Wednesday, August 28, 2013

Obamacare: insurers remain with no agreement regarding insurance exchanges

“The Obama administration has delayed a step crucial to the launch of the new healthcare law, the signing of final agreements with insurance plans to be sold on federal health insurance exchanges starting October 1.

The U.S. Department of Health and Human Services (HHS) notified insurance companies on Tuesday that it would not sign final agreements with the plans between September 5 and 9, as originally anticipated, but would wait until mid-September instead, according to insurance industry sources.” - Exclusive: U.S. delays deadline for finalizing Obamacare health plans, Reuters, 08/28/2013

Link to entire article appears below:

Thursday, August 22, 2013

UPS and Obamacare: Working Domestic Partner Coverage is a Package Too Far

"UPS and a growing list of other big companies will end health insurance coverage of employees' spouses this fall if they can get coverage elsewhere — an unwelcome result, at least in part, of Obamacare.

Increased medical costs, "combined with the costs associated with the Affordable Care Act (ACA), have made it increasingly difficult to continue providing the same level of health care benefits to our employees at an affordable cost," UPS said in a memo to employees.

A survey by consultant Towers Watson found that in 2013, 4 percent of large employers excluded spouses who also had coverage at their own workplace, and 8 percent planned to implement the restriction next year, Kaiser Health News and USA Today reported.

"When healthcare reform came on the scene a few years ago we definitely saw an uptick in companies wanting to explore a working-spouse provision," Steve Noury, national sales director for HMS Employer Solutions, told Kaiser. "We have seen [them] over the past two or three years putting those in place."

While Obamacare requires large employers to cover employees and dependent children, it does not require them to cover spouses or domestic partners.

The move by UPS will affect an estimated 15,000 working spouses at that company, which UPS estimated would save about $60 million annually.”
- UPS Cutting Back Spousal Health Coverage, Blames Obamacare, Newsmax, 08/21/2013

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Obamacare and the “Navigator”: The Scilly Naval Disaster of 1707 at $20 an Hour?

“The Obama administration added millions of dollars to ObamaCare's enrollment push Thursday, a surprise move designed to help bolster participation in new insurance plans.

The Health and Human Services Department (HHS) announced $67 million in funding for “navigators,” which are people and community groups who will help people make sense of their options under the healthcare law.

HHS had initially said navigators would receive $54 million in grants, but officials said they pulled an extra $13 million from the healthcare law’s prevention fund to help broaden the reach of the program.

“Navigators will be among the many resources available to help consumers understand their coverage options in the marketplace,” HHS Secretary Kathleen Sebelius said in a press release. “A network of volunteers on the ground in every state — health care providers, business leaders, faith leaders, community groups, advocates, and local elected officials — can help spread the word and encourage their neighbors to get enrolled.”

All told, more than 100 organizations in 34 states received grants on Thursday.

The list of navigators includes a host of healthcare networks and universities, which will add ObamaCare education to existing programs that offer healthcare counseling to low-income families.

Some community organizations will use the money to print brochures and organize informational forums. Other recipients will promote enrollment through food banks and religious centers.”
- Officials add millions of dollars to ObamaCare enrollment drive, the, 08/15/2013

Link to the entire article appears below:

Note: what exactly is a “navigator“?

“Tens of thousands of health care professionals, union workers and community activists hired as "navigators" to help Americans choose Obamacare options starting Oct. 1 could earn $20 an hour or more, according to new regulations issued Wednesday.

The 63-page rule covering navigators, drawn up by the Centers for Medicare & Medicaid Services, also said the government will provide free translators for those not fluent in English -- no matter what their native language is.

"The proposed requirements would also include that such entities and individuals provide consumers with information and assistance in the consumer's preferred language, at no cost to the consumer, which would include oral interpretation of non-English languages and the translation of written documents in non-English languages when necessary to ensure meaningful access," said the regulations.

The rules also addressed conflict of interest and other potential issues that navigators could face as the public's first stop on the Obamacare trail.

It is still not clear how many navigators will be required. California, however, provides a hint. It wants 21,000.

That could be an expensive proposition. The proposed rules, now open for public comment, suggest an estimated pay of $20-$48 an hour.” - Tens of thousands Obamacare 'navigators' to be hired, Washington Examiner, 04/03/2013

Link to the entire article appears below:



Monday, August 19, 2013

Chicago Tribune Editorial 08/18/2013: How President Obama is flouting Obamacare

"Democrats strong-armed Obamacare into law three years ago. Now they're busy flouting it.

The mandate that employers provide insurance next year or pay a penalty, as the law requires? Delayed for at least a year.

The law's dictate that people applying for federal subsidies to buy insurance provide proof that they're eligible for the government aid? Scaled back.

Sharp limits on Americans' out-of-pocket costs for health care? Suspended for a year.

Providing members of Congress and more than 10,000 staff members with federal health care subsidies that the law does not allow? Done, via a deal brokered by President Barack Obama.

And on and on.

The Affordable Care Act, aka Obamacare, is a hugely complex law that sets up online health insurance marketplaces, requires people to have coverage or pay penalties, and doles out subsidies and incentives to nearly everyone in health care. Doctors, hospitals and insurers have spent large sums to gear up for its requirements. Employers are mulling: Hire? Fire? Cut workers' hours?

Millions of Americans, that is, stand to gain or lose from how this law is enforced — with the Obama administration bending that enforcement in ways that test, and arguably exceed, the boundaries of lawful conduct.

Every time the White House undercuts one provision of Obamacare, there is a massive ripple effect on other provisions. It's generally a zero-sum game: When someone gains, someone else loses. Example: When employers are relieved of their mandate to provide insurance, taxpayers risk having to subsidize more of those companies' employees.

The administration asserts that it can make these changes under the president's broad executive authority. Yet critics make a compelling argument that the president is stretching the limits. Former federal appellate Judge Michael McConnell, director of the Constitutional Law Center at Stanford Law School, writes in The Wall Street Journal about a different sort of mandate: the mandate in Article II of the Constitution that the president "'shall take Care that the Laws be faithfully executed.' This is a duty, not a discretionary power. ... As the Supreme Court wrote long ago (Kendall v. United States, 1838), allowing the president to refuse to enforce statutes 'would be clothing the president with a power to control the legislation of Congress, and paralyze the administration of justice.'"

Like most issues of presidential authority, this isn't cut and dried. Presidents do have broad discretion on how laws are enforced. But they're on shaky ground when they decide whether to enforce a law. It's not hard to understand why: Imagine the outcry if President Mitt Romney refused to enforce, say, Obamacare.

Granted, any president may decline to enforce statutes he believes are unconstitutional. But Obama is making no such claim here. Basically, he is admitting that parts of law are impossible to enforce on the deadlines imposed by Congress — deadlines he signed into law. He's also admitting he doesn't want to have Congress make these changes, for fear that if lawmakers get their mitts on this unpopular program, they would at least debate far more extensive changes than he'd like.

Congressional Democrats, and some Republicans, may agree with the numerous delays, changes and special favors. But the president invites chaos when he picks which parts of Obamacare to enforce, and which, in retrospect, he has decided are unworkable or unwise." - Editorial: How President Obama is flouting Obamacare, More reasons to delay and rewrite this ill-conceived law, Chicago Tribune, 08/18/2013

Link to the entire article appears below:,0,5666959.story


George WIll on the Unilateral Rewrite of ACA

"Barack Obama's increasingly grandiose claims for presidential power are inversely proportional to his shriveling presidency.

Desperation fuels arrogance as, barely 200 days into the 1,462 days of his second term, his pantry of excuses for failure is bare, his domestic agenda is nonexistent and his foreign policy of empty rhetorical deadlines and redlines is floundering. And at last week's news conference he offered inconvenience as a justification for illegality.

Explaining his decision to unilaterally rewrite the Affordable Care Act, he said: "I didn't simply choose to" ignore the statutory requirement for beginning in 2014 the employer mandate to provide employees with healthcare. No, "this was in consultation with businesses."


He continued: "In a normal political environment, it would have been easier for me to simply call up the speaker and say, you know what, this is a tweak that doesn't go to the essence of the law . . . it looks like there may be some better ways to do this, let's make a technical change to the law. That would be the normal thing that I would prefer to do. But we're not in a normal atmosphere around here when it comes to Obamacare. We did have the executive authority to do so, and we did so."


Serving as props in the scripted charade of White House news conferences, journalists did not ask the pertinent question: "Where does the Constitution confer upon presidents the 'executive authority' to ignore the separation of powers by revising laws?" The question could have elicited an Obama rarity: Brevity. Because there is no such authority.


Obama's explanation began with an irrelevancy: He consulted with businesses before disregarding his constitutional duty to "take care that the laws be faithfully executed." That duty does not lapse when a president decides Washington's "political environment" is not "normal."


When was it "normal"? The 1850s? The 1950s? Washington has been the nation's capital for 213 years; Obama has been here less than nine years. Even if he understood "normal" political environments here, the Constitution is not suspended when a president decides the "environment" is abnormal.


Neither does the Constitution confer on presidents the power to rewrite laws if they decide the change is a "tweak" not involving the law's "essence." Anyway, the employer mandate is essential to the ACA.


Twenty-three days before his news conference, the House voted 264-161, with 35 Democrats in the majority, for the rule of law — for, that is, the Authority for Mandate Delay Act. It would have done lawfully what Obama did by ukase. He threatened to veto this use of legislation to alter a law. The White House called it "unnecessary," presumably because he has an uncircumscribed "executive authority" to alter laws.


In a 1977 interview with Richard Nixon, David Frost asked: "So, what in a sense you're saying is that there are certain situations . . . where the president can decide that it's in the best interests of the nation . . . and do something illegal?"


Nixon: "Well, when the president does it, that means that it is not illegal."


Frost: "By definition."


Nixon: "Exactly, exactly."


Nixon's claim, although constitutionally grotesque, was less so than the claim implicit in Obama's actions regarding the ACA. Nixon's claim was confined to matters of national security or (he said to Frost) "a threat to internal peace and order of significant magnitude." Obama's audacity is more spacious; it encompasses a right to disregard any portion of any law pertaining to any subject at any time when the political "environment" is difficult." - George Will, Obama Ignores Law, Like Nixon, 08/18/2013, Newsmax.
Link to the entire article appears below:

Friday, August 16, 2013

ObamaCare Spending Spike Coming Your Way?

"The convergence of the opening of the Obamacare exchanges and the end of the fiscal year could result in a huge spike in spending on Obamacare from the federal government in the coming weeks.

Spending by federal agencies typically surges at the end of the fiscal year as agencies rush to spend their remaining funds. If they do not spend all their allotted money, the agencies have to return the funds to the Treasury Department, a mechanism referred to as “spend it or lose it.

“We know that it happens. It is visible, it is apparent,” said Romina Boccia, a federal budget expert at the Heritage Foundation.

Boccia noted that agency spending in the last week of the fiscal year, which ends Sept. 30, is typically five times the weekly average for the rest of the year.

The Department of Health and Human Services (HHS), the principal agency tasked with implementing Obamacare, is no exception to this government-wide trend, according to an analysis by Public Notice, a nonprofit that analyzes fiscal and economic matters.

A Public Notice and Washington Free Beacon analysis of weekly spending on contracts by HHS over the past four years shows a distinct jump in spending in the last few weeks of the fiscal year. Average weekly spending on contracts between fiscal years 2010 and 2012 hovered under $500 million, although it steadily climbed above that over the last few weeks of the year. HHS spent on average over $2 billion in the last week alone between 2010 and 2012.

“The explosion of spending at the end of each fiscal year shows HHS has been operating like a department with money to burn,” said Bill Riggs, the deputy communications director for Public Notice." - Obamacare Spending Could Spike in Next Few Weeks, Washington Examiner, 08/13/2013

Link to the entire article appears below:

Tuesday, August 13, 2013

Another Day, Another Delay: Obamacare Delays Out-of-Pocket Caps.

“WASHINGTON — In another setback for President Obama’s health care initiative, the administration has delayed until 2015 a significant consumer protection in the law that limits how much people may have to spend on their own health care.

The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014.

The grace period has been outlined on the Labor Department’s Web site since February, but was obscured in a maze of legal and bureaucratic language that went largely unnoticed. When asked in recent days about the language — which appeared as an answer to one of 137 “frequently asked questions about Affordable Care Act implementation” — department officials confirmed the policy.

The discovery is likely to fuel continuing Republican efforts this fall to discredit the president’s health care law.

Under the policy, many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors’ services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager.

Some consumers may have to pay even more, as some group health plans will not be required to impose any limit on a patient’s out-of-pocket costs for drugs next year. If a drug plan does not currently have a limit on out-of-pocket costs, it will not have to impose one for 2014, federal officials said Monday.” - A Limit on Consumer Costs Is Delayed in Health Care Law, NYT, 08/12/2013

Link to the entire article appears below:




Saturday, August 10, 2013

ACA and the Ohio and Florida Individual Insurance Markets: Massive Price Increases Await.

“While many residents in New York and California may see sizable decreases in their premiums, Americans in many places could face significant increases if they buy insurance through state-based exchanges next year.

That's because these people live in states where insurers were allowed to sell bare-bones plans and exclude the sick, which has kept costs down. Under Obamacare, insurers must offer a package of essential benefits -- including maternity, mental health and medications -- and must cover all who apply. But more comprehensive coverage may lead to more expensive insurance plans.

Under Obamacare, all Americans must have insurance coverage starting in 2014 or face penalties of $95 or 1% of family income, whichever is greater. Enrollment in the exchanges begins October 1, with coverage kicking in in January. Plans will come in four tiers, ranging from bronze to platinum.

Some lightly regulated states, including Indiana, Ohio, Florida and South Carolina, have recently released preliminary rate information highlighting steep price increases. Unlike the blue states of California and New York, these are Republican-led states that have strongly opposed the Affordable Care Act, as Obamacare is officially known.

Comparing this year's and next year's plans isn't easy because the structure of the plans is so different. Each state comes up with its own method.

Behind the numbers in 3 key states. In Florida, for instance, officials constructed a hypothetical silver-level plan based on the offerings available today. Then they looked at how the cost of that plan compares to the average silver plan that will be available on the exchange. Florida found premiums will rise between 7.6% and 58.8%, depending on the insurer. The average increase would be 35%.

The main driver of the premium increases is the Obamacare mandate that coverage be offered to everyone, said Kevin McCarty, Florida's insurance commissioner. There are just short of a million enrollees in the individual market in Florida, while 3.8 million are uninsured. The state does not allow new entrants into a "high-risk pool," which provides coverage to the sick.

"People who are in their 50s with high blood pressure have no coverage options," he said.

Ohio, meanwhile, said there would be an average increase of 41% by comparing a trade association's report of premiums for all plans available today with the average premium expected on the exchange.

Indiana officials said prices would rise an average of 72%. But they were looking at the cost of providing care, not actual premiums.

All of these rate hikes must still be reviewed by the federal government and do not take into account the fact that Americans with incomes up to $45,960 for an individual and $94,200 for a family of four will be eligible for federal subsidies.

So why aren't there such big premium increases in other states? New York, for example, already required that insurers provide comprehensive coverage to all who apply. Rates there could fall by half since the pool will expand to include many younger, healthier residents under Obamacare. But New York is more the exception than the rule, experts said.” - Where Obamacare premiums will soar, CNN Money, 08/06/2013


Link to the entire article appears below:





Wednesday, August 7, 2013

Opening An Obamacare Account

You can now open your own personal "Obamacare" account — but you'll have to wait awhile before you can actually use it to pick a health insurance plan.

Just eight weeks before the Oct. 1 launch of open enrollment under President Barack Obama's health care overhaul law, administration officials announced Monday that the Affordable Care Act is a step closer to reality for millions of uninsured Americans.

Health and Human Services Secretary Kathleen Sebelius said consumers can now go online to and create personal accounts by establishing a username and password.

However, serious shopping will have to wait until sometime in September, when details on insurance plans and premiums offered in local areas will become available through the new online marketplace.

While Monday's announcement may sound like partial progress only, Sebelius quickly moved to put the law's doubters on notice. "Let me be clear," she said. "We are on target and ready to flip the switch on Oct. 1."

The congressional Government Accountability Office and Treasury's inspector general for the Internal Revenue Service have been among the nonpartisan oversight organizations warning of possible delays with the rollout of the law.

The new personal account feature unveiled Monday will be available just in English for the time being. HHS said personal accounts will be coming soon to the Spanish-language marketplace, at” - Personal 'Obamacare' accounts debut, AP, 08/05/2013

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Monday, August 5, 2013

Obamacare Informational Events: Build It and They Didn’t Come.

“The poor turnout here in Centreville wasn’t necessarily indicative of what’s happening across the country at other OFA events Sunday afternoon and evening, which coincide with President Barack Obama’s birthday. OFA sent out pictures of bigger and more enthusiastic turnout elsewhere, including some events in places like Ohio, Florida and Missouri where volunteer enthusiasm will be needed to overcome state government resistance to implementation. Most of the events were intentionally small-scale — house parties, leafleting near a beach or a farmer’s market, not big rallies.

But in some ways, this suburban community 20 miles from Washington, D.C., captures the national ambivalence about the health law. Centreville is perched on the edge of two congressional districts, a red one represented by Rep. Frank Wolf — an ardent Republican opponent of Obamacare — and a blue one by Rep. Gerry Connolly, one of the health law’s Democratic champions.

The Centreville event’s lone attendee, Lynn Duvall of Fairfax, Va., told POLITICO that it was her family’s own medical burdens that fueled her passion for Obamacare. Duvall’s son Logan has Crohn’s disease and under the law’s provisions can stay on her health plan until he turns 26, next January. Then he’ll be able to get coverage in the health exchange, despite his pre-existing condition.” - Obamacare message war goes local, Politico, 08/04/2013

Link to the entire article appears below:

Saturday, August 3, 2013

Social Security Disability Trends: A Closer Look

"Recipients of federal disability checks often admit that they are capable of working but cannot or will not find a job, that those closest to them tell them they should be working, and that working to get off the disability rolls is not among their goals.

More baffling, most have never received significant medical treatment and not seen a doctor about their condition in the last year, even though medical problems are the official reason they don't work. Those who acknowledge they're on disability because they can't find a job say they make little effort to find one, according to a Washington Examiner analysis of federal survey results.

Unearned disability, called SSI, is for individuals who have petitioned to be classified as disabled. Many of them have never worked and have never paid into Social Security. Earned disability, or SSDI, is for those who have held jobs for significant periods of time and paid at least partially into Social Security before becoming disabled.

Those collecting government checks in the unearned program are in less pain than their counterparts who paid into the system, the analysis showed. They are typically overweight, uneducated and from broken homes.

But the analysis also revealed more practical barriers to weaning recipients off the disability rolls: The jobs they'd be candidates for often don't provide health insurance, which is essential for those with medical problems, and they'd rather receive the federal benefit. Many also say they don't have transportation to work.

In 2009, the Social Security Administration conducted a detailed study of disability recipients' characteristics, desire to work and their impediments from doing so. Geared towards academics, only the raw, individual-level responses were released, and until the Examiner's analysis here, there has been little in the way of published tallies.

The survey included responses from 2,300 disability benefits recipients. There are approximately 11 million SSDI recipients and approximately seven million SSI recipients.

Among the most notable results of the survey:

* Returning to work is not a goal for 71 percent of the SSDI recipients, 60 percent of the SSI recipients.

* 75 percent of the SSDI recipients don't see themselves returning to work within five years, 65 percent of the SSI recipients don't.

* 72 percent of the small number of SSDI recipients who started a job while on disability got cash under the table, as did 70 percent of the small number of SSI recipients who started a job while on disability.

* 24 percent of the SSDI recipients lack even GEDs, as do 43 percent of the SSI recipients. "

- Luke Rosiak, Exography: many disability recipients admit they could work, Washington Examiner, 07/30/2013

Link to the entire article appears below: