Archive | Health Care Bill Impact on Business

Cost-control plan for health care could cost you

You just might want to pay attention to the latest health insurance jargon. It could mean thousands of dollars out of your pocket.

  • The Obama administration has given the go-ahead for a new cost-control strategy called “reference pricing.” It lets insurers and employers put a dollar limit on what health plans pay for some expensive procedures, such as knee and hip replacements.

*Some experts worry that patients could be surprised with big medical bills they must pay themselves, undercutting financial protections in the new health care law. That would happen if patients picked a more expensive hospital — even if it’s part of the insurer’s network.

  • The administration’s decision affects most job-based plans as well as the new insurance exchanges.

How does “reference pricing” work? It treats anything above the flat-rate limit covered by insurers as out-of-network costs, even if a patient is seeing a provider inside the network. Before ObamaCare, insurers would negotiate in-network prices for these procedures, and providers were forced to accept them as payment in full. Now providers will have much less incentive to agree to that kind of pricing structure, and instead go after the patients for the balance.

  • As if to rub salt in the wounds, the overage won’t count as out-of-pocket expenses. The Obama administration loudly insisted on such caps to protect consumers, and used those caps as proof that the ACA would keep Americans from facing bankruptcy over an illness. Reference pricing all but buries the caps, though. If a patient needed a $40,000 operation but the insurer only had a $30K reference price on it, the patient would have to cough up the other $10,000 plus all of the deductibles and out-of-pocket expenses otherwise under the cap. The AP notes this with some concern:

*That’s crucial because under the health care law, most plans have to pick up the entire cost of care after a patient hits the annual out-of-pocket limit, currently $6,350 for single coverage and $12,700 for a family plan. Before the May 2 administration ruling, it was unclear whether reference pricing violated this key financial protection for consumers.

It’s not on the radar yet for most people, but the new approach is gaining ground. The Mercer benefits consulting firm said 12 percent of the largest employers were using reference pricing last year, nearly double the 7 percent in 2012.

*Modified from an AP.org, and Hotmail.com web articles.

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New McKinsey Survey: 74% Of Obamacare Sign-Ups Were Previously Insured

As stated by Avik Roy in a May 10th Forbes.com article, “One of the principal flaws in the coverage of Obamacare’s exchange enrollment numbers to date has been that the press has not made distinctions between those who have “signed up” for Obamacare-based plans, and those who have actually paid for those plans and thereby achieved enrollment in health insurance. A new survey from McKinsey indicates that a large majority of people signing up are now paying for their coverage. This is progress for the health law. But the survey still indicates that three-fourths of enrollees were previously insured.”

“Two months ago, I wrote about a prior McKinsey survey that found that the vast majority of people signing up for individual-market coverage in 2014 were previously insured, and that of the minority who had been previously uninsured, only 53 percent had paid their first month’s premium.”

The upshot of that figure was that of the people shopping for coverage on their own who had actually enrolled in a new plan in 2014, the vast majority had been previously insured. Another way to say that is that for all of the talk about 7-million this and 8-million that, the Obamacare exchanges’ expansion of coverage to the uninsured was far smaller.

  • New data: 83% of previously uninsured have paid up

The new McKinsey report, authored by Amit Bhardwaj, Erica Coe, Jenny Cordina, and Ruchira Sara, indicates that the proportion of uninsured individuals paying for coverage has shot up, from 53 percent in February to 83 percent in April. For previously insured individuals, the percentage of payers increased from 86 to 89 percent.

The survey data was collected from 2,874 individuals whose incomes made them ineligible for Medicaid: above 100 percent of the Federal Poverty Level in states that haven’t expanded Medicaid, and above 138 percent in states that have. (For a childless adult, this means incomes above $11,670 or $16,105, respectively.) 1,434 of those polled—roughly half of the sample—were previously uninsured, of which 83 percent were eligible for exchange-based subsidies.

53 percent of those who enrolled in 2014 coverage did so by renewing their 2013 plan or enrolling in a plan before the January 1 deadline that made many old plans illegal. The remainder of enrollees “selected a new 2014 ACA plan,” of which nearly two-thirds signed up through an ACA exchange.

