Obamacare critics have warned of a potential surge in improper federal subsidies due to the administration's recently announced delay in federal verification of income and lack of employer coverage to qualify for insurance subsidies on the state exchanges. A Wall Street Journal editorial called it the “liar's subsidy.” But Americans tempted to shade the truth to qualify for the generous subsidies should take a close look at other obscure provisions of the healthcare reform law.
The July 5 rule allowing those delays led supporters to highlight provisions in the Patient Protection and Affordable Care Act meant to discourage applicants from gaming the system and garnering federal subsidies to which they were not entitled. The law allows civil penalties of up to $25,000 for applicants who submit inaccurate information because of “negligence or disregard of any rules or regulations.”
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Boehner
A week after the Obama administration announced a yearlong delay in the healthcare reform law's employer mandate, House Republicans are demanding that the White House explain why it hasn't extended the same reprieve to individuals and families.
“Healthcare costs are going through the roof. I think Sen. Baucus had it right—this is a train wreck,” House Speaker John Boehner (R-Ohio) said Tuesday during a news conference on Capitol Hill, referring to the Montana Democrat's limited remark about the implementation of health insurance exchanges.
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Here's a health reform snafu that many Americans will benefit from.
Older smokers are likely to pay less for health insurance in 2014 because of a computer system glitch that the Obama administration said would limit the penalties insurers could charge tobacco users under the ACA.
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“Looking for connections and ways to make life easier” were the goals at UMass Memorial Medical Center when staff at a hospital in Worcester, Mass., began beefing up its social media presence.
That's what the hospital's social media manager, Rob Brogna, told the authors of a white paper released by ICF International that looks at how Facebook, Twitter and other social media sites are utilized in healthcare.
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Instantaneous eligibility determination for exchange subsidies or Medicaid will not happen on Oct. 1 because of the Obama administration's decision to put off for one year requiring employers to report their employee health coverage, as well as a CMS-proposed rule published Friday loosening verification of individuals' income for the purpose of federal insurance subsidies.
In 2014, eligibility evaluations for premium tax credits and Medicaid eligibility will be based on the “honor system,” and will be performed manually by the state exchanges, rather than being based on IRS data provided to the exchanges through the new federal data hub. Experts say this will increase staff costs to manually determine eligibility. And it may increase fraud as well, thus costing the federal government more in premium subsidies.
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Delays in key provisions of the Patient Protection and Affordable Care Act last week last week are spawning congressional actions this week.
The Obama administration's surprise July 2 announcement that it will delay for one year the requirement that large employers provide qualifying insurance coverage for their workers or face tax penalties spurred told-you-sos from Republicans in Congress.
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How can the IRS and the Obama administration simply waive a key provision of the Patient Protection and Affordable Care Act passed by Congress?
Section 1513(d) of the law unequivocally states that the employer mandate “shall apply to months beginning after December 31, 2013.” Could the administration's decision to delay the penalty on employers of more than 50 full-time employees for not providing coverage to their workers be challenged in court?
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First Aetna, and now UnitedHealth.
United, the nation's largest health insurer based on enrollment, followed in the footsteps of Aetna's move last month and decided to exit California's individual market. That includes leaving the state's individual health insurance exchange after saying it would participate, the Los Angeles Times reported Tuesday.
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There's been much media discussion about how the Obamacare tax penalty may be too small to prod so-called young invincibles to buy health insurance come Jan. 1, 2014. Many news reports and commentaries have scoffed at the idea that Obamacare's tax penalty will be stiff enough to convince healthy 30-somethings to pay what could be a relatively hefty premium for coverage and also face high deductibles, copayments and coinsurance. Quite a few media reports, including those in the Washington Post, have described the penalty simply as $95 for the first year, 2014. Pundits have predicted many uninsured Americans will choose to pay that paltry penalty rather than pony up what could be a lot more to buy insurance they don't think they need.
But many Americans—and many journalists—may not be aware of what the Patient Protect and Affordable Care Act and the implementing IRS rule actually establish as the penalty in 2014 and beyond for failing to buy coverage.
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Providers may have good reason to worry about a 2014 surge in patients covered by health plans with high deductibles and copays.
One of the first examinations of deductibles and copays in states where health insurance exchange plan rates have been filed found both types of cost-sharing amounts will jump from current levels. The review of exchange filings by HealthPocket in seven states—California, Connecticut, Ohio, Oregon, Rhode Island, Vermont and Washington—found that average copays in the individual market will jump 46% from a national average of $28 to $41 in the exchanges' lowest-cost bronze plans.
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A University of Texas academic has concluded after pouring over Kaiser Permanente's proposed rates for its exchange offerings in California that the high rate on its lowest-cost health insurance plan is not due to the plan's generosity.
Comparing Kaiser's proposed “bronze” offering to its existing plans for healthy young adults, the researcher wrote on The Incidental Economist blog that the new premium, at $205 a month, will be more than double the old premium. Yet the benefits and available provider network (they both used Kaiser) will be essentially the same.
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