Posts tagged with: Patient Protection and Affordable Care Act

What just happened with Obamacarehealthcaregov site?

In a two-to-one decision, the U.S. Court of Appeals for the District of Columbia Circuit dealt a serious blow to Obamacare by ruling the government may not provide subsidies to encourage people to buy health insurance on the new marketplaces run by the federal government.

What did the court decide?

Section 36B of the Internal Revenue Code, enacted as part of the Patient Protection and Affordable Care Act (Obamacare) makes tax credits available as a form of subsidy to individuals who purchase health insurance through marketplaces—known as “American Health Benefit Exchanges,” or “Exchanges” for short.

This provision authorized low-income Americans to receive tax credits for insurance purchased on an Exchange established by one of the fifty states or the District of Columbia. (The credits were for household incomes between 100 and 400 percent of the federal poverty line.) But the Internal Revenue Service interpreted the wording broadly to authorize the subsidy also for insurance purchased on an Exchange established by the federal government.

The court ruled that a federal Exchange is not an “Exchange established by the State,” and section 36B does not authorize the IRS to provide tax credits for insurance purchased on federal Exchanges.

Can you explain that without the legalese?
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Last week was a busy one, news-wise, and this may have slipped by you. Suddenly, 4.5 million people in the 5 U.S. territories (American Somoa, Guam, Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands) are now exempt from Obamacare. Just like that.

What’s the story? Obamacare costs too darn much, and insurance providers were fleeing the U.S. territories, leaving many without insurance or at least affordable insurance. These territories have spent the last two years begging to get out from under this law, only to be told the Department of Health and Human Services

has no legal authority to exclude the territories” from ObamaCare. HHS said the law adopted an explicit definition of “state” that includes the territories for the purpose of the mandates and the public-health programs, and another explicit definition that excludes the territories for the purpose of the subsidies. Thus there is “no statutory authority . . . to selectively exempt the territories from certain provisions, unless specified by law.”

Laws, let us remember, are made by Congress. Unless they’re not. For instance, last week, the Department of Health and Human Services said they’d reviewed the situation and

the territories will now be governed by the “state” definition that excludes the territories for both the subsidies and now the mandates too. But the old definition will still apply for the public-health spending, so the territories will get their selective exemption after all.

As the Wall Street Journal notes, there seems to be some elasticity in the White House’s definition of “state.” And, may I add, some elasticity in the democratic process, the Constitution and rule of law. Perhaps a review via Schoolhouse Rock will help.

hospiceI don’t know anyone who doesn’t believe that hospice is a good idea. The medical and emotional support offered by hospice workers to the terminally ill and their families is invaluable. And thanks to the Affordable Care Act, hospice is going away. Michigan Hospice of Holland is closing their doors. Their executive director explains:

The biggest issue under the Affordable Care Act is…that we’re going to see cuts in reimbursement- it’s going to be at least 12 percent. We projected out what those cuts are going to do to the organization long term and we realized that in a short period of time, we’re going to be pulling money from our savings in order to keep the house open…”

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eat the richThe rich get richer and the rest of us…well, we struggle along. Shouldn’t those with more money be spreading it out a bit more? My coffers clink with spare change; I sure could use some of that money. It only seems fair, right?

Peter Morici, at Breitbart News, tackles the truth of income inequality. Those of us in the “rest of us” category are getting crushed by monopolies, unjust taxation, and political corruption. That, Morici says, is the truth of income inequality. It’s so bad that Vermont Senator Bernie Sanders (I) compared our situation to that of Russia, and a lot of folks nodded their heads in agreement.

Vermont Senator Bernie Sanders (I) recently asked Federal Reserve Chairwoman Janet Yellen “are we still a capitalist democracy or have we gone over into an oligarchic form of society in which incredible economic and political power now rests with the billionaire class?”

Russia’s oligarchy has two salient characteristics. The government uses its power to regulate markets to concentrate wealth in the hands of an influential few, while most of its citizens stay poor by western standards.

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Market in the Soviet Union, circa 1986

Market in the Soviet Union, circa 1986

We Americans like choices. Go to any large grocery store and stand in awe at the vast array of cereals: everything from regular old oatmeal to some sort of toasted rainbow sprinkles of joy. The market economy is built upon choice: not only does the consumer have a choice in what she wants, she can stay away from things she doesn’t want, like bad service or poorly prepared food. Yes, we like choices.

