Category Archives: Health & Human Services

$21.8 million in ObamaCare tax credits awarded to individuals who were not eligible to receive them

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From Fox News: The Affordable Care Act exchanges awarded $21.8 million in advance premium tax credits to individuals who were not eligible to receive them, according to an audit from the Treasury Inspector General for Tax Administration.

Advance premium tax credits are awarded to those with low to moderate income to help rein in the cost of purchasing health care insurance on the exchanges.

The Centers for Medicare and Medicaid Services is responsible for overseeing the Obamacare exchanges which should ensure that an individual who applies for the tax credit has his identity verified and that the individual is eligible to receive the payment.

Individuals are asked a number of questions regarding their personal information such as their address, telephone number, date of birth, and out-of-wallet questions to determine their identity. After this process, individuals can submit an application to see if they are eligible to receive benefits.

The audit found that the exchanges did not successfully verify the identity of 35,276 individuals, and these individuals received $112 million in advance premium tax credits. The report notes that the majority of these applications—99 percent—had no verification process performed on them, and 251 failed identity verification.

Click for more from The Washington Free Beacon.

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Humana to quit Obamacare exchanges in 2018, providing fuel for Trump’s ‘repeal’ efforts

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From Yahoo:  While Republicans continue to grapple with plans to repeal and replace Obamacare and stabilize health insurance rates, Humana (HUM) is the first major insurer to say it is dropping out of the individual market for 2018.

“Based on our initial analysis of data associated with the company’s health-care exchange membership following the 2017 open enrollment period, we continue to see further signs of an unbalanced risk pool,” said Humana CEO Bruce Broussard, on a conference call with analysts Tuesday. “Therefore, the company has decided that it cannot continue to offer this coverage for 2018.”

In the wake of the news, President Donald Trump tweeted that the insurer’s decision was another example of the failure of the Affordable Care Act, and he reiterated his plan to “repeal, replace & save healthcare for ALL Americans.”

The health insurer made the announcement with its earnings update, following the mutual termination of its $34 billion merger agreement with Aetna (AET) earlier in the day. The two insurers agreed to part ways , after a federal court judge blocked the deal on antitrust grounds.

Humana now expects to earn $10.80 to $11.00 per share for 2017, excluding anticipated losses on its exchange business.

Humana cut back its Affordable Care Act exchange participation to 11 states last July, when the Department Of Justice sued to block its deal with Aetna. The insurer said that despite efforts to mitigate losses on its exchange plans in 2017 through narrower networks and selective market participation, it is seeing early signs of high pharmacy utilization among its new members.

Right now, the insurer estimated that it will lose a modest $45 million on ACA exchange plans, but it cautioned that this is an early estimate and “a number… that we’re going to have to evaluate.”

Other health insurers have threatened to pull out of the individual market if there is no clarity from Capitol Hill or Trump’s health officials on stabilizing the markets, but Humana is the first to say that it will pull out altogether.

Leading up to 2017 open enrollment, the exchange markets experienced tremendous turbulence last year, after most major insurers, including Humana, cut back on participation after suffering big losses on exchange plans.

Humana is a leading Medicare Advantage plan provider, and executives said that they don’t believe that they can achieve the same kind of health-care models on the Obamacare exchanges that they achieve with health plans for seniors.

The company does not hold out hope for more detail on Republican “repeal and replace” plans in the near term.

“We’re really feeling that this organization needs to stay focused on what we do well,” Broussard said, and the company can’t do that with Obamacare plans. “I think with that particular program, the way it is designed today and most likely the way it is designed in the future, will limit our ability… to get back into that marketplace.”

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NY gov requires insurance companies to cover contraception

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From Fox News: New York governor Andrew Cuomo said Saturday said he was requiring health insurance companies to cover medically necessary abortions and most forms of contraception at no cost to women, a move that further protects and safeguards coverage under the federal Affordable Care Act.

The state department of financial services is mandating that health insurers in New York provide for at least one form of FDA-approved contraception exceeding a month’s supply at a time. And women must be provided medically necessary abortions without co-pays or deductibles.

President Donald Trump and Republican members of Congress have said they will repeal the health care act as soon as possible, and that is why New York must act fast to ensure women’s access to coverage and care, Cuomo said.

“These regulatory actions will help ensure that whatever happens at the federal level, women in our state will have cost-free access to reproductive health care and we hope these actions serve as a model for equality across the nation,” Cuomo said. “Women deserve to make a fair wage and the same salary as any man, they deserve to work in an office free of sexual harassment, they deserve comprehensive paid family leave, and they deserve control over their health and reproductive decisions.”

The regulations go a step further to ensure insurance companies can’t skirt laws in any way to deny coverage. Insurance companies would face steep fines if found to be violating the mandate.

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Hollyweird libtard tweets sick joke about abortion

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A serious case of TARD: Michael Ian Black

Michael Ian black is an American comedian (which I’m sure will probably enable him to use the “it was a joke” non-apology for his tweet, if his PR agent deems it necessary), actor, writer and director. Yesterday he tweeted the following:

“Not a recommendation to the Republicans trying to replace Obamacare, but aborted babies are A LOT cheaper than babies carried to term.”

All because he’s got butt hurt about the republicans trying to repeal Obamacare, which he’ll never have to purchase in his life seeing that his net worth is $1.5 million.

Ugly man, inside and out.

h/t Twitchy

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U.S. judge blocks transgender, abortion-related Obamacare protections

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U.S. District Judge Reed O’Connor

From Yahoo: A federal judge in Texas on Saturday issued a court order barring enforcement of an Obama administration policy seeking to extend anti-discrimination protections under the Affordable Care Act to transgender health and abortion-related services.

The decision sides with Texas, seven other states and three Christian-affiliated healthcare groups challenging a rule that, according to the judge, defines sex bias to include “discrimination on the basis of gender identity and termination of pregnancy.”

In granting an injunction one day before the new policy was to take effect, U.S. District Judge Reed O’Connor held that it violates the Administrative Procedure Act, a federal law governing rule-making practices.

The judge also ruled that plaintiffs were likely to prevail in court on their claim that the new policy infringes on the rights of private healthcare providers under the Religious Freedom Restoration Act.

As explained in O’Connor’s 46-page opinion, the plaintiffs argued that the new regulation would “require them to perform and provide insurance coverage for gender transitions and abortions, regardless of their contrary religious beliefs or medical judgment.”

The same judge issued a similar court order in August blocking a separate Obama administration policy that would have required public schools, over the objections of 13 states, to allow transgender students to use restrooms of their choice.

It was not immediately clear whether the Obama administration, which has just 20 days left in office, would seek to appeal the latest injunction.

White House spokeswoman Katie Hill decried the ruling. “Today’s decision is a setback, but hopefully a temporary one, since all Americans – regardless of their sex, gender identity or sexual orientation – should have access to quality, affordable health care free from discrimination,” she said.

The Affordable Care Act (ACA), also known as Obamacare, was passed in 2010 with an anti-discrimination section designed to prevent insurers from charging customers more or denying coverage based on age, race, national origin, disability or sex.

The rule in dispute on Saturday was adopted by the U.S. Health and Human Services (HHS) Department to implement those provisions, including definitions for sex discrimination that encompassed transgender and abortion services.

According to the court opinion, gender identity was defined under that rule as “an individual’s internal sense of gender, which may be male, female, neither, or a combination of male and female, and which may be different from an individual’s sex assigned at birth.”

The state of Texas has led a string of legal cases brought by Republican-controlled states contesting various social policies advanced by President Barack Obama, most notably his 2014 executive action to protect millions of immigrants in the United States illegally and give them work permits.

That plan, challenged by Texas and other states, has been barred by the courts. But the U.S. Supreme Court in 2012 and 2015 issued rulings that kept the Affordable Care Act, his top legislative achievement, intact.

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Nearly half of Americans want to keep ObamaCare

I’ll bet that those in favor of Obamacare didn’t receive an 80 percent increase notice for their health care premiums for 2017.

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Via NY Post: Barely a quarter of Americans want ObamaCare completely dismantled, while nearly half want it kept as is — or even expanded, pollsters said Thursday.

In a post-election poll commissioned by the nonpartisan Kaiser Family Foundation, 26 percent of respondents said they want all of the Affordable Care Act repealed. Pollsters found that 19 percent of those surveyed said they like the status quo, and 30 percent want ObamaCare expanded.

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President-elect Donald Trump — who spent the campaign trashing ObamaCare and promising to repeal it — has already backtracked on that pledge.

Trump now says he wants to keep at least two major ObamaCare provisions — allowing children to remain on a parent’s plan until age 26, and barring insurers from denying coverage based on pre-existing conditions.

That approach seems to match with 17 percent of poll respondents, who want ObamaCare scaled back but not thrown out entirely.

Republican respondents, at a 52 percent clip, were strongly in favor of killing ObamaCare altogether, this poll found. But even that’s a shift down from 69 percent of GOP backers who said a month ago they wanted all of ObamaCare trashed.

This poll was conducted between Nov. 15 and 21 with a margin of error of plus or minus 3 percentage points.

DCG

Happy Halloween: I just received the worst trick ever…

My health insurance company sent my notice for my 2017 health care plan. Guess how much my premium is going up?

EIGHTY PERCENT. Yep. A big fat 80%. Fortunately, my deductible remains at $14,300 (obvious sarc).

Starting next year, my monthly plan will cost MORE than 50% of my take-home pay.

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And I’m not the only one facing this type of an increase.

Remember this at the polls on November 8th.

electionshaveconsequences

DCG