How much can the Affordable Care Act wind-up costing you? In one instance, getting an answer means getting into the story about at least one Obamacare contractor. According to the St. Louis Post-Dispatch (online, Apr. 20; article by Chuch Raasch) Serco, a British based concern operated under a five-year agreement, “worth up to $1.2 billion,” . . . “to process applications for the Affordable Care Act. It was paid $114 million for the first year of the contract and $98 million for the current year, with annual renewal options.”
Maybe no one would have paid much notice until the whistleblowing by ACA processing workers began in Wentzville, Mo. The St. Louis Post Dispatch elaborates: ”Lavonne Takatz, who had worked at Wentzville from October 2013 to April, 2014 said: We played Pictionary. We played 20 Questions. We played Trivial Pursuit.”
Also, according to Raasch’s story, “From May 1 through Aug. 15 last year, workers in the Wentzville facility logged 13,228.25 hours of overtime to process ‘backlogged inconsistency work.’” This information comes from a report by Serco Inc. itself. Serco operated the contracting services for the Federal Centers for Medicare and Medicaid (or CMS) in Wentzville.
CMS would wind up prohibiting Serco officials from responding to reports of waste. Yet, a CMS spokesperson said, according to the St. Louis Post-Dispatch, “the company was not denying the reports of what happened.”
The St. Louis Post-Dispatch also filed Freedom of Information Act (FOIA) requests – this following allegations made by whistle blowers, “that workers in Wentzville were playing games or purposely working slowly because they had so little to do.” Back in February of this year, Serco said such “slow-downs” were because of computer-based issues, but that, while disputing the such claims, took such allegations to heart, retraining its employees to perform other job functions, so says the St. Louis Post-Dispatch.
More Obamacare news from The Sunshine State. Republicans are huddling in there – in the state’s capital, Tallahassee – as they gear up to oppose Medicaid Expansion full throttle. Meanwhile, Florida State Senators have held a “public workshop,” according to the Orlando Sentinel – in a report (online, by Gray Rohrer, Apr. 22).
Indicative of the depths of feelings over the Obamacare issue in Florida, the Orlando Sentinel report elaborates, “Members of the Interfaith Council of Central Florida, group of leaders from multiple faiths, added to that pressure Tuesday [Apr. 21]. They met with [Senate President Andy Gardiner, R-Orlando] to thank him for pushing for the Medicaid expansion plan, after first praying for the House to come around on the issue.”
Meanwhile Florida state senators have also “pushed for Medicaid expansion as a replacement for care for the poor and uninsured.” Additionally, according to the Orlando Sentinel, one plan supported by Gardiner, “requires the 800,000 newly eligible Medicaid recipients to pay co-pays and premiums and be employed or looking for work.”
Rohrer’s report also notes, “Americans for Prosperity, a free-market advocacy group backed by the Koch brothers, is running ads across the state attacking senators from supporting Medicaid expansion.”
“Government overreach” frequently sparks lively debates about the proper role of federal, state and municipal ruling bodies. A report in The Washington Examiner (online Apr. 20, by Paige Winfield Cunningham) says, “The two biggest states to reject Obamacare’s Medicaid expansion are accusing the administration of trying to force them into it.”
Texas Gov. Greg Abbott, R-Texas, recently voiced his advocacy for a lawsuit filed by Florida Gov. Rick Scott. Scott initiated the litigation against the Obama White House “over ending federal funds to pay hospitals for caring for the uninsured,” according to The Washington Examiner.
The Feds have are saying they will stop such funding unless the Sunshine State grows its Medicaid program under the auspices of the Affordable Care Act. The Examiner report additionally explains, some U.S. states have “funding pools.” These reimburse hospitals – who would otherwise receive no monies for care dispensed. Yet as Cunningham’s article points out, Medicaid expansion, “would reduce the need for such funds.”
Gov. Abbott (speaking for Florida) is quoted by Cunningham as saying, “Florida’s approach should be determined by Floridians, not coerced by federal bureaucrats.”
Back in December, 2014 Jeb Bush hinted at a 2016 presidential run. While a Jeb Bush candidacy could place the former Florida governor under the spotlight on issues ranging from immigration to Common Core, what about his stance on Obamacare “Death Panels”? If Bush holds fast to his viewpoints, will he, in the words of The New Republic’s Brian Beutler (online, Apr. 21) “set a new and incredibly high bar of boldness for Republican presidential candidates and make a lasting contribution to the public debate”? Or, will he back down out of fear of being seen as, in the words of Beutler’s New Republic’s article, “a real supporter of Obamacare and national healthcare more generally”?
Of concern to some, is Bush’s position on the purported ACA panels. If they are not “death,” per se, but rather “end of life” counseling sessions, is their concept really as ghoulish as it sounds?
Beutler’s story goes on to explain, it was actually Sarah Palin (in 2009) who came up with the term. During that time, The New Republic story contends – with regard to the descriptor, “it had a much more concrete and un-ironic meaning. Reformers wanted to allow doctors to bill Medicare for providing end-of-life counseling to sick and elderly patients. They also wanted to increase the incentive for doctors to incorporate comparative effectiveness research findings into their practices. Taken together, reform foes alleged, Obamacare would leave the most infirm patients without access to potentially lifesaving treatments, and they would die avoidably.”