  • Only 22% of Obamacare sign-ups are paid, previously uninsured enrollees

*However, the proportion of individuals purchasing ACA plans who had been previously uninsured remained low. In February, McKinsey reported that only 27 percent of those selecting a new 2014 plan were previously uninsured; in April, the proportion was 26 percent.

Combining that with the payment figures: of the people signing up for new ACA plans in 2014, only 22 percent were previously uninsured individuals who have paid for coverage and therefore enrolled in health insurance. That’s a meaningful improvement from February’s 14 percent figure, but it’s still low.

*”Combining all of this data: of the 8 million sign-ups on the exchange, we can only be confident that around 1.7 million are previously uninsured and enrolled. We can add another 865,000 or so for those purchasing coverage off the exchange, for a total of 2.6 million previously uninsured individual-market enrollees.”

  • McKinsey data consistent with feedback from insurers

Earlier this week, representatives of the insurance industry testified before the House Energy and Commerce Committee regarding enrollment trends in the exchanges. Four of the five witnesses stated that more than 80 percent of their sign-ups had paid for coverage. That’s consistent with what McKinsey found, and also with my own discussions with insurers.

  • Bottom line: Exchanges are having modest impact on the uninsured

Obamacare is beginning to expand coverage to the uninsured; however, it’s far from clear that the exchanges specifically are a primary engine. At most around 930,000 people have gained coverage from Obamacare’s under-26 “slacker mandate” (not 3 million, as is commonly suggested); another 3 million or so have gained coverage from the law’s expansion of Medicaid. Approximately 2.6 million previously uninsured individuals have obtained coverage through the ACA exchanges and the related off-exchange individual markets; however, the off-exchange purchases are mostly unsubsidized, and therefore can’t necessarily be credited to Obamacare.

  • What the exchanges appear to be doing is mainly helping people who were previously insured. If you’re 62 years old, say, and your income is $30,000, and you were paying for your own coverage before, you’re now eligible for plans that are much cheaper for you, thanks to taxpayer-funded subsidies and higher premiums for young people.

Of course that means that other people are paying more. “My old plan was canceled under Obamacare,” an exasperated Californian told me last week. “The new Obamacare plan costs twice as much, and the deductibles are higher. And yet Obama is counting me as one of his 8 million people!” But hey—at least he has maternity coverage.

*Modified from a Forbes.com article, and a just released McKinsey survey

 

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2.7 Million ObamaCare Enrollees Still Unaccounted For

Affordable Care Act: President Obama has for a while been bragging that 8 million people have signed up for ObamaCare. But the administration still hasn’t released the state-by-state numbers to back up that number.

As a result, we still don’t know where 2.7 million ObamaCare enrollees came from.

Here’s what we do know:

  • The exchanges run by 15 states and Washington, D.C., have reported final enrollment numbers at least through March, and most have numbers through April 15. The combined total for these exchanges is 2.6 million.

  • For the remaining 36 states, all we have are the numbers HHS released through February. At that point, these states accounted for 2.7 million sign-ups.

  • Add the two together, and you get 5.3 million. That means roughly 2.7 million must have signed up in just these 36 states after March 1 to reach the 8 million mark. And that means enrollment in these states must have doubled in just the last six weeks of a 28-week open enrollment period.

  • To call this an incredible achievement is putting it mildly, particularly since the state-run exchanges saw enrollment climb only 62% in those final six weeks.

So where did these 2.7 million come from? We won’t know until the HHS report comes out, which presumably could be any day now. But even if Obama can account for these fantastic gains, there are still several questions that need answering.

First, of course, is: How many have paid?

  • Georgia says that only 48% of the 221,604 who enrolled through March 31 have paid their premiums. In South Carolina, only 59% of the 114,789 who enrolled through April 15 had done so.

  • Another question: Do the numbers account for people who dropped coverage earlier? We know at least some have been kicked off for nonpayment, and others canceled their plans for one reason or another. Is HHS netting out these losses, or is it simply adding new enrollment numbers on top of the old ones?

