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Obamacare Premium Increase Coming as Subsidies lapse

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the staff of the Ridgewood blog

Ridgewood NJ, the Affordable Care Act (Obamacare)  marks its 12th anniversary in March , and despite a record 14.5 million enrollees, the Biden administration is preparing for the possibility that millions could lose coverage next year.

Continue reading Obamacare Premium Increase Coming as Subsidies lapse

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Governor Murphy Signs Legislative Package Protecting the Affordable Care Tax in New Jersey

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the staff of the Ridgewood blog

Trenton NJ, Governor Phil Murphy today signed a package of bills to safeguard the provisions of the Affordable Care Act (ACA) in New Jersey. The bills, which will codify into state law the basic protections for health care consumers that are part of the Affordable Care Act, include protections for no-cost preventative care and contraception, prohibit exclusions for pre-existing conditions, allow children to stay on their parents’ plan until age 26, and incorporate mental health and maternity care as part of essential benefits, among others. The Governor highlighted the importance of these bills during an armchair discussion with Hackensack Meridian Health Chief Executive Officer Bob Garret.

Continue reading Governor Murphy Signs Legislative Package Protecting the Affordable Care Tax in New Jersey

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Phil Murphy Rolls Out “Murphycare”

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the staff of the Ridgewood blog

Trenton NJ,  Acting to improve health care access for New Jersey residents, Governor Murphy today announced that the State of New Jersey will move to a State-Based Health Exchange for the year 2021 .

Transitioning to a State-Based Exchange (SBE) will give the state more control over the open enrollment period; access to data that can be used to better regulate the market, conduct targeted outreach and inform policy decisions; and allow user fees to fund exchange operations, consumer assistance, outreach and advertising. By redirecting the assessment on premiums, currently paid to the federal government to utilize a Federally-Facilitated Exchange (FFE), New Jersey can operate an exchange that is tailored and efficient for New Jersey residents.

Continue reading Phil Murphy Rolls Out “Murphycare”
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The Affordable Care Act has been anything but affordable

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Heather Darling, a Lawyer from Morris County 

Ridgewood NJ, Obamacare has been an epic fail for many who had insurance. The Affordable Care Act has been anything but affordable for those of us paying in part or in full for our own Healthcare. For many, basic health care previously covered by insurance is now approaching prohibitive cost levels. Although insurance was previously expensive, after payment for insurance was rendered the cost of medical care itself was substantially covered by the insurance company.

Shortly after Obamacare was introduced, many did see a significant reduction in their premiums. However, there was an equal and sometimes greater increase in their out-of-pocket costs after the care was rendered. Over a short period of time, premiums increased to pre-Obamacare levels and the out-of-pocket costs continue to climb. These facts alone indicate that the program was overreaching and a failure.

Additionally, here in New Jersey, those such as small business owners or independent contractors responsible for their own insurance coverage are limited to a minimal number of insurance companies and an even smaller number of those companies are actually accepted by a majority of medical care providers. The net result is that many who were previously insured are now unable to afford insurance and those who were previously uninsured currently remain either uninsured or covered by government programs paid for by the very people who can no longer afford insurance of their own.

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“Obamacare” Ruled Unconstitutional

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the staff of the Ridewood blog

Fort Worth Tx, On Friday night a federal judge in Texas ruled the Affordable Care Act unconstitutional , likely setting up a final decision on the law’s fate at the Supreme Court.

The law, known as Obamacare, was effectively nullified by the ruling. Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas, in Fort Worth, heard arguments in the case in early September, but did not issue his ruling until Friday evening.

He did not, however, grant the plaintiffs’ request for an injunction, meaning the law’s provisions remain in effect until an appeal reaches the Supreme Court, or the ruling is reversed by an Appeals Court. That means that the current open enrollment period regulated by Obamacare continuing through its Saturday deadline.

At issue in the case was the individual mandate, the provision in Obamacare that requires everyone to have health insurance or face a penalty in the form of a tax. The Supreme Court upheld that part of the law in 2012, ruling it fell in line with Congress’ power to levy taxes.
Congress, eliminated the tax penalty last December as part of President Trump’s major tax overhaul which, means the mandate is no longer a tax and therefore is unconstitutional.