So where does Jeb Bush stand? Beutler’s article quotes Bush as having said during a recent New Hampshire political gathering, “In hindsight, the one thing I would have loved to have seen was an advance directive where the [Schiavo] family would have sorted this out,” adding, “I think if we’re going to mandate anything from government, it might be that if you’re going to take Medicare, you also sign up for an advance directive where you talk about this before you’re so disabled.”
Sen. David Vitter, R-La., sits on the Senate Small Business and Entrepreneurship Committee on Capitol Hill. Vitter has been troubled by members of Congress and their respective staffs, who have, according to the National Journal report, “received their health insurance on D.C.’s small business exchange – - and the employer contribution that goes along with that designation – - rather than the individual marketplace.” Now Vitter’s committee will vote on subpoenaing documents allegedly sent to the District of Columbia Health Benefit Exchange Authority, the body supervising the D.C. health marketplace. Vitter who may be remembered for other things (back in June, 2002) may also be well-remembered for his December, 2014 stance on Obamacare. According to The National Journal article (online, by Rachel Roubein, Apr. 21) – “Vitter prompted Senate Republicans to pass a nonbinding party rule requiring all committee, office, and leadership staff to receive their health insurance through the D.C. marketplace.” At the time, not all Republican chairs planned on falling into line on the issue. Will they now toe the line on issuing the subpoenas Sen. Vitter is seeking?
According to a Reuters report (online, Apr. 20 – Susan Cornwell) “More Republican proposals are popping up.” This refers to possible conservative Affordable Care Act alternatives should the U.S. Supreme Court rule against the Obama White House in King v. Burwell.
One ACA option offered by Rep. Ron Johnson, R-Wis., according to Reuters, “wants to make the Obamacare taxpayer subsidies available through August, 2017, while repealing the individual and employer mandates.” On the other hand, the Reuters story says, “Louisiana Republican Representative John Fleming favors putting taxpayer money into tax-exempt health savings accounts that individuals can use to pay for healthcare expenses.”
Cornwell additionally relates, with regard to Paul Ryan, R-Wis., Chairman of the House Ways and Means Committee: “In an e-mailed statement to Reuters, Ryan said tax credits would ‘empower Americans to make their own healthcare decisions rather than government mandates.’”
Another report by Aimee Picchi on the CBS Interactive web page (Apr. 14) says, “The U.S. is the biggest pharmaceutical spender among developed and emerging countries, contributing about one-third of $989.3 billion in global spending in 2013. The European Union is the second biggest spender on prescription drugs, with 2013 spending totaling $156.3 billion across the region. Globally, purchases of pharmaceuticals are expected to jump 30 percent by 2018.”
According to Pichhi’s CBS report, expenditures for drugs requiring a prescription may increase as much as 41 percent. The results in dollars would be $480 billion by the year 2018. This information (according to CBS) comes from a report by the IMS Institute for Healthcare Informatics. The primary causes? The execution of Obamacare, a U.S. population increasingly getting older, and higher sticker prices for medications.
If Obamacare doesn’t bill you or your estate, following death, it will while you’re alive. Some of the charges for ACA-based or related coverage and care may cause some to feel an appreciable level of sticker shock when all is said and done. Especially during and after tax season.
A recent report on CNBC (online, Apr. 13) relates the story of Mike Highsmith – who “was one many Obamacare financial-aid recipients in 2014 who didn’t know their plans were being subsidized,” according to CNBC healthcare reporter Dan Mangan.
Mangan’s CNBC report quotes Highsmith as saying, at one point, “I wasn’t very happy.” The reason for the 61 year old former flight attendant’s unhappiness? Following his taxes having been prepared, “he has to pay back every cent of the $6,624 in federal subsidies that helped pay the lion’s share of his HealthCare.gov-purchased plan,” according to CNBC.
Yet, for those with real incomes being lower than what they had calculated while applying for health coverage, they will fall under the category of not having to pay money back at tax time.
CNBC also says, “[a]bout 5 percent will neither owe back any part of their subsidy nor get more money in the way of a subsidy for last year.“
Aimee Picchi, in a new CBS Interactive report (online, Apr. 13) tells of The Wall Street Journal account of Stephanie Graham, whose mother joined Medicaid in 2014. This was because of the Affordable Care Act’s requirement for healthcare coverage. Without it they would wind up paying an Obamacare fine.
The CBS report describes “The Estate Recovery Law,” which permits U.S. states “to recover Medicaid costs for patients who are older than 55 when they die, although some limits apply, such as exceptions for the disabled and hardship exemptions for survivors.” Picchi’s CBS report adds, “The law is taking some newly enrolled Medicaid patients by surprise, but it’s also prompting a few states to push back on the practice.”
Surveys are often about trends, and trends may reflect not only ever-changing public opinion, but the public’s general taste for concepts, or even ideals. A recent report in The New York Times by Thomas B. Edsall (online, Apr. 15) quotes Robert Blandon, Harvard University School of Health policy professor and political analyst, who says healthcare arguments began their transformation during the 2008 presidential campaign. Prior to that, “the major issue was the moral principle of providing care for the poor. In the context of the presidential campaign, however, the public focus shifted.”
This directional change in American public opinion with regard to care for the least fortunate is seen by some as “a major victory for the Republican Party,” according to Edsall. Specifically, the area of transformation is over society’s concept of “share the wealth,” even when it comes to single-payer healthcare. Edsall’s NYT report clarifies, “[i]t is part of a larger trend: a steady decline in support for redistributive government policies.”
The causes? Possibly, worries on the part of many over the cost of Obamacare-based health insurance plans – which then translate into tax increases and premium jumps for those in possession of such coverage.