  • And, did the agency screen out duplicate enrollments? One broker told us that in the last month his company was encouraged to simply start a new application if something went wrong during the process, so as to speed things up. He figures 30% of the ObamaCare applications his firm handled in the home stretch were duplicates. Did these get counted in the final tally?

The mainstream media, unfortunately, have shown zero interest in trying to make sense of these numbers, much less independently verify them. Instead, they obeyed Obama’s command to “move on.”

But until we get more data, and get answers to these questions, we’re reluctant to accept any ObamaCare numbers put out by this administration.

Modified from an IBD.com article

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Obama Says Health-Insurance Enrollees Reach Eight Million

WASHINGTON—President Barack Obama said Thursday that eight million people had picked health-insurance plans through the Affordable Care Act, a number that significantly outstripped initial projections and emboldened him to step up criticism of Republicans seeking to repeal the law.

The eight million sign-ups go beyond earlier projections by the Congressional Budget Office that six or seven million people would enroll through the exchanges in 2014. Mr. Obama pointed to the number to declare the law a success and that Republicans should stop trying to overturn it.

“The point is, the repeal debate is and should be over,” the president said. “The Affordable Care Act is working and I know the American people don’t want us spending the next 2½ years refighting the settled political battles of the last five years.”

Some 35% of those who signed up through the federal health-insurance exchange were in the coveted under-35 demographic, Mr. Obama said. The participation of younger, relatively healthy people is needed to balance out the cost of medical claims from older and sicker ones.

The announcement contained few other new details about enrollment. Republicans quickly pointed to missing information—such as the number of people who had actually gained coverage after being uninsured, as opposed to those replacing an existing policy—to suggest the figures could be overblown as a measure of success.

Democrats up for re-election in the fall have been bracing for a renewed debate around the law as the Senate prepares to hold confirmation hearings for a successor to Health and Human Services Secretary Kathleen Sebelius, whose resignation was announced last week.

Rep. Carol Shea-Porter (D., N.H.), who has come under strong criticism from Republicans for supporting the law and is in a tough race for re-election, called the development great news. She has made her frustrations with the law known to the Obama administration, but she said Thursday she has also heard from constituents in both parties who have been helped by the law. “The Affordable Care Act still has challenges, but today’s news is clearly a giant step forward,” she said in a statement.

Polls regularly show that while opinion remains sharply divided over the law and more people dislike it than like it, a majority of Americans don’t want it repealed. The White House has seized on that finding, and on Thursday Mr. Obama also suggested that the final enrollment numbers could provide Democrats with some measure of political cover amid a likely barrage of election-year attacks.

“If Republicans want to spend all their time talking about repealing a law that’s working, that’s their business,” Mr. Obama said. “I think what Democrats should do is not be defensive, but we need to move on and focus on the things that are really important to the American people right now.”

GOP lawmakers continued to emphasize information not contained in the numbers, including how many people have paid their first month’s premium, the final step in enrolling for insurance.

“How many of those who have signed up were among the millions who had their plans canceled? How many were already insured but forced to sign up for an Obamacare plan?” said Sen. Lamar Alexander (R., Tenn.). “This law promised to insure the uninsured, let those who liked their insurance keep it, and lower the cost of insurance—let’s talk about what the law was supposed to do instead of how many millions of people the president has so far forced into Obamacare.”

The new total reflects people who had signed up through April 15 through the federal and state exchanges, the last date on which most Americans were allowed to finish applications. The official enrollment deadline had been March 31, but the federal exchanges gave people who tried to sign up but got stuck in long lines or computer overloads an additional 15 days to finish their applications. Most states offered similar extensions.

Bringing the uninsured into the health system was a key promise in Mr. Obama’s push for the law. Federal officials said earlier that only insurers know how many people have paid their first month’s premium, and that they aren’t collecting information on what proportion of enrollees had been uninsured.

The president’s announcement didn’t include state-by-state information about enrollment, which will be key to determining premiums for 2015 and beyond since each state’s insurance market is different and rates are based on the makeup of people who sign up within each.

White House officials said Thursday that 28% of the enrollees in the federally run exchanges serving 36 states are in the 18-34 demographic. Some 7% are children covered by family plans. The administration didn’t release demographic information for the 14 states running their own exchanges.

Insurance officials previously said 80% to 85% of enrollees paid the first month’s premium, a proportion that would suggest the administration will ultimately hit enrollment targets for the exchanges for 2014 even if some people drop out or have picked more than one plan and are overrepresented in the numbers, especially since some people who have a change in their life circumstances such as a divorce or job loss are still allowed to sign up after March 31.

The figures represent a slight increase in young people compared with the previous five months. The administration said earlier that through Feb. 28, about 4.2 million people were covered by plans picked via the federal and state-run exchanges. Of those, 25% were 18 to 34, and 6% were children covered by family plans.

The mix of younger people buying coverage is considered by health plans to be crucial in determining future insurance prices. Under the law, insurers no longer can charge premiums based on health histories, and are restricted in how much more they can charge older consumers.

Mr. Obama offered a muted warning about premiums next year, saying he expected them to rise, though he also said they had done so before the law was passed because of the increase in health costs.

The president also criticized states that opted not to expand their Medicaid programs to include all adults making around the poverty line, a decision made available to them after the Supreme Court ruled in June 2012 that they couldn’t be required to participate in that part of the health law.

Governors and legislators in 24 states, most of whom are Republicans, say they don’t believe state budgets or Washington can withstand the additional costs of expanding Medicaid.

Mr. Obama on Thursday characterized the decision as one motivated by “political spite.”

“That’s wrong. It should stop,” he said. “Those folks should be able to get health insurance like everybody else.

*Modified from a WSJ.com article

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ObamaCare makes it more difficult to buy insurance year-round

Here’s more fallout from the health care law: Until now, customers could walk into an insurance office or go online to buy standard health care coverage any time of year. Not anymore.

Many people who didn’t sign up during the government’s open enrollment period that ended Monday will soon find it difficult or impossible to get insured this year, even if they go directly to a private company and money is no object.

  • With limited exceptions, insurers are refusing to sell to individuals after the enrollment period for HealthCare.gov and the state marketplaces. They will lock out the young and healthy as well as the sick or injured. Those who want to switch plans also are affected. The next wide-open chance to enroll comes in November for coverage in 2015.

It’s a little-noted consequence of President Obama’s health care overhaul, which requires nearly all Americans to be insured or pay a fine and requires insurers to accept people with health problems.

  • Those who act now may still be able to get in, depending on where they live. Following the lead of the government marketplaces, some companies are extending off-marketplace sales for a week or a month to help people who hit snags trying to enroll by this week’s deadline. Rules vary from state to state.

After those extensions, eligibility for coverage during 2014 is guaranteed only for people who experience certain qualifying life events, such as losing a job that provided insurance, moving to a new state, getting married, having a baby or losing coverage under a parent’s health plan.

  • The federal law doesn’t prevent companies from selling policies to everyone all year. But insurers consider it too risky now that the law prohibits them from rejecting people in poor health.

“If you didn’t have an open enrollment period, you would have people who would potentially enroll when they get sick and dis-enroll when they get better,” said a spokesman for insurer Kaiser Permanente. “The only insured people would be sick people, which would make insurance unaffordable for everyone.”

  • A survey by the Kaiser Family Foundation in mid-March found that 6 out of 10 people without insurance weren’t aware of the marketplace deadline on March 31. The Obama administration, insurance companies and nonprofit groups scrambled to spread the word, often with messages that focused on the cost savings available to many people through the government marketplaces.

There wasn’t much public discussion about people who prefer to buy policies outside the marketplaces, sometimes finding better deals or options more to their liking.

  • A Health and Human Services spokesman pointed to a cryptic note on the HealthCare.gov website: It says “in some limited cases some insurance companies may sell private health plans outside the marketplace and outside open enrollment” that satisfy the law’s coverage mandate. It doesn’t say how to find any companies doing that.

A health law expert at the Kaiser Family Foundation, said it’s “highly unlikely” that companies will offer such coverage after the deadline window fully closes. Some do still offer temporary plans, lasting from a month to a year. But those plans don’t cover pre-existing conditions and don’t get buyers off the hook for the law’s tax penalty.

*Modified from a FoxNews.com article

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15-20 Percent Aren’t Paying Obamacare Premiums, Insurer Says

New data from a major insurer suggest real enrollment is at roughly 6 million. One of the biggest players in Obamacare’s exchanges says 15 to 20 percent of its new customers aren’t paying their first premium—which means they’re not actually covered.

  • The latest data come from the Blue Cross Blue Shield Association, whose members—known collectively as “Blues” plans—are participating in the exchanges in almost every state. Roughly 80 to 85 percent of people who selected a Blues plan through the exchanges went on to pay their first month’s premium, a BCBSA spokeswoman said Wednesday.

The new statistics, particularly from such a large carrier, help define how many people are actually getting covered under the Affordable Care Act.

  • The Blues’ experience is in line with anecdotal estimates from other insurance executives, who indicated earlier in the enrollment process that they received payments from about 80 percent of people who selected their plans. The Blues’ latest estimate includes policies that took effect Feb. 1 or earlier, the spokeswoman said.

Some health care analysts have suggested that the payment rate could improve later in the enrollment window, as plans had more time to track down consumers who hadn’t paid.

  • Wherever the final number ends up, it will be the real measure of how many people are actually covered through the Affordable Care Act’s exchanges. The Obama administration has been releasing the number of people who selected a plan, but says it doesn’t have accurate data on how many have actually paid. And consumers don’t have coverage they can use until they make that first payment.

If the nationwide payment rate, across all carriers, remains at 80 to 85 percent, the 7.1 million sign-ups Obama announced Tuesday would translate into somewhere between 5.7 and 6 million people who are actually covered.

*Modified from a Nationaljournal.com article

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Exchange plans worry California docs

Dr. Mark Dressner says California’s public exchange need to act now to keep physicians in the networks. Dressner, president of the California Academy of Family Physicians, said doctors who treat Covered California exchange plan patients feel confused, frustrated and poorly paid.

  • Doctors say plan reimbursement rates are 20 percent to 40 percent lower than traditional plan rates. “Our physicians describe these payment reductions as unaffordable to their practices,” Dressner says.

“Carriers seem to think they can change contract terms by simply sending letters to the physicians. Physicians have trouble finding out what the plan contract terms are, or even finding out whether they’re really in a plan provider network”.

  • “In parts of California, for example, low reimbursement rates have resulted in a doctor rebellion, as nearly seven out of 10 doctors refuse to participate in the exchanges.”

Meanwhile, nationally known health insurance providers like United Healthcare, Aetna, Cigna are staying out of the Obamacare exchange marketplaces. Anthem Blue Cross and Blue Shield are in, but are sharply narrowing their networks to exclude many doctors, as well as elite hospitals.

As a result, well-known hospitals like Los Angeles’ Cedars-Sinai, New York’s Memorial Sloan-Kettering and the NewYork-Presbyterian Hospital will be out of reach for many exchange patients.

*Modified from a LifeHealthPro.com and Washingtonexaminer.com article

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O-Care premiums to skyrocket

Health industry officials say ObamaCare-related premiums will double in some parts of the country, countering claims recently made by the administration. The expected rate hikes will be announced in the coming months, and the sticker shock would likely hamper ObamaCare insurance enrollment efforts in 2015.

The industry complaints come less than a week after Health and Human Services (HHS) Secretary Kathleen Sebelius sought to downplay concerns about rising premiums in the healthcare sector. She told lawmakers rates would increase in 2015 but grow more slowly than in the past. “The increases are far less significant than what they were prior to the Affordable Care Act,” the secretary said in testimony before the House Ways and Means Committee.

