The Foxes Long Ago Took Over the Hen House

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08.06.2013
Last Friday, the President met behind closed doors with Congress to grant they and their staff (who have incomes of $100,000 or more) a waiver from paying for participation in health insurance exchanges. Supposedly, 75% of their premium will be paid by us – regardless of their income.You already knew he had reserved the right to grant waivers to unions and donor corporations, correct? And he has done that over 1,200 times to date. Well now he has done it for our employees who ultimately determine their own salaries and benefits. News of this was not released until they had left town under cover of darkness for their month long recess.
It is anticipated this special dispensation will be formally acknowledged next week by President Obama’s Office of Personnel Management (OPM)–one in the same as the federal government’s H.R. department–which is charged with administering federal benefits within the government.

For a succinct and cogent summation of what the unintended consequences of full Affordable Care Act implementation mean to the quality of our nation’s health care, please view this video of Michigan’ Congressman Rodgers as he makes his opening statement to the Chair on health care reform:

http://safeshare.tv/w/zwhKdMtFHf
Admin. – Kenton Henry
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Feature Article

Grassfire

08.05.2013

Moments before shuttering Capitol Hill for a month-long recess, Congress exempted 11,000 members and staff from ObamaCare. News of Friday’s last-minute deal making is especially frustrating since part of ObamaCare’s original sell to the American people was that lawmakers and aides had to use the plan.
According to The Wall Street Journal, both parties went ballistic when they learned staff would incur dramatically higher healthcare costs. “Democrats in particular, begged for help,” and President Obama leapt into action telling them in a closed-door meeting that “he would personally moonlight as H.R. manager and resolve the issue.”

He did … for Congress.

“A behind-closed-doors deal announced after Congress is safely away from the crime scene. This is exactly why America rightly hates Washington,” charged Sen. David Vitter (R-LA) in a press release posted on his official website. “Obamacare’s a train wreck, even for Congress. So it gets fixed … FOR CONGRESS ONLY” (emphasis in original).
Vitter is right. All Americans should be extended the same “resolution” that Congress is getting.

But with Congress safely tucked away in their districts, the countdown continues for the “less fortunate” Americans who, on October 1, start enrolling in ObamaCare.

* Congress returns on Monday, August 9

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Obama About To Do Another Side-Step?

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08.01.2013
Obama About To Do Another Side-Step?
Op-Ed

Do you remember when the snidely Governor of Texas, played by actor Charles Durning, in the movie, The Best Little Whorehouse in Texas, croon’s …
” Ooh … I love to dance the little sidestep / Now they see me, now they don’t / I’ve come and gone / And ooh, I love to sweep around a wide step / Cut a little swath / And lead the people on!”?
This is exactly the image I have of the President so often but–most recently this morning–on hearing his plans to meet again with the federal Office of Personnel Management. The purpose will be to address their concerns about being forced to abandon their Cadillac federal health plans to enter the Federal Health Insurance Exchange like so many of the rest of us. While this mandate became law when the Senate surprisingly went along with the House vote to do so – now that the time for them to enroll in the exchange is rapidly approaching – they are beginning to balk. (I guess they didn’t read the bill till it was passed!) Now it seems they would like, at the very least, for their premiums to be subsidized by the taxpayers to the tune of (a minimum) 75% as is currently the case. This in-spite of the fact that low paid interns and aides can apply for a regular subsidy (just like you and I) while Rank and File Senators and Representatives receive $174,00 in annual salary; Senate Majority and Minority Leaders $193,400; and The Speaker of the House $223,500. Doesn’t your heart just bleed for them?
Rumor has it the President has promised to see what he can do about it and meet with them again soon. Hence, I hear the words …
” Ooh I love to dance a little sidestep, now they see me now they don’t-I’ve come and gone and, ooh I love to sweep around the wide step, cut a little swathe and lead the people on.
I’m a poor boy, come to greatness. So, it follows that I cannot tell a lie.”
Admin. – Kenton Henry
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FEATURED ARTICLE:

POLITICOPro
Lawmakers, aides may get Obamacare exemption
By JOHN BRESNAHAN and JAKE SHERMAN | 4/24/13 9:49 PM EDT
Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama’s health care overhaul, sources in both parties said.
The talks — which involve Senate Majority Leader Harry Reid (D-Nev.), House Speaker John Boehner (R-Ohio), the Obama administration and other top lawmakers — are extraordinarily sensitive, with both sides acutely aware of the potential for political fallout from giving carve-outs from the hugely controversial law to 535 lawmakers and thousands of their aides. Discussions have stretched out for months, sources said.
A source close to the talks says: “Everyone has to hold hands on this and jump, or nothing is going to get done.”
Yet if Capitol Hill leaders move forward with the plan, they risk being dubbed hypocrites by their political rivals and the American public. By removing themselves from a key Obamacare component, lawmakers and aides would be held to a different standard than the people who put them and aides would be held to a different standard than the people who put them in office.

Democrats, in particular, would take a public hammering as the traditional boosters of Obamacare. Republicans would undoubtedly attempt to shred them over any attempt to escape coverage by it, unless Boehner and Senate Minority Leader Mitch McConnell (R-Ky.) give Democrats cover by backing it.
There is concern in some quarters that the provision requiring lawmakers and staffers to join the exchanges, if it isn’t revised, could lead to a “brain drain” on Capitol Hill, as several sources close to the talks put it.
The problem stems from whether members and aides set to enter the exchanges would have their health insurance premiums subsidized by their employer — in this case, the federal government. If not, aides and lawmakers in both parties fear that staffers — especially low-paid junior aides — could be hit with thousands of dollars in new health care costs, prompting them to seek jobs elsewhere. Older, more senior staffers could also retire or jump to the private sector rather than face a big financial penalty.
Plus, lawmakers — especially those with long careers in public service and smaller bank accounts — are also concerned about the hit to their own wallets.
House Minority Whip Steny Hoyer (D-Md.) is worried about the provision. The No. 2 House Democrat has personally raised the issue with Boehner and other party leaders, sources said.
“Mr. Hoyer is looking at this policy, like all other policies in the Affordable Care Act, to ensure they’re being implemented in a way that’s workable for everyone, including members and staff,” said Katie Grant, Hoyer’s communications director.
Several proposals have been submitted to the Office of Personnel Management, which will administer the benefits. One proposal exempts lawmakers and aides; the other exempts aides alone.
When asked about the high-level bipartisan talks, Michael Steel, a Boehner spokesman, said: “The speaker’s objective is to spare the entire country from the ravages of the president’s health care law. He is approached daily by American citizens, including members of Congress and staff, who want to be freed from its mandates. If the speaker has the opportunity to save anyone from Obamacare, he will.”
Reid’s office declined to comment about the bipartisan talks.
However, the idea of exempting lawmakers and aides from the exchanges has its detractors, including Rep. Henry Waxman (D-Calif.), a key Obamacare architect. Waxman thinks there is confusion about the content of the law. The Affordable Care Act, he said, mandates that the federal government will still subsidize and provide health plans obtained in the exchange. There will be no additional cost to lawmakers and Hill aides, he contends.

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Polls Clearly Indicate the Affordable Care Act Losing Popularity

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07.30.2013

Polls clearly indicate that the Patient Protection and Affordable Care Act is losing popularity with not only Democrats and Republican politicians but the American public in general. In spite of the fact that no real costs of the Affordable Care Act to employers have been realized (other than those spent in attempts to decipher it through paid consultants or in house benefits directors and actuaries) popularity for the law continues to diminish. Much of this disenchantment could stem from the fact that more of us are realizing we really may lose our current health coverage and–perhaps more importantly–our providers. Others realize part-time employment may become the norm as employers attempt to avoid the mandate they provide health insurance to full time employees, i.e., those working 30 or more hours per week. It is a highly unpopular mandate with labor unions which have always supported a minimum 40 hour work week as the definition of full-time employment. It seems only logical many employers will restrict workers to less than 30 hours in attempt to avoid providing health insurance coverage. Another unintended consequence of government’s attempts to improve things.

Admin. – Kenton Henry

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Featured Articles (Reprints June 30th and 26th Editions of the National Association of Health Underwriter’s Washington Update)

Is Health Reform Losing Its Base?

