medicaid eligibility rules are set in state regulations, which can be changed by executive order, rather than state code, which is set by the legislature.

Expansion by executive action might be more difficult in Virginia, where the state constitution requires the legislature to approve all appropriations — even pass-through funding from Washington, which has promised to foot the full bill for Medicaid expansion for the first three years.

For months, while still pushing for expansion through the General Assembly, McAuliffe advisers have been searching for a solution even if the House won’t go along, the three people familiar with those discussions said. They’ve picked the brains of health-care advocates and assured expansion-minded legislators that they are “exploring their options,” as one person familiar with those discussions put it.

Sen. Emmett W. Hanger Jr. (Augusta), one of three Senate Republicans who support expansion, said the possibility has come up many times in meetings between legislators and administration officials. Hanger stopped short of saying that the administration is pursuing that strategy; he said no one has ever told him.

“They’re intrigued by what Governor Kasich did in Ohio,” Hanger said. “There have been numerous instances where the speculation turned to whether or not it could be done administratively, but there’s never been anyone that has clearly said, ‘Yes and we’re working on a plan.’”

Political backlash

Officials have always said in such meetings that McAuliffe’s legal authority to make such a move was a “gray area,” said Hanger. In any case, Hanger thinks such a move would stir up too much ill will and might not stand up to a legal challenge.

“Whether they can or can’t, that’s not where I want to be,” Hanger said. “I think it would be a bold step that would lead to a lot of controversy and lawsuits because it would not be clear [legally]. But on the other hand, if a governor felt that strongly about it and just proposed to do it, I suppose the only way to stop him would be a lawsuit. But it would be quick in coming.”

McAuliffe’s more partisan supporters, meanwhile, said they would stand behind him. “If the governor concludes he has that ability, I support him 1,000 percent,” said Sen. A. Donald McEachin (D-Henrico).

House Republicans have grown increasingly vocal about the possibility, particularly after Herring bucked the General Assembly’s wishes this week by declaring that some young illegal immigrants are eligible for in-state tuition. Three months earlier, Herring had announced that the state’s ban on gay marriage — something the legislature still supports — is unconstitutional.

McAuliffe’s comments in recent days have only strengthened the perception that there was an executive plan in the works. Asked on a radio program whether he was pursuing a way to sidestep the General Assembly to make expansion happen, Mc­Auliffe said: “Everybody says that. I’d like them to tell me and all my lawyers exactly how we do that. … I ran saying I want to work in a bipartisan way. I want to get this done legislatively.”

Mark Lewis, co-host of WTOP’s “Ask the Governor” program, pressed him. “So you don’t have the authority to make this happen?”

“I want to do this legislatively, Mark,” McAuliffe responded.

In a news conference in Richmond this week to discuss his action on in-state tuition for the children of illegal immigrants known as “dreamers,” Herring similarly dodged questions about whether he was exploring the legality of expanding without the legislature’s consent.

Those responses have fed House Republicans’ fears that McAuliffe will try to enact expansion on his own.

“You see President Obama certainly using executive orders, executive fiat, to delay [portions of] the Affordable Care Act, and you’re seeing the same thing with the attorney general and the governor, with these vague statements,” said House Majority Leader M. Kirkland Cox (R-Colonial Heights). “He certainly looks like he’s going to go down this road of using executive orders.”

A policy priority

McAuliffe has made expanding Medicaid under the Affordable Care Act his top priority, and he came into office upbeat about his ability to sell wary House Republicans on opening the program to 400,000 low-income Virginians. Nearly four months into his term, the House has not budged. The stalemate has blocked passage of a state budget and threatens to shut down the government if it is not resolved by July 1.

McAuliffe has said that, in addition to helping needy Virginians, expansion would boost the state’s economy with $5 million per day in federal funding.

Republicans have argued that the federal government cannot afford to keep its promise to bankroll most of the $2 billion-a-year price tag. They also say the state should get the soaring costs of its existing Medicaid program under control before considering expansion.

Senate Majority Leader Richard L. Saslaw (D-Fairfax) said he was not aware of plans by the administration to go it alone if a deal cannot be struck, but he did not rule it out.

“The best way to do it, I think, would be through the [legislative] process, but that may or may not be the only way to do it,” Saslaw said.

Independent of the governor, some health-care experts have been looking for months for a way for McAuliffe to make expansion happen on his own, according to two people familiar with those discussions. They considered whether the governor could stack the state’s Medicaid board, which sets eligibility standards, with his own appointees. They wondered whether McAuliffe could expand Medicaid by claiming emergency powers, perhaps in the event of a looming hospital closure or the government shutdown.

The experts ultimately were not convinced that any of those options would work, although it was not clear if the governor or attorney general had dismissed them, according to the two people, who spoke on the condition of anonymity to discuss private strategy.

Former governor and attorney general James S. Gilmore III (R) was skeptical that McAuliffe could expand Medicaid under the emergency authority that might be invoked to continue essential government functions during a shutdown.

“I believe they will reach an agreement [on the budget], but the failure to reach an agreement does not empower the governor to become a dictator,” Gilmore said.

Although Howard, the constitutional scholar, could not think of a way for McAuliffe to make it happen, he said the governor and his staff might find one.

“I think it might be a reach to put this under the umbrella of emergency powers,” Howard said. “But there may be some independent ground that they could stand on for doing this.”

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Re: VA governor Terry Tarkin (er, McAuliffe) trying to bypass VA legislature to expand Medicaid

Posted by orange blossom special on Sat May 3 10:34:48 2014, in response to VA governor Terry Tarkin (er, McAuliffe) trying to bypass VA legislature to expand Medicaid, posted by Olog-hai on Sat May 3 03:12:14 2014.

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Lots of duplicate www.healthcare.gov signups; website problems blamed

Posted by Olog-hai on Wed May 7 16:18:06 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Insurers Say Most Who Signed Up Under Health Law Have Paid Up

By Robert Pear
May 6, 2014

Most of the people choosing health plans under the Affordable Care Act — about 80 percent — are paying their initial premiums as required for coverage to take effect, several large insurers said Tuesday on the eve of a House hearing about the law.

But the health insurance industry said the total of eight million people who signed up included “many duplicate enrollments” for consumers who tried to enroll more than once because of problems on the website.

“Insurers have many duplicate enrollments in their system for which they never received any payment,” said Mark Pratt, a senior vice president of America’s Health Insurance Plans, an industry trade group.

“It may be a matter of months,” Mr. Pratt added, “before insurers know how many people activated their coverage by paying their share of premiums.”

President Obama said last month that eight million people had signed up for health insurance under the Affordable Care Act, surpassing the administration’s original goal of seven million in the federal and state insurance exchanges.

In testimony prepared for a hearing of a panel of the House Energy and Commerce Committee on Wednesday, Mr. Pratt said, “Health insurers have been doing everything possible to encourage exchange enrollees to pay their premiums.”

Paul Wingle, the executive director of exchange operations and strategy at Aetna, said: “As of the third week of April, Aetna had over 600,000 members who had enrolled and roughly 500,000 members who had paid. For those who had reached their payment due date, the payment rate, though dynamic, has been in the low- to mid-80 percent range.”

Aetna said it was selling insurance to individuals and families in the exchanges of 17 states.

The Obama administration extended deadlines for people to sign up and pay for insurance, making it difficult to establish an accurate count of enrollment, insurers said. The federal government is still working on a financial management system to reconcile enrollment records of insurers and the exchanges.

J. Darren Rodgers, the chief marketing officer of the Health Care Service Corporation, which offers Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas, said his company had received 600,000 applications through the exchanges in Texas and the four states it serves. On average, according to data provided by Mr. Rodgers, about 15 percent of customers missed their initial payment deadlines from January through April.

About two-thirds of subscribers with exchange policies scheduled to take effect on May 1 have paid their premiums, Mr. Rodgers said, but some of the others have more time to pay.

Dennis Matheis, the executive in charge of exchange strategy for WellPoint, said the company was satisfied with returns on its business in the 14 states where it was selling health plans on the exchanges.

“We are seeing strong membership growth and large percentages of our newly enrolled customers are successfully paying their premiums by the due date,” Mr. Matheis said.

For people who signed up from Oct. 1 to April 15, Mr. Matheis said, about 70 percent have paid their premiums. For people who have passed the payment deadline, he said, the proportion is higher, “ranging up to 90 percent, depending on the state.”

Republicans on the committee said last week that only about two-thirds of people signing up for private health insurance in the federal exchange had paid their premiums as of April 15. Administration officials and congressional Democrats called that statistic grossly misleading. Given the surge in enrollment near the end of March, they said, it is understandable that some policyholders would not have paid by April 15.

Frank E. Coyne a vice president of the Blue Cross and Blue Shield Association, said 283,800 people had signed up for coverage offered by “multi-state plans” sold by Blue Cross and Blue Shield under contract with the federal government.

Congress authorized the multi-state insurance program to increase options for consumers shopping in the online insurance markets. The plans are available in the marketplaces, or exchanges, of 30 states.

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Re: Lots of duplicate www.healthcare.gov signups; website problems blamed

Posted by bingbong on Wed May 7 17:00:50 2014, in response to Lots of duplicate www.healthcare.gov signups; website problems blamed, posted by Olog-hai on Wed May 7 16:18:06 2014.

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Re: Lots of duplicate www.healthcare.gov signups; website problems blamed

Posted by mtk52983 on Wed May 7 17:38:47 2014, in response to Re: Lots of duplicate www.healthcare.gov signups; website problems blamed, posted by bingbong on Wed May 7 17:00:50 2014.

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More than a million Americans getting "wrong" ACA subsidy; government unable to fix (whoops)

Posted by Olog-hai on Sat May 17 13:29:15 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Federal health-care subsidies may be too high or too low for more than 1 million Americans

By Amy Goldstein and Sandhya Somashekhar
Published: May 16, 2014

The government may be paying incorrect subsidies to more than 1 million Americans for their health plans in the new federal insurance marketplace and has been unable so far to fix the errors, according to internal documents and three people familiar with the situation.

The problem means that potentially hundreds of thousands of people are receiving bigger subsidies than they deserve. They are part of a large group of Americans who listed incomes on their insurance applications that differ significantly — either too low or too high — from those on file with the Internal Revenue Service, documents show.

The government has identified these discrepancies, but is stuck at the moment. Under federal rules, consumers are notified if there is a problem with their application and asked to upload or mail in pay stubs or other proof of their income. Only a fraction have done so, according to the documents. And, even when they have, the federal computer system at the heart of the insurance marketplace cannot match this proof with the application because that capability has yet to be built, according to the three individuals.

So piles of unprocessed “proof” documents are sitting in a federal contractor’s Kentucky office, and the government continues to pay insurance subsidies that may be too generous or too meager. Administration officials do not yet know what proportion are overpayments or underpayments. Under current rules, people receiving unwarranted subsidies will be required to return the excess next year.

The inability to make certain the government is paying correct subsidies is a legacy of computer troubles that crippled last fall’s launch of HealthCare.gov and the initial months of the first sign-up period for insurance under the Affordable Care Act. Federal officials and contractors raced to correct most of the technical problems hindering consumers’ ability to choose a health plan. But behind the scenes, important aspects of the Web site remain defective — or simply unfinished.

White House officials recently have begun to focus on the magnitude of income discrepancies. Beyond their concerns regarding overpayments, members of the Obama administration are sensitive because they promised congressional Republicans during budget negotiations last year that a thorough income-verification system would be in place.

Under White House pressure, federal health officials and the contractor, Serco, are this weekend beginning to step up efforts at resolving a variety of inconsistencies that have appeared in applications, including income discrepancies. One White House official, speaking on the condition of anonymity about internal discussions, said that White House and federal health officials are “all on the same page that the issue needs to be resolved as soon as possible.”

Because the computer capability does not yet exist, the work will start by hand, according to two people familiar with the plans. It will focus at first not on income questions, but on another roughly 1 million cases in which people enrolled — or tried to enroll — in health plans and ran into questions about their citizenship status. Throughout the sign-up period that ended earlier this spring , flaws in HealthCare.gov blocked many naturalized citizens or permanent legal residents, requiring them to submit immigration documents that are, like the income information, caught in a backlog.

The work of sorting out inaccurate incomes — and inaccurate subsidies, as a result — will likely begin sometime this summer, two individuals familiar with the plans said.

Julie Bataille, communications director for the Centers for Medicare and Medicaid Services, the agency overseeing the federal insurance exchange, said: “The marketplace has successfully processed tens of millions of pieces of data — everything from Social Security numbers to tribal status to annual income. While most data matched up right away during the application process, we take seriously the cases that require more work and have a system in place to expeditiously resolve these data inconsistencies.”

Bataille also added that “an inconsistency does not mean there is a problem with a consumer’s enrollment” but that the consumer must send in additional documentation to verify whether their application information is accurate. “We’re working every day,” she said, “to make sure individuals and families get the tax credits they deserve and that no one is receiving a tax credit they shouldn’t.”

Of the various technical problems that remain with HealthCare.gov, the difficulty in straightening out discrepancies affects an especially large number of consumers. Of the roughly 8 million Americans who signed up for coverage this year under the health-care law, about 5.5 million are in the federal insurance exchange. And according to the internal documents, more than half of them — about 3 million people — have an application containing at least one kind of inconsistency. These inconsistencies have arisen as the information listed on their applications has been cross-checked, via a newly built federal data hub, with the Social Security Administration and other federal agencies, as well as incarceration, IRS and immigration records.

The income information is significant because the government for the first time is providing subsidies to help working-class and middle-class Americans buy private health plans. Under the federal rules, an application is “flagged” for special checking if the income someone says that they expect this year is at least 10 percent above or below the most recent income in their IRS tax returns.

According to various recent internal documents, income discrepancies are the most frequent kind of inconsistencies among insurance applicants, and they exist on 1.1 million to 1.5 million out of nearly 4 million inconsistencies overall. Of the total inconsistencies, the documents show, consumers have uploaded or mailed in about 650,000 pieces of “proof” — or for about one inconsistency in six.

The federal rules say that consumers have 90 days after applying to try to prove that their information is correct and, if an inconsistency is not resolved by then, whatever the federal records show is assumed to be correct. By now, about one-third of people with inconsistencies have passed their 90-day window. But because of the trouble verifying incomes, the government has not lowered or raised anyone’s subsidies.

Making sure that incomes — and subsidies — were accurate became a prominent issue during budget negotiations last year, as House and Senate Republican opponents of the health-care law warned of potential fraud. Health and Human Services Secretary Kathleen Sebelius promised to thoroughly vet the salary information that people submitted as part of their health insurance applications.

From their vantage point, consumer advocates have also been concerned about the possibility of inaccurate income information. They worry that some consumers who have innocently overstated their incomes should be getting higher subsidies — and perhaps better insurance — than they are receiving, while those who accidentally understated their income may get a nasty surprise during tax season next year when the IRS demands that they return any subsidy money they have improperly collected.

“The longer it takes and the more months … go by, the more serious the consequences of any error that may have occurred,” said Judy Solomon, vice president for health policy at the Center on Budget and Policy Priorities, which has been pressing its concern with administration officials.

“I have this sick feeling that there are these people out there who have made unintentional errors, and in a few years will be subject to massive tax bills,” said Jessica Waltman, senior vice president for government affairs at the National Association of Health Underwriters, a lobbying group for health insurance brokers.

Juliet Eilperin contributed to this report.

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Workers for www.healthcare.gov at Wentzville MO facility paid to do nothing

Posted by Olog-hai on Sat May 17 23:11:03 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Whistleblower: ACA contractor in Wentzville pays employees to do nothing

By KMOV Staff
Posted on May 12, 2014 at 10:44 PM
Updated Thursday, May 15 at 1:13 PM

Employees at an Affordable Care Act processing center in Wentzville with a contract worth $1.2 billion are getting paid to do nothing but sit at their computers, a whistleblower tells News 4.

The facility is operated by Serco, which is owned by a British company awarded $1.2 billion partially to hire workers to handle paper applications for coverage under the new healthcare law.

A worker tells News 4 weeks can pass without employees receiving even a single application to process. Employees reportedly spend their days staring at their computers.

“They’re told to sit at their computers and hit the refresh button every 10 minutes, no more than every 10 minutes,” the employee said. “They’re monitored, to hopefully look for an application.”

The Centers for Medicaid and Medicare services told News 4 in a statement that "Serco is committed to making sure federal funds are spent appropriately, and the number of Serco staff is reviewed on a regular basis."

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Re: Workers for www.healthcare.gov at Wentzville MO facility paid to do nothing

Posted by SubwaySurf on Sun May 18 05:23:50 2014, in response to Workers for www.healthcare.gov at Wentzville MO facility paid to do nothing, posted by Olog-hai on Sat May 17 23:11:03 2014.

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Re: Workers for www.healthcare.gov at Wentzville MO facility paid to do nothing

Posted by Fred G on Sun May 18 06:26:45 2014, in response to Workers for www.healthcare.gov at Wentzville MO facility paid to do nothing, posted by Olog-hai on Sat May 17 23:11:03 2014.

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POTUS changes ACA unilaterally again: New regs provide for ins. co. bailouts

Posted by Olog-hai on Thu May 22 12:38:25 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Critics call Obama funding plan for health insurer losses a 'bailout'

By Noam N. Levey
May 21, 2014 3:00 AM

The Obama administration has quietly adjusted key provisions of its signature healthcare law to potentially make billions of additional taxpayer dollars available to the insurance industry if companies providing coverage through the Affordable Care Act lose money.

The move was buried in hundreds of pages of new regulations issued late last week. It comes as part of an intensive administration effort to hold down premium increases for next year, a top priority for the White House as the rates will be announced ahead of this fall's congressional elections.

Administration officials for months have denied charges by opponents that they plan a "bailout" for insurance companies providing coverage under the healthcare law.

They continue to argue that most insurers shouldn't need to substantially increase premiums because safeguards in the healthcare law will protect them over the next several years.

But the change in regulations essentially provides insurers with another backup: If they keep rate increases modest over the next couple of years but lose money, the administration will tap federal funds as needed to cover shortfalls.

Although little noticed so far, the plan was already beginning to fuel a new round of attacks Tuesday from the healthcare law's critics.

"If conservatives want to stop the illegal Obamacare insurance bailout before it starts, they must start planning now," wrote Conn Carroll, an editor of the right-leaning news site Townhall.com.

On Capitol Hill, Republicans on the Senate Budget Committee began circulating a memo on the issue and urging colleagues to fight what they are calling "another end-run around Congress."

Obama administration officials said the new regulations would not put taxpayers at risk. "We are confident this three-year program will not create a shortfall," Health and Human Services spokeswoman Erin Shields Britt said in a statement. "However, we want to be clear that in the highly unlikely event of a shortfall, HHS will use appropriations as available to fill it."

The stakes are high for President Obama and the healthcare law.

Although more than 8 million people signed up for health coverage under the law, exceeding expectations, insurance companies in several states have been eyeing significant rate increases for next year amid concerns that their new customers are older and sicker than anticipated.

Insurers around the country have started to file proposed 2015 premiums, just as the midterm campaigns are heating up. Obamacare, as the law is often called, remains a top campaign issue, and big premium increases in states with tightly-contested races could prove politically disastrous for Democrats.

If rates go up dramatically, consumers may also turn away from insurance marketplaces in some states, leading to their collapse.

Proposed increases in a few states where insurers have already filed 2015 rates have been relatively low, with several major carriers seeking just single-digit hikes. But insurers in closely watched states, such as Florida, Pennsylvania, North Carolina and Arkansas, are still preparing their filings.

"It's absolutely paramount to keep premiums in check," said Len Nichols, a health economist at George Mason University who has advised officials working on the law.

The state-based marketplaces, which opened last year, allow consumers who do not get health coverage at work to shop among plans that meet basic standards. Sick consumers cannot be turned away, and low- and moderate-income Americans qualify for government subsidies to offset their premiums.

To stabilize this new system, the law set up a complex system of funds, including one known as the Temporary Risk Corridors Program, that collect money from insurers and transfer it from companies with healthier, less expensive consumers to those with sicker, more costly consumers.

This system was supposed to pay for itself, as does a similar one used to shift money between drug plans in the Medicare Part D program.

But insurance industry officials have grown increasingly anxious about the new system's adequacy.

Pressure is most acute on insurers in states where healthy consumers were allowed to remain in old plans that are not sold on the new online marketplaces, an option Obama offered to states amid a political firestorm over plan cancellations last year. The president had promised people would be able to stick with their plans.

The renewal temporarily solved a political problem for the White House, but created a new one. Maintaining these old plans kept many healthy consumers out of the marketplaces, making the pool of new customers less healthy and therefore potentially more expensive for insurers, according to experts.

In a series of White House meetings over the last several months, Obama and other senior administration officials have sought to persuade insurance company CEOs to nonetheless hold rates in check, arguing that the marketplaces would stabilize over time.

But with proposed 2015 rates beginning to come in, the administration acceded to industry demands for a clear guarantee that more money would be available to cover potential losses.

"In the unlikely event of a shortfall for the 2015 program year, HHS recognizes that the Affordable Care Act requires the secretary to make full payments to issuers," the regulation published Friday notes. "In that event, HHS will use other sources of funding for the risk corridor payments, subject to the availability of appropriations."

That language allows the administration to tap funds appropriated for other health programs to supplement payments to insurers, according to administration and industry officials.

Among congressional Republicans, the decision has raised concerns. "If the program costs more than it brings in, the secretary would be able to divert money intended for other programs," Republicans on the Senate Budget Committee warned.

Whether the new regulations will be sufficient to control rates remains unclear.

America's Health Insurance Plans, the industry's Washington-based lobbying arm, welcomed the administration's move, saying in a statement that the regulations "provide important clarity about how these insurer-financed programs will work as health plans prepare their rates for 2015."

In a note to investors this week, J.P. Morgan also noted that the new rules "should improve stability of the exchange market."

But some insurers continue to warn of bigger increases. Larry Levitt, an insurance expert at the nonprofit Kaiser Family Foundation, cautioned that some consumers may still be in for sticker shock.

"Premium hikes will likely be modest in much of the country," he said. "But probably not everywhere."

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Re: POTUS changes ACA unilaterally again: New regs provide for ins. co. bailouts

Posted by Chris R16/R2730 on Thu May 22 12:40:04 2014, in response to POTUS changes ACA unilaterally again: New regs provide for ins. co. bailouts, posted by Olog-hai on Thu May 22 12:38:25 2014.

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Re: POTUS changes ACA unilaterally again: New regs provide for ins. co. bailouts

Posted by Olog-hai on Thu May 22 13:13:49 2014, in response to Re: POTUS changes ACA unilaterally again: New regs provide for ins. co. bailouts, posted by Chris R16/R2730 on Thu May 22 12:40:04 2014.

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