Report: N.J. residents pay highest premiums on U.S. marketplace for health insurance
JUNE 17, 2014, 7:32 PM LAST UPDATED: TUESDAY, JUNE 17, 2014, 7:32 PM BY LINDY WASHBURN STAFF WRITER THE RECORD
New Jersey residents who bought health insurance on the federal marketplace paid the highest premiums in the nation, even after the tax subsidies provided under the Affordable Care Act, a report released Tuesday by the federal government said.
The average premium after tax credits was $148 a month, compared with $82 a month in the 36 states that relied on the federal marketplace. Not included in the report are states with their own exchanges, among them California and New York.
The report analyzed 2014 premiums. Next year’s premiums are to be submitted to the state Insurance Department later this month.
“It will be critical that any increases be kept to a minimum,” said Raymond Castro, an analyst with New Jersey Policy Perspective. The new rates will apply not only to those eligible for subsidies, but also to those who buy individual plans outside the marketplace.
This year, New Jersey had less competition than most other states for customers who bought coverage through the marketplace. Only three insurance companies issued plans, compared with as many as 11 companies in other states, the report said. That tended to make premiums higher in New Jersey.
Obamacare Taxes: Next Filing Season Could Be “one of the most chaotic in years.” Posted by John Kartch on Tuesday, June 10th, 2014, 10:25 AM
Problems with a key component of Obamacare will lead to unpleasant surprises for Americans during the 2015 tax filing season, according to testimony from a top tax expert before the House Ways and Means subcommittees on Health and Oversight today.
“I am here today to tell you that the upcoming tax filing season has the potential to be one of the most chaotic in years,” said Ryan Ellis, an IRS Enrolled Agent and Tax Policy Director at Americans for Tax Reform.
According to the testimony:
“One of the key elements of the Affordable Care Act, popularly known as “Obamacare,” is the creation of advanceable tax credits for the purchase of exchange health insurance plans.
Taxpayers applying for credit assistance must be evaluated by government entities ranging from the SSA to CMS to the IRS. The goal is to have an educated estimate, based on the most immediately-available government documents (e.g. prior year tax returns, etc.), of the taxpayer’s probable income for the year–which in turn determines the size of the tax credit.
In an effort to get this tax benefit out quickly, the estimated credit is advanced to the insurance company by the IRS, which applies it to customer premiums.
This is an important point—the money has left the IRS’ hands up to over a year before the taxpayer actually calculates his final credit amount. The insurance companies have collected it, and they are not required to pay it back.
Press reports this month indicated that the government was having a hard time doing all this, with 1.2 million of the 6 million federal exchange applicants having to be asked for additional income verification information from CMS. That is not surprising. Applicants are asked to complete a detailed, confusing twelve-page application which asks for income, family size, etc. It is rather like trying to fill out a 1040 on the fly. Added to this is the lack of employer reporting requirements and the failure to complete the back-end of the web site.
Inconsistencies–some of which are the result of failures of the healthcare.gov system, some of which are poor records from the government, and some of which are mistakes from the individual–are not surprising. But they are a problem. It is the middle of June, and many people have now been receiving inaccurate subsidies for six months. To the public’s knowledge, not a single advanced tax credit has been adjusted this year.
So what happens if the flawed, confusing process results in a tax credit larger than what the law calls for?
A hypothetical example might help illustrate: a health exchange customer selects an Obamacare exchange plan. The government estimates that this taxpayer will earn $30,000 this year, which makes her eligible for a $2000 tax credit. This $2000 is paid to the taxpayer’s insurance company to help with premiums.
The next spring, our customer/taxpayer is filling out her tax return. Unfortunately, the government estimated the taxpayer earned too little and paid too large a credit. She actually earned $40,000, and so only had a $1500 credit coming to her.
Depending on the taxpayer’s income level and availability of verified affordable workplace insurance, she will have to pay back much or all of the $500 overage to the IRS. This means skinnier refunds and maybe even liabilities, and it won’t be the taxpayer’s fault—it will be the government’s fault.
It is also inevitable that many people are receiving tax credits for which they are completely ineligible. The firewall of the offer of employer sponsored insurance is a new concept — tax preparers will have difficulty figuring out how it works in operation. There is virtually no way to catch it on the front end — but come tax filing season, many people will end up owing thousands of dollars, and it will be a complete surprise.”
Surprise! The Government Now Can’t Even Guess How Much Obamacare Ultimately Will Ultimately Cost. Genevieve Wood June 06, 2014
It’s no secret Obamacare is unaffordable. But now we also know that even the Congressional Budget Office can’t predict how much more this disastrous law will cost.
According to a footnote from a Congressional Budget Office report released in April but reported this week by Roll Call, the law’s true costs and long-term fiscal impact are simply impossible to track.
That’s a change in tune for the CBO, which originally reported in 2010 that Obamacare would pay for itself and over the course of a decade would decrease the deficit,
So what’s changed? Well, thanks to the constant modifications to the law, the only thing predictable about Obamacare’s provisions is that they’re unpredictable. Many of the “savings” and “revenue” (read: mandates and tax increases) originally proposed to pay for this redesign of one-sixth of the U.S. economy, whether Medicare cuts or employer mandates, have been waived, stalled or simply not implemented, making a defensible revised forecast impossible. The changes occurred because it became clear such measures were both politically unpopular and realistically unaffordable.
There are other reasons it’s virtually impossible to even guess how much Obamacare will ultimately cost. We learned this week that more than 2 million people—a whopping quarter of those enrolled in Obamacare—who signed up for insurance via Obamacare’s health care exchanges have discrepancies in their records and paperwork. Apparently the government has inaccurate or inadequate information regarding the income levels of more than 1 million people who signed up and can’t verify the immigration or citizenship status for more than 900,000. That means some current enrollees may not be eligible for Obamacare subsidies and may lose their coverage or may have been given too generous a subsidy and eventually will have to pay the government back.
Serco, Inc., a government contractor hired to track down and verify the missing information, released a statement saying, “Current system access and functionality…limits the ability to resolve outstanding inconsistencies.” That means the government’s websiteis again was not up to par and much of the work to resolve the data discrepancies will require hands-on work to figure out who among these 2 million people should be getting insurance and subsidies through the exchange and who should not. In other words, there will need to be a significant number of extra staffers brought onto fix this mess. Guess the Obama administration finally is delivering on those “job creation” promises—too bad it’s at the taxpayers’ expense.
Not all the bad news regarding the spending train wreck that is Obamacare emanates from Washington. Many of the statesthat chose to set up their own exchanges spent hundreds of millions of federal dollars to do so—and yet ended up with exchanges that don’t work.
As we approach the next enrollment period in November, lawmakers in those states are frantically trying to figure out whether they can get more dollars from Washington to fix their problems or if they are going to have to use their own state funds. State Rep. John Delaney, a Democrat in Maryland, worries his state will have to divert dollars from education, fixing potholes and other programs to fix its broken exchange. “You can’t just print money in the states,” he said,
That’s right. But the printing presses in Washington have been overused for some time as well—and states that gladly jumped on the Obamacare bandwagon and took the bait shouldn’t be let off the hook by Congress.
So to sum up, the CBO can’t calculate Obamacare’s future costs, confusion about enrollees’ actual salaries could lead to wildly varying numbers on how much it costs this year, and there’s no telling how much money some states ultimately will weasel out of Washington to set up Obamacare.
Talk about a monstrosity of a government program.
What we do know for sure is that Obamacare will cost far more than President Obama and all those who voted for it in Congress told us it would. Which most of us realized all along.
Genevieve Wood advances policy priorities of The Heritage Foundation as senior contributor to The Daily Signal.
Doctor Shortages Aren’t Just a Veterans Affairs Problem. They’re a Nationwide Problem.
The country is running out of physicians to treat a growing pool of patients.
Last week, an investigative report revealed that 1,700 veterans who wanted to see a doctor at a Phoenix Veterans Affairs hospital were missing from an official waiting list, mirroring a tactic used at two dozen other facilities across the country to mask long waits for medical care.
A few hundred other people are missing from the Veterans Affairs system, too: doctors.
