I hate to burden my subjects with my personal issues, but I had the worst dream last night. I need to share.
It started like this:
Sticker shock is around the corner for many Americans with government-brokered medical coverage, as insurance companies are beginning to apply their first-year costs to next year’s premiums.
In the case of Florida, some consumers will pay as much as 23 per cent more when their plans are renewed in the fall, according to the Florida Office of Insurance Regulation.
The numbers in virtually every state are all across the board, with the biggest rate hikes announced to date coming in states where the federal government runs the Obamacare marketplaces.
I woke up in a cold sweat. Once I had a glass of water, I tried to go back to sleep.
“The Obama administration on Friday appealed the ruling that some subsidies underObamaCare are illegal,” reports the Hill. “The Justice Department filed a petition with the full D.C. Circuit Court asking the judges to review the ruling in Halbig v. Burwell that overturned some of the subsidies distributed to help people pay for health insurance.”
A day earlier the plaintiffs in King v. Burwell filed an appeal petition directly with the Supreme Court, The Wall Street Journal reports. The cases raise the same question, but a three-judge panel of the Fourth U.S. Circuit Court of Appeals ruled in favor of the government. Both appeals were expected: The Obama administration has reason to expect a more favorable hearing from the D.C. Circuit, newly packed with Democratic appointees, than from the high court.
The Halbig court held that because the ObamaCare law expressly authorizes premium subsidies only for medical-insurance policies purchased on an exchange established by a state, it precludes a 2012 Internal Revenue Service regulation providing subsidies via the federal exchange, HealthCare.gov, as well. Administration supporters seem to have given up arguing that the IRS rule is consistent with what the law actually says, so instead they’ve rested their case on congressional intent.
Forget dreams about falling or being naked in public, this was petrifying. Somehow, a law was passed that forced rises in medical costs, yet subsidized fewer people. When did our country get taken over by rich, greedy bastards?
Once I convinced myself this was twisted fantasy, I allowed myself to try sleep again.
[F]ederal health officials are finding themselves swamped as they fact-check a flood of paperwork from applicants seeking taxpayer subsidies.
The Department of Health and Human Services seems to be caught between critics on both sides as it confronts the task.
The department, which oversees the implementation of the Affordable Care Act, has gotten hit by audits showing it hasn’t done enough to crack down on fraudsters trying to scam the system. At the same time, some frustrated applicants say they have played by the rules — signed up on time and submitted the necessary paperwork — only to be caught up in bureaucratic red tape.
The scramble to verify eligibility comes on the heels of a Government Accountability Office report that raised fresh doubt about the ability of the health care program to prevent or intercept costly fraud schemes.
Government investigators posing as fake applicants were able to go online, purchase health plans using fake documents and set themselves up to receive undeserved federal subsidies.
Eleven of the 12 fictitious applicants were able to dupe the system using invalid Social Security numbers as well as inaccurate citizenship information, according to the report. The 11 were given the go-ahead to receive $30,000-a-year in health care credits and subsidies.
STOP! The government caught barely 8% of fraudulent applications? Over 90% of con men and grifters could score an easy 30k without breaking a sweat?
Was I going mad?
I passed out again, feverish:
Vermont, a bellwether for healthcare reform, has fired the main technology contractor behind its bungled health insurance website, dealing the latest blow to CGI Federal, the company that was axed over its disastrous jobs in making the federal healthcare exchange website and a similarly troubled site for Massachusetts.
With Vermont still lacking a fully functioning health website more than 10 months after its glitch-plagued debut last October, Vermont officials said late Monday that they were pulling the plug on CGI’s CGI Technologies and Solutions’ contract. CGI’s Fairfax, Virg.-based subsidiary had stood to make at least $83 million from its work for Vermont but will now make just $66.7 million, a figure that incorporates a $5.1 million penalty levied by the state for shoddy work.
Despite the tangles, Vermont is pushing ahead with plans to become the nation’s first system in which the state foots all health-care bills for all residents — what conservatives call “socialized medicine,” and others call “single-payer” or “universal financing.” Miller told Newsweek that “development of the Vermont universal coverage system is proceeding” and that the Shumlin administration would provide cost estimates and an operational plan to the state legislature in January 2015.
The grand plan will require more federal dollars, in the form of grants, and federal approval to effectively bypass the Affordable Care Act, the very law that Vermont Health Connect was built to comply with. Vermont, Miller told Newsweek, is working with the Centers for Medicaid and Medicare Services, the federal agency overseeing the Affordable Care Act, “to submit requests for the waivers that will be needed.”
I am a changed man, a shell of myself. I went to bed thinking we had a health care system that worked for the vast majority of us. I woke up dizzy with the thought that we had passed some lurid gargoyle of a law that raised prices, cut subsidies, wasted hundreds of millions of dollars on botched websites, and was wide open to fraud.
Please tell me this isn’t so.
Many of the eight million sign-ups in Obamacare exchanges nationwide already face more limited choices for physicians and hospitals than those in the private insurance market. But with low physician reimbursement rates, the problem could get even worse.
For a typical quick patient visit, Dr. Doug Gerard, a Connecticut internist, told NPR a private insurer would pay $100 while Medicare would pay around $80. But Obamacare plans are more likely to pay closer to $80, which Gerard says is unsustainable for his practice.
“I cannot accept a plan [in which] potentially commercial-type reimbursement rates were now going to be reimbursed at Medicare rates,” Dr. Gerard told NPR. ”You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on.”