  • Her comment baffled insurance officials, who said it runs counter to the industry’s consensus about next year. “It’s pretty shortsighted because I think everybody knows that the way the exchange has rolled out … is going to lead to higher costs,” said one senior insurance executive who requested anonymity.

The insurance official, who hails from a populous swing state, said his company expects to triple its rates next year on the ObamaCare exchange. The hikes are expected to vary substantially by region, state and carrier.

Areas of the country with older, sicker or smaller populations are likely to be hit hardest, while others might not see substantial increases at all.

Much will depend on how firms are coping with the healthcare law’s raft of new fees and regulatory restrictions, according to another industry official.

  • Some insurers initially underpriced their policies to begin with, expecting to raise rates in the second year. But insurance officials are quick to emphasize that any spikes would be a consequence of delays and changes in ObamaCare’s rollout.

They point out that the administration, after a massive public outcry, eased their policies to allow people to keep their old health plans. That kept some healthy people in place, instead of making them jump into the new exchanges.

  • Perhaps most important, insurers have been disappointed that young people only make up about one-quarter of the enrollees in plans through the insurance exchanges, according to public figures that were released earlier this year. That ratio might change in the weeks ahead because the administration anticipates many more people in their 20s and 30s will sign up close to the March 31 enrollment deadline. Many insurers, however, don’t share that optimism

“We’re exasperated,” said the senior insurance official. “All of these major delays on very significant portions of the law are going to change what it’s going to cost.”

  • “My gut tells me that, for some people, these increases will be significant,” said Bill Hoagland, a former executive at Cigna and current senior vice president at the Bipartisan Policy Center. Hoagland said Sebelius was seeking to “soften up the American public” to the likelihood that premiums will rise, despite promises to the contrary.

Insurers will begin the process this spring by filing their rate proposals with state officials. Insurance commissioners will then release the rates sometime this summer, usually when they’re approved. Insurers could also leak their rates earlier as a political statement.

Jon Gruber, who also helped design the Affordable Care Act, said, “The bottom line is that we just don’t know. Premiums were rising 7 to 10 percent a year before the law. So the question is whether we will see a continuation of that sort of single digit increase, or whether it will be larger.”

In Iowa, rates are expected to rise 100 percent on the exchange and by double digits on the larger, employer-based market, according to a recent article in the Business Record.

*Modified from a Hill.com article

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Health Insurance Rates Likely to Rise in 2015

Health and Human Services Secretary Kathleen Sebelius said health-insurance premiums are “likely to go up” in 2015, an acknowledgment that the Obama administration doesn’t believe the sweeping changes to the health-insurance marketplace will end premium increases in the near term.

  • The range of premiums people will see in 2015 is expected to be an important measure of the health-care law’s success. Supporters have staked its success on providing coverage that people consider to be “affordable,” though they have generally stopped short of claiming that its provisions will directly lead to premium decreases.
  • For now, the impact of those changes is unknown, because insurers have just begun weighing their rates for the year to come. The enrollment period for coverage in the coming year is still open—it closes at the end of this month—and insurers are hoping to have more information about medical claims by the time they need to submit their proposed rates to federal and state governments later this spring.
  • Many consumers across the U.S. saw premiums increase in 2014 because of requirements that new plans be more generous. Premiums for individuals who had previously benefited from the lowest rates because they could show clean bills of health also rose. But many of those rates were based on guesswork by health plans about the riskiness of the customers they would end up with, and as our Exchange Explorer tool shows, they have bet all over the map.
  • The law’s messy rollout added another twist, as it may have skewed the makeup of people who obtained coverage toward those who knew they were more likely to need it.
  • So far, the proportion of young Americans signing up for coverage through state and federal exchanges created under the health-care law has remained below levels thought necessary to keep premiums stable.
  • On Tuesday, the Obama administration released enrollment numbers for February showing that about 25% of people age 18 to 34 picked a plan, lower than a 40% target believed to keep premiums relatively stable. However, there are risk-adjustment provisions in the law designed to compensate insurers that end up with higher medical claims now that they can’t charge people more based on their medical history, and federal officials have previously said they expected those to mitigate any premium increases.
  • Overall, the administration said 4.2 million people enrolled in health-insurance plans through February, a number that suggests enrollment could fall short of projections made by the nonpartisan Congressional Budget Office that 6 million to 7 million people would enroll in private plans for 2014.

*Modified from a WSJ.com article

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ObamaCare’s Secret Mandate Exemption

HHS quietly repeals the individual purchase rule for two more years.

ObamaCare’s implementers continue to roam the battlefield and shoot their own wounded, and the latest casualty is the core of the Affordable Care Act—the individual mandate. To wit, last week the Administration quietly excused millions of people from the requirement to purchase health insurance or else pay a tax penalty.

  • This latest political reconstruction has received zero media notice, and the Health and Human Services Department didn’t think the details were worth discussing in a conference call, press materials or fact sheet. Instead, the mandate suspension was buried in an unrelated rule that was meant to preserve some health plans that don’t comply with ObamaCare benefit and redistribution mandates. Our sources only noticed the change this week.
  • That seven-page technical bulletin includes a paragraph and footnote that casually mention that a rule in a separate December 2013 bulletin would be extended for two more years, until 2016. Lo and behold, it turns out this second rule, which was supposed to last for only a year, allows Americans whose coverage was cancelled to opt out of the mandate altogether.
  • In 2013, HHS decided that ObamaCare’s wave of policy terminations qualified as a “hardship” that entitled people to a special type of coverage designed for people under age 30 or a mandate exemption. HHS originally defined and reserved hardship exemptions for the truly down and out such as battered women, the evicted and bankrupts.
  • But amid the post-rollout political backlash, last week the agency created a new category: Now all you need to do is fill out a form attesting that your plan was cancelled and that you “believe that the plan options available in the [ObamaCare] Marketplace in your area are more expensive than your cancelled health insurance policy” or “you consider other available policies unaffordable.”
  • HHS is also trying to pre-empt the inevitable political blowback from the nasty 2015 tax surprise of fining the uninsured for being uninsured, which could help reopen ObamaCare if voters elect a Republican Senate this November. Keeping its mandate waiver secret for now is an attempt get past November and in the meantime sign up as many people as possible for government-subsidized health care.
  • Sources in the insurance industry are worried the regulatory loophole sets a mandate non-enforcement precedent, and they’re probably right. The longer it is not enforced, the less likely any President will enforce it.
  • This lax standard—no formula or hard test beyond a person’s belief—at least ostensibly requires proof such as an insurer termination notice. But people can also qualify for hardships for the unspecified nonreason that “you experienced another hardship in obtaining health insurance,” which only requires “documentation if possible.” And yet another waiver is available to those who say they are merely unable to afford coverage, regardless of their prior insurance. In a word, these shifting legal benchmarks offer an exemption to everyone who conceivably wants one.
  • Keep in mind that the White House argued at the Supreme Court that the individual mandate to buy insurance was indispensable to the law’s success, and President Obama continues to say he’d veto the bipartisan bills that would delay or repeal it. So why are ObamaCare liberals silently gutting their own creation now?
  • The answers are the implementation fiasco and politics. HHS revealed Tuesday that only 940,000 people signed up for an ObamaCare plan in February, bringing the total to about 4.2 million, well below the original 5.7 million projection. The predicted “surge” of young beneficiaries isn’t materializing even as the end-of-March deadline approaches, and enrollment decelerated in February.
  • Meanwhile, a McKinsey & Company survey reports that a mere 27% of people joining the exchanges were previously uninsured through February. The survey also found that about half of people who shopped for a plan but did not enroll said premiums were too expensive, even though 80% of this group qualify for subsidies. Some substantial share of the people ObamaCare is supposed to help say it is a bad financial value. You might even call it a hardship.
  • The larger point is that there have been so many unilateral executive waivers and delays that ObamaCare must be unrecognizable to its drafters, to the extent they ever knew what the law contained.

*Modified from a WSJ.com article

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