Sunday, March 29, 2015

ACA/Obamacare Subsidy Debit or Credit and Penalty/Tax: Time to Pony-Up

“Understand the new health-care provisions. Under the Affordable Care Act, filers this year must check a box on Line 61 on the 1040 form if they had approved health-care coverage for all of 2014, or possibly pay a penalty if they didn’t. The instructions for Form 8965 explain how to calculate the penalty.

Employers aren’t required to provide evidence of ACA-approved insurance to employees until the 2015 tax year.

Last year, several million people received an upfront tax credit to help them buy insurance, and they could owe more tax now if their income was larger than expected or less if it was smaller than expected. According to estimates by the Kaiser Family Foundation, about half of tax-credit recipients will need to make a repayment that averages $794 for 2014, while about 45% will get back an average of $773. The average refund for all taxpayers is currently $2,893.

In February, the Department of Health and Human Services said it sent erroneous forms to about 800,000 tax-credit recipients living in 37 states. People who already had filed returns using the erroneous information were given a free pass by the IRS, but the rest have been told to wait for corrected forms before filing.

Millions of people also qualify for exemptions from required ACA coverage. They need to attach a Form 8965 to this year’s return.” - Last-Minute Tax Moves,, 03/27/2015.

Link to the article appears below:




Another ACA/Obamacare Supreme Court Case?

In 2009, the American Recovery & Reinvestment Act (ARRA) offered states stimulus funds if they agreed to a maintenance-of-effort (“MOE”) provision that required them to maintain Medicaid-eligibility standards at July 2008 levels through December 2010. MaineCare, Maine’s Medicaid program, accepted those funds and the accompanying MOE provision. In relevant part, MaineCare covered low-income individuals ages 18 to 20 in 2008 — even though Medicaid doesn’t require states to include non-pregnant, non-disabled 18- to 20-year olds — so that MOE provision required Maine to continue to do so through 2010. Then the Affordable Care Act came along and added its own MOE provision, which required states to “freeze” eligibility levels until 2019 or risk losing all federal Medicaid funding.

When the ACA took effect on March 23, 2010, Maine was still bound by the ARRA’s MOE requirements, and thus had to continue to cover 18- to 20-year olds for an additional nine years. In August 2012, however, the Maine DHHS sought to drop this coverage. The federal Center for Medicare and Medicaid Services (CMS) rejected Maine’s position regarding alleged inconsistencies between the MOE provisions.

On appeal, Maine argued that the ACA’s MOE provision is unconstitutionally coercive under the Spending Clause, that it unconstitutionally applies retroactively to ARRA MOE provisions, and that it violates Maine’s right to equal sovereignty. Nevertheless, the U.S. Court of Appeals for the First Circuit affirmed the CMS decision, so Maine now seeks Supreme Court review.

Cato has filed a brief supporting that petition. We outline the significance of the case and reiterate concerns over the executive branch’s interpretations of NFIB v. Sebelius (the previous Obamacare case at the Supreme Court). The issues presented here need to be resolved so states can decide whether to establish exchanges — regardless of how King v. Burwell is decided — or expand their Medicaid programs. In enforcing the eligibility freeze, the ACA creates inequality among states in administering their Medicaid programs and threatens state sovereignty. - The Next Big Obamacare Case?, 03/28/2015

Link to the entire article appears below:

Monday, March 16, 2015

An Enrollment Too Far: ACA Special Enrollment Period of 03/15/2015 - 04/30/2015

“Several million people hit with new federal fines for going without health insurance will get a second chance to sign up starting Sunday, and that could ease the sting of rising penalties.

But, as the enrollment window reopens, it’s unclear how many know about the time-limited opportunity, let alone will take advantage of it.

Fines payable to the IRS are the stick behind the offer of taxpayer-subsidized private insurance under President Barack Obama’s health care law. Virtually everyone in the country is now required to have coverage through an employer or a government program, or by buying individual policies.

This is the first year fines are being collected from uninsured people the government deems able to afford coverage. Tax preparation company H&R Block says the penalty averages about $170 among its affected customers. It usually is deducted from a person’s tax refund.

Those penalized are mainly the kind of people the law was intended to help: low- and middle-income workers who do not have coverage on the job or are self-employed. Roughly 4 million people are expected to pay fines, according to congressional estimates. Many more will qualify for exemptions.”

“Penalties for being uninsured are going up this year to a minimum of $325 for the full 12 months. That’s a significant increase from the $95 minimum in 2014.

The new sign-up opportunity runs through April 30. To qualify, individuals have to certify to the government that they meet certain conditions, including:

– They did not know or understand that they were legally required to have coverage until after open enrollment officially ended Feb. 15.

– They owed a penalty for being uninsured in 2014.

Those requirements are for the 37 states served by the federal website. States running their own insurance exchanges may have different rules and deadlines. Penalties for 2014 are not refundable.” - Cool reception for new ACA sign-up window, Albuquerque Journal, 03/15/2015

Link to the entire article appears below:

Thursday, March 12, 2015

State Run Obamacare Exchanges: Red Ink

“The Washington Health Benefit Exchange call center in Spokane is so busy that staffing has been quadrupled, with the center receiving up to 10,000 calls a day. The problem is not enough of those callers are actually signing up for insurance.

The state has enrolled 160,000 paying customers in ObamaCare exchange health plans but that's more than 50,000 short of goal, which has led to an extension of the enrollment deadline and a request that the Washington State Legislature fork over $125 million to fund the exchange.”

“Only 14 states, including Washington, are operating their own ObamaCare exchanges and many are struggling to make it without help from taxpayers.

New York’s governor wants a $69 million tax on non-exchange health insurance policies while Vermont has projected a $20 million shortfall by the end of 2015. There also is a bill in Rhode Island to scrap the state exchange and go with the federal exchange to avoid a $24 million hit to taxpayers. Massachusetts, which has been at this longer than anyone, does not have a general tax to fund its exchange, but does rely on a hefty cigarette tax and an employer’s tax.” - Washington state's ObamaCare exchange faces funding shortfall, Foxnews, 03/12/2015

Link to the entire story appears below:





Saturday, March 7, 2015

King v. Burwell: Which Coercion Within the ACA Suits Your Fancy?

"If ObamaCare subsidies on federal exchanges survive their brush with the Supreme Court, it may be because the law is even more coercive without them.

Chief Justice John Roberts, who saved the individual mandate by calling it a tax in 2012, has been seen as the swing vote who will determine whether ObamaCare remains viable in states without their own exchanges. But a second potential swing vote emerged during Wednesday's oral arguments in the

If ObamaCare subsidies on federal exchanges survive their brush with the Supreme Court, it may be because the law is even more coercive without them.

Chief Justice John Roberts, who saved the individual mandate by calling it a tax in 2012, has been seen as the swing vote who will determine whether ObamaCare remains viable in states without their own exchanges. But a second potential swing vote emerged during Wednesday's oral arguments in the King v. Burwell case challenging the legality of tax subsidies issued to 34 states via the federally run

Justice Anthony Kennedy told plaintiffs attorney Michael Carvin: "If your argument is accepted, the states are being told, 'Either create your own exchange, or we'll send your insurance market into a death spiral.'"

Because of other ObamaCare regulatory mandates — requiring insurers to take all comers and offer a rate without regard to one's health — exchanges could be unworkable without subsidies. That's because the population willing to pay the full cost of the policies would most likely be in disproportionately poor health — which could send premiums soaring.”

“In the view of the conservative challengers, spearheaded by the Competitive Enterprise Institute, "the plain language of the statute dictates the result."

That reading reflects the desire of the 2010 Congress that passed the law to provide a strong incentive for states to set up their own exchanges, Carvin argued.

He also took issue with Kennedy's suggestion that the law is less coercive with the subsidies than without, noting that the subsidies trigger the employer mandate penalties.” - ObamaCare Subsidies Ruling May Hinge On 'Coercion', IBD, 03/04/2015

Link to the entire article appears below:

Thursday, March 5, 2015

The Health-care Supply Side: Certificate-of-Need and Restrictions Upon Supply

“Thirty-six states and the District of Columbia currently limit entry or expansion of health care facilities through certificate-of-need (CON) programs.1 These programs prohibit health care providers from entering new markets or making changes to their existing capacity without first gaining the approval of state regulators. Since 1973, Florida has been among the states that restrict the supply of health care in this way, with 11 devices and services—ranging from acute hospital beds to organ transplants to psychiatric services—requiring a certificate of need from the state before the device may be purchased or the service may be offered.2

CON restrictions are in addition to the standard licensing and training requirements for medical professionals, but are neither designed nor intended to ensure public health or ensure that medical professionals have the necessary qualifications to do their jobs. Instead, CON laws are specifically designed to limit the supply of health care, and are traditionally justified with the claim that they reduce and control health care costs.3 The theory is that by restricting market entry and expansion, states might reduce overinvestment in facilities and equipment. In addition, many states—including Florida—justify CON programs as a way to cross-subsidize health care for the poor. Under these “charity care” requirements providers that receive a certificate of need are typically required to increase the amount of care they provide to the poor. In effect, these programs intend to create quid pro quo arrangements: state governments restrict competition, increasing the cost of health care for some, and in return medical providers use these contrived profits to increase the care they provide to the poor.4 “

- Certificate-of-Need Laws: Implications for Florida, Koopman and Stratmann, 03/03/2015

Link to the paper appears below:

Sunday, March 1, 2015

ACA: Is It Only The Tunnel Vision of the Enrollment Number That Makes for Success?

‘Last week, the White House took to Twitter for purposes of publicizing its latest Obamacare enrollment blarney. Far more informative than the tweet’s fictitious sign-up numbers was the schmaltzy video to which it was linked. Staged in the Oval Office, this one-act farce features a simpering HHS Secretary briefing our Thespian in Chief, who then delivers the following soliloquy: “The Affordable Care Act is working. It’s working better than we anticipated. It’s certainly working a lot better than many of the critics talked about early on.” In Obama’s 27-word script, “working” appears three times. The President doth protest too much, methinks.”

But don’t take my word for it. Ask the folks who learned last Friday that Obama’s bureaucrats sent them erroneous tax information relating to PPACA. The Associated Press reports, “Officials said the government sent the wrong tax information to about 800,000 customers, and they’re asking those affected to delay filing their 2014 returns.” And, as with most government blunders, the price will be paid by those who can least afford it. Robert Pear points out in the New York Times, “[T]housands of lower-income Americans who qualified for subsidized insurance had hoped for tax refunds and now must wait for weeks to file their taxes.”

Obama and his minions will, of course, rewrite PPACA’s tax and enrollment provisions in yet another attempt to contain the political damage wrought by the disastrous “reform” law. This is nothing new. It will merely be the latest of nearly 50 emergency revisions to which Obamacare has been subjected since it was signed into law. Prior to February’s pratfalls, according to a tally kept by the Galen Institute, “47 significant changes already have been made to the Patient Protection and Affordable Care Act: at least 28 that President Obama has made unilaterally, 17 that Congress has passed and the president has signed, and 2 by the Supreme Court.”’ - No, Mr. President, Obamacare Isn’t Working, The American Spectator, 02/23/2015

Link to the article appears below: