Tag Archives: Affordable Care Act

Thousands mistakenly enrolled in California’s Medicaid expansion

you don't say

Shocker, not.

From CNN Money: California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services’ chief watchdog.

In a Feb. 21 report, the HHS’ inspector general estimated that California spent $738.2 million on 366,078 expansion beneficiaries who were ineligible. It spent an additional $416.5 million for 79,055 expansion enrollees who were “potentially” ineligible, auditors found.

Auditors said nearly 90% of the $1.15 billion in questionable payments involved federal money, while the rest came from the state’s Medicaid program, known as Medi-Cal. They examined a six-month period from Oct. 1, 2014, to March 31, 2015, when Medicaid payments of $6.2 billion were made related to 1.9 million newly eligible enrollees.

There were limitations to the California review, however. The audit extrapolated from a sample of 150 beneficiaries. The authors reported a 90% confidence level in their results — whereas 95% would be more common. That meant that the number of those ineligible could have been as low as 260,000 or as high as 630,000.

“If HHS has a strong reason to believe that California is systematically making enrollment errors, it would be helpful to show that in a more robust analysis,” said Ben Ippolito, a health care economist at the American Enterprise Institute, a conservative think tank. “The federal government should ensure that states are being good stewards of federal money.”

Nonetheless, the audit highlighted weaknesses in California’s Medicaid program, the largest in the nation with 13.4 million enrollees and an annual budget topping $100 billion, counting federal and state money. Medicaid covers one in three Californians.

The inspector general found deficiencies in the state’s computer system for verifying eligibility and discovered errors by caseworkers. The Medicaid payments cited in the report covered people in the state’s fee-for-service system, managed-care plans, drug treatment programs and those receiving mental health services.

California’s Department of Health Care Services, which runs Medi-Cal, said in a statement that it agreed with nearly all of the auditors’ recommendations and that the agency “has taken steps to address all of the findings.”

In a written response to the inspector general, California officials said several computer upgrades were made after the audit period and before publication of the report that should improve the accuracy of eligibility decisions.

Among the 150 expansion enrollees analyzed in detail, 75%, or 112, were deemed eligible for the Medicaid program in California. Auditors discovered a variety of problems with the other 38 enrollees.

During the audit period, 12 enrollees in the sample group had incomes above 138% of the federal poverty line, making them ineligible financially for public assistance, according to the report.

In other instances, beneficiaries were already enrolled in Medicare, the federal health insurance for people 65 and older or who have severe disabilities, and did not qualify for Medi-Cal. Onewoman indicated she didn’t want Medi-Cal but was enrolled anyway.

In 2014, the state struggled to clear a massive backlog of Medi-Cal applications, which reached about 900,000 at one point. Many people complained about being mistakenly rejected for coverage, or their applications were lost in the state or county computer systems.

California was one of 31 states to expand Medicaid under the 2010 Affordable Care Act. The health law established a higher federal reimbursement for these newly eligible patients, primarily low-income adults without children. After expansion started in 2014, the HHS inspector general’s office began reviewing whether states were determining eligibility correctly and spending taxpayer dollars appropriately.

Read the rest of the story here.

DCG

Seattle Mayor’s plan for free college: No US citizenship or minimum GPA required

jenny durkan

From Seattle Times: One of Seattle Mayor Jenny Durkan’s top goals is to make community college free for every Seattle high-school graduate, and last week, she rolled out a program that would do so over several years.

The plan, which would likely work in concert with College Bound and other state and federal aid programs, would pay for two years of community college for every Seattle public high-school graduate. It will not have an income or GPA cutoff, nor does it require students to sign up years in advance or exclude students who have gotten into legal trouble.

Her proposal coincides with a new report by a progressive think tank, The Century Foundation, that examines the success of so-called “promise” programs — which guarantee to pay tuition for graduates of a state’s high school — and details those elements that lead to a high success rate.

