Legislation overturning the Affordable Care Act’s expansion of the small-group insurance market is likely to get a look this fall, according to multiple sources on and off Capitol Hill, and it may be the Obamacare “fix” with the best chance of becoming law.
Drew Altman’s new, lengthy blog in The Wall Street Journal, ponders the scope and breadth of the current 2016 GOP presidential candidate field; specifically their opinions on the Affordable Care Act. As Altman’s WSJ account says (online, 8/25) “With every Republican candidate feeling compelled to establish his or her anti-ACA bona fides, distinguishing between their positions will be challenging for voters. Some will call for repeal and not much more. Others will outline a general direction and only a few steps they would take to ‘reform’ healthcare. Some may offer more comprehensive ACA replacement plans.”
One example cited in the Journal story is Ohio Gov. John Kasich, who according to Altman, “has broken with the pack somewhat by taking a stance that is anti-ACA but pro-Medicaid expansion on pragmatic and moral grounds.”
The 2016 political season is generating plenty of heat and opinion, especially on the topic of healthcare, and the ACA. Tom Kertcher’s recent article in PolitiFact is offering some punch lines from La. Gov. Bobby Jindal, as he continues criticize Wis. Gov. Scott Walker’s proposal(s) for an alternative to Obamacare. Jindal describes Walker’s healthcare overhaul proposal as “a new entitlement.”
For his part, Walker has proposed a 14 point (or “page”) idea for healthcare in the U.S.
According to Kertcher’s PolitiFact story, “Walker’s proposal, called ‘The Day One Patient Freedom plan,’ doesn’t use the word entitlement of course. But Walker also would provide tax credits to people who do not have employer-based coverage, saying they would make health insurance more affordable and more portable.”
Herein lies the rub with Jindal (and arguably others). The Louisiana governor has brought to the fore, certainly for purposes of political argument, the term “tax credits.” As Kertcher clarifies, “Several experts, from across the political spectrum, agreed that Walker’s credits are an entitlement.”
Also according to the PolitiFact account, Avik Roy of the conservative think tank, The Manhattan Institute, adds ”The core of Walker’s approach is a new, universal entitlement that every legal U.S. resident would be eligible for, regardless of income or need.”
At one point, a two year battle took place in the Florida State Legislature (c. 2013-2015) – resulting in the granting of powers (or at least the return of same) to state regulators, letting them approve health insurers rate increases.
Now such power may be coming home to roost. In a recent article in The Hill, by Sarah Ferris, who cites the two year battle above, says ”The cost of Obamacare plans in Florida will rise about 9.2 percent next year,” . . . “Under the new rates, the average monthly premium will rise to $400 next year, up from $384, not taking into account Obamacare subsidies.”
While a number approaching 10 percent for a rate increase of any kind may not be music to the ears of some, Ferris’ Hill story points out, “The state’s new negotiating abilities were clear in some cases. Aetna, one of the largest companies, had proposed a rate hike of 20.9 percent. The final rate was 13.9 percent.”
Nevada, all too well known for its multi-faceted gambling forays is now on a losing steak, at least when it comes to its ACA-oriented, non-profit healthcare co-op.
“Nevada Health CO-OP” is also federally funded. And it is so, in the words of Jennifer Robison (8/26) – – writing for the Las Vegas Review Journal, “to offer health coverage through the Nevada Health link marketplace.” Yet the Nevada healthcare co-op says “that is cannot make enough money to stay in business after Jan. 1,” according to Robison’s account.
A certain irony may be key here. For as the Review Journal goes onto explain, “Amid reports that the Affordable Care Act slashed the nation’s share of uninsured from more than 17 percent to less than 12 percent, the co-op’s fate is a reminder that some components of the law didn’t work as intended.”
Structures may only be as strong as their weakest point(s). And that point (or points) for the Affordable Care Act may well be the healthcare drama, continually unfolding in individual U.S. states.
The latest scene for this saga: The Land of Enchantment.
Robert King, writing for The Washington Examiner (online, 8/27), describes “a disagreement over insurance rates,” as the reason for Blue Cross/Blue Shield’s departure from the U.S. state of New Mexico.
According to King’s Examiner report, “The decision could have lasting ramifications if other insurers decide to also exit Obamacare exchanges. That is, “[i]f the cost of insurance becomes too high for insurers, then they could opt out of the Obamacare marketplaces,” thus “potentially restricting the types of plans offered by the marketplace, if any at all.”
You may like your flexible spending account … you might not be able to keep it.
Obamacare’s impeding “Cadillac tax” on high-cost health plans threatens to hit 1 in 4 U.S. employers when it takes effect in 2018—and will impact 42 percent of all employers by a decade later, according to a new analysis.
And many of those employers will be subject to the heavy Obamacare tax because they offer popular health-care flexible spending accounts to workers, which, ironically, are designed to reduce the income tax burden to those employees.
As a result, the co-author of the analysis expects the health FSAs to start being phased out and “largely disappearing” over time by companies looking for reduce their exposure to the Cadillac tax.
Just before Louisiana Gov. Bobby Jindal revealed his plan to replace Obamacare last year, he sat down with 15 of Washington’s top conservative healthcare wonks to discuss it. They didn’t approve.
That’s because any attempt to roll back Obamacare might lead to losing votes from milions of people that already have the coverage.
In other words, even Obamacare’s toughest critics say that parts of the ACA are here to stay.
According to a recent article by Tom Howell, Jr., in The Washington Times (online, Aug. 11), a flaw in The Affordable Care Act ” means the IRS will never be able to recoup nearly $350 million in overpayments on Obamacare tax credits last year, and one top senator says he is worried that fraudsters will exploit the loophole to wring more cash out of the government.”
That key Senator is Sen. Chuck Grassley, R-Iowa, who says, “It’s unclear how many people might be intentionally underestimating their income to get an overpayment, and whether the statutory repayment cap should be changed to minimize this incentive.” Grassley adds, “The challenge is to balance cracking down on the intentional gaming of the credit with fairly treating taxpayers who have been overpaid through no fault of their own.”
Howell’s Washington Times report also quotes Timothy Jost, a professor law at law at Washington and Lee University. Jost closely monitors Obamacare. The Washington Times summarizes Jost’s position on the issue by saying, “exchange customers should get better at estimating their income over time, and 2014 might have been an aberrant year as customers had a difficult time logging onto balky Web systems to update their income status. “We’re going to get a closer fix on what people actually owe.”
An Aug. 10 story in The Washington Examiner says (Robert King, online) says (in July of this year) “11 fake Obamacare applications were able to re-enroll in the healthcare program and continue to get subsides.” The source of these findings is a study by the Government Accountability Office (GAO). Predictably, this ignited a fire under members of the GOP, who later said, “the administration fails to create appropriate safeguards to federal tax dollars,” according to The Washington Examiner.
Compounding matters along these lines, an HHS IG (Health and Human Services Inspector General) investigation found that under the Obama administration there has not been an accurate review whether some ACA applicants “were U.S. citizens or in jail, two factors that should disqualify people from getting health insurance under the law,” as King’s Examiner article explains it.
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