In “Finance & Company News” on the ADVFN web page is a recent report (5/14) regarding a healthcare tech concern – - Optum. At one point, according to writer Louise Radnofsky, around the time of the ill-fated roll-out of HealthCar.gov (for Obamacare) “federal officals widely praised the company for its work fixing HealthCare.gov. Andy Slavitt, a group executive at Optum, left the company and took on the formal role within the federal government in the summer of 2014. He is now the acting administrator at the Centers for Medicare and Medicaid Services.”
Tellingly, Radnofsky’s report adds, “Some Republican members of Congress have raised questions about the transition, noting that CMS regulates Optum’s insurance parent company as well as its technology unit.” Meanwhile, according to the ADVFN story, “Enrollment workers who have been using HealthCare.gov frequently to sign up the uninsured say the system-wide problems have been fixed, though glitches arise from time to time.”
Elizabeth Colvin, who heads up Insure Central Texas is cited in the ADVFN account. Her contention, as recapped by ADVFN, is “the remaining problems typically stem from complicated situations such as very low-income, legal immigrants who have different eligibility or financial assistance than their U.S.-born counterparts. But more broadly, she said the biggest challenges remaining for the system rest on the intricacies of the law’s various rules for eligibility to users.”
ADVFN is a financial market web site.
A recent report on the Politico.com site (5/18) says the feds are picking up the full tab for Medicaid expansion expenditures through the year 2016. After that the feds plan a cutback, dropping that level down from 100 to 90 percent. This prospective scenario has raised the ire of conservatives who say that such financial responsibility winding up on the states’ backs (according to Rachana Pradhan writing in Politico) “are just too big a burden, and they see vindication in the sign up numbers, proof that costs will be more than projected as they have warned all along.”
Conservatives like Florida Gov. Rick Scott are quoted by Politico as saying, “The expansion of Obamacare will cost our state taxpayers $ 5 billion.” “Name the healthcare program – - I think the only one is Medicare Part D – that cost less than what they initially anticipated. . . . Historically, if you look at the numbers, with the growth in Medicare costs. Medicaid costs, it’s always multiples.”
Meanwhile, the legislature in Florida is bitterly divided over Medicaid policy. At one point Gov. Scott had advocated Medicaid expansion, but later had second thoughts.
Other governors are worried as well. In Utah, for example, Gov. Gary Herbert is scratching his head, trying to figure out a way for his state to expand Medicaid. According to Pradhan’s Politico account, “Herbert met with HHS Secretary Sylvia Mathews Burwell in late April and later voiced worries that any form of expansion could mean Medicaid consumes an even bigger chunk of the state budget starting in 2017.”
Meanwhile ACA advocates say “(Medicaid) expansion is providing significant health and economic benefits to states that more than offset costs.”
Yet another Capitol Hill lawmaker has a plan, an alternative to the Affordable Care Act – - at least as we may now know it. Freshman Sen. Bill Cassidy, R. La., according to The Wall Street Journal (online, 5/13 – Louise Radnofsky) has an ACA alternative whereby, “states could take the money they would have received under the law and give it to their residents to pay for health insurance in other ways. Also, in participating states, people wouldn’t have to pay a penalty for going without health insurance, and employers wouldn’t be fined for not offering benefits.” Additionally, Radnofsky outlines Cassidy’s proposals for HSAs (health savings accounts). These would have accompanying “age-linked contributions.” At the same time, those with them would not be “means-tested.” This means, according to the Wall Street Journal, “lower-income people would pay the same for premiums as wealthier consumers.”
Cassidy’s Obamacare alternative also contains this provision, that “Insurers would have to sell coverage to everyone initially but could later limit coverage for people based on their medical history if they hadn’t bought enough insurance during the sign-up window.”
Noted tax expert and attorney Robert W. Wood returns to Forbes. The subject this time is the dreaded-by-business Obamacare “Cadillac Tax.” According to Wood’s recent post in Forbes (online, 5/15) it seems increasingly this levy will affect both individuals and healthcare plans.
Wood also writes (and compellingly asks) “The tax is increasingly under fire from Congress, and this marketplace reaction is fueling the bonfire. If no one pays it, how else will we pay for Obamacare? The Supreme Court upheld Obamacare as a tax law, and it contains many taxes. One tax that hasn’t yet kicked in is the Cadillac tax. In enacting the law in 2010, the Cadillac tax was buried, not applying until 2018.”
Wood’s Forbes column gives some history of at least the intent of the 2010 Affordable Care Act, that “The theory of the law is that health insurance should be the great leveler. The Affordable Care Act included the Cadillac tax as a tool to cut healthcare costs. It puts direct and forceful pressure on employers to offer less-generous health insurance plans. Starting in 2018, Obamacare imposes a 40 percent tax on the cost of individual healthcare plans above $10,200 for individuals and $27,500 for family coverage.”
Wood describes the tax as “decidedly punitive.” The purpose of the tax is to ensure “that more health insurance dollars are spent across a greater number of people,” according to Wood in Forbes.
A recent article in Human Events (online, 5/15) by conservative blogger Michelle Malkin confirms what many Affordable Care Act observers have suspected, if not outright known: “While private health insurance exchanges have operated smoothly and satisfied customers for decades, the Obamacare models are on life support. Oregon’s exchange is six feet under – - shuttered last year after government overseers squandered $300 million on their failed website and shady consultants who allegedly set up a phony website to trick the feds,” so writes Ms. Malkin.
