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Audit Shows Healthcare.gov Still Failing to Verify Eligibility of Enrollees

August 14th, 2015 / Kristina Ribali / 0 comments

A recent audit showed that Healthcare.gov, the federal marketplace website for ObamaCare enrollment, is having multiple problems verifying the eligibility of enrollees for coverage.

The Washington Free Beacon reported that the Department of Health and Human Services (HHS) audit showed that Healthcare.gov’s internal controls were failing to consistently verify Social Security Numbers, citizenship status, annual household income, and family size.

What is supposed to happen is that the website should cross-check information submitted by enrollees with other available databases. For example, if an enrollee states that their income is $20,000, this should be compared to the income that enrollee has declared on their income taxes. Citizenship status is supposed to be verified through the Social Security Administration and the Department of Homeland Security.

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IRS: So About That $350 Million…

August 13th, 2015 / Kristina Ribali / 0 comments

We learned earlier this year that the IRS overpaid ObamaCare tax credits to some Americans to the tune of $350 million dollars. Well, now it seems like they may not be able to get that money back. “A quirk in the law means the IRS will never be able to recoup nearly $350 million in […]

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The ObamaCare Cadillac Tax May Get Even Worse!

August 12th, 2015 / Kristina Ribali / 0 comments

We have already seen that premiums for ObamaCare plan are going to go up significantly next year. We have already seen that premiums for private plans are also likely to go up next year. Now it seems that the so called “Cadillac Tax” may also be going up – way up.

As Forbes notes, “Of all the taxes in the ironically named Affordable Care Act, none is more onerous,” as the Cadillac tax which is “a whopping 40% on top of all other federal taxes.”

Although the tax is the target of many bills to repeal or modify it, many companies have found a way to avoid it altogether. In fact, “One survey showed that 62% of companies facing a 40% Cadillac tax hit in 2018 are already changing coverage to avoid it. Conversely, only 2.5 percent of companies say they will pay it.”

What does that mean for consumers? Well for starters it generally means that plans offered by employers are often shifted to higher deductible plans, with lower benefits, or companies canceling coverage altogether. It’s definitely not what employees thought they would be getting when having their insurance provided through their employer.

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ObamaCare Update: CVS Chooses Which Drugs to Cover

August 12th, 2015 / Kristina Ribali / 0 comments

When ObamaCare was first being debated, Republicans and its other opponents warned that the legislation would lead to picking and choosing care based upon cost, not need. Now that fear has manifested itself, and it comes via CVS.

“CVS announced that through its Pharmacy Benefit Manager (PBM) operation it will no longer permit insurance coverage of Pfizer’s Viagra.”

What’s a PBM you ask? A PBM is “a newly and massively empowered byproduct of the overreaching ObamaCare.” PBM’s, in this case CVS, “can now determine which medicine you’ll be taking for everything from allergies to erectile dysfunction.”

Medication to treat or cure a condition is a very personal selection. Some drugs work with a patient’s chemistry, and some do not. That is why drug companies give consumers and their physicians a range of drugs to utilize in their treatment.

That may no longer be the case though…

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Is Alaska’s Proposed Medicaid Expansion Illegal?

August 4th, 2015 / Kristina Ribali / 0 comments

FGA’s Josh Archambault and Jonathan Ingram have a new piece at Forbes about Alaska’s entrance into ObamaCare’s Medicaid expansion. In other states the legislature and the governor have collaborated to pass Medicaid expansion. In Alaska it has not been a joint effort.

Last month, Alaska’s Governor Bill Walker announced that he would “unilaterally implement Obamacare’s Medicaid expansion.” As we have seen in other states that have been down this troubled road, Alaska’s expansion “would shrink Alaska’s economy, discourage work, crowd out resources for truly needy patients and ultimately put funding for education, pensions and other critical services at risk,” as Jonathan and Josh say.

It’s not just a bad policy move by the Governor – it may also be illegal.

Earlier this year, Gov. Walker lobbied unsuccessfully to expand Medicaid under Obamacare. Seeing that his efforts had failed, Gov. Walker waited until after the legislature had adjourned and announced that he would expand Medicaid without legislative approval.

As you can imagine, that’s not going over well with Alaskan legislators. In fact, “state lawmakers are beginning to stand up and demand answers. Alaska Senate Majority Leader John Coghill, for example, recently questioned the legality of Gov. Walker’s actions in the Alaska Dispatch.”

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Poll: ObamaCare Enrollees Unhappy With Their Health Insurance

August 4th, 2015 / Kristina Ribali / 0 comments

A new poll shows that Americans who obtained their health insurance through ObamaCare are less satisfied than people with other types of health insurance.

Only 30 percent of ObamaCare enrollees are satisfied with their health insurance plans, according to a poll by the Deloitte Center for Health Solutions. In comparison, 42 percent of people with employer-sponsored health insurance said they were satisfied with their plans.

The biggest factor driving the dissatisfaction is cost. Despite President Barack Obama’s promises that ObamaCare would premiums by “up to $2,500 a year” and “if you like your plan, you can keep your plan,” the reality has been far different for many. Millions of Americans had their health insurance cancelled, and those who kept their plans often saw major premium increases.

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Obama’s Pick to Head CMS Has History of Medical Fraud

August 3rd, 2015 / Kristina Ribali / 0 comments

Fraud in government health care is a known problem. Will Obama’s pick to head the Centers for Medicare and Medicaid Services (CMS) be the one to fix it? Well, according to The Daily Caller, Andy Slavitt, President Obama’s choice to run CMS has a history with fraud and “was linked seven years ago to a massive medical data fraud scheme that resulted in what was then the largest settlement ever by an insurance company.”

In 2009, Slavic was the CEO of Ingenix, a “health data analytics firm” that was forced to provide a $50 million settlement “with then-New York Attorney General Andrew Cuomo and a $350 million settlement with the American Medical Association.”

Here’s what Ingenix was caught doing:

Cuomo and the AMA charged that Ingenix supplied databases to insurance companies that fraudulently calculated reimbursements for out-of-network medical services provided to policyholders, according to a Daily Caller News Foundation investigation.

At the time, the company was owned by UnitedHealth Group, “which did not admit to any criminal wrong-doing in the settlements.”

Attorney General Cuomo charged “that Ingenix was running a “scheme” that sought ‘to defraud consumers by manipulating reimbursement rates.'” The fraud involved hundreds of millions of dollars.

It was estimated that years of data manipulation by Ingenix affected as many as 110 million Americans — about one in three patients — who used doctors, labs or hospitals that were out of their insurance network.

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ObamaCare Forces Wheaton College to Cancel Student Health Insurance

July 30th, 2015 / Kristina Ribali / 0 comments

One of the most controversial portions of ObamaCare was its mandate that contraception must be covered in all health insurance plans. Many religious institutions have objected to the provision, seeing it as an affront on their beliefs against abortion.

Now one college is canceling the health insurance they provide to students because of their disagreement with this mandate.

On Friday, Wheaton College will stop providing student health insurance.

Officials at the evangelical Christian liberal arts college in the suburbs west of Chicago made the decision because they refuse — for religious reasons — to abide by the contraception provisions mandated under the Affordable Care Act.

Beginning this August, students will have to look to the private insurance market or the ObamaCare exchange for coverage, something that may be financially difficult for college students who do not have a job.

Paul Chelsen, Wheaton’s vice president for student development said, “We regret that we were not able to provide earlier notice of this significant change, which affects roughly a quarter of our student body.” Should insurance requirements change, the school may consider offering student health insurance plans in the future.

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State ObamaCare Exchanges Struggle with Costs

July 27th, 2015 / Kristina Ribali / 0 comments

Only 12 states and the District of Columbia operate their own state ObamaCare exchanges. Those exchanges are now dealing with a financial burden that many state lawmakers have not prepared for in their budgets. From the Associated Press:

State-run health insurance markets that offer coverage under President Barack Obama’s health law are struggling with high costs and disappointing enrollment. These challenges could lead more of them to turn over operations to the federal government or join forces with other states.

Hawaii is one of the best (worst) examples of what can go wrong when states opt to embrace ObamaCare. Hawaii’s state marketplace has received $205 million in start up costs from Washington, has spent nearly $140 million and enrolled 8,200 people. The Aloha State is now turning its exchange over to the feds after realizing they cannot sustain the marketplace on their own.

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California Senate Votes to Expand ObamaCare to Illegal Immigrants

July 25th, 2015 / Kristina Ribali / 0 comments

A new bill passed by the California State Senate to expand ObamaCare eligibility to illegal immigrants is raising concerns that it will lead to a new wave of medical tourism, as foreigners travel to take advantage of the law’s benefits.

According to Forbes, the bill, SB 4, would allow illegal immigrants to buy unsubsidized health insurance policies through California’s ObamaCare exchange. Additionally, illegal immigrants under the age of 19 would also be eligible to enroll in the state’s fully paid-for Medicaid program.

The financial impact of this bill, should it become law, is enormous. The Pew Research Center estimates there are 2.5 million illegal immigrants currently living in California. “To say that granting any kind of access to ObamaCare for illegal immigrants is controversial is an understatement,” writes Forbes.

Beyond just the issue of expanding an entitlement program to millions of illegal immigrants currently living in California, the program further threatens the financial stability of the program.

When ObamaCare’s supporters were pushing the bill, they argued that the individual mandate, coupled with the subsidies, was necessary to ensure that enough healthy people participated so as to offset the higher costs associated with providing health care to those who were sicker.

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