It is no secret that public support for health reform has always been mixed at best and that many Republicans have strongly disliked this law from the start. Now it seems like moderate Democrats are joining the pessimistic about health reform crowd. A recent poll conducted by the Washington Post and ABC News showed that moderate Democrats (who were previous PPACA supporters) are becoming lukewarm about the health reform law. When the law was initially passed in 2011, 74% of moderate and conservative Democrats were in favor of the law. Now, that number is down to 46%. Even more notable is that support is 11 points lower than what it was last year at this time. Liberal Democrats on the other hand still strongly support the law, with 78% of them still loving it to be exact. Among the public at large, 42% support and 49% oppose the law, retreating from an even split at 47% last July. On average, 56% of Democrats now support the law, according to the poll, down 10% from last year.
The same day these polling results were released, President Obama gave a speech out of Knox, Illinois on the economy. While the focus of the speech was the nation’s economy, President Obama unsurprisingly, given the magnitude of its economic impact, brought up the health reform law and tried again to raise support. This time, the president noted that the law is in fact working in the states that embrace it. Many of the states that have decided to fight the law are not seeing as many positive results. He cited states such as California and New York as proof that the law is driving costs down. The president also said that we are “well on our way” to full implementation of the law and that once implemented, the law’s benefits will provide security to middle class families.

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Legislation and Policy

Republicans Divided Over Threat To Defund ACA.
Many outlets, mostly out of the beltway, focus on the political machinations surrounding funding for the Affordable Care Act. The reports highlight a growing rift among factions of the Republican party: those who are pushing to defund the law using a spending bill, and those who believe the move, which could ultimately result in a government shutdown, would be politically dangerous.
Roll Call (7/30, Dennis, Fuller, Subscription Publication) reports that “with 60 Republicans already pushing…to defund Obamacare in any spending bill,” Speaker John Boehner “may not be able to cobble together a House majority” to stave off a government shutdown without courting Democrats. The article notes, though, that “several prominent Republicans” have spoken out against the effort, as this threat “would surely backfire on Republicans if they carry it out.”
FOX News (7/30) reports on the “divide” in the GOP, saying that the “aggressive” push to defund the Affordable Care Act is “increasingly pitting Republicans against Republicans.”
Indeed, several Republicans have spoken out against defunding the law. Politico (7/30, Arkin) reports that in an appearance on MSNBC Monday, House Deputy Whip Tom Cole (R-OK) warned that “shutting down the government to defund Obamacare is a ‘suicidal political tactic.’” Cole is quoted as saying, “Shutting down the government is a suicidal political tactic. Eventually it will be reopened, but the president will not have capitulated and you will have discredited yourself and along the way you will have hurt the American people.”
The Washington Examiner (7/30, Carroll) reports on another high profile Republican who is against defunding the Affordable Care Act, Oklahoma Senator Tom Coburn, who called the efforts “dishonest” and “hype.”
Also reporting on Republican opposition to the tactic are MSNBC (7/30, MacDonald) and the Tulsa (OK) World (7/30, Greene).
However, many Republicans are still pushing for the tactic, led Monday by Texas Senator Ted Cruz. Politico (7/30, Kopan) reports that in an interview with Glenn Beck Monday, Cruz argued that Republicans have the opportunity to can defund the ACA, but “‘scared’ Republicans are standing in the way.” Cruz said, “What I can tell you is there are a lot of Republicans in Washington who are scared. They’re scared of being beaten up politically.”
The Washington Examiner (7/30, Spiering) reports that Senator Marco Rubio (R-FL) “defended” the proposal, saying, “With all these problems why would anyone want to continue with this failed experiment? Only in Washington do people double down on their mistakes.”
Other outlets reporting on Republicans who support fighting for defunding the ACA include the Huffington Post (7/30, Schlanger), the NBC News (7/30, Hunt) website, the Deseret (UT) News (7/30, Askar), The Hill (7/30, Baker) “Healthwatch” blog, The Hill (7/30, Jaffe) “Ballot Box” blog, and the Washington Examiner (7/30, Spiering).
As one of the few Democrats inserting himself into the intra-GOP rift, Politico (7/30, Everett) reports that on Monday, Senate Majority Leader Harry Reid said, “If Republicans force us to the brink of another government shutdown for ideological reasons, the economy will suffer. I would suggest to any of my Republican colleagues that has this idea: Give a call to Newt Gingrich. … Ask him how it worked. It was disastrous for Newt Gingrich, the Republicans and the country.”
Commentary Considers GOP Rift Over Defunding ACA. In addition to accounts of the Republican rift over defunding the Affordable Care Act, several outlets carry analyses and opinion pieces reacting to the debate. Despite some maintaining sympathies for the Republican cause, all conclude that the tactic is certain to fail at the least, and potentially dangerous for the party at the most.
Well-known conservative blogger Jennifer Rubin, in her Washington Post (7/30) “Right Turn” blog, quotes various Republican leaders who are speaking out against the tactic, including Senator Richard Burr (R-NC), who called it “the dumbest idea I’ve ever heard.” Rubin concludes that it is a “certainty” that “the GOP is not going to defund Obamacare on its namesake’s watch.”
Sean Sullivan, in his Washington Post (7/30, Sullivan) “The Fix” blog, calls Cruz’s decision to call his GOP colleagues “scared” for not going along with his plan “a perilous move.” While he is confirming his “conservative bona fides,” Sullivan writes, Cruz is also highlighting his “willingness to be an antagonist at virtually every turn.”
Brent Budowsky, in a piece for The Hill (7/30) “Pundits Blog,” writes that as many Republicans agree, “threatening to shut the government down over healthcare is profoundly unwise policy for America and profoundly unwise politics for the GOP.”
Avik Roy offers a lengthy analysis of the tactic in his Forbes (7/30) “Apothecary” blog, saying that a one year delay of the ACA’s central provisions may be better than a complete repeal.
On the MSNBC (7/30) website, Geoffrey Cowley criticizes Senator Marco Rubio (R-FL) for doubling down on the “kill-it-at-all-costs rhetoric,” seeking to blame President Obama for a potential government shutdown.
Dennis Byrne, a Chicago writer, calls the plan “more than stupid,” in the Chicago Tribune (7/30). He argues that the tactic “will surely fail,” and could very well “cost the GOP in the 2014 elections, possibly including control of the House.” The only way to repeal the law, he concludes, is to “turn the spotlight on what they’d replace it with.”
Similarly, in an editorial, the Baton Rouge (LA) Advocate (7/30) criticizes Republicans for continuing to oppose the Affordable Care Act without coming up with a viable alternative. The paper argues that any sort of GOP-sanctioned replacement “requires legislative initiative, not just opposition.”
Syndicated columnist Jules Witcover writes in the Baltimore Sun (7/30) that despite continued unpopularity, the Affordable Care Act “will nevertheless prevail.”
House To Vote This Week To Repeal Part Of ACA For 40th Time.
The Hill (7/30, Baker) “Healthwatch” blog reports that this week, the House will vote “for the 40th time to repeal part of ObamaCare.” The bill, sponsored by Representative Tom Price (R-GA), restricts the IRS from implementing any part of the law. The article points out that this is part of the GOP’s “effort to keep up the negative pressure” following the employer mandate delay.
Republicans Seek To Change ACA’s Definition Of Full-Time Employment.
CQ (7/30, Attias, Subscription Publication) reports on the “ongoing debate” over whether Congress should revise the Affordable Care Act’s definition of full time employment. So far, “Republicans and business representatives” have voiced their support for “an effort to change the definition to 40 hours a week,” but Democrats aren’t behind it.
The Delmarva (MD) Daily Times (7/30, Gaudiano) also reports on the effort to change the full-time employment threshold.
ACA Call Center Under Fire For Not Offering Health Benefits To All Workers.
FOX News (7/30) reports that a call center set up to offer Affordable Care Act assistance in Contra Costa, California, is making news for not offering health insurance to all of its employees. The state’s budget “only allows for half of the customer service agents hired to work full-time,” which many in the community find “disappointing.”
Feds’ Marketing Of ACA To Young People May Violate Age Discrimination Act.
The Daily Caller (7/29, Howley) reports that the Obama Administration’s public relations campaign touting “the benefits of enrolling in Obamacare” to young people “appears to violate the federal Age Discrimination Act,” which “states that no program that receives federal money can discriminate with respect to age.” The Daily Caller notes that the “campaign-style demographic targeting” would “at least initially have the discriminatory effect of not equally promoting subsidized health care to older participants whose participation would not be as favorable for Obamacare’s convoluted apparatus.”

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No Joke! – IRS Employee’s Union Wants No Part of ACA Exchange Coverage

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07.26.2013

No Joke! – IRS Employee’s Union Wants No Part of ACA Exchange Coverage
Op Ed:
In an ultimate case of hypocrisy (which would be hysterical were it not foretelling a travesty of monumental proportions about to be inflicted on the American people) the Union of IRS employees wants no part of the Obamacare and the Affordable Care Act (ACA)! The Union urges its members to write their congressmen expressing reservation about being forced out the Federal Health Benefits Program and into the insurance exchanges scheduled to be up and functional by October 1. The Federal Health Benefits Program is the “Cadillac” health plan we have always heard federal employees enjoy at our expense. In the meantime, many of us will be forced to give up our current health insurance and providers to acquire what they dictate is right for us. The very representatives who passed and will enforce the legislation and mandates say it is good enough for you and me while not wanting to accept it for themselves. They want no part of the very thing they are forcing down our throats!
We cannot make this up people! And you’re not outraged? Or are you?
(For more details, please see our first feature article below.)

Admin. – Kenton Henry
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FEATURE ARTICLES:
Washington Examiner
IRS employee union: We don’t want Obamacare
BY JOEL GEHRKE | JULY 26, 2013 AT 11:45 AM
TOPICS: ANALYSIS BELTWAY CONFIDENTIAL

National Taxpayer Employee Union officials are giving members a form letter expressing concern…
IRS employees have a prominent role in Obamacare, but their union wants no part of the law.
National Treasury Employees Union officials are urging members to write their congressional representatives in opposition to receiving coverage through President Obama’s health care law.
The union leaders are providing members with a form letter to send to the congressmen that says “I am very concerned about legislation that has been introduced by Congressman Dave Camp to push federal employees out of the Federal Employees Health Benefits Program and into the insurance exchanges established under the Affordable Care Act.”
The NTEU represents 150,000 federal employees overall, including most of the nearly 100,000 IRS workers.
Like most other federal workers, IRS employees currently get their health insurance through the Federal Employees Health Benefits Program, which also covers members of Congress.
House Ways and Means Committee Chairman Dave Camp offered the bill in response to reports of congressional negotiations that would exempt lawmakers and their staff from Obamacare.
“Camp has long believed every American ought to be exempt from the law, which is why he supports full repeal,” Camp spokeswoman Allie Walkersaid.
“If the Obamacare exchanges are good enough for the hardworking Americans and small businesses the law claims to help, then they should be good enough for the president, vice president, Congress and federal employees,” she also said.
“The NTEU represents Internal Revenue Service employees who have the responsibility to enforce much of the health insurance law, especially in terms of collecting the taxes and distributing subsidies that finance the whole system,” said Paul Kersey, director of Labor Policy at the Illinois Policy Institute.
“IRS agents will also collect data and apply penalties for those who fail to comply with many of Obamacare’s requirements,” Kersey said.
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Polls Identify Americans’ Disapproval Of ACA.
In continuing coverage, the Washington Times (7/26, Sherfinski) “Inside Politics” blog reports on a Fox News poll which shows that 53% of respondents would choose to repeal the Affordable Care Act, given the choice between keeping the law in entirety or overhauling it. The piece also reports on a separate poll, from CBS News, which found that “fifty-four percent disapprove of the law and 36 percent approve of it.”
The National Journal (7/26, Shepard, Subscription Publication) reports on the findings from the new United Technologies/National Journal Congressional Connection Poll which found that “opponents of President Obama’s health care law overwhelmingly believe the Affordable Care Act will worsen the quality of their care.” Further, more of the law’s supporters than not “don’t think it will improve their health care.”
Klein Extols Opportunities Brought By ACA. Washington Post blogger and MSNBC political analyst Ezra Klein writes about the coming “opportunity to change American health-care forever,” in a piece for Bloomberg News (7/26). He explains that the Affordable Care Act “carries the potential for both huge profits and huge social benefits,” as long as “Washington can stop bickering over the politics long enough to pay attention.”
Wonkblog Explores Former Republican Alternative To ACA. The Washington Post (7/26, Matthews) “Wonkblog” reports on a former Republican plan to “replace” the Affordable Care Act, proposed in 2009 by Sen. Tom Coburn (R-OK) and Rep. Paul Ryan (R-WI). Known as the Patients’ Choice Act, the law was “a credible way of covering almost all Americans,” picking up 13 co-sponsors in the House and seven in the Senate. After describing the central aspects of the bill, pointing out its similarities with the ACA.
Papers Offer Opposite Opinions On Repealing ACA. In an editorial, the Colorado Springs (CO) Gazette (7/26) encourages Republicans to work to defund the Affordable Care Act, because “most Americans don’t want” it. The paper argues that “perhaps nothing would give our country’s economy a greater jump-start than” stopping the law “in its tracks.”
However, in an opposing editorial, the Ogden (UT) Standard-Examiner (7/26) asks Congress to “respect” the Affordable Care Act. Although the paper has “problems” with the law, it argues that implementation “should not be hijacked through the inappropriate use of a filibuster, or the House refusing to vote for its funding.”

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Christie Slams ACA At GOP Governors’ Meeting.
The Newark (NJ) Star-Ledger (7/26, Portnoy) reports that in a discussion with fellow Republican Governors in Aspen, Chris Christie of New Jersey on Thursday called the Affordable Care Act a “sad legacy” for President Barack Obama. During the talk, Christie said that while he has expanded Medicaid under the law, “he twice vetoed health exchanges.” Criticizing the law, Christie said, “This is what happens when you use Parliamentary maneuvers to jam an absolute sea change in American life down the throats of the American people with bare majorities and not one Republican vote.”
Jindal, Walker Say ACA Is Not Workable. In an op-ed for the Wall Street Journal (7/26, Jindal, Subscription Publication), Louisiana Gov. Bobby Jindal and Wisconsin Gov. Scott Walker write that the ACA is not workable and predict chaos as the Oct. 1 deadline for health insurance exchanges to launch. The Governors argue that while delaying implementation off the ACA is a good idea, outright repeal of the law would be better.
New Jersey Policy Analyst Discusses ACA Benefits. NJ Today (7/26) carries video of an interview with New Jersey Policy Perspective Senior Policy Analyst Raymond Castro, who discusses the benefits of the Affordable Care Act to “New Jersey residents and business owners.” In the interview, Castro drew attention to the law’s subsidies, available to those purchasing insurance on the state’s exchange, calling them “the most important part of the reform.” Castro also pointed out that New Jersey stands to “save a lot of money” under the ACA, as the Federal government will take over a large chunk of costs.
Panels Answer ACA Questions In Utah And Alabama. The Salt Lake (UT) Tribune (7/26) reports that on Thursday, a “panel of Utah health care advocates, experts and state policy leaders answered questions” about the Affordable Care Act in “a televised town hall” event. The article links to recorded versions of the event.
Alabama Live (7/26, Berry) reports that the Chamber of Commerce of Huntsville/Madison County held a panel Thursday morning to inform “several dozen professionals” how the Affordable Care Act “will impact their small businesses in Madison County.” Led by Small Business Administration Alabama District Director Tom Todt, the Affordable Care Act 101 seminar “featured an overview of the Small Business Health Care Tax Credit, Small Business Health Options Program (SHOP) and Employer Shared Responsibility for Employee Health Coverage.”

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White Castle Considering Upping Part-Time Hires Due To ACA.
The Huffington Post (7/26) reports that in response to the Affordable Care Act’s employer mandate, White Castle “is considering hiring only part-time workers in the future,” its Vice President Jamie Richardson said in an interview Thursday. Richardson insisted, though, that “the restaurant chain has no intention of firing members of its current full-time staff or reducing benefits.”
The Los Angeles Times (7/26, Lopez) reports that in an interview with NPR Wednesday, Richardson further outlined his plan to deal with ACA implementation, saying, “As we look to the future, when the new healthcare law takes effect, we are considering at that point, for new hires, letting those people know upfront, ‘Hey, at this point we’re only able to hire part-time team members.’”
Brooks-LaSure Speaks At Senate Hearing On ACA. Bloomberg BusinessWeek (7/26, Clark) reports on Wednesday’s Senate Committee on Small Business and Entrepreneurship hearing on concerns about the Affordable Care Act. According to the article, “the big questions…didn’t have easy answers.” Will, when asked whether “all health exchanges will be up and running as scheduled on Oct. 1,” HHS Deputy Director Chiquita Brooks-LaSure “said she expects all exchanges will be up and running.”
Survey: Business Owners In New England More Optimistic About ACA. The Boston Globe (7/26, Reidy) reports that a new survey out of Deloitte LLP shows that “mid-size companies in New England seem to be more optimistic about containing health care costs than their national counterparts.” Overall, 60% of executives “cited rising health care costs as a major obstacle to US growth,” while only 46% did in New England.

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What will my health insurance premiums go to January 1?

