Feds Can’t Verify $2.8 Billion in Obamacare Subsidies | Washington Free Beacon

The federal government cannot verify nearly $3 billion in subsidies distributed through Obamacare, putting significant taxpayer funding “at risk,” according to a new audit report.

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) released an audit Tuesday finding that the agency did not have an internal system to ensure that subsidies went to the right enrollees, or in the correct amounts.

“[The Centers for Medicare and Medicaid Services] CMS’s internal controls did not effectively ensure the accuracy of nearly $2.8 billion in aggregate financial assistance payments made to insurance companies under the Affordable Care Act during the first four months that these payments were made,” the OIG said.

So what does CMS do when they learn about the control issue (as if they didn’t already have a clue)?

In response to the audit, CMS said they issued a regulation to change their accounting methods.“CMS takes the stewardship of tax dollars seriously and implemented a series of payment and process controls to assist in making manual financial assistance payments accurately to issuers,” they said.

THEY ISSUED AN EFFING REGULATION. Oh yeah, that will fix everything.

A Rube Goldberg law implemented by a Rube Goldberg system. The phrase Keep It Simple Stupid (KISS), never came within light-years of anyone involved with writing or passing Obamacare.



BY ROBERT LASZEWSKI – Why Are The 2016 Obamacare Rate Increases So Large?

Instead of moderate rate increases for one more year, the big rate increases have begun.

Example #1:

Texas Blue Cross stands out. The health plan commented in its federal government rate filings that it covered 730,833 Obamacare individuals in 2014 with premium of $2.1 billion and claims totaling $2.5 billion––for a medical loss ratio of 119%. The plan further commented that, after the “3Rs” reinsurance adjustments, they lost 17% to 20% of premium in 2014–that would be about $400 million. And, they are only asking for a 20% rate increase.

As they say, read the whole thing.

The overriding issue is the healthy aren’t signing up. The sick people will sign up, however, for Obamacare to be actuarily sound requires the healthy to enroll. So far, it ain’t happening.




Obamacare, PERA adds stress to JeffCo schools budget

ObamaCare will permanently JeffCo’s budget by approximately $7 million for all budget years for the foreseeable future after 2017.

This about sums it up…

Once all of the increases are added up, and if the one-time administrative setup costs are omitted, ObamaCare will have permanently increased JeffCo’s budget by $8 million for all budget years for the foreseeable future after 2017.

To put the $8 million annual increase into some context, the JeffCo board is currently considering the construction of a new school, which has been estimated to cost from $15 to 25 million. If the district were able to forego the costs of the ObamaCare requirements and save those monies instead, it would roughly afford the district a newly constructed school every two to three years. For another point of comparison, $7 million represents roughly one percent of the school district’s yearly budget.

This issue appears to be somewhat restricted to Jeffco, who previously provided benefits only to full time workers, as in 40 hours per week. The Obamacare definition of 30 hours per week for f/t employees is responsible for much of the cost increase.



Humana: Obamacare indigestion in Georgia

Obamacare Setback Has Humana Attempting a Georgia Turnaround – Bloomberg Business

Humana’s Georgia struggle shows the challenges health insurers face entering unfamiliar markets. President Barack Obama’s 2010 health-care law will provide an estimated $19 billion in subsidies and helped about 12 million people buy coverage for this year. As insurers have raced to capture those customers, some are doing well, and others have overreached.

Humana, which touts its skills at selling health insurance directly to individuals, ran into trouble in Georgia after charging too little for plans it sold on the state’s new marketplace. Customers came running.

Unfortunately, more of them were sicker than Humana expected. Flooded with patients, Humana let them see doctors who aren’t in its networks. That’s expensive — health insurers make deals with doctors and hospitals to add them to their networks, negotiating lower prices in return for business.

Unfortunately, more of them were sicker than Humana expected. Flooded with patients, Humana let them see doctors who aren’t in its networks. That’s expensive — health insurers make deals with doctors and hospitals to add them to their networks, negotiating lower prices in return for business.

Sounds like everyone is unhappy to me. When a company prices plans to low, price sensitive consumers take the bait.


Colorado health insurance exchange / marketplace: Obamacare enrollment

Colorado health insurance exchange / marketplace: Obamacare enrollment

Connect for Health Colorado reported that 141,639 people signed up for qualified health plans, including about 47,000 consumers who were new to the marketplace in 2015.

The lack of Medicaid reimbursement is nothing short of a travesty…

The four other state-run exchanges with similar enrollment totals all receive at least a third of their funding – and as much as more than half of their funding – from Medicaid.  But Connect for Health Colorado doesn’t get any funding from Medicaid (and agents/brokers who enroll people in Medicaid through Connect for Health Colorado don’t receive any compensation, unlike other states).

The exchange can request reimbursement from CMS for expenses incurred to enroll people in Medicaid, and the 2016 revenue projection includes $2.5 million in recouped funds from CMS.  That still pales in comparison with the $15 million to $29 million that other similarly-sized exchanges are reimbursed annually by Medicaid.

There’s plenty of incompetence to go around, but Colorado Medicaid stands out as both arrogant and incompetent.



Obamacare tax requirements

Many Americans unaware of Obamacare tax requirements.

Last year, for the first time, most Americans were required by the Affordable Care Act to have some kind of health coverage or be subject to a tax penalty. But this year is the first that the tax is being collected—and the first time that income tax returns ask about filer’s health coverage.

The Kaiser poll found that 53 percent overall—and 57 percent of people without health insurance—know that this is the first year they are required to disclose their coverage status.

About a third overall named a different year for the requirement, and 16 percent admitted to not knowing when the requirement starts.

Among respondents who personally completed and filed their returns, 76 percent said they had seen “a place to indicate whether they had health insurance,” according to Kaiser.

But the remaining self-filers either didn’t see such a place, or were unsure if they did see it, the poll found.

Sounds like the Obamacare marketing leaves just a little to be desired!


The Affordable Care Act meets your tax return

IRS Will Ask On Your 1040: Did You Have Health Insurance?.

See Line 61 on the 1040 tax form: “Health care: individual responsibility (see instructions) full-year coverage.” If the taxpayer, and spouse (if married), and all dependents had coverage all 12 months of 2014, then all’s well. Check the box and move on. For those who can’t check the box, there could be a penalty, or as the government calls it, a “shared responsibility payment.”

Have fun!


Saturday: Trying to contact Connect for Health Colorado

Called them around 10am. It’s 10:42a and no answer. By my phone I’ve been on hold for 43′ 10″. Why do they even say they are open? I plan to ask how many people are working if I don’t give up.

Why even claim you’re open if you can’t answer a call in 43 minutes on a Saturday? What say, Connect for Health? Hey they answered at 43/44 min, supposedly 10 people working.


Another Obamacare Supporter Just Got A Hard Dose Of Reality – Chicks on the Right

This time from Covered California – Another Obamacare Supporter Just Got A Hard Dose Of Reality – Chicks on the Right. Poor Melissa Klein of San Francisco discovers the unfortunate reality that the government is decades behind Amazon.

Another liberal learns the hard lesson of big government bureaucracy. Click on the link to get the details. This paragraph sums it up regarding expectations for Obamacare exchange subsidies and health care nirvana…

I find a number of things absolutely fascinating about her story – not the least of which that she expected government healthcare exchanges to work with the same fluidity of ordering a product from Amazon or some other private online retailer. I hesitate to use the tired old analogy of standing in line at the DMV but – the same people who make a trip to the DMV utterly painful are the same people you have running government healthcare! 

It’s sad that it’s taken THIS long for people to get it – but until government regulations actually affect your life, you keep buying into the washed-out academic theories that haven’t been proven, even though those theories have had plenty of time to show their merits. That is, if they had any merit to begin with.

Welcome to Reality Town, Melissa. You won’t enjoy your stay.

Earth to enlightened liberals and progressives, it’s PRIVATE industry that can build websites and fulfillment systems such as Amazon. To expect that of your government, especially once a dose of politics is mixed in, is well, how should I say it…. Un effing realistic.


King v Burwell: What does the plain text of the Obamacare law say?

The Plain Text of ObamaCare – WSJ.

The problem…

Unlike the 2012 ObamaCare cases, King v. Burwell is not a challenge to the constitutionality of the health law. To the contrary, the plaintiffs are asking the Justices to vindicate the law’s plain text and uphold the statute that Congress passed in 2010, rather than the version the Administration rewrote. (emphasis added)

How the law was drafted?

The law’s Democratic drafters wanted the states to participate and assumed all of them eventually would, much as with Medicaid and many other familiar programs under cooperative federalism. Conditioning subsidies on state action was meant to give Governors and legislatures an irresistible incentive to contribute to ObamaCare’s implementation and lend political legitimacy. In return, their constituents were eligible for benefits.

This routine legislative arrangement turned out to be an epic political miscalculation. The opposition to ObamaCare failed to ebb as liberals expected, and 36 states refused the invitation to create exchanges. In those states, the law provides for a federal exchange fallback—without subsidies.

What will the judges decide?

In King, the High Court will scrutinize this IRS decree using the traditional canons of statutory construction. The English language is clear: Congress wrote that subsidies would be available on state exchanges only, so Washington cannot deputize itself as the 51st state—especially when the black-letter law is as consistent, tightly worded and cross-referenced as the Affordable Care Act.

To take one example, the Secretary of Health and Human Services was empowered to grant unlimited sums of money to states to establish exchanges. But the law appropriated not a penny for the federal exchanges, and HHS raided internal slush funds to build them. If there is no legal difference between the federal and state exchanges, why did HHS need this budget ruse?

It turns out that in prior drafts, Federal exchanges were eligible for subsidies but that text was purposely removed…

As the Mountain States Legal Foundation and other amici briefs point out, previous versions of the Affordable Care Act extended subsidies to the federal exchanges too. But that language was deleted in the secret negotiations to combine various Senate bills. After Scott Brown’s Massachusetts special election ended the Democratic supermajority, Democrats accepted and President Obama signed the final Senate bill as the last helicopter out of Saigon.

The President cannot now unilaterally revise those details because they are politically inconvenient. Blessing this lawless behavior sets a dangerous precedent, handing the bureaucracy a license to reshape statutes without the consent of Congress. King is an opportunity for the Court to rebuke this growing merger of legislative and executive power.

NOTE: the emphasis added in all the above quotes are from the poster.

And the last paragraph sums up it. Can the President unilaterally revise the details of the law? Lately it seems that he can, what will the Supremes decide?


From the commenter Alan Wolfe:

The language of Obamacare is clear.  Subsidies are available only through exchanges established by the state.  SCOTUS should be true to their oath and declare subsidies granted through federal exchanges illegal.

If the insurance industry and the health care industry are turned upside down as a consequence, so be it.

Americans need to learn that laws have consequences, and to hold their legislators responsible for getting it right. The progressive left, in their ideological haste to write a comprehensive change to health care got it wrong.  Now let them pay the price for their hubris. (emphasis added, what a surprise?)

I couldn’t agree more, except I don’t believe there is a price to pay on the Progressive side. In fact, if the Republican’s aren’t prepared to “run the gauntlet” perfectly, they will be the ones paying the price.


‘I am going to stab a bitch’; Liberal journalist discovers the joys of Obamacare

The wonderful auto-renewal system at Connect for Health Colorado failed for liberal journalist Laura Krantz –  ‘I am going to stab a bitch’; Liberal journalist discovers the joys of Obamacare | Twitchy. As you might guess, her solution is single payer but that’s to be expected.

Others apparently have the same problem, which is no surprise. There’s not an easy way to post the tweets except by screen capture so I recommend reading the whole thing.

All you had to do to “break” Connect for Health’s auto-renewal system was log in and look at alternate plans. I put “break” in quotes as this is how the system was designed. That said, it’s not clear that’s what happened in this case and why would her 2014 coverage be cancelled?



Obamacare and taxes: Full employment for H&R Block

H&R Block Out to Help Americans’ Resolve to Tax Preparation – Video – TheStreet.

If you’re on Obamacare, and especially if you are receiving a subsidy or intend to claim it on your tax return, things just got complicated. No more 1040EZ if you’re in subsidy land.

No doubt, Obamacare is a full employment service for H&R Block and other tax preparation services.


Shared Eligibility System: Who IS in charge?

Who’s in charge of the Shared Eligibility System (SES)? Balance of Power: De-glitching Colorado healthcare. Former Connect for Health Colorado Ellen Daehnick, who was terminated as a board member by Governor John Hickenlooper, discusses the enrollment issues, incompetence and general overall accountability issues that exist at Connect for Health Colorado and whomever is in charge of the Shared Eligibility System. Video, and text, at link.

The main topic of discussion is the Shared Eligibility System (SES) and the overall lack of accountability.

In her roughly year-and-a-half on the board of Connect, she says she couldn’t get answers to basic questions like this about the systems like SES, which were implemented to make the exchange work.

“You don’t have a responsible individual or entity, you don’t know who’s at fault, or who has the power to fix the problem,” Daehnick said. “You want to know who has the power to fix this and make it better.”

Apparently no one. It would be really nice if the Democrats would stop protecting the whole Connect for Health, Medicaid, Colorado Peak infrastructure but they continue to live in a fantasyland.

But committee Democrats defended the exchange’s performance as impressive— starting from scratch in a complex regulatory environment, they said.

You can’t make this stuff up. Getting back to the SES and Ms. Daehnick, I agree with every word spoken by her. Governor Hickenlooper better have a damn good reason for “firing” her. SHINE THE LIGHT on the problem Gov.

As a broker I or my clients have encountered numerous problems with Connect for Health (or SES or Medicaid, take your choice). Very few have been directly addressed by a specific person. One way or another we worked it out, but it takes hours of unproductive time and effort. I don’t see how 2016 open enrollment can be any worse.



Taxpayers duck Obamacare tax

Taxpayers duck Obamacare tax, snubbing IRS – Washington Times.

The episodes raise questions for the revenue agency, which is trying to figure out just how far it’s prepared to go to collect the Obamacare tax — and if future administrations will enforce it at all.

Under the 2010 law the IRS cannot pursue criminal penalties or put liens on the property of people who ignore the Affordable Care Act’s mandate.

“All the IRS can do to get the money is ask an individual to pay it, and, if they don’t, reduce their future refunds,” said Brendan Buck, spokesman for House Committee on Ways and Means Chairman Paul Ryan, Wisconsin Republican, who oversees tax policy.

Be careful out there…