Author Jennifer Mishory, a Century Foundation senior fellow, says simple plans tend to work best. Plans that have fewer restrictions tend to attract more students. “The clearer the message, the easier it is to understand for students who might not otherwise enroll,” she said.

Mishory already counts Washington as one of the 16 “promise” states, although the program is far from simple. Washington’s College Bound program pays college tuition and fees for students who are low-income, sign up by eighth grade, maintain at least a C average and don’t get into legal trouble. It’s good for both two- and four-year colleges.

Durkan’s plan represents the expansion of an idea first launched in 2008. Called the 13th Year, it began as a partnership between Cleveland High School and South Seattle College and guaranteed every graduate a year at the college tuition free. It was funded by private donations.

No US Citizenship Required: Durkan’s proposal would also be open to all students regardless of citizenship status. That’s true as well for the State Need Grant. And this session, the Legislature passed a bill expanding College Bound to include students who have Deferred Action for Childhood Arrival (DACA) status, known as dreamers.

The Cost: Durkan’s office estimates the expansion will cost $1.7 million in 2018-19, and will serve about 1,000 high-school and college students, including outreach and college preparation services. About 215 students will receive 13th-year scholarships, and an estimated 120 students will be eligible to receive 14th-year scholarships. The money will come from the city’s general fund, the sweetened-beverage tax and the Seattle Colleges.

As more students take advantage of the program, the costs will increase — to $4.4 million in 2019-20, $5.7 million in 2020-21 and $6.3 million in 2021-22.

Read the whole story here.

About the progressive think tank, The Century Foundation (TCF), whose report was cited in this article:

  • “The Century Foundation is a progressive, nonpartisan think tank that seeks to foster opportunity, reduce inequality, and promote security at home and abroad.”
  • Mark Zuckerman, President of TCF: Mark served in the Obama White House as the deputy director of the Domestic Policy Council, leading teams on key initiatives, including reducing student debt, increasing accountability at for-profit educational institutions, reducing workplace discrimination, increasing wages for home health care workers, and expanding access to job training. Prior to that, as staff director of the House Education and Labor Committee, he helped win passage of landmark legislation such as the Affordable Care Act; the Lilly Ledbetter Fair Pay Act; the Healthy, Hunger-Free Kids Act; and the Student Aid and Fiscal Responsibility Act.
  • Melissa “break through our private idea that kids belong to their parents” Harris-Perry is an advisor to the foundation.

And take a wild guess as to who also has ties to TCF…

  • Richard Leone, former president of TCF (1989-2011), was a member of the board of directors of Center for American Progress (CAP). CAP is the think tank conceived by George Soros and headed by former Clinton chief of staff John Podesta.
  • In 2005, TCF and CAP launched the Security and Peace institute (SPI). The SPI “will build on the work of both of its parent organizations by promoting a shared foreign policy agenda for the United States and its international partners.”
  • The director of the SPI was Morton H. Halperin, a senior advisor to George Soros’ Open Society Foundations.

If this free college plan is something that Soros and Company are pushing, you know the message is clear: promote progressive ideology and policies at any cost to taxpayers.

DCG

Big rate hikes for health insurance will slam Washingtonians

O laughs

Obamacare going as planned…

This is not happening just in Washington. I have health insurance with BCBS OK and pay $550/month – up from $380/month last year. I have no co-pays (I pay the full contracted price when I walk through the doctor’s door) and a $6,800 annual deductible. BCBS informed me that my wonderful plan is being eliminated and I will soon receive my options for next year. I can hardly wait to see how much I get slammed.

From MyNorthwest.com: Open enrollment for health insurance in 2018 starts on Nov. 1 and thousands of people in Washington state will see big increases in their premiums.

The state’s insurance commissioner will officially release rates next week, and his office is warning that hundreds of thousands of people who do not get their insurance through an employer, will see a rate hike in the double digits.

Some 330,000 Washingtonians don’t get health insurance through an employer.

“I’m one of the folks who has to go out and get insurance on my own,” said Edward Weatherly, who is currently working a temp job. His monthly premiums?  “It costs me about $430 a month,” Weatherly said.

And the state’s insurance commissioner, Mike Kreidler, says rates for 2018 will go up – by a lot. “We’re looking at rate increases that are going to be in the 20s (percentage). We haven’t seen that, except going back before the Affordable Care Act,” Kreidler said.

The ones hardest hit will be the middle class – people who don’t qualify for a subsidy.

“It’s that person who doesn’t receive any help that I’m worried about. That’s going (to) say, ‘I’m going to hit the wall and I can’t afford this any longer,’” Kriedler said.

Weatherly is one of those individuals. He says it’s already difficult to make ends meet. “In addition to the rent, it’s pretty tough every month,” Weatherly said. “And there have been a couple of times I’ve thought about letting the insurance go.”

It gets worse – the insurance commissioner says people who are not subsidized with the most popular “Silver Plan” could see even more dramatic rate hikes. “On top of the mid-20 percent rate increase, they could see a 9 to 27 percent (increase) on top of that,” Kreidler said.

He says one reason for the steep increases is the uncertainty coming out of Washington, D.C. “I don’t care if they call it ‘Trumpcare’ whatever it is. But you’ve got to do something to make sure you’re taking care of the people. Access to affordable quality health insurance,” he said.

Weatherly says he’s hoping for a change.

I’m hoping we just get to a point where it becomes a right. So many things that we argue about, at both the national and the state level, that to me in the overall scheme of things don’t mean anything. It’s not life and death. Whereas health insurance, to me, is life and death,” Weatherly said.

The state insurance commissioner plans to release official rate hikes Thursday. Where you live could also impact how much your rates will go up, and the rates will be broken down by region, insurer and plan.

DCG

Aetna drops last 2 state markets under Affordable Care Act

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Obamacare going as planned. Let’s hope we can get rid of this monstrosity.

From Yahoo: While Republicans rewrite the Affordable Care Act in Washington, the future of the current law has grown hazier with the nation’s third-largest health insurer completely divorcing itself from state-based insurance markets.

Aetna said late Wednesday that it won’t sell individual coverage next year in its two remaining states — Nebraska and Delaware — after projecting a $200 million loss this year. It had already dropped Iowa and Virginia for next year. The insurer once sold the coverage in 15 states, but slashed that to four after losing about $450 million in 2016.

The government-backed marketplaces are a pillar of the Obama-era federal law because they allow millions of people to buy health insurance with help from income-based tax credits. But insurers like Humana, and now Aetna, have been fleeing that market, and the remaining coverage options are growing thin. Other companies like the Blue Cross-Blue Shield insurer Anthem say they are wary of returning without a guarantee that the government will provide cost-sharing subsidies that reduce expenses like co-payments. Those are separate from the tax credits that help pay premiums.

The White House has assured lawmakers it will continue paying the subsidies, but it has offered no long-term guarantee.

About 12 million people bought coverage for this year on the exchanges, and every market had at least one insurer offering coverage. But a growing number were down to one.

Companies are in the middle of figuring out their prices and coverage plans for next year, and insurance experts expect some holes to develop in those marketplaces.

“All it takes is one insurance company to exit, and that can create panic for other insurers and they pull out too,” said Cynthia Cox, a health insurance expert for the nonprofit Kaiser Family Foundation, which studies health care. “Insurers don’t want to be the last one holding the bag.”

The federal law prevents insurers from rejecting patients based on their health, so if competitors pull out, the last insurer may be left covering all the high-cost patients in that market.

Metropolitan or highly populated areas are still expected to draw several insurers. But rural areas may not be attractive to insurers looking to cut losses. They generally have a smaller, older population.