The Veterans Affairs Department is 400 doctors short, The New York Times reports. But the doctor deficit is not limited to the VA—it’s a nationwide problem.
As Healthcare Paradigm Shifts, NJ Hospitals Face Uncertain Future
New Jersey hospitals are in a bind. Some of them may close in the next few years, experts say, unless they find a way to transform themselves into healthcare systems that focus on keeping patients healthy in an outpatient setting, while dealing with the reality that most revenue is still based on in-hospital services they provide.
Hospitals must have cash reserves and an operating margin of at least 3 percent or they may face a financial crisis, according to current and recent hospital executives.
“If you’re not in a system that has that financial foundation, I don’t know how you manage the next three to five years,” said Judith Persichilli, recently retired president of Catholic Health East-Trinity Health, a national hospital system.
The hospitals that survive this transition period will look very different from the hospitals of the recent past. They will have fewer beds, more links with primary-care and medical specialty providers, and more partnerships with other hospitals in which each hospital only provides specific services.
That was the verdict of a panel assembled yesterday by the New Jersey Health Care Quality Institute in Ewing. (Kitchenman/NJSpotlight)
Hospitals Look to Health Law, Cutting Charity By ABBY GOODNOUGHMAY 25, 2014
Hospital systems around the country have started scaling back financial assistance for lower- and middle-income people without health insurance, hoping to push them into signing up for coverage through the new online marketplaces created under the Affordable Care Act.
The trend is troubling to advocates for the uninsured, who say raising fees will inevitably cause some to skip care rather than buy insurance that they consider unaffordable. Though the number of hospitals tightening access to free or discounted care appears limited so far, many say they are considering doing so, and experts predict that stricter policies will become increasingly common.
Driving the new policies is the cost of charity care, which is partly covered by government but remains a burden for many hospitals. The new law also reduces federal aid to hospitals that treat large numbers of poor and uninsured people, creating an additional pressure on some to restrict charity care.
Federal health-care subsidies may be too high or too low for more than 1 million Americans
By Amy Goldstein and Sandhya Somashekhar, Published: May 16 E-mail the writers
The government may be paying incorrect subsidies to more than 1 million Americans for their health plans in the new federal insurance marketplace and has been unable so far to fix the errors, according to internal documents and three people familiar with the situation.
The problem means that potentially hundreds of thousands of people are receiving bigger subsidies than they deserve. They are part of a large group of Americans who listed incomes on their insurance applications that differ significantly — either too low or too high — from those on file with the Internal Revenue Service, documents show.
Income discrepancies have been flagged, but the government has been unable to fix the problems.
The government has identified these discrepancies but is stuck at the moment. Under federal rules, consumers are notified if there is a problem with their application and asked to upload or mail in pay stubs or other proof of their income. Only a fraction have done so, according to the documents. And, even when they have, the federal computer system at the heart of the insurance marketplace cannot match this proof with the application because that capability has yet to be built, according to the three individuals.
So piles of unprocessed “proof” documents are sitting in a federal contractor’s Kentucky office, and the government continues to pay insurance subsidies that may be too generous or too meager. Administration officials do not yet know what proportion are overpayments or underpayments. Under current rules, people receiving unwarranted subsidies will be required to return the excess next year.
The inability to make certain the government is paying correct subsidies is a legacy of computer troubles that crippled last fall’s launch of HealthCare.gov and the initial months of the first sign-up period for insurance under the Affordable Care Act. Federal officials and contractors raced to correct most of the technical problems hindering consumers’ ability to choose a health plan. But behind the scenes, important aspects of the Web site remain defective — or simply unfinished.
At Forbes.com, Wanda Buckley writes about how Obamacare has affected her health insurance:Her insurance policy, which she liked, was cancelled because the government decided it was not good enough.
Obamacare is forcing her to buy coverage she doesn’t want or need (which is why, in part, her premiums have doubled).
Obamacare outlaws her ability to buy a plan tailored to her needs and lifestyle.Buckley describes herself as the government’s “pawn” — a characterization which is spot on, applying to every American under today’s health care system.
The government today does not see us as individuals with the right to make choices about our own health care. Instead, over the last hundred years, the government has increasingly forced us to make different choices.
