A project of the Galen Institute
The Washington Post
05/27/15
At some point between now and the end of June, the Supreme Court will decide King v. Burwell and, in the process, determine whether the phrase “established by the State” actually means “established by the State.” This phrase, which appears twice in the Patient Protection and Affordable Care Act (PPACA) provisions authorizing tax credits for the purchase of health insurance in exchanges, has bedeviled defenders of the IRS rule purporting to authorize credits in federally established exchanges. Some claim this phrase is “convenient shorthand” for “exchange” (even though it’s neither more convenient nor shorter), while others argue the phrase is effectively meaningless, or actually means something else (such as established in the State). The plaintiffs, on the other hand, maintain that the language means precisely what it says.
The Fiscal Times
05/27/15
A group of Republican Senators is getting ready for a game of chicken with the administration if the Supreme Court strikes down Obamacare health care subsidies. Sen. Ron Johnson (R-WI) and a handful of senators are rallying around a contingency plan if the court rules against the administration in King v. Burwell and eliminates health subsidies for millions of people currently enrolled in the federal exchange, HealthCare.gov, Politico first reported. Related: Some States are in Debt Over Obamacare Exchanges The GOP plan would create a patch for the subsidies until 2017, sparing millions from losing health coverage. In exchange, the proposal eliminates two major provisions of Obamacare—the employer mandate and the individual mandate, which, policy experts warn, would cause a crippling ripple effect through the insurance market.
Investor's Business Daily
05/26/15
Health Reform: So much for the "affordable" part of the Affordable Care Act. Looks like ObamaCare premiums will rocket next year while sky-high deductibles make it too costly for many to see the doctor. Last Monday, IBD's Jed Graham broke the news that big insurers in six states "are seeking to raise rates an average 18.6% next year." BlueCross BlueShield of Tennessee — which currently accounts for 70% of the ObamaCare enrollees in that state — is looking to increase premiums a whopping 36.3%. CareFirst — which has 80% of the ObamaCare enrollees in Maryland — is pushing for a 30% increase. Oregon's Moda Health wants a 25.6% increase, on average, for the roughly half of ObamaCare enrollees it covers in the state. The Wall Street Journal followed up on Graham's reporting later in the week, noting that New Mexico's market leader, Health Care Service, wants an average 51.6% boost in premiums.
Fortune
05/26/15
Health insurers on many state exchanges are requesting the right to increase premiums by upwards of 50% President Obama’s signature legislative achievement–the healthcare law popularly known as Obamacare–is facing a potentially existential fight in the Supreme Court in 2015. But it’s not just the courts that supporters of the program need to worry about. According to a report published Friday in the The Wall Street Journal, health insurers are requesting the right in many states to increase premiums by upwards of 50%. Health Care Service Corp.–the leading health insurer in New Mexico, has asked state regulators to allow it to increase its premiums on average by 51.6%, for instance. Customers of CareFirst BlueCross BlueShield in Maryland may face an average premium increase of 30.4%.
The Washington Times
05/22/15
Though supporters of President Obama's healthcare program tout its success in providing insurance to millions of Americans, recent rate filings from large insurers have revealed that the law is built on a shaky foundation. In recent weeks, large insurers selling coverage through Obamacare have proposed massive rate increases for 2016 – even exceeding 40 percent – because they haven't been able to sign up enough young and healthy customers.
The Tennessean
05/22/15
Community Health Alliance, a Knoxville-based health insurance cooperative, is looking to increase monthly premiums by double digits in 2016 for those who enroll in plans on the federally run exchange as the newly established company tries to find an equilibrium. The co-op's plans — ranging from $68.22 to $1,062.05 per month — were the least expensive while they were available for purchase on the exchange. The co-op is asking the Tennessee Department of Commerce and Insurance for an average 32.6 percent increase for 2016 plans. The minimum a plan will increase is 16.2 percent, while the maximum increase is 65.2 percent.
The Washington Post
05/21/15
The Internal Revenue Service (IRS) is charged with administering many key provisions of the Patient Protection and Affordable Care Act (PPACA). One might expect the IRS to follow the law when doing so. In drafting regulations to implement the PPACA’s tax credit provisions, however, the IRS seems to have a habit of ignoring the statutory text where the IRS does not like the result. University of Iowa law professor Andy Grewal has found multiple instances of the IRS expanding tax credit eligibility beyond that provided for by the text of the PPACA and, in the process, increasing potential employer exposure to penalties under the Act. I discussed two of professor Grewal’s finds in a prior post. (See also this forthcoming article.) In a new post on the Yale Journal on Regulation blog, “Notice & Comment,” professor Grewal identifies another IRS departure from the statutory text.
Tacoma Weekly
05/19/15
Federal programs rarely come in under budget. Consider Medicare, which will soon celebrate its 50th anniversary. In 1967, lawmakers projected annual spending in the program would reach $12 billion in 1990. The actual tab that year? A cool $110 billion. A new report from the Congressional Budget Office says that Obamacare will buck the trend. The CBO has lowered its projections for the cost of the president's healthcare law by $142 billion over the coming decade, from $1.35 trillion to $1.2 trillion. Obamacare may cost the feds less than anticipated, but it's extracting far more from consumers' wallets than they bargained for. Consequently, Obamacare has put insurance out of reach for many Americans – breaking its promise to make health care more affordable. The decline in Obamacare's cost is not as impressive as it seems. The total price tag is still some $250 billion higher than the president promised when he signed Obamacare in March 2010.
Yale Journal
05/19/15
I might be accused of picking at low-hanging fruit, but I’d nonetheless like to devote another blog post to more IRS regulations that expand and contradict Section 36B. My prior blog posts, which I’ve adapted into an essay upcoming in Bloomberg BNA, discuss regulations that improperly extend ACA premium tax credits to persons in the Medicare coverage gap and to some unlawful aliens. In this post, I want to highlight regulations that improperly penalize employers and that give credits to taxpayers already enrolled in employer-sponsored minimum essential coverage. Broadly speaking, Section 36B offers premium tax credits, on a month-by-month basis, to taxpayers who purchase Exchange policies only when they can’t otherwise obtain minimum essential coverage. However, the mere offering of minimum essential coverage by an employer to a taxpayer will not disqualify her from tax credits. Instead, the employer coverage must be affordable and provide minimum value.
Forbes
05/18/15
ObamaCare supporters have produced study after study warning of the devastation to come if the Supreme Court decides the IRS did in fact illegally extend health insurance subsidies to people in states operating under federal exchanges. But the American Action Forum (AAF), a dynamic think tank led by former CBO director Douglas Holtz-Eakin, has produced new research that provides balance to what has been a one-sided debate. He shows how people in 37 states will be helped if the petitioners prevail in King v Burwell. AAF estimates that more than 11 million people would be liberated from having to purchase expensive ObamaCare insurance and freed from the onerous penalties of the individual mandate, which cost those who don’t comply an average of $1,200 in fines this year. The study also finds that workers could earn nearly $1,000 more, and 1.2 million more people would join the workforce in federal exchange states if King prevails in the lawsuit.

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