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07.23.2013
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What will your health insurance premiums be come January 1? If you are covered by a small business (less than 50 employees)group plan – projections are you can expect your company’s premiums to increase by a minimum of 8%. If you are not covered by an employer group plan, you will be forced to buy from a federal, state or partnership (between the two) exchange or directly from the private market. While premiums are predicted to go down in as many as 10 states, that leaves 40 where potentially they will not. The question remains – what will your premiums go to? The federal exchange which–will be the source for plans in 34 states which are not creating their own exchange–is yet to release their premiums for the plans which must be available by October 1st. The word is that you better qualify for a subsidy or you are looking at rates at least 30% higher for those currently covered.
As our feature article details, the debate still continues as to how accurate and complete is the information we are being fed as to what our costs will be.
Admin. – Kenton Henry
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Feature Article:
GOP: Obama administration selective with health law data
By Tom Howell Jr. – The Washington Times
Congressional Republicans on Monday accused the Obama administration of withholding data on insurance premiums because it would undermine positive trends the White House touted last week while promoting the health care law.
Citing news reports, three senior GOP senators and the chairmen of House health-related committees said the administration has collected premium filings for 34 states that will use a federally run or federal-state partnership exchange — a market where those without employer-based insurance can buy coverage with the help of government subsidies — but it will not release the information until September as it negotiates the final rates.
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SPECIAL COVERAGE: Health Care Reform
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“We believe it is essential that the U.S. Department of Health and Human Services provide transparent pricing as soon as possible for the millions of Americans who will be impacted by this law,” they said in a letter to HHS Secretary Kathleen Sebelius, arguing many Americans’ premiums will rise under the Affordable Care Act.
They also accused the Obama administration of negotiating rates in secret, something the Wall Street Journal editorial page described as “running Obamacare as a black-ops mission.”
Supporters of the law have been buoyed by news out of New York, where officials last week said premiums on the state’s health care exchange in 2014 will be about 50 percent lower than last year’s direct-pay rates for individuals.
The Obama administration then released a report showing that, on average, premiums would drop by 18 percent in about 10 states and the District of Columbia. Those states have made information available for the individual market in 2014, when their health exchanges open under “Obamacare.”
Since then, Republicans have cited states where early data suggest that premiums will rise.
“Instead of selectively highlighting provisions and data that paint a rosy picture, we encourage the administration to give the American people as much information as possible so they can plan and prepare, and so that we can continue the necessary oversight,” the senior Republicans said in their letter.

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Can we really say we didn’t see the cuts to Medicare Part B coming? (These are described in the Houston Chronicle, our feature article below.) Last year the administration made the decision to cut $716 billion from Medicare over the next ten years. $156 billion of this is predicted to come from Medicare Advantage. If you are a Medicare Advantage policyholder, did this news somehow fail to appear in your “Annual Notice of Change” which arrived last October? If so–could this be because we were in the middle of a Presidential election and cuts to your Medicare Advantage Plan might not have helped someone’s re-election? Fortunately for me, I have always encouraged my clients to enroll in Medicare Supplement to fill in their gaps in Medicare if it was at all affordable.
Admin. – Kenton Henry

*OBAMACARE CUTS

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Feature Article:
Houston Chronicle Medicare Part B, life and death
By Michael Hazel | July 19, 2013 | Updated: July 21, 2013 7:04pm
Across Texas, seniors with serious medical conditions could soon lose access to the medical treatments they need.
Right now, in an effort to trim federal spending, lawmakers are considering cuts to Medicare Part B, the component of Medicare that covers cancer treatments and other medicines that are administered by physicians. Lawmakers must reject this proposal and work to balance the budget without restricting access to medical care.
Under Medicare Part B, health care providers purchase drugs that require administration by the provider and are later reimbursed by Medicare, after administering the treatments in their office, according to a preset formula.
For almost a decade, physicians have been reimbursed the average sales price (ASP) of each medicine plus an additional 6 percent. That extra 6 percent helps to cover costs related to the shipping, handling and storage of the drugs, in addition to health care providers’ other overhead and administrative costs.
The federal “sequester,” which took effect in April, has in effect reduced Medicare Part B’s payment formula for drugs from ASP, plus 6 percent, to ASP, plus 4 percent. Now, some lawmakers want to cut that reimbursement rate even further. Such reductions could mean big problems for Medicare patients.
Medicare patients in Texas are understandably worried. John Peterson, a patient at Texas Oncology who’s been battling leukemia for 12 years, is concerned about future treatments. “I have a lot of exotic drugs that we have Medicare pick up the cost … it’s been a life saver,” Peterson told News Channel 25 in Waco. He fears Part B reductions will make continuing treatments at his current cancer center impossible.
Such reservations are not unfounded. Further Medicare Part B cuts could very well force cancer clinics to start closing. According to the Community Oncology Alliance, approximately 240 oncology clinics have closed in the past four and a half years and another 400 are struggling financially.
“Without adequate reimbursement, providers will close their doors, forcing patients to either forgo treatment or be relocated to inpatient facilities, many outside their communities or region,” reports the National Patient Advocate Foundation.
Such closures are particularly problematic in states like Texas, because our state is home to so many rural residents. With fewer community clinics available, rural Texans will have to travel far distances to other centers or hospitals for treatment. For those suffering from life-threatening illnesses, unnecessary travel is exactly what they should be avoiding.
Treating patients in hospitals instead of doctors’ offices is also far more expensive. Milliman, a respected actuarial firm, found that a chemotherapy patient who receives treatment at a hospital costs Medicare about $600 more per month than a patient who is seen at a physician’s office.
For Texans like John Peterson, Medicare Part B is a matter of life and death. It’s unacceptable that politicians in Washington are considering further reductions to the program’s payments for Part B drugs.
Texas’ representatives should make certain that patients can continue to access the medical care they need.

Michael Hazel is the incoming president of Texas Nurse Practitioners.

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Health Insurance Premiums To Increase 72% in State Exchange

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07.19.2013

So much for the “affordable” part of the Affordable Care Act. At least in some states, like Indiana, where along with Texas and Ohio, I have many clients. As October 1st winds nearer, the date when the Federal and State Health Insurance Exchanges must unveil the new health care compliant policies for 2014 that individuals, families and small groups must choose from – it is evident costs will skyrocket. According to the Indiana Department of Insurance rates there will increase 72%! (See Feature Article below.) In Texas–which is one of 34 states which elected not to establish a state exchange–the Federal Exchange will be the (default) exchange from which to elect coverage. It’s premiums are yet to be revealed but are predicted to be at least 30% higher than for those who currently have health insurance in Texas.

In conclusion, if you do not qualify for a federal subsidy for at least a portion of your coverage–prepare yourself for a significant rate increase. What does it take to qualify for a subsidy? Your annual reportable income must be less than 400% of the Federal Poverty Limit. *Refer to the chart below that limit, increasing increments and the accompanying subsidy.

Admin. – Kenton Henry

********************************

FEATURED ARTICLE:

In Indiana, Individual Health Insurance to Cost 72% More Due to Obamacare

8:15 AM, Jul 19, 2013 • By DANIEL HALPER

Obamacare will be costly for Hoosiers who already have health insurance, according to a report from Indystar.com.

“Insurance rates in Indiana will increase 72 percent for those with individual plans and 8 percent for small group plans under President Barack Obama’s healthcare overhaul, according to the state’s insurance department,” reads the report.

“The spike in costs is due primarily to new mandates under the law, which requires insurers to cover those with pre-existing conditions and to offer a minimum level of benefits, said Logan Harrison, chief deputy commissioner with the Indiana Department of Insurance under Republican Gov. Mike Pence. New taxes and fees under the law also contributed, Harrison said.

The Indiana governor tells the paper: “This new data regrettably confirms the negative impact of the Affordable Care Act on the insurance market in Indiana. … The Affordable Care Act requires many Hoosiers to purchase more comprehensive and more expensive health insurance than they may want or need. These rates call into question just how affordable health insurance will really be for many Hoosiers.”

Costs for individual plans is expected to increase from an average of $255 per member per month in 2012 to $570 in 2014, when the most aspects of the law go into effect.

***************************************

*2013 Federal Poverty Guidelines


48 Contiguous States and DC

Note: The 100% column shows the federal poverty level for each family size, and the percentage columns that follow represent income levels that are commonly used as guidelines for health programs.