Obamacare is built on fewer choices, however. The New York Times tells us that we are facing fewer choices for our health care, fewer doctors and high costs if we wish to go outside of our prescribed network. Reed Abelson:

No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.These so-called narrow networks, featuring limited groups of providers, have made a big entrance on the newly created state insurance exchanges, where they are a common feature in many of the plans.

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uncle sam life supportAmerica has been underwhelmed by Obamacare. Beyond the website glitches and stories of waiting for hours to sign up, we can start assessing the actual program.

An April 8 Rasmussen poll finds only 23 percent of Americans call Obamacare a “success,” and 64 percent believe it will be repealed. the White House is in a tough spot; the program was built with the understanding that young people would flock to it, eager to snap up inexpensive health care plans. These purchases would help pay for the less-healthy and older enrollees. Young people would be paying their premiums, but since they don’t get sick as often, that money would be used for those who are typically less healthy. Those signing up, though, are tending to be older and sicker than expected:

People who signed up early for insurance through the new marketplaces were more likely to be prescribed drugs to treat pain, depression and H.I.V. and were less likely to need contraceptives, according to a new study that provides a much-anticipated look at the population that signed up for coverage under the new health care law.

The health of those who enrolled in new coverage is being closely watched because many observers have questioned whether the new marketplaces would attract a large share of sick people, which could lead to higher premiums and ultimately doom the new law.

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The Sword of Damocles - artist Wencelas Hollar

The Sword of Damocles – artist Wencelas Hollar

Like the proverbial sword of Damocles, the Obamacare deadline looms. Today is the last day to sign up…sort of. I’ll explain that momentarily.

First, let’s look at the proverb mentioned above, lest there be any misunderstanding. As classics scholar Daniel Mendelsohn says, there is often confusion as to exactly what this allusion means.

The real point of the story is very clearly a moral parable. It’s not just, oh, something terrible is going to happen, but it’s about realizing that what looks like an enviable life, a life of wealth, a life of power, a life of luxury is, in fact, fraught with anxiety, terror and possibly death.

I cannot think of a more apt description of what is facing the Obama administration regarding health care. In the U.S. today, almost 49 million people are uninsured. The plan was, of course, to get all those folks insured under Obamacare. Yet, less than 2 percent of those eligible have enrolled. And today is the deadline to enroll. Sort of. You can start the enrollment process today, and the government will give you until next week to complete the process. Unless they extend the deadline again. Despite the “hard and fast” date of March 31, it has become clear to the White House that this simply isn’t going to work. (more…)

pathetic uncle samThe Affordable Care Act [ACA] has seen more than it’s share of disasters. The clunky website got off to a horrendous start, the “fixes” didn’t work, Kathleen Sebelius got raked over the coals (“Don’t do this to me!”) at a House hearing, and not enough young people are signing up.

The solution? The White House has created an “ACA Bracket” (Get it? Huh? Get it?) site where young folks can go and vote for their favorite GIFs and then head on over to HealthCare.gov and get signed up.

How bad is this website? The word “doomed” comes to mind, as in “If this is the best our government can do, we are doomed.”

There’s a dancing duck proclaiming “I’m so excited” about free birth control, a cat in a tux with a disco-glitter background telling you about rebates, and Michelle Obama “raisin’ the roof” with some woman in mom jeans. Horrifying, absolutely horrifying. (And I’ve seen “The Shining.” Twice.) (more…)

A recent report from the CBO contains an appendix detailing updated estimates of the labor market effects of the Affordable Care Act (ACA). Pundits for and against the ACA have wasted no time in putting their own particular spin on the projections. Republicans and some other opponents have seemingly celebrated the idea that these estimates may show that the ACA is “a job-killing, economy-crushing villain,” while Democrats and some other supporters have claimed that in times of high unemployment, it’s “an economic benefit” that some will be voluntarily reducing hours or dropping out of the labor force because that means greater demand for labor — those currently unemployed would therefore have more options.

So who’s right? These are mutually contradictory claims, or so it appears. The report is ultimately limited and mixed, but nevertheless raises some serious concerns, caused, in part, by the polarization of Congress both when the law was passed and up to the present. (more…)

Watch as employees at a small Pennsylvania business learn about their new benefits under the Affordable Care Act.