And this trouble does not start or stop in The Beaver State. Also according to Malkin’s Human Events account earlier this month, the feds subpoenaed the Massachusetts Obamacare Exchange – after whistleblowers who worked brought to light catastrophic technological shortfalls in its Health Connector program.
The report goes on to cite Josh Archambault, a senior healthcare fellow at Boston’s Pioneer Institute. It seems Archambault recently released a report recently outlining “the complete incompetence” of the state’s health officials.
Meanwhile, Malkin additionally claims . . . “Obamacare exchanges across the country are instead bleeding money, seeking more taxpayer bailouts.” And, in citing The Washington Post, the Human Events report says this is in spite of $5 billion worth of taxpayer’s subsidies.
A report in The Washington Post blogs section (online, 5/16: Katie Zezima) recaps the less-than-secret opposition to the Affordable Care Act by Sen. Ted Cruz, R-Texas. Additionally, according to The Washington Post, Cruz’ 2016 campaign manager Rick Tyler says, “He continues to have an opposition to the ACA, and he’s very vocal about that. It’s definitely part of campaign, running against Obamacare. He has continually said he’d like to repeal every word of it.”
Yet, the Texas Republican senator and 2016 GOP presidential contender now concedes he may have to enroll in Obamacare. The explanation? Cruz’ wife having taken “a leave from her job and its benefits.”
According to a recent report by Jason Hart in Florida Watchdog.org (online, 5/11) one hope the Obama administration had about Affordable Care Act implantation was that states would fall right into line, at least when it came to Medicaid expansion.
But, as the FloridaWatchdog.org account also says, “combined with nationwide spending and emergency room data, threats to existing Medicaid waivers are solidifying Obamacare opposition.” The result is a backfire on the Obama administration.
Christie Herrera, who is a senior fellow at Florida’s Free-Market Foundation for Government Accountability, is quoted by Watdog.org, as saying: “I think people are starting to see that it’s not the little guy pushing Obamacare in Florida. It’s big hospitals, big business, big insurance companies.”
One result, according to Florida Watcdog.org, is Florida gov. Rick Scott having filed suit against the federal Department of Health and Human Services (HHS). That suit is over “plans to stop funding the state’s Low Income Pool program, which compensates hospitals for seeing uninsured patients,” according to Hart’s Watchdog report.
Others suing HHS include Gov. Greg Abbott, R.-Texas, and Gov. Sam Brownback, R-Kan.
An emerging, even challenging aspect of Obamacare it may well be, according to The Los Angeles Times (Michael Hiltzik – online 5/8) “holding insurance companies to their promises and obligations to keep their networks adequate – - and to keep them from lying about the availability of doctors.”
Hiltzik’s L.A. Times Article explains, “One of the most controversial and least understood aspects of coverage under the Affordable Care Act is the network concept. More precisely, the narrow-network concept, since the whole goal of health insurers that steer patients to networks of preferred doctors and hospitals is to keep the provider roster limited and therefore (so they expect) cheaper.”
But, do these “networks” cater to patients adequately? The Times report also asks:
“This Facility is CLOSED,” reads a sign posted on the door of a Nicholas County, Kentucky hospital. Reading further, the sign also directs those needing “immediate care,” to “call 911.” This is then followed by a listing of “Closest Emergency Rooms.”
The blame, some say, for such notices winding up on now shuttered hospital entryways in the Blue Grass State can be laid right at the doorstep of the Affordable Care Act.
According to a recent report in USA Today (online 5/8, by Laura Ungar) the reasons are traceable to the scenario as recently outlined by the Kentucky Hospital Association (KHA) during a recent press conference. Those concerns have been released in its report entitled “Code Blue,” which says, according to USA Today, that “payment cuts to hospitals are expected to reach nearly $7 billion through 2024,” and also that “Kentucky hospitals will lose more money under the Affordable Care Act than they gain in revenue from expanded coverage.” USA Today also says, a net loss of $ 1billion will be realized by the year 2020.
Ungar adds, “Meanwhile many patients with job-based private insurance, and plans purchased on the state exchange, face high deductibles and co-pays. When they can’t pay their bills, a hospital’s bad debt grows. This pushes up uncompensated care, even as charity care to the uninsured drops.”
During the recent press conference KHA President Mike Rust alluded to Medicaid expansion as having provided many Kentucky residents with healthcare insurance which also brought fresh funds to hospitals, but Rust is also said, “the rest of the story is the cuts.”
Is the Obama White House now a consumer advocate – - at least when it comes to single-payer healthcare? The administration is seeking to address areas of Obamacare purportedly causing angst among healthcare consumers. This is the recent word coming from veteran New York Times reporter Robert W. Pear (online, 5/8) who writes, “The White House is moving to address two of the most common consumer complaints about the sale of health insurance under the Affordable Care Act: that doctor directories are inaccurate, and that patients are hit with unexpected bills for costs not covered by insurance.”
As Pear elaborates: “The problems that consumers face with unexpected costs may result, in part, from the way plans are listed on HealthCare.gov, the website for the federal marketplace. More than 8.5 million people are in private health plans selected through the site, and the plans are listed on order of their premiums, from lowest to highest.” Pear’s report adds, “The Medicare Agency said it had received complaints about insurance company directories that included doctors who ‘have retired from practice, have moved locations or are deceased.’”
Pear also says, “New federal rules will require insurers to update their Medicare directories each month, ‘with specific notations to highlight those providers who are closed or not accepting new patients.’”