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U.S. Department of Justice says Obamacare individual mandate unconstitutional

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June 10 ,2018
the staff of the Ridgewood blog

Washington DC, The U.S. Department of Justice said on Thursday that the part of Obamacare requiring individuals to have health insurance aka the individual mandate is unconstitutional. This should be interesting to New Jersey voters with the recent signing by Governor Phil Murphy of a rule requiring the enforcement of the individual mandates and thereby fining individuals without insurance .

In a brief filed in a federal court in Texas, the department said a tax law signed last year by President Donald Trump that eliminated penalties for not having health insurance rendered the so-called individual mandate under Obamacare unconstitutional.
The Justice Department said that also nullifies two other major provisions of Obamacare linked to the individual mandate, including one barring insurance companies from denying coverage to people with pre-existing conditions.

Attorney General Jeff Sessions, in a letter to House of Representatives Speaker Paul Ryan, said he had determined the individual mandate will be unconstitutional when the tax law becomes effective in 2019.

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Government control of healthcare is reducing access

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Any reasonable person could have predicted this when analyzing the Affordable Care Act as written. Premiums rise, payments to physicians go down, and those who want to fix this law believe that increased subsidies to insurance companies will help. It is truly time to scrap ObamaCare and start over. Minimizing the federal role would be a great place to start , Alieta Eck, MD For Real Health Care Reform

Government control of healthcare is reducing access

by Dr. Deane Waldman and Jennifer Minjarez | Aug 29, 2017, 12:01 AM

The Affordable Care Act has made health insurance even more unaffordable than before Obamacare was enacted. Many insurers have lost hundreds of millions of dollars selling Obamacare insurance and have exited the market. The remaining insurance sellers are charging prices many cannot afford and are planning to raise rates an average of 19 percent.

To make the situation worse, payment schedules to doctors continue to go down, making care even less accessible.

https://www.washingtonexaminer.com/government-control-of-healthcare-is-reducing-access/article/2632520

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She called the offices of many surgeons and was always rebuffed– “We don’t take Medicaid.”

“We don’t take Medicaid

August 25,2017
Alieta Eck, MD

Meet Kelly Kelly. She is a 36 year old mother of two who was found to have gallstones two years ago. She was on Medicaid. She had frequent abdominal pain that sent her to the ER many times. The solution for gallstones is removal of the gallbladder, but she could not find a surgeon who takes Medicaid. When she was diagnosed, she went to her primary Medicaid doctor and was told that having the gallbladder removed would increase her chances of getting diabetes. Another told her to eat hummus and couscous and take probiotics.

One ER physician told her that with her Medicaid “insurance” she would need to be dying to get an operation– which meant having the gallbladder be on the verge of bursting. Apparently, only a fever, high white cell count and elevated liver enzymes qualified for an admission and emergency surgery. Persistent gallbladder pain only qualifies for 5 days of pain meds.

She called the offices of many surgeons and was always rebuffed– “We don’t take Medicaid.”

Half the patients we see at the Zarephath Health Center are on Medicaid and cannot find a doctor. Most notably, patients who need psychiatrists, pain control specialists and those who need surgery on a non-emergent basis are out of luck. This is especially irksome since the taxpayers of NJ are paying $15 billion on Medicaid per year, up because most newly insured patients under the Affordable Care Act are on Medicaid.

We at the Zarephath Health Center work to find solutions. We called a local surgeon and offered to have the Zarephath Health Center pay a fair fee. The surgery is being scheduled for next week and we will follow up.

This demonstrates why we need NJ S239– the Volunteer Medical Professional Health Care Act. Tell Senator Vitale to bring it up before the NJ Senate Health Committee.

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Could A Democratic Corruption Scandal Help Repeal ObamaCare?

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ED MORRISSEYPosted at 12:01 pm on August 18, 2017

Remember Robert Menendez? The Democratic Senator from New Jersey has kept a relatively low profile since being indicted in early 2015on corruption charges, perhaps hoping to play out the clock. His effort to stave off a trial by using the Speech or Debate Clause ran aground at the Supreme Court in April, and the scene will shift to the courtroom in just under three weeks.

So far, Menendez has steadfastly proclaimed his innocence and refused to resign. A conviction for corruption will leave no choice but to vacate his seat, and as Shane Goldmacher reports at the New York Times, that will have consequences far beyond the electoral complications. With Chris Christie able to appoint an interim replacement, Democrats worry that Mitch McConnell might finally get the 50 votes he needs to repeal ObamaCare once and for all:

https://hotair.com/archives/2017/08/18/democratic-corruption-scandal-help-repeal-obamacare/

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Health insurance premiums expected to increase for New Jerseyans in 2018

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By Anjalee Khemlani, August 11, 2017 at 8:05 AM

Weeks after the collapse of the attempt to repeal and replace the Affordable Care Act, uncertainty around federal action is affecting premium rates and continues to unsettle the health insurance industry.

“The continued uncertainty is making it very difficult for carriers,” said New Jersey Association of Health Plans president Ward Sanders.

In two recent reports, from the Kaiser Family Foundation and the Stop the Health Insurance Tax Coalition lobbying firm, premiums are estimated to increase by hundreds of dollars for New Jerseyans.

According to Stop the HIT, with the reintroduction of the premium fee:

Individuals will see an increase of at least $178.
Small group plans will increase by $209 for individuals and $556 for families.
Large groups will see an increase of $207 for individuals and $615 for family.
Seniors and disabled individuals in Medicare Advantage will see their premiums increase $516 per couple (or $248 for every individual).
State Medicaid programs will incur an additional cost of $268 for each of their insured Medicaid enrollees in 2018.

“From what we’ve seen from other state filings (as highlighted in the KFF report), the cost sharing reduction payments, if they are not going to be there, it is going to have a significant impact on insurance premiums,” Sanders said.

Whether or not the individual mandate and federal subsidies are kept intact, plus the reintroduction of the premium fee on insurers — which alone will increase premiums by close to 3 percent — are forcing significant increases for 2018 plans.

If subsidies are cut off for marketplace enrollees and the individual mandate is removed, insurers are likely to see fewer (mostly healthy) enrollees and therefore need to increase premiums.

https://www.njbiz.com/article/20170811/NJBIZ01/170819977/health-insurance-premiums-expected-to-increase-for-new-jerseyans-in-2018

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To Save Money On Health Costs, Try Putting Away Your Insurance Card

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Jeanne Pinder ,  CONTRIBUTOR

Psst: You might pay less for health care if you put away your insurance card.

Like most of us, you probably think your insurance policy gives you access to better prices. But that’s not always true.

How do you find out? It takes a little bit of work. But when you’re done, you’ll know more about health care and insurance – whether you’re an individual looking for a simple blood test or a sore-throat visit, or whether you’re an employer trying to beat back health costs.

And with the confusion in Washington over the future of health care in this country, we will all need to take ownership of issues we previously left to the insurer and the doctor.

Here’s an example: A person in California was asked to pay $1,850 for an MRI. Because he has a high deductible, he asked the office manager and she said if he agreed not to report the transaction to his insurance company, he could have the MRI for $580.

https://www.forbes.com/sites/jeannepinder/2017/08/09/to-save-money-on-health-costs-try-putting-away-your-insurance-card/#6451a5104255

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Assemblywomen blasts Gubernatorial candidate Phil Murphy and Democrat led ACA hysteria

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file photo Phil Murphy

August 11,2017

the staff of the Ridgewood blog

Ridgewood NJ, Assemblywomen Holly Schepisi  blasts Gubernatorial candidate Phil Murphy  and Democrat led ACA hysteria yesterday on Facebook ,

“I’ve taken some very targeted hits over the past month with claims that I am responsible for women dying and/or I hate women. These comments have been reprehensible and are flat out false as well as bizarre considering I am female and my own grandma died of ovarian cancer. For the record I support access for women to all health care, including family planning services. Several years before I ever ran for office a $7.5 million budgetary cut was made to “family planning services.” During this same period of time the ACA was enacted and several hundred thousand more people in New Jersey became eligible for health insurance coverage and Medicaid services. Certain medical providers, including Planned Parenthood saw significant increases in reimbursements during this time. Indeed Planned Parenthood has been funded to the tune of $1.5 BILLION per year and has felt financially secure enough to increase their executive salaries by 20 percent over the past two years (for an average executive salary of over $350-$400,000 per year) while giving out over $35 million in campaign contributions. But we shouldn’t let facts get in the way of hysteria.

Murphy’s Comments on Women Dying Are False, NJ Health Officials Say

By Christian Hetrick • 08/10/17 7:52pm

New Jersey health officials fired back at Phil Murphy on Thursday after the Democratic gubernatorial nominee said “women are dying” because of Gov. Chris Christie’s cuts to Planned Parenthood.

https://observer.com/2017/08/murphys-comments-on-women-dying-are-false-nj-health-officials-say/?utm_content=nj+politics&utm_campaign=social+flow&utm_source=facebook&utm_medium=social+

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Americans Are Dying Younger, Saving Corporations Billions

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Life expectancy gains have stalled. The grim silver lining? Lower pension costs
By
John Tozzi
August 8, 2017, 4:00 AM EDT

Steady improvements in American life expectancy have stalled, and more Americans are dying at younger ages. But for companies straining under the burden of their pension obligations, the distressing trend could have a grim upside: If people don’t end up living as long as they were projected to just a few years ago, their employers ultimately won’t have to pay them as much in pension and other lifelong retirement benefits.

In 2015, the American death rate—the age-adjusted share of Americans dying—rose slightly for the first time since 1999. And over the last two years, at least 12 large companies, from Verizon to General Motors, have said recent slips in mortality improvement have led them to reduce their estimates for how much they could owe retirees by upward of a combined $9.7 billion, according to a Bloomberg analysis of company filings. “Revised assumptions indicating a shortened longevity,” for instance, led Lockheed Martin to adjust its estimated retirement obligations downward by a total of about $1.6 billion for 2015 and 2016, it said in its most recent annual report.

Mortality trends are only a small piece of the calculation companies make when estimating what they’ll owe retirees, and indeed, other factors actually led Lockheed’s pension obligations to rise last year. Variables such as asset returns, salary levels, and health care costs can cause big swings in what companies expect to pay retirees. The fact that people are dying slightly younger won’t cure corporate America’s pension woes—but the fact that companies are taking it into account shows just how serious the shift in America’s mortality trends is.

https://www.bloomberg.com/news/articles/2017-08-08/americans-are-dying-younger-saving-corporations-billions

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Judicial Watch: HHS Documents Reveal Known Pre-Launch Security Flaws in Healthcare.gov 

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July 29,2017
the staff of the Ridgewood blog
 Washington DC,  Judicial Watch today released two productions of documents 1123 pages of Department of Health and Human Services (HHS) records showing security officials’ concerns about the Obamacare website prior to its launch.

Judicial Watch obtained the HHS documents in response to a court order in a Freedom of Information Act (FOIA) lawsuit (Judicial Watch v. U.S. Department of Health and Human Services (No. 1:14-cv-00430)).  The lawsuit was filed in March 2014 after HHS failed to respond to a December 20, 2013, FOIA request seeking:

  • All records related to the security of the healthcare.gov web portal including, but not limited to, studies, memoranda, correspondence, electronic communications (e-mails), and slide presentations from January 1, 2012 to the present.

The documents show a flippant disregard for Senior IT Security Official Tom Schankweiler’s security concerns in a September 23, 2013, email exchange, one week before the launch of Obamacare, Fryer and CMS official Jacqueline Toomey. Toomey tells Fryer: “Breathe … don’t allow him to suck you in.” Toomey responds later in the exchange: “I’m afraid of who he’s ‘blind copying’ on his emails.”  Fryer says: “When [Consumer Information and Insurance Systems Group] gets theirs, can you make a gagging sound for me?” Toomey responds: “Giggling.”

In a September 28, 2013, review, Chief Information Security Officer (CISO) Jane Kim notes that “the risk associated with the Illinois Integrated Eligibility System ATC [Authorization to Connect] as “high,” noting that “87 security controls  [were] not documented or incomplete.” Risk associated with Minnesota’s application to connect was also deemed “high,” with 110 incomplete or undocumented security controls. Pennsylvania’s risk was also deemed “high,” with 10 high level security findings. Hawaii was also considered a “high” risk, with 23 “high-impact” security findings.

A security spreadsheet in a September 19, 2013, email exchange shows a “high” level defect in the Obamacare website was discovered. That finding prompted top IT security officials to schedule an emergency conference call in which Senior IT Security Official Tom Schankweiler tries to persuade then-CMS Chief Information Officer Teresa Fryer to issue a “short term ATO [Authorization of Operate]”

In the CMS “Pre-Flight Checklist” published on September 20, 2013, is a chart that indicates that the “Hub,” designed to help with verifying applicant information used to determine eligibility for enrollment, was unable to perform its tasks. Regarding verification of citizenship is the comment: “Hub has been too irregular to work thorough this, and still don’t have the right data to test to the 5 year bar.” Regarding verification of SSN is the comment: “Hub has reliability issues …” The Pre-flight Checklist also notes nine “high” security risks, 123 “moderate” security risks, 68 “low” and 17 “common” risks in various components of the Obamacare system.

On October 1, 2013, Americans started shopping for health insurance on healthcare.gov, and the site crashed.

“The Trump administration should do an immediate security audit of the Obamacare official website,” said Judicial Watch President Tom Fitton. “In the meantime, Americans should be warned that their private health data is at risk on the Obamacare website.”

In September 2014, Judicial Watch released 94 pages of documents obtained from the U.S. Department of Health and Human Services (HHS) including Security Controls Assessment Test Plans sent by CMS to Mitre Corporation.  CMS advised Mitre that the highest “Risk Rating” should be given to flaws that could cause “political” damage to CMS.  Moderate and low “Risk Ratings” were to include those resulting in potential “public embarrassment” to the agency.

In March 2015, Judicial Watch released  documents from the U.S. Department of Health and Human Services (HHS) revealing that Department of Homeland Security (DHS) worked with HHS on security for healthcare.gov.

In January 2016, Judicial Watch released documents showing federal health care officials’ concerns with the Obamacare website in two productions of records:  a 143-page production and an 886-page production.  The emails showed that CMS Security Officer Teresa Fryer’s refused to approve the “ATO” (Authorization to Operate).

Recently, Judicial Watch released 944 pages of Department of Health and Human Services records showing that the Obamacare website was launched despite serious concerns by its security testing contractor, Mitre Corporation, as well as internal executive-level apprehension about security.

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Price Transparency In Medicine Faces Stiff Opposition — From Hospitals And Doctors

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“The hospitals complain that they cannot publish their prices because they would have to ask the insurer in order to state the price up front. What other industry thinks like that? “How much is this dress?” Answer, “What credit card are you using?” Forget the insurer. What is the best CASH, check or credit card price? ” Alieta Eck, MD For Real Health Care Reform

By Rachel Bluth July 25, 2017

COLUMBUS, Ohio — Two years after it passed unanimously in Ohio’s state Legislature, a law meant to inform patients what health care procedures will cost is in a state of suspended animation.

One of the most stringent in a group of similar state laws being proposed across the country, Ohio’s Healthcare Price Transparency Law stipulated that providers had to give patients a “good faith” estimate of what non-emergency services would cost individuals after insurance before they commenced treatment.

But the law didn’t go into force on Jan. 1 as scheduled. And its troubled odyssey illustrates the political and business forces opposing a common-sense but controversial solution to rein in high health care costs for patients: Let patients see prices.

Many patient advocates say such transparency would be helpful for patients, allowing them to shop around for some services to hold down out-of-pocket costs, as well as adjust their household budgets for upcoming health-related outlays at a time of high-deductible plans.

https://khn.org/news/price-transparency-in-medicine-faces-stiff-opposition-from-hospitals-and-doctors/