This is why, for example, under Obamacare:
Buckley must buy maternity coverage even though she’s had a hysterectomy, pediatric coverage even though her children are adults, and substance abuse coverage even though she consumes only two drinks a year. The government has, for more than 60 years, decided that non-users of certain medical services must subsidize the users (read more, here).
Young people must overpay for health insurance. The government has, for decades, decided that young people should be footing the medical bills of those older (read more, here).
Almost everyone must buy coverage. The government has decided that people shouldn’t be able to circumvent the myriad wealth redistribution schemes it orchestrates through health insurance (read more, here).
The consequence of the government dictating the health care choices we should be making is that individuals like Wanda Buckley are seen, not as individuals whose interests and desires are to be respected, but as pawns whose lives the government can dispose of for its own schemes.
Obamacare’s Killer Burden on Nurses Amy Dertz 12:01 AM ET
The Affordable Care Act means more and sicker patients are entering hospitals, and less comprehensive and timely health care.
As the first enrollees in the Affordable Care Act begin seeking care at my hospital, I wonder how my practice as a Registered Nurse will change. We’re told the goal of the new law is to remodel healthcare in the United States into a system that promotes wellness and prevention, rather than just providing care to sick people. This seems like a great objective, but I worry that the switch may compromise the quality of the care our patients receive.
As a bedside RN working at an acute care hospital in Oakland, California, I care for an incredibly diverse patient population. Most of my patients have had health insurance through employer-based programs, private purchase, or Medi-Cal. Most have interacted with the health care system prior to being admitted to my hospital.
Now, I will take care of patients who are new to health care. Some haven’t had care in a long time (or ever). Some may have pre-existing conditions that enabled insurance companies to refuse them coverage. As they enter my care, their needs may be more complicated.
Own a small business? Brace for Obamacare pain
By JENNIFER ROBISON
LAS VEGAS REVIEW-JOURNAL
Local business owners might be hoping the Affordable Care Act’s insurance mandates cover sticker shock.
The law’s employer coverage mandate doesn’t take effect until 2015, but early plan renewals are starting to roll in. And for some businesses, the premium jumps are positively painful.
Local insurance brokers are reporting spikes ranging from 35 percent to 120 percent on policies that renew from July to December. The increases are especially acute among employers with workforces made up of younger, healthier men. That’s because Obamacare prohibits offering lower rates to healthier groups. It also narrows the allowed premium gap between older and younger enrollees.
“It’s like if there were no more safe-driver discounts with State Farm,” said local insurance broker Frank Nolimal of Assurance Ltd. “Everybody has the same rate, whether you have three DUIs, or you’re a (nondrinking) churchgoing Mormon.”
The changes put as many as 90,000 policies across Nevada at risk of cancellation or nonrenewal this fall, said Las Vegas insurance broker William Wright, president of Chamber Insurance and Benefits. That’s more than three times the 25,000 enrollees affected in October, when Obamacare-compliant plans first hit the market.
Some workers are at higher risk than others of losing company-sponsored coverage. Professional, white-collar companies such as law or engineering firms will bite the bullet and renew at higher prices because they need to compete for scarce skilled labor, Nolimal said.
But moderately skilled or low-skilled people making $8 to $14 an hour working for landscaping businesses, fire-prevention firms or fencing companies could lose work-based coverage because the plans cost so much relative to salaries.
Employees who keep their coverage might see leaner take-home pay, which could hurt the economy.
Nolimal said one business client whose monthly premiums will rise from $160 to $340 in June plans to shift most of the increase onto his employees.
“Just like when you see gasoline prices going up an extra dime a gallon, it takes money out of the economy for things like buying a new stereo or having dinner out on the town,” Nolimal said.
The premium hikes could have political implications, as well. Nolimal estimated that as many as 85 percent of small-group plans will renew in November and December. Because new premiums go out 60 days before coverage takes effect, those price hikes will hit mailboxes in September and October — just before November’s elections.
That may be why Wright said Nevada lawmakers seemed keenly interested in hearing what he and other brokers had to say during a recent visit to Washington.
He said lawmakers were “very receptive” to the idea that Nevada officials should embrace a federally established transition period that would let businesses keep their existing plans for at least one more year to blunt the effect of today’s higher costs.
Nevada Insurance Commissioner Scott Kipper said March 25 that he doesn’t have the discretion to allow noncompliant plans to stay in place, based on advice from Nevada Attorney General Catherine Cortez Masto. That decision mirrored a fall conclusion that it would be illegal to reinstate the first wave of canceled plans.
But Wright said he has an opinion from a national law firm that says the small-group situation is different, because it involves policies not yet canceled. He said he and other brokers will work over the next few weeks to sway the commissioner.
GOP foolish to think ObamaCare is fixable By Betsy McCaughey April 30, 2014 | 10:37pm
Rep. Cathy McMorris Rodgers (R-Wash.), the No. 4 House Republican, is walking back comments attributed to her that ObamaCare can’t be repealed. But she’s not the only one suggesting Congress merely make changes within the framework of the health law. Senate Minority Leader Mitch McConnell (R-Ky.) says the goal is to get the law “fixed.” It seems many GOP lawmakers still haven’t read the law, or they’d know the framework is corrupt.
Even Sen. Rand Paul (R-Ky.) speculated Friday that repeal is unlikely because it will be “difficult to turn the clock back.”
Nonsense. Even by the most inflated administration claims, some 8 million people have signed up for exchange plans, out of a nation of 318 million. ObamaCare is repealable, and should be replaced with a plan to cover the uninsured and reduce costs.
ObamaCare’s authors paid lip service to these goals but had an ulterior motive: forging a permanent Democratic majority. The law creates a huge infrastructure for enrolling millions of people not just in insurance but also for food stamps, housing assistance and other welfare programs — and registering them to vote.
It’s time to defy health-care mandates issued by bureaucrats not in the healing profession.
By DANIEL F. CRAVIOTTO JR. Updated April 28, 2014 7:34 p.m. ET
In my 23 years as a practicing physician, I’ve learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patients is the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it.
As a group, the nearly 880,000 licensed physicians in the U.S. are, for the most part, well-intentioned. We strive to do our best even while we sometimes contend with unrealistic expectations. The demands are great, and many of our families pay a huge price for our not being around. We do the things we do because it is right and our patients expect us to.
So when do we say damn the mandates and requirements from bureaucrats who are not in the healing profession? When do we stand up and say we are not going to take it any more?
Dem Congressman on Obamacare: The Worst Is Yet to Come, It’s ‘Going to Hit the Fan’
By Andrew Johnson April 21, 2014 2:45 PM
Massachusetts representative Stephen Lynch isn’t just worried about the negative impact Obamacare will have on his party’s performance this fall — he also thinks its worst effects on our health-care system are still to come. Lynch, who voted against the Affordable Care Act in 2010, warned that the situation is “going to hit the fan” when the law’s delayed provisions go into effect down the road.
“There are parts of Obamacare, or the Affordable Care Act, that were postponed because they are unpalatable,” he told the Boston Herald. The “Cadillac tax” that goes into effect in a few years and taxes employer health plans over a certain value, he said, will be “the first time in this country’s history that we have actually taxed health care.”
WASHINGTON — Kathleen Sebelius, the health and human services secretary, is resigning, ending a stormy five-year tenure marred by the disastrous rollout of President Obama’s signature legislative achievement, the Affordable Care Act.
Mr. Obama accepted Ms. Sebelius’s resignation this week, and on Friday morning, he will nominate Sylvia Mathews Burwell, the director of the Office of Management and Budget, to replace her, officials said.
The departure comes as the Obama administration tries to move beyond its early stumbles in carrying out the law, convince a still-skeptical public of its lasting benefits, and help Democratic incumbents, who face blistering attack ads after supporting the legislation, survive the midterm elections this fall.
Officials said Ms. Sebelius, 65, made the decision to resign and was not forced out. But the frustration at the White House over her performance had become increasingly clear, as administration aides worried that the crippling problems at HealthCare.gov, the website set up to enroll Americans in insurance exchanges, would result in lasting damage to the president’s legacy.
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