 Household   Size

 100%

 133%

 150%

200%

 300%

400%

 1

$11,490

$15,282

$17,235

$22,980

$34,470

$45,960

 2

15,510

 20,628

23,265

  31,020

46,530

62,040

 3

19,530

 25,975

29,295

  39,060

58,590

78,120

 4

23,550

 31,322

35,325

  47,100

70,650

94,200

 5

27,570

 36,668

41,355

  55,140

82,710

110,280

 6

31,590

 42,015

47,385

  63,180

94,770

126,360

 7

35,610

 47,361

53,415

  71,220

106,830

142,440

 8

39,630

 52,708

59,445

  79,260

118,890

158,520

 For   each additional person, add

$4,020

 $5,347

$6,030

  $8,040

$12,060

$16,080


Alaska

 Household Size

 100%

    133%

 150%

200%

 300%

 400%

 1

$14,350

$19,086

$21,525

$28,700

$43,050

$57,400

 2

19,380

25,775

29,070

38,760

58,140

77,520

 3

24,410

32,465

36,615

48,820

73,230

97,640

 4

29,440

39,155

44,160

58,880

88,320

117,760

 5

34,470

45,845

51,705

68,940

103,410

137,880

 6

39,500

52,535

59,250

79,000

118,500

158,000

 7

44,530

59,225

66,795

89,060

133,590

178,120

 8

49,560

65,915

74,340

99,120

148,680

198,240

 For   each additional person, add

$5,030

$6,690

$7,545

$10,060

$15,090

$20,120


Hawaii

 Household   Size

 100%

 133%

  150%

 200%

 300%

 400%

 1

$13,230

$17,596

$19,845

$26,460

$39,690

$52,920

 2

17,850

23,741

26,775

35,700

53,550

71,400

 3

22,470

29,885

33,705

44,940

67,410

89,880

 4

27,090

36,030

40,635

54,180

81,270

108,360

 5

31,710

42,174

47,565

63,420

95,130

126,840

 6

36,330

48,319

54,495

72,660

108,990

145,320

 7

40,950

54,464

61,425

81,900

122,850

163,800

 8

45,570

60,608

68,355

91,140

136,710

182,280

 For   each additional person, add

$4,620

$6,145

$6,930

$9,240

$13,860

$18,480

Source: Calculations by Families USA based on data from the U.S. Department of Health and Human Services

Courtesy of All Med & Life Quote

http://allplanhealthinsurance.com

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House Votes to Suspend Individual and Employer Mandate

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07.18.2013

More symbolic than practical, was yesterday’s House Vote to suspend the employer and individual mandates. As the feature article reiterates, the chances of the Senate considering a vote, much less concurring, is very slim. In my opinion, the Senate will do nothing to lend credibility to the House or its votes and will only vote to perpetuate the political agenda of their own majority. In this case, they need do nothing relative to the employer mandate except sit back and accept the White House decision to suspend it. Theoretically, this will result in less fallout for them at the polls in 2014’s midterm elections. I anticipate the individual mandate will also be a non-issue as far as they are concerned. Their rational will be the undoubted influx of policyholders into health care compliant policies (effective January 1) will make it much more difficult to ultimately repeal the Affordable Care Act regardless any election results. I have to agree with that.

Admin. – Kenton Henry

********************************

FEATURED ARTICLE:

(REPRINTED FROM THE HOME PAGE OF NATIONAL ASSOCIATION OF HEALTH UNDERWRITERS)

House Votes To Delay ACA’s Employer, Individual Mandates.

As expected, the House voted Wednesday to delay two key aspects of the Affordable Care Act: its employer and individual mandates. Though symbolic, as the Senate is highly unlikely to even consider the bills, the votes were designed to capitalize on the negative attention currently surrounding the law. Some outlets, in addition to their reporting, draw distinction between the two mandates, noting that the White House is delaying the employer penalties while maintaining that the individual mandate is central to the law’s success.

The AP                          (7/18, Cassata) reports that on Wednesday, House Republicans voted “to delay core provisions of President Barack Obama’s health care law, emboldened by the administration’s concession that requiring companies to provide coverage for their workers next year may be too complicated.” The piece notes that “the House voted largely along party lines, 264-161, to delay by one year the so-called employer mandate,” and “it voted 251-174 to extend a similar grace period to virtually all Americans who will be required to obtain coverage beginning Jan. 1, the linchpin of the law.”

The New York Times

(7/18, Pear, Subscription Publication) reports that “the legislation has little prospect of approval in the Senate,” although the House debate allowed Republicans “to reiterate their opposition to the individual mandate,” and “gave them a rare opportunity to portray Mr. Obama as a friend of big business while presenting themselves as defenders of ordinary Americans.”

Politico

(7/18, Cunningham, Cheney) reports that “the point” of the votes “was to put Democrats on the spot, getting them to vote for the relief for employers but not individuals and families,” although “it didn’t exactly work as planned.”

The Hill

(7/18, Kasperowicz) “Floor Action” blog notes that both measures “won over dozens of Democrats.” The bill delaying the employer mandate, “a vote the GOP says authorizes Obama’s decision,” was approved by 35 Democrats. The bill delaying the individual mandate was approved by less, just 22 Democrats voted for it.

The Washington Post

(7/18, Johnson) reports that while “many Republicans see this as an effort to counteract a flawed law that is unraveling,” several “Democrats see it as grandstanding to please voters — and a complete waste of time.”

Illustrating this point, the Wall Street Journal

(7/18, Boles) “Washington Wire” blog quotes some statements made on the floor during debate of the bills. Minority Whip Steny Hoyer (D-MD) said, “This is about gotcha politics. Isn’t it a shame when millions of Americans have no health care…that we spend our time on this floor of gotcha politics.” Later, Rep. Candice Miller (R-OH) said, “The president is not the king, he is a president. He doesn’t have the authority to delay a law on his own. Congress would have to do that.”

The Los Angeles Times

(7/17, Memoli), in noting that this was the “38th attempt by congressional Republicans to repeal part or all of the law, according to Democrats who keep a tally,” White House Secretary Jay Carney quipped, “I’ve lost count; I think they have, too.”

Offering similar accounts of the votes are the Washington Times

(7/18, Howell), Bloomberg News  (7/18, Tiron), Reuters  (7/18, Lawder), CQ  (7/18, Khatami, Subscription Publication), the ABC News  (7/18, Parkinson) “The Note” blog, NBC News  (7/18, Dann), the CNN  (7/18, Walsh) “Political Ticker” blog, MSNBC  (7/18, Koenig-Muenster), US News & World Report  (7/18, Fox), the Daily Caller  (7/18, Levinson), Roll Call  (7/18, Dumain), the Washington Examiner  (7/18, Lengell), FOX News  (7/18), The Chattanoogan  (7/18), and the New Orleans Times-Picayune  (7/18, Alexander).

Outside of reporting on the votes to delay both mandates, several pieces account for the political machinations surrounding the actions Wednesday. Many of these, found mostly in the beltway publications, were published before the vote. For example, The Hill

(7/18, Baker) “Healthwatch” blog reports that the National Retail Federation “said Wednesday it would score as a ‘key vote’ a bill to delay the employer mandate in President Obama’s healthcare law.” As the article explains, “Retailers are among the harshest critics of the mandate, which requires large employers to offer affordable healthcare coverage to employees who work more than 30 hours per week.” The National Federation of Independent Business also planned to score the vote.

Similarly, The Hill

(7/18, Viebeck) “Healthwatch” blog reports that the U.S. Chamber of Commerce “is threatening to punish lawmakers in the 2014 midterm elections if they oppose a vote today to delay ObamaCare’s employer mandate.”

Other reports include those in The Hill

(7/18, Kasperowicz) “Floor Action” blog, another found in The Hill  (7/18, Kasperowicz) “Floor Action” blog, The Hill  (7/18, Viebeck) “Healthwatch” blog, the Washington Times  (7/18, Howell), the Washington Times  (7/18, Howell) “Inside Politics” blog, CQ  (7/18, Attias, Subscription Publication), the Puget Sound (WA) Business Journal  (7/18, Bauman, Subscription Publication), the Sacramento (CA) Business Journal  (7/18, Robertson, Subscription Publication), Forbes  (7/18, Japsen), and the Atlantic  (7/18, Lazarus).

Commentary Considers Implications Of House Votes. Many outlets carry opinion pieces reacting to the House votes to delay both the employer and individual mandates of the Affordable Care Act. The commentary is mostly favorable toward the ACA, criticizing Republicans for continuing to push for repeal of the law, rather than work to improve it. A handful take the opportunity, however, to blast the law.

Senate Finance Committee Chairman Max Baucus (D-MT) commends the Obama Administration for delaying the employer mandate in a piece for Politico

(7/18), arguing that it “shows the administration is listening to the business community and working to address its concerns, as well as the concerns of Congress.” He criticizes Republicans for not being similarly accommodating, instead remaining “engaged in a quixotic bid to repeal the ACA and take away its many benefits for America’s families and businesses.” Baucus concludes, “Wouldn’t it be better if both parties worked together to improve the law?”

