Saturday, February 21, 2015

ACA/Obamacare: Reprieving Blunderers

“WASHINGTON — The Obama administration is giving a reprieve to up to 6 million Americans who face fines for failing to sign up for health insurance this year, opening up enrollment again during the critical tax filing season.

At the same time, it’s admitting another colossal blunder: 800,000 ObamaCare enrollees were sent the wrong tax information and have been asked to delay filing their returns until they can get the corrected data.”

“Under the revised deadline, enrollment for 2015 opens again from March 15 through April 30 for those who face tax penalties, according to the Centers for Medicare and Medicaid Services.”

“The administration also announced Friday that it mistakenly sent out the wrong tax information to 800,000 customers on the website. It’s now asking those people to delay filing their returns until they can get the correct data.”

“California made a similar announcement affecting 100,000 people in the state-run exchange — bringing the total close to 1 million. Another 50,000 may have to resubmit returns already filed.” - Nearly 6M uninsured to get reprieve from ObamaCare fines, New York Post, 02/20/2015

Link to the entire article appears below:

ACA/Obamacare: Narrow Networks and Heavy Users of Health-care

“The health insurance market is changing. And the changes are not good. Even before there was Obamacare, most insurers most of the time had perverse incentives to attract the healthy and avoid the sick. But now that the Affordable Care Act has completely changed the nature of market, the perverse incentives are worse than ever.

Writing in the New York Times Elizabeth Rosenthal gives these examples:

When Karen Pineman of Manhattan sought treatment for a broken ankle, her insurer told her that the nearest in-network doctor was in Stamford, Connecticut – in another state.

Alison Chavez, a California breast cancer patient, was almost on the operating table when her surgery had to be cancelled because several of her doctors were leaving the insurer’s network.

When the son of Alexis Gersten, a dentist in East Quogue New York, needed an ear, nose and throat specialist, the insurer told her the nearest one was in Albany – five hours away.

When Andrea Greenberg, a New York lawyer, called an insurance company hotline with questions she found herself speaking to someone reading off a script in the Philippines.

Aviva Starkman Williams, a California computer engineer, tried to determine whether the pediatrician doing her son’s 2-year-old checkup was in-network, the practice’s office manager “said he didn’t know because doctors came in and out of network all the time, likening the situation to players’ switching teams in the National Basketball Association.” 
But aren’t these insurers worried that if they mistreat their customers, their enrollees will move to some other plan? Here’s the rarely told secret about health insurance in the Obamacare exchanges: insurers don’t care if heavy users of medical care go to some other plan. Getting rid of high-cost enrollees is actually good for the bottom line.” - How Obamacare Is Destroying Health Insurance, John Goodman,, 02/21/2015

Link to the entire article appears below:



ACA/Obamacare: Behind the Enrollment Numbers

“ObamaCare’s enrollment in its second year is at 11.4 million people, a total far exceeding the 7 million who signed up last year.”

“Here’s three reasons why it is getting better numbers for ObamaCare 2.0:

A functioning

The first year of ObamaCare enrollment was largely defined by its barely functional, $2 billion website, The mess of glitches prevented millions from logging on and made headlines nationally.

New faces

The Obama administration tapped Burwell to take over at the agency after flak from Democrats over last year’s botched rollout.

A more targeted outreach

After millions of people gained insurance for the first time last year, the administration shifted its focus to groups who were more likely to remain uninsured – Latino and black populations.

HHS nearly tripled the amount of dollars spent to reach Spanish speakers, relying on networks TeleMundo and Univision and running ads during popular telenovelas.” - Three reasons ObamaCare is up,, 02/20/2015

Link to the entire article appears below:









Sunday, February 15, 2015

And About Those ACA Created Consumer Operated and Oriented Plans (Co-ops)

After receiving $2.5 billion in taxpayer dollars from the federal government, the vast majority of nonprofit insurance companies created under the Affordable Care Act recorded losses in revenue, an analysis by The Daily Signal found.

Consumer Operated and Oriented Plans, or co-ops, are nonprofit insurance companies created by the Affordable Care Act. Though the concept is not new, 23 of these entities were created to foster competition in areas where few options are available.

Now, CoOportunity, a co-op created to serve Iowa and Nebraska, will be liquidated. Some lawmakers question the viability of the remaining 22 co-ops.

The Daily Signal examined the latest quarterly filings for 22 of the 23 co-ops and found that just one was profitable last year. Data was not available for New Jersey’s co-op, Health Republic Insurance of New Jersey.

The co-ops received an average of $108.7 million each through the program set up under the Affordable Care Act, leaving taxpayers on the hook for billions if the insurers fail to repay their loans.