Ultimately, insurers with the most common brand in health insurance, Blue Cross-Blue Shield, will decide the fate of the marketplaces. Many of those plans specialize in individual insurance and have a long-standing presence in their markets. They also are the only remaining option on exchanges in nearly a third of the nation’s more than 3,100 counties.

DCG

Candlelight vigils and funerals are being planned to highlight those who, activists say, will die under Trumpcare

hyperbole

From Vocativ: Activists are planning several protests around the country — at elected representatives’ offices and places of worship — to mourn for those they say will die if the Affordable Care Act is repealed.

Protesters are holding candlelight vigils, symbolic funerals, and die-in demonstrations to protest President Trump and the Republican Party’s efforts to repeal and replace Obamacare with a new bill, called the American Health Care Act or AHCA. The first vote by the House of Representatives on the measure is scheduled for Thursday.

One of the more grim protests being planned will be held in Des Moines, Iowa, in front of Republican Congressman David Young’s office. Organizers say the event is “a vigil to mourn the deaths of the Iowans and Americans that will die if Trumpcare is passed. Almost 200 Iowans are projected to die each year, 2000 total over the next decade. We need to make sure David Young knows what he would be voting for.”

Organizing For Action, the political advocacy group that grew out of President Obama’s first presidential campaign, is planning a funeral procession in New York’s Staten Island with an effigy of Trump as the grim reaper. The protest, planned for Thursday, will march to Representative Dan Donovan’s office.

Indivisible, an organization made up of former Congressional staffers, is also organizing a series of candlelight vigils for the estimated 24,000 people who will die yearly if the GOP plan is passed as it currently stands. One demonstration, to be held at a San Diego church, will “pray for mercy for the sick and suffering in San Diego and across America.”

In Cincinnati, nearly 100 people have said they will attend a “die-in” protest on Wednesday. Each participant is instructed to lie down on the ground while holding a sign stating their hypothetical cause of death. Among the suggestions are “I died from a bacterial infection because I couldn’t afford to go to the doctor” and “My cervical cancer wasn’t discovered in time because I couldn’t go to Planned Parenthood.”

The American Health Care Act is scheduled for a floor vote in the House of Representatives on March 23. President Trump and his administration have reportedly held a series of phone calls and meeting intended to pressure Republicans opposed to the bill to fall in line.  Several Republican lawmakers have come out against the bill, which they say fails to live up to promises of a full Obamacare repeal.

According to the non-partisan Congressional Budget Office, some 24 million Americans are estimated to lose health insurance over the next decade if the plan goes through.

DCG

UN warned Trump that ObamaCare repeal could violate international law

United Nations

From Fox News: The United Nations warned the Trump administration earlier this year that repealing ObamaCare without providing an adequate replacement would be a violation of multiple international laws, according to a new report.

Though the Trump administration is likely to ignore the U.N. warning, The Washington Post reported the Office of the U.N. High Commission on Human Rights in Geneva sent an “urgent appeal” on Feb 2.

The Post reported that the confidential, five-page memo cautioned that the repeal of the Affordable Care Act would put the U.S. “at odds with its international obligations.”

The warning was sent to the State Department and reportedly said the U.N. expressed “serious concern” about the prospective loss of health coverage for 30 million people, that in turn could violate “the right to social security of the people in the United States.”

Congressional Republicans failed in March to pass an ObamaCare replacement bill. A new proposal is emerging on Capitol Hill, but it’s unclear when it might be considered and how sweeping it may be.

A spokesman for the U.N.’s human rights office in Geneva confirmed the authenticity of the letter, which was sent by Dainius Puras, a Lithuanian doctor who serves the U.N. as “Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”

Xabier Celaya, a spokesman for the U.N., said Puras cannot comment on his ObamaCare letter until it becomes public in June.

Though the report calls out the Trump administration, there’s very little the U.N. can actually do. 

According to the report, the letter sent to the Trump administration also was supposed to be shared with the majority and minority leaders in both houses of Congress — but that did not happen.

House Minority Leader Nancy Pelosi’s office and Senate Minority Leader Charles Schumer’s office said they never received the letter, as did officials in House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell’s office. The letter from Puras did make its way to the Department of Health and Human Services, where an unnamed employee supposedly leaked it.

DCG

Poll: Most young people say gov’t should pay for health care

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The public education indoctrination system has succeeded.

From Seattle Times: Most young Americans want any health care overhaul under President Donald Trump to look a lot like the Affordable Care Act signed into law by his predecessor, President Barack Obama.

But there’s one big exception: A majority of young Americans dislike “Obamacare’s” requirement that all Americans buy insurance or pay a fine.

A GenForward poll says a majority of people ages 18 to 30 think the federal government should be responsible for making sure Americans have health insurance. It suggests most young Americans won’t be content with a law offering “access” to coverage, as Trump and Republicans in Congress proposed in doomed legislation they dropped March 24. The Trump administration is talking this week of somehow reviving the legislation.

Conducted Feb. 16 through March 6, before the collapse of the GOP bill, the poll shows that 63 percent of young Americans approve of the Obama-era health care law. It did not measure reactions to the Republican proposal.

The most popular element of the law is allowing young adults to stay on their parents’ insurance until age 26, which is favored by 75 percent of 18-30 year olds. It’s not just that they personally benefit — an Associated Press-NORC Center for Public Affairs Research poll conducted in January found that provision was equally popular among all adults. That proposal was included in the failed GOP overhaul.

But the Republican plan also contained provisions that most young Americans — the racially diverse electorate of the future — do not support, according to the poll. Two-thirds of young people agree with a smaller majority of Americans overall that the government should make sure people have health care coverage. And they understand that will cost more: Sixty-three percent want the government to increase spending to help people afford insurance.

Those feelings cut across racial lines and include most whites, who formed the base of Trump’s political support in the presidential election. “I do believe the government should offer it because we pay taxes,” said Rachel Haney, 27, of Tempe, Arizona. “I do feel like it’s a right.”

GenForward is a survey of adults age 18 to 30 by the Black Youth Project at the University of Chicago with the AP-NORC Center. The poll pays special attention to the voices of young adults of color, highlighting how race and ethnicity shape the opinions of a new generation.

Only about a quarter of young people want “Obamacare” repealed. That includes 16 percent of young adults who want it repealed and replaced as Trump has vowed and another 10 percent who want it repealed without a replacement. Just over a third of young whites want to see the law repealed, making them more likely than those of other racial and ethnic groups to say so.

“He just wants to protect us from al-Qaida, and terrorism,” said Kervin Dorsainvil, 18, a computer technician from Port Charlotte, Florida. “I feel like health care should be much higher on the list. I feel like we have the resources, the medical technology and everything in place to provide the health care to the people. So why wouldn’t we do that?”

Young people are more likely than Americans overall to say the government should make sure people have health care. A recent AP-NORC poll of U.S. adults, conducted during and after the collapse of the GOP proposal, found just 52 percent called it a federal government responsibility to make sure all Americans have coverage.

Despite their overall approval of “Obamacare,” young Americans’ views on the law aren’t all rosy. Just a third say the law is working relatively well, while another third think the health care policy has serious problems. About 2 in 10 consider the law to be fatally flawed.

The law’s requirement that all Americans buy insurance or pay a fine is opposed by 54 percent of young people and favored by just 28 percent.

On the other hand, 71 percent favor the law’s Medicaid expansion, 66 percent of young adults favor the prohibition on denying people coverage because of a person’s medical history, 65 percent favor requiring insurance plans to cover the full cost of birth control, 63 percent favor requiring most employers to pay a fine if they don’t offer insurance and 53 percent favor paying for benefit increases with higher payroll taxes for higher earners.

About a quarter of young adults say they personally have insurance through their parents, while another 1 in 10 have purchased insurance through an exchange.

Read the rest of the story here.

DCG