In his Washington Post

(7/18) column, Dana Milbank writes that “Congress has voted to repeal all or part of Obamacare” 67 times, while “Wednesday’s 66th and 67th attempts went much like the previous 65, except for a mid-debate recess so that lawmakers could have their official photograph taken on the House floor.” Milbank notes that “the overkill isn’t irrational,” as “research shows that people resist regulations more vigorously if they think the requirements will eventually be repealed. … And so Republicans continue to tee up the repeal votes — far more than anybody realized.”

Jamelle Bouie, a staff writer and blogger at The American Prospect, writes in the Washington Post

(7/18) “Plum Line” blog that because the votes took place on the same day that New York announced its premiums were plummeting by up to 50 percent thanks to the law, “It’s Republicans who are caught in a bind.” He concludes, “Soon, they’ll either have to accommodate the law in order to satisfy their constituents, or continue their quest for repeal, and in the process, further harm their political standing.”

Similarly, Jon Healey, in his Los Angeles Times

(7/18) column, writes that the New York news should have stopped Republicans “in their tracks.” And what’s more, “the fact that it didn’t shows that Republican lawmakers are so determined to undermine the law, they don’t care what might happen to their constituents.”

Chris Stirewalt, in his “Power Play” column for FOX News

(7/18), argues that the vote to repeal part of the Affordable Care Act, “again,” means “quite a lot.” He writes that in delaying the employer mandate, the President has “armed” Republicans with a talking point “about unequal treatment for consumers while big businesses benefit.”

Research Shows ACA Could Encourage People To Leave Work Force.

In continuing coverage, Fox Business

(7/18, Brooks) reports on a new study which found that “nearly a million employees could drop out of the work force when new, cheaper health care options are officially offered to U.S. residents.” The research, conducted by economists from Northwestern, Columbia University and the University of Chicago, found that “between 500,000 and 900,000 Americans may choose to stop working because they are no longer dependent on their employers for health insurance.”

Ross Douthat, in his New York Times

(7/18) “Evaluations” blog, discusses the study, concluding that he is somewhat “untroubled” by its findings because “many of the people dropping out of the workforce would be near-retirees or people dealing with severe family health issues, rather than the kind of able-bodied workers whose declining workforce participation we should actually be worried about.”

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House to Vote on Affordable Care Act Individual and Employer Mandates

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07.17.2013

Currently we have over 800,000 veterans awaiting decisions on their disability claims. The back log is so great–according to the most recent numbers available–the average wait time for a veteran is 15 months in Chicago, 16 months in New York and a year and a half in Los Angeles. Social Security’s disability program, which helps support 11 million Americans, will run through its trust fund in 2016, two years earlier than predicted. Couple this with the prediction Social Security, the fund that finances benefits for 44 million senior citizens and their survivors, will be exhausted by 2035 and Medicare, the health care program for those age 65 and over, will be have depleted its funds by 2024. Now consider a law has been passed which mandates health coverage for every American. Its objectives are largely, and initially, funded via subsidies from the federal government (you the tax payer). Can you possibly believe this is feasible given their track record? Given a federal debt of almost 17 trillion dollars? How long do you believe it will take before all private insurance companies are forced to withdraw from participation to be replaced by a single payer federally administrated program which can’t possibly be any more financially feasible than our government’s disability program, Social Security or Medicare?

Admin. – Kenton Henry

http://allplanhealthinsurance.com

****************************************************************

Today’s Feature Articles:

Legislation and Policy

House Votes To Target ACA Individual, Employer Mandates.

Coverage of the Obama Administration’s decision to delay the Affordable Care Act’s employer mandate continues Wednesday, the same day the House is set to vote to further capitalize on the weak position they believe the move has put Democrats in. Most reports, some national in scope, focus on the House votes to delay both the employer and individual mandates, while others focus on the implications of both of these provisions.

McClatchy                          (7/17, Kumar) reports that on Wednesday, the Republican-ruled House is expected to vote to delay key parts of the Affordable Care Act, a move that “is the latest in a sweeping legislative and political campaign to weaken the 2010 law and raise even more opposition in the eyes of an already skeptical nation, especially as it heads into 2014 elections that will decide control of the Congress and set the stage for the 2016 campaign for the White House.” The back-to-back votes will determine “whether to delay insurance mandates for both employers and individuals.”

The Washington Times

(7/16, Howell) reports that “President Obama has threatened to veto” the bills. Meanwhile, “the votes will force Democrats to align with the president or distance themselves from the overhaul in the wake of its recent stumbles.” In addition, it has put the “Office of Management and Budget in the awkward position of threatening, in the case of the employer mandate, to kill a bill that would reflect the White House’s own decision-making.”

CNN

(7/16, Walsh) reports that “most House Democrats are expected to oppose two House Republican bills on Wednesday that would delay key provisions of Obamacare,” according to House Democratic Whip Steny Hoyer (D-MD).

The Hill

(7/17, Baker) “Healthwatch” blog reports that the bill to delay the individual mandate “would cut the deficit, but would cause insurance premiums to rise,” according to the Congressional Budget Office.

Implications Of Employer Mandate Delay Still Unclear. The AP

(7/17, Alonso-Zaldivar) reports on the “domino effect” that is currently “undercutting” the Affordable Care Act: the Obama Administration’s delaying of the law’s employer mandate could “weaken” the individual mandate, because the requirement that companies report health insurance details for employers has also been pushed back. As the article explains, “without employers validating who’s covered, a scofflaw could lie, and the government would have no easy way to check.” The piece calls this yet “another incentive for uninsured people to ignore a new government requirement that for many will cost hundreds of dollars.”

****************************************************************

Not All Insurers Game for State Exchanges: The Consumer Impact

By Kate Rogers

Published July 11, 2013

FOXBusiness

As more insurers decide to pack up and leave certain states as health exchanges start to take form, experts say consumers are going to be left  feeling the pain.

Over the last few weeks, several departure announcements have sent a ripple through the health insurance industry, as companies weigh whether or not they want to play ball under Obamacare. So far, California has experienced the biggest migration  with Aetna (AET), UnitedHealthcare (UNH) and Cigna (CI) leaving the state’s exchange, Covered California.

Aetna also reportedly sent out a note to select customers last week, warning that the Patient Protection and Affordable Care Act is “changing health insurance.” Recipients were customers across the country with non-grandfathered health plans, meaning their plan was not in effect on March 23, 2010 and wouldn’t carry over under new state and federal exchange regulations under ACA.

“This includes adding preventative care and essential health benefits. The ACA also ends medical underwriting. Due to these and other changes, many people will pay more for their health insurance coverage in 2014 than they do today,” the letter stated according to the carrier.

Wellmark Blue Cross/Blue Shield also decided not to list on the individual exchange in Iowa for 2014, due to a lack of information available in the state, according to a spokesperson for the Iowa Insurance Division.

Fifteen states and the District of Colombia are in the process of creating their insurance exchanges before the 2014 deadline; when individuals must purchase insurance or face a fine for failing for comply with the individual mandate. The employer mandate has been pushed back to 2015, and some in the GOP including House Majority Leader Eric Cantor, (R-VA), are calling for the individual mandate to be rolled back as well.

More or Less Competition for Consumers?

Some experts say the recent departures hint consumers will have limited health-insurance choices thanks to the regulatory burdens of the law. Basic supply and demand dictates that with fewer insurers to choose from, consumers will have limited options and potentially higher prices, says Michael Cannon, director of Health Policy Studies at the CATO Institute.

A similar “exodus” occurred within the first six months of the implementation of the Affordable Care Act, Cannon says, when child-only care was enacted. Seventeen major insurers dropped child-only coverage, in an attempt to skirt the law’s new regulations and increased costs. The same may begin to take shape in the individual market.

“The program says you can’t charge higher premiums to the sick, so you have a situation where only low-risk consumers would be charged a premium much higher than their regular costs, so only people who buy it would be those who really needed it,” he says.

The employer mandate rollback is also a factor in the situation, says Grace-Marie Turner, founder of the Galen Institute, a health and tax policy research organization, as employers will now be incentivized to drop coverage and push their employees into the exchanges until 2015.

“It’s using employers to push more people into the exchanges,” Turner says.

Fewer insurers in state exchanges mean less competition, bottom line, she adds. “The whole point is we want more players, and more competition.”

Why California Matters

What happens in California is a big deal for the future of the Affordable Care Act, says Taylor Burke, associate professor and program director, MPH in Health Policy, at George Washington University.

“It’s an exit out the individual market, but [the insurers] only represent 8% of the individual market companies in the state,” Burke says. “California has the 7th largest economy on the globe, so whatever happens in California is a big deal for the stand up of the state exchanges.”

He points to two main reasons insurers leave a state: they don’t like the price points being offered in the exchanges nor the coverage they would have to offer under Obamacare’s 10 essential health benefits.

“In California, you can make the argument that there would be less choice, but if they stay in the market, their prices would be off the charts,” he says. “It would be a thing on the shelf, a high-ticket item that you couldn’t afford anyway.”

And if insurers take too long to make the decision, that may impact them negatively as well, he says.

“No one will want to buy their product. There’s a lot of hemming and hawing, but if the price point is too high, no one will buy it.”

But can consumers blame the insurer for higher prices? Turner says no, it’s the nature of the law’s regulations.

“Insurers can’t help the demands on the benefits they will have to cover—it will absolutely be more expensive,” she says. “It’s like going to buy a car with every accessory in the books—heated seats, fancy wheels, satellite radio, and saying you can’t charge more for it.”

What Insurers are Deciding

Robert Zirkenbach, spokesman for America’s Health Insurance Plans (AHIP), says each individual company will have to make their own decisions about which states to participate in as exchange bids come in.

“It will be based on a variety of reasons, but plans are offering coverage on the exchange, some will be outside the exchange—there will be options for consumers,” Zirkenbach says. “It will depend on the state and regulatory environment.”

He says the AHIP wants competition among insurers to keep consumer prices in check.  “Choice and competition is a good thing—when states have been setting up their exchanges, we are trying to encourage this,” he says.

The National Association of Insurance Commissioners says insurers who are leaving these markets are likely doing so because they have core businesses in other segments, including the large group market.

“The carriers we have seen exiting the individual market are not major players in that market segment, and therefore we don’t anticipate a major disruption of coverage for a large portion of the market,” a spokesperson said in an email statement. “Each insurance company is making decisions regarding its participation in exchanges based upon a number of factors.  Some are opting to participate in the exchanges, while others are not; however, nearly all of the requirements that apply to policies sold on the exchange also apply to policies sold outside the exchange, so insurers will not be avoiding a lot of requirements by opting out of the exchanges.”

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Welcome to The MedPlus Messenger Blog!

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THE MEDPLUS MESSENGER

VOL I, ISSUE 1, 16 JULY 2013

THE MEDPLUS MESSENGER blog is for the dissemination and discussion of information regarding health, Medicare and life insurance legislation; laws; trends; products and related topics. It is intended to be of use to the general public; clients and prospective clients of ALL PLAN MED & LIFE QUOTE the parent company of ALLPLANINSURANCE.COM: http://allplaninsurance.com; ALLPLANHEALTHINSURANCE.COM; ALLPLANINTERNATIONALHEALTHINSURANCE.COM and IndianaHealthInsurance4U.com.

ADDRESSING: HEALTH AND MEDICARE RELATED INSURANCE ISSUES INCLUDING THE AFFORDABLE CARE ACT (ACA); COMPLIANCE WITH THE AFFORDABLE CARE ACT; STATE AND FEDERAL HEALTH INSURANCE EXCHANGES; CURRENT BEST VALUES IN HEALTH INSURANCE; IMPACT OF THE ACA ON EMPLOYERS; DECLINATION DUE TO PRE-EXISTING CONDITIONS; MEDICARE AND MEDICARE RELATED INSURANCE (MEDIGAP); PART D PRESCRIPTION DRUG PLANS

While The MedPlus Messenger has existed for sometime as an industry and marketing newsletter–today is the first time we have existed and published as a blog. The reasons for this are numerous but the greater ones are: the tremendous amount of confusion, on the part of the public, regarding the ACA and its implementation; the diverse opinions and perspectives on it; apprehension as to its effects on the quality of health care; the cost of insuring for medical expense and the options for doing so available to employer groups, individuals and families and Medicare recipients. Only through intelligent discourse of these topics can our subscribers transition through implementation into optimal utilization of health care, as well as protection against the cost for such, with as little inconvenience as possible. Only by discussing your concerns, , perspective, frustrations and opinion can Allplanhealthinsurance.com better meet your needs in this rapidly changing marketplace. Already the availability of health insurance has become an entitlement by law and its issue and administration may well be on the brink of falling within the exclusive confines of another federal program. For these reasons, not only are your insights and questions welcomed but your disagreements and protests encouraged as well.    

OUR MISSION:

It has and will remain the goal of Allplaninsurance.com to provide the most objective health, Medicare related, life and dental insurance quotes–along with the very best of service to the our policyholders. We serve residents of all fifty states (US) and the international community. We see it as our responsibility to monitor the state of the national and international insurance and the political process as it relates to such. It is our objective and, we feel–our duty–to inform the public of such matters. ALL PLAN MED & LIFE QUOTE has been based in The Woodlands, Texas since 1991.

THE MEDPLUS MESSENGER is not copyrighted and articles and analysis presented in THE MEDPLUS MESSENGER may be reproduced at your discretion. However, articles and analysis should not be construed as representing the policy, endorsement or opinion of ALL PLAN MED & LIFE QUOTE, or its agents, unless so stated. Although carefully verified, data are not guaranteed as to accuracy or completeness. ALL PLAN MED & LIFE QUOTE cannot be held directly responsible for any direct or incidental loss incurred by applying any of the information in this publication.

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IMPORTANT PHONE NUMBERS AND LINKS:

THE AFFORDABLE CARE ACT, SECTION BY SECTION (U.S. Department of Health and Human Services Website): http://www.hhs.gov/healthcare/rights/law/index.html

CENTERS FOR MEDICARE & MEDICAID SERVICES: 1.800.633.4227: http://www.medicare.gov

U. S. (Federal) Pre-Existing Condition Health Insurance Plan:  https://www.pcip.gov/

The United States Senate: http://www.senate.gov/general/contact_information/senators_cfm.cfm

Texas Department of Insurance: 800.252.3439: http://www.tdi.state.tx.us/

Texas Health Insurance Risk Pool (for those uninsurable by private health insurance):

888.398.3927; TDD 1.800.735.2989: http://txhealthpool.com/

New York Department of Insurance: 800.342.3736: http://www.ins.state.ny.us/

Illinois Department of Insurance: 217.782.4515: http://www.idfpr.com/

Indiana Department of Insurance: 317.232.2410: http://www.state.in.us/idoi/

California Department of Insurance: 916.322.3555: http://www.insurance.ca.gov/

United States Treasury Health Savings Account Guidelines:  http://www.treasury.gov/

Doctor Comparison:  http://www.bcbstx.com/bluecompare/tour/index.html

National Association of Health Insurance Underwriters:  http://www.nahu.org/

VISIT OUR WEB SITES AT:

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TODAY’S ISSUE OF DISCUSSION:

The Affordable Care Act (ACA) and its current state of implementation; the impact of such on health insurance premiums and the delayed Employer Mandate.

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FEATURE ARTICLES:

Op-Ed:

The ensuing articles demonstrate that efforts to implement the Affordable Care Act remain behind schedule and the mechanisms in place to ensure such were never for this herculean task. It is logical to conclude this is, in large part, due to the burden of  comprehending the content and demands of two thousand plus pages of the act itself and nine thousand plus pages of accompanying regulations. Both the public and private sector responsible for implementation are obviously overwhelmed with massive work this requires. This, along with the greatly underestimated costs of implementation and regulation, does not bode well for a smooth and efficient transition into compliance. Even less assured is  the long term solvency of the ever-decreasing number of participating health plans or the feasibility of guaranteed health care.

Due to the minimal penalties for failing to purchase health insurance during the next two years, it is predicated participation by those currently choosing to be uninsured will be negligible. When compared to the cost of insuring which is predicted to increase in many cases by as much or more than 100%–it is reasonable to conclude most will simply choose to pay the penalty. This will disprove the assumption that a huge influx of young, healthy insured members will subsidize the cost of insuring the older, and generally less healthy, individuals which the was the main premise on which feasibility arguments were based.

We can see from recent legislative action that portions of the bill which would impede implementation have been suspended. This, at worst, appears politically motivated and, at best, an effort to make certain as many as possible sign up for individual and family coverage through an exchange. Whether or not you are in favor of the latter is probably dependent on whether you would like to see a “single payer” health insurance system in place as, I feel, this will be the ultimate result of the exchanges and their plan mandates. In the meantime, The ACA is law. Suspension of portions of a passed act inconvenient to implementation of the act itself is unprecedented to my knowledge and there appears no legal basis for doing so.

The featured articles below begin with an overview of the distinction between “Minimum Essential Coverage” and “Essential Health Benefits” and conclude with recent abatements in enforcement of certain portions of the law. That these abatements, suspensions, moratoriums are convenient is unquestionable. The question remains, “for whom?”

Kenton Henry

Administrator, Editor: The MedPlan Messenger

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OVERVIEW MINIMAL REQUIRED COVERAGE AND PENALTIES FOR NON-COMPLIANCE

Beginning in 2014, the Affordable Care Act includes a mandate for most individuals to have health insurance or potentially pay a penalty for noncompliance. Individuals will be required to maintain minimum essential coverage for themselves and their dependents. Some individuals will be exempt from the mandate or the penalty, while others may be given financial assistance to help them pay for the cost of health insurance.

What type of coverage satisfies the individual mandate?

“Minimum essential coverage”

What is minimum essential coverage?

Minimum essential coverage is defined as:

  • Coverage under certain      government-sponsored plans
  • Employer-sponsored      plans, with respect to any employee
  • Plans in the individual      market,
  • Grandfathered health      plans; and
  • Any other health      benefits coverage, such as a state health benefits risk pool, as      recognized by the HHS Secretary.

Minimum essential coverage does not include health insurance coverage consisting of excepted benefits, such as dental-only coverage.

How does “Minimum Essential Coverage” differ from “Essential Health Benefits”?

Essential health benefits are required to be offered by certain plans starting in 2014 as a component of the essential health benefit package.  They are also the benefits that are subject to the annual and lifetime dollar limit requirements.

This is different than minimum essential coverage, which refers to the coverage needed to avoid the individual mandate penalty.  Coverage does not have to include essential benefits to be minimum essential coverage.

What is the penalty for noncompliance?

The penalty is the greater of:

  • For 2014, $95 per      uninsured person or 1 percent of household income over the filing      threshold – whichever is greater
  • For 2015, $325 per      uninsured person or 2 percent of household income over the filing      threshold – whichever is greater
  • For 2016 and beyond,      $695 per uninsured person or 2.5 percent of household income over the      filing threshold –whichever is      greater

There is a family cap on the flat dollar amount (but not the percentage of income test) of 300 percent, and the overall penalty is capped at the national average premium of a bronze level plan purchases through an exchange.  For individuals under 18 years old, the applicable per person penalty is one-half of the amounts listed above.

Beginning in 2017, the penalties will be increased by the cost-of-living adjustment.

Who will be exempt from the mandate?

Individuals who have a religious exemption, those not lawfully present in the United States, and incarcerated individuals are exempt from the minimum essential coverage requirement.

Are there other exceptions to when the penalty may apply?

Yes.  A penalty will not be assessed on individuals who:

  1. cannot afford coverage      based on formulas contained in the law,
  2. have income below the      federal income tax filing threshold,
  3. are members of Indian      tribes,
  4. were uninsured for      short coverage gaps of less than three months;
  5. have received a      hardship waiver from the Secretary, or are residing outside of the United      States, or are bona fide residents of any possession of the United States.

*Further Clarification of the Applicable penalty
The individual one-time penalty under ACA in 2014 will be $95 per adult, or one percent of your income, whichever is greater. So say your annual income is $50,000, you’d pay $500. For every uninsured child, the penalty is $47.50. The family maximum is $285.
Coverage is assessed on a monthly basis, So if you were uninsured for six months, you’d owe half the otherwise applicable penalty.”
She said that the government has given a wide window – from Oct. 1, 2013 to March 31, 2014 – for enrollment this time, but from next year on there will only be a three-month window to sign up.
Will people take the gamble and skip coverage, hoping that their youth or good health will protect them?
If the state of Massachusetts, which passed a landmark health care law in 2006, which became the blueprint for the 2010 ACA, is any indication the number of people who will refuse to get some form of coverage will be low.
In Massachusetts, “there’s a culture of coverage. Most people want to comply with the law.”

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FORBES

Pharma & Healthcare |

7/06/2013 @ 6:25PM |290,284 views

Not Qualified For Obamacare’s Subsidies? Just Lie — Govt. To Use ‘Honor System’ Without Verifying Your Eligibility

If you thought the delay in the employer mandate was bad news for Obamacare, just wait. On Friday, Sarah Kliff and Sandhya Somashekhar of the Washington Post discovered that the Obama administration had buried in the Federal Register the announcement that the government won’t be able to verify whether or not applicants for Obamacare’s insurance exchange subsidies are actually qualified for the aid, in the 16 states that are setting up their own exchanges. Instead, until at least 2015, these states will be able to “accept the applicant’s attestation [regarding eligibility] without further verification.”

Without employer mandate, Feds to rely on applicant ‘attestations’

If you’ve been following the latest news around Obamacare, you know that on Tuesday evening, just before the Independence Day holiday, the White House announced that it would be delaying the implementation of the health law’s employer mandate—requiring all firms with more than 50 employees to provide health coverage to their workers—until 2015.

I, and several others at the time, said “wait a minute.” According to the law, you aren’t eligible for Obamacare’s subsidies if your employer has offered you what the government considers “affordable” coverage. But if employers are no longer going to report whether or not they’ve offered “affordable” coverage, how can the government verify whether or not workers are eligible for subsidies?

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DELAYED EMPLOYER MANDATE THE LATEST CHANGE FOR INCREASINGLY UNSTEADY HEALTH-CARE LAW

July 4, 2013 | Washington Post

The Obama administration has postponed one of the fundamental provisions of the health-care reform law, responding to mounting concerns from business owners who would have been required to start providing health coverage to their employees next year. On Tuesday evening, Treasury Department officials announced the government would not penalize businesses that fail to provide health insurance next year, delaying what is known as the “employer mandate” component of the law until 2015. Starting then, firms with more than 50 employees will be required to provide at least a minimum level coverage to their workers or pay a steep fine to the federal government. Officials made the decision to push the requirement back after fielding a flood of complaints from business owners about its implementation. “We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively,” Mark Mazur, assistant secretary for tax policy, wrote in a blog post announcing the postponement, later adding that the administration plans to use the additional time to “consider ways to simplify the new reporting requirements” for business owners. The newly delayed mandate has been a major point of contention for small business owners and lobbyists since it was approved as part of the Affordable Care Act in 2010. Many warned that it would cause administrative nightmares for small employers and discourage those near the cutline from expanding beyond 50 workers. Meanwhile, some firms have started scaling back their payrolls to get underneath the cap. “Small companies have told us they are confused by the law and are simply finding it difficult to comply with, no matter when it goes into effect,” Rep. Sam Graves, chairman of the House Small Business Committee, said in an email to The Washington Post. “Instead of providing relief for businesses, this simply kicks the can down the road.” A White House official said the added time would help small business owners adapt to the changes, arguing that the law will still drive down prices for coverage on Main Street. “This allows employers the time to .?.?. make any necessary adaptations to their health benefits while staying the course toward making health coverage more affordable and accessible for their workers,” Valerie Jarrett, an adviser to Obama, wrote in a blog post on Tuesday. This latest delay is the most consequential in a series of setbacks for the president’s signature law, which has shown signs of fragility as the initial deadline for full implementation approaches at the end of the year. In April, the administration announced it would delay for one year a key cost-cutting feature of the law’s new small business health insurance marketplaces. Initially, the exchanges were supposed to allow employers to choose different plans for different workers; now, for the first year, they must select only one plan from a single carrier for their entire business. More recently, the Government Accountability Office announced that federal and state officials have fallen well behind schedule setting up the marketplaces, which are scheduled to open for enrollment in October. “This is simply the latest evidence that implementation of this terrible law is going to be difficult if not impossible, and the burden is going to fall on the people who create American jobs,” Amanda Austin, director of federal public policy at the National Federation of Independent Business, said in a statement. The NFIB, a small business lobbying group, has pushed back against the health care law since it was making its way through Congress, later spearheading an effort to repeal the legislation that ended at the hands of the Supreme Court. The group has since focused on repealing some of the provisions it considers most detrimental to businesses on Main Street, including the employer mandate and a new tax on insurers. Instead of delayed, Austin argued the mandate should be eliminated altogether. “Temporary relief is small consolation,” she said. “We need a permanent fix to this provision to provide long term relief for small employers.” – See more at: http://congress.org/2013/07/04/delayed-employer-mandate-the-latest-change-for-increasingly-unsteady-health-care-law/#sthash.JwCb3wWY.dpuf

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Now is a good time to remind you, if you do not like the options and laws as they apply to insurance consumers, the time to vote your opinions is nigh. For a continually updated list of legislative and state-wide candidates, or to view more election information such as where to vote, visit: http://www.sos.state.tx.us/elections/index.shtml

To let your opinion be known to your Senators go to: http://www.senate.gov/general/contact_information/senators_cfm.cfm

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ALL PLAN MED & LIFE QUOTE and ALLPLANINSURANCE.COM sincerely appreciate your participation.

Please take care and voice your concerns and opinion here.

Sincerely,

Kenton Henry

Administrator; Editor

PHONE: 800.856.6556

http://allplanhealthinsurance.com

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