“That speaks to the problems with a lot of federal loan programs,” Republican Rep. Adrian Smith of Nebraska told The Daily Signal.”

“According to the Oversight committee, allegations of fraud surrounded many of the co-ops that received taxpayer dollars from the federal government.

And several investigations conducted by the Washington Examiner found that co-ops in Louisiana, Maine, Ohio and New York and their top officials had checkered pasts.

The Louisiana Health Cooperative’s former Chief Executive Officer Terry Shilling benefited from a $4 million contract at a consulting firm where he worked as a principal. The Securities and Exchange Commission also sanctioned Shilling for insider trading in 1998.

The co-op received $65.7 million from Centers for Medicare and Medicaid Services.

Similarly, the Maine Community Health Options co-op was investigated by the Oversight Committee after it learned the co-op’s president, the Rev. Bob Carlson, had a history of sexual child abuse. Carlson later committed suicide.

Maine Community Health Options received $132.3 million from the federal government, including $67.6 million in solvency funding awarded in September 2014.

The company behind the Ohio co-op, Coordinated Health Mutual, has a long history of issues, including having been overpaid $10 million by South Carolina’s Medicaid program and owing thousands in back taxes to the state of Kentucky.

Two of the company’s top officials also had troubled business pasts. Brett Baby, CEO of the co-op, started an insurance company that was later shuttered by state regulators. Dale Schmidt, CEO of the company behind Coordinated Health Plans of Ohio, filed for bankruptcy for four companies he also owned.

Coordinated Health Mutual received $129.2 million from Centers for Medicare and Medicaid Services.” - One Year After Obamacare’s Implementation, Taxpayer-Funded Co-Ops Struggle to Survive,, 02/09/2015

Link to the entire article appears below:



Saturday, February 14, 2015

ACA Co-op Creation Price Tag: $17,000 Per Enrollee

“More than 500,000 people enrolled in health plans offered by nonprofit insurance companies created under the Affordable Care Act.

And with the co-ops receiving an average of $108.7 million from the federal government, taxpayer-backed funding per enrollee topped $17,000.

Twenty-three co-ops received a total of $2.5 billion from the federal government and enrolled more than 520,000 people in plans through September. However, an analysis conducted by The Daily Signal published yesterday found that just one, Maine Community Health Options, was profitable last year.

Using the latest quarterly filings for 22 co-ops, The Daily Signal examined how much money (in federal dollars) co-ops received per consumer who enrolled in a group or individual plan. On average, each co-op received $17,344 from the Centers for Medicare and Medicaid Services per enrollee. Data for New Jersey’s co-op, Health Republic Insurance of New Jersey, was not available.” - Obamacare Co-Ops Cost Taxpayers $17,000 Per Enrollee,, 02/11/2015

Link to the entire article appears below:


ACA Price is Increasing Not Decreasing: Try $2 Trillion Not $940 Billion

Late last month, the Congressional Budget Office reported that the provisions within Obamacare expanding access to insurance coverage would cost 20% less than the agency estimated in 2010, when the law passed.

The White House was ecstatic. “The estimates released today by CBO once again confirm the progress we’ve made,” said deputy press secretary Eric Schultz.

Taxpayers, however, should worry. A closer look at the CBO’s numbers shows that Obamacare is growing much more expensive — and disruptive.

The CBO now expects Obamacare to cover far fewer uninsured than it previously thought. In a March 2011 report, the nonpartisan agency predicted that Obamacare would extend coverage to 34 million uninsured by 2021. It has since downgraded that number to 27 million — and concluded that Obamacare will leave 31 million Americans without insurance.

So the law’s overall price tag has declined only because it’s covering fewer people.

Left unsaid is the fact that Obamacare is set to spend more per person. If the law is not repealed, Obamacare will shell out $7,740 in subsidies for every person who gains coverage in 2021. That’s a 7% increase over the agency’s per-person estimate in 2011.

The CBO now projects that the law will cost nearly $2 trillion over the next ten years. Obamacare’s subsidies alone will cost $1.1 trillion. In 2010, the agency put the cost of the entire law at $940 billion over its first decade.

Obamacare hasn’t just failed to expand coverage as projected — it’s caused more people to lose their insurance than its architects intended. The CBO now estimates that 10 million people will lose their employer-provided health benefits by 2021. That’s a tenfold increase over the agency’s 2011 projections. - Buried In The Numbers: Obamacare's Costs Are Climbing, Not Receding, Forbes, 02/09/2015

Link to the entire article appears below:





Friday, February 13, 2015

ACA/Obamacare: Hundreds of Thousands About to be Dropped From Coverage

“Some 200,000 Obamacare enrollees are about to be kicked off their insurance policies after they failed to confirm that they are legally living in the United States administration officials announced Thursday. Under the health law, people enrolled in exchange policies must be able to prove legal status.

Last summer, the administration announced that there were significant discrepancies in hundreds of thousands of Obamacare applications—specifically dealing with citizenship. Health officials sent out letters in August to about 300,000 enrollees with application discrepancies asking them to send in relevant documents to confirm their legal status and resolve the issue.

About 112,000 of those people never responded and got dropped from their plans in September.” - Thousands to Get Booted From Obamacare Plans, msnmoney, 02/13/2015

Link to the entire article appears below:

Sunday, February 8, 2015

Firms Socializing the Price of Health Insurance and King v. Burwell

“More and more businesses are figuring out that continuing to offer health benefits puts them at a competitive disadvantage vis-à-vis firms who socialize the cost of health care by shifting their employees onto Obamacare exchanges. These crafty firms, however, probably don’t realize they are putting their employees at enormous risk. If they are operating in one of 36 states where Obamacare might come to a screeching halt in the second half of 2015, their workers could lose their subsidized Obamacare plans as early as July.

This is what will happen if the Supreme Court decides in favor of the petitioner in the Obamacare case of King v. Burwell. This case addresses the question of whether or not the federal government can pay subsidies to insurers in states that did not establish their own health-insurance exchanges.

The Court will hear oral arguments on March 4, and is expected to announce its decision in June or July. If it finds in favor of King, tax credits to health insurers via the federally operated exchanges in 36 states will likely stop within a few weeks. Enrollees would then face the true premiums of their policies for the first time. Many would not be able to afford them.

Enrollees are likely unaware of this possibility, because the exchanges were designed to camouflage the subsidies. The Obama administration likes to pretend that it has actually lowered the cost of health insurance in the individual market. Thus, the exchanges are designed show applicants only the premiums net of subsidies.

According to a recent report from the Department of Health and Human Services, the agency headed by the very same Sylvia Burwell named in the lawsuit, the average Bronze plan for a single person in 2015 is $265 per month. Silver, the most popular plan, has an average premium of $336 per month. Platinum, the most expensive, costs $439. However, the agency also notes that 8 of 10 returning enrollees will be able to get a plan for less than $100, regardless of the metal level they selected in 2014.

A 27-year old single woman earning a little over $25,000, for example, would pay a maximum of $148 for the second-lowest-cost Silver plan. However, the actual premium of that plan is $222. So, if the Supreme Court knocks out the subsidy, her premium will jump by $74, an increase of 50 percent!” - Administration should fully disclose risks to enrollees in Obamacare exchanges, The Hill, 02/06/2015

Link to the entire article appears below:

Friday, February 6, 2015

ACA/Obamacare: 9,000 New Employees Requested at the IRS

“As millions of Americans brace for tax season, the Internal Revenue Service is requesting a $2 billion boost to its budget and 9,000 new employees as it prepares to enforce Obamacare’s tax provisions.

President Obama released his $4 trillion budget proposal for fiscal year 2016 this week, which includes $13.9 billion for the Internal Revenue Service. The agency asked Congress for close to $2 billion more for operations than last year—a 16 percent increase.

The billions of dollars will help the agency bolster its staff by adding more than 9,280 full-time employees. The proposed jump in employment at the IRS is an 11 percent increase from 2015.” - IRS Seeks 9,000 New Employees as It Prepares to Enforce Obamacare, The Daily Signal, 02/05/2015

Link to the entire article appears below:


Anthem Hacked With Private Health Records Targeted

"The massive computer breach against Anthem, the nation’s second-largest health insurer, exposes a growing cyberthreat facing health-care companies that experts say are often unprepared for large attacks.
Hackers gained access to the private data of 80 million former and current members and employees of Anthem in one of the largest medical-related cyber-intrusions in history.

Authorities said the breach, which was discovered late last month and disclosed this week, did not involve private health records or credit card numbers but did expose Social Security numbers, income data, birthdays, and street and e-mail addresses.

Investigators suspect Chinese hackers may be responsible for the breach, according to an individual briefed on some aspects of the probe. There are also some indications that other health-care companies may have been targeted, said the individual, who spoke on the condition of anonymity to discuss the ongoing investigation.

Security experts said health care has become one of the ripest targets for hackers because of its vast stores of lucrative financial and medical information. Health insurers and hospitals, they added, have often struggled to mount the kinds of defenses­ used by large financial or retail companies, leaving key medical information vulnerable." - China suspected in major hacking of health insurer, Washington Post, 02/06/2015

Link to the entire article appears below: