A project of the Galen Institute

Issue: "States"

Average California Obamacare Rate Increase Only 4%––Success!!!

Bob Laszewski
Thu, 2014-07-31
"The weighted average increase for plans being sold on the Obamacare California public exchange in 2015 will be 4%. So, that means Obamacare is working really well, right? Well, wait a minute. Let's consider a few things: 1.This week the California insurance commissioner reported that the average unsubsidized 2014 rate increase carriers charged going into Obamacare was between 22% and 82%. That was a pretty healthy bump to get everyone into Obamacare in the first place. 2.California voters will go to the polls this fall to vote on Proposition 45. That ballot initiative would regulate health insurance rates in California for the first time. Big rate increases on part of the carriers would do a lot to get that proposition passed and very low increases would do a lot toward defeating it. 3.The health plans competing in the Obamacare exchanges are limited to tiny losses this year because of the Obamacare reinsurance program that runs through 2016.

The Potential Side Effects of Halbig

Larry Levitt and Gary Claxton
Thu, 2014-07-31
"The recent decision of a three-judge panel in the Halbig case, if it prevails, would have a direct effect on the availability of subsidies under the Affordable Care Act (ACA). People buying coverage on their own in insurance exchanges run by the federal government would be ineligible for income-based subsidies. Depending on how you count, that would take premium subsidies away from 4.6 million people in 34 states, or 4.7 million people in 36 states if you count New Mexico and Idaho (which have signaled their intention to operate their own exchanges but are still using the federal marketplace). Many more people are eligible for subsidies but haven’t yet signed up.

Cover Oregon gave ex-technology director Aaron Karjala a $70,000 contract after resignation under pressure

Nick Budnick, The Oregonian
Tue, 2014-07-29
"Cover Oregon has given a $70,000 contract to Aaron Karjala, the health insurance exchange's former top technology official, to assist with litigation against Oracle Corp. Clyde Hamstreet, formerly the exchange's acting executive director, signed the contract with Karjala June 3, less than three months after Gov. John Kitzhaber publicly called for his firing."

Warner-Gillespie debate offers look at the politics of health care

Markus Schmidt, Richmond Times-Dispatch
Mon, 2014-07-28
"When Sen. Mark R. Warner faces his Republican challenger Ed Gillespie in their first debate today at The Greenbrier resort in West Virginia, the two are likely to clash over the Democrat’s support for the Affordable Care Act, which Gillespie wants to see repealed. But seven months after entering the race, seven weeks after his nomination as the GOP candidate and three months before the November election, Gillespie, who has repeatedly attacked his opponent for “casting the deciding vote” for the health care law, has yet to roll out his own ideas for policies that would replace the measure. “I do believe there are reforms that would be helpful,” the former GOP strategist and chairman of the Republican National Committee said in an interview last month. “(But) I haven’t finalized or settled on these in terms of the policy moving forward.”"

U.S. attorneys turn up heat on healthcare fraud

The Associated Press
Mon, 2014-07-28
"The top federal prosecutors from South Dakota and North Dakota say they have increased their efforts to fight healthcare fraud. U.S. Attorney Brendan Johnson of South Dakota said he has restructured his office to allow lawyers in the criminal and civil divisions to devote "significant time" to investigating medical fraud. He predicted it will be among the fastest-growing area of criminal investigation and wants his office to be in position to pursue increasing "complex and egregious" cases. "My advice to the medical community is to stay away from gray areas or outright fraud that wastes tax dollars, because we will be watching," Johnson told the Sioux Falls Argus Leader. "The end result in many of these cases will be that the taxpayers get their money back with interest and penalties, and the medical professional loses their license." Johnson's office recently settled an alleged fraud case involving two doctors at Dakotas-based Sanford Health.

New Mexico to continue with federally operated health insurance exchange

The Associated Press
Mon, 2014-07-28
"New Mexico decided Friday to stick with a federal online system for another year to enroll individuals in health insurance plans. The state's health insurance exchange governing board voted 11-1 to continue using the federal computer system for determining eligibility and to enroll individuals starting in November when the next open enrollment begins. A majority of board members worried that New Mexico wasn't ready to switch to a state-run online system for individuals. Any technical failures could delay enrollment and discourage consumers from trying to obtain health coverage, they said. Continuing with the federal system for another year is the "safest, most risk-free" way of enrolling New Mexicans, New Mexico Health Connections CEO Martin Hickey said."

States want more time on ACA funds

Kyle Cheney and Sarah Wheaton, Politico
Mon, 2014-07-28
"States running their own Obamacare exchanges were supposed to wean themselves off federal funding by the end of this year, but some of them want that Obama administration spigot open a bit longer. The states aren’t asking for the feds to dole out more money on top of the $4.6 billion already dedicated to exchange planning and construction. But they do want to be able to spend their federal exchange grants into 2015 as they grapple with core components of the insurance portals that are balky, unfinished or in disrepair. The viability of state exchanges became more urgent this week after conflicting court rulings created uncertainty about whether Affordable Care Act subsidies would be available through the federal exchange — or whether the state market would be the only legal route. A POLITICO survey of the 15 state-run exchanges (including Washington, D.C.) found that 11 are thinking about using federal dollars in 2015 — and four of those states have already applied."

Barone: Dems lose health exchanges bet

Michael Barone
Mon, 2014-07-28
Words mean what they say. That’s the basis for the decision of the U.S. Court of Appeals for the D.C. Circuit in Halbig v. Burwell invalidating the Internal Revenue Service regulation approving subsidies for Obamacare consumers in states with federal health insurance exchanges. The law passed by Congress, Judge Thomas Griffith explained, provided for subsidies in states with state-created exchanges, but not in states with federal exchanges. That’s factually correct, and under the Constitution, the government can’t spend money not authorized by Congress. This has not prevented Democrats from calling the decision “judicial activism,” which makes as much sense as the claims that the Supreme Court decision overturning the Obamacare contraception mandate cuts off all access to contraception. “We reach this conclusion,” wrote Judge Griffith, “with reluctance.” Judge Roger Ferguson, writing for the Fourth Circuit whose King v.

Varying health premium subsidies worry consumers

Kelli Kennedy, The Associated Press
Sat, 2014-07-26
"MIAMI (AP) -- Linda Close was grateful to learn she qualified for a sizable subsidy to help pay for her health insurance under the new federal law. But in the process of signing up for a plan, Close said her HealthCare.gov account showed several different subsidy amounts, varying as much as $180 per month. Close, a South Florida retail worker in her 60's, said she got different amounts even though the personal information she entered remained the same. The Associated Press has reviewed Close's various subsidy amounts and dates to verify the information, but she asked that her financial information and medical history not be published for privacy reasons. "I am the kind of person the Affordable Care Act was written for: older, with a pre-existing (condition) and my previous plan was being cancelled. I need it and I'm low income," said Close, who has spent more than six months appealing her case. "The government pledged to me that original tax credit amount. It's crazy."

The Stakes Beyond the Halbig Lawsuit

Drew Altman for Wall Street Journal
Fri, 2014-07-25
"A lot of attention is being paid to the dueling decisions in two U.S. appeals courts about whether the U.S. government can provide tax credits to people in federal- as well as state-run insurance exchanges. In human terms, the stakes are high: Millions of moderate-income people will not be able to afford health coverage without a subsidy, and a court ruling could gut coverage expansion in the 36 states with federally run insurance exchanges, unless states decide to set up their own exchanges. One of the cases, Halbig v. Burwell, also adds uncertainty to the enrollment process set to begin this fall, when millions more people are expecting to get tax credits–and wondering if they may be taken away. Amid the reaction, little attention has been paid to whether Americans will perceive Halbig as a legitimate legal question or as more inside-Washington politics. The plaintiffs paint this as a case about statutory language and intent.

ObamaCare Watch Weekly

* indicates required

View previous campaigns.

Check out Jim Capretta's new book.

ObamaCare Primer