The Trump administration is freezing payments that are part of an Obamacare program that protects insurers with sicker patients from financial losses, a move expected to add to premium increases next year.
At stake are billions in payments to insurers with sicker customers. The latest administration action could disrupt the Affordable Care Act, the health care law that has withstood President Donald Trump’s efforts to repeal it completely.
In a weekend announcement, the Centers for Medicare and Medicaid Services said the administration is acting because of conflicting court rulings in lawsuits filed by some smaller insurers that question whether they are being fairly treated under the program.
The so-called risk adjustment program takes payments from insurers with healthier customers and redistributes that money to companies with sicker enrollees. Payments for 2017 were $10.4 billion. No taxpayer subsidies are involved.
The idea behind the program is to remove the financial incentive for insurers to cherry-pick healthier customers. The government uses a similar approach with Medicare private insurance plans and the Medicare prescription drug benefit.
Major insurer groups said Saturday that the administration’s action interferes with a program that’s working well.
The Blue Cross Blue Shield Association, whose members are a mainstay of Affordable Care Act coverage, said it was “extremely disappointed” with the administration’s action.
The Trump administration’s move “will significantly increase 2019 premiums for millions of individuals and small-business owners and could result in far fewer health plan choices,” association president Scott Serota said in a statement. “It will undermine Americans’ access to affordable coverage, particularly those who need medical care the most.”
Serota noted that the payments are required by law and said he believes that the administration has the legal authority to continue making them despite the court cases. He warned of “turmoil” as insurers finalize their rates for 2019.
America’s Health Insurance Plans, the main health insurance industry trade group, said in a statement that it is “very discouraged” by the Trump administration’s decision to freeze payments.
“Costs for taxpayers will rise as the federal government spends more on premium subsidies,” the group said.
Rumors that the Trump administration would freeze payments were circulating late last week. But the Saturday announcement via email was unusual for such a major step.
The administration argued in its announcement that its hands were tied by conflicting court rulings in New Mexico and Massachusetts.
Medicare and Medicaid Administrator Seema Verma said the Trump administration was disappointed by a New Mexico court ruling that questioned the workings of the risk program for insurers.
The administration has asked the court to reconsider its ruling, she said, to “prevent more adverse impacts on Americans who receive their insurance in the individual and small-group markets.”
More than 10 million people buy individual health insurance plans through HealthCare.gov and state insurance marketplaces. The vast majority of those customers receive taxpayer subsidies under the Obama-era health law and would be shielded from premium increases next year.
The brunt of higher prices would fall on solid middle-class consumers who are not eligible for the income-based subsidies. Many are self-employed and small-business owners, generally seen as a Republican constituency.
The latest Obamacare flare-up does not affect most people with employer coverage.
More than 20 million people have coverage through former President Barack Obama’s law. Close to half get subsidized private coverage that would be affected by Saturday’s Trump administration announcement. The other half are covered by expanded Medicaid.
On – 09 Jul, 2018 By Associated Press
When the Affordable Care Act was passed in 2010, its supporters celebrated the legislation, calling it a landmark bill that would make Americans healthier and lower health care costs for families. Eight years later, it’s clearer than ever the ACA’s “Obamacare” exchanges have done quite the opposite. Not only are health care costs skyrocketing, the health insurance provided by Obamacare is so expensive for people to use that millions more Americans are now choosing not to go to the doctor — even when they’re sick or injured.
According to a survey by the West Health Institute and NORC at the University of Chicago, 47 percent of respondents said within the past 12 months they chose not to see a doctor or dentist because of the high cost of health care. Four-in-10 said they elected not to pursue a recommended medical treatment or test.
Even more disturbingly, 44 percent claimed they avoided seeing a doctor on at least one occasion while sick or injured because of costs. Twenty-nine percent said they chose not to see a doctor while sick or injured “more than once.” Forty percent said they are “extremely/very afraid” of getting “seriously ill” because of high health care costs.
The survey included only those who self-identified as insured. About two-thirds of respondents reported having private health insurance. Twenty-seven percent said they received their insurance from Medicare. Only 7 percent said they were enrolled in Medicaid.
These results are a dramatic departure from several similar surveys conducted over the past two decades. For instance, in 2014, the Associated Press and NORC conducted a survey that found only 19 percent of privately insured individuals choose not to go to the doctor because of costs. Only 18 percent said they avoided “preventive and recommended care.”
Similarly, a Gallup survey found in 2001 that 19 percent of Americans said they or a family member had over the previous 12 months “put off any sort of medical treatment because of cost.” In 2014, Gallup determined the answer to that question had risen to 33 percent, which is a remarkable increase but still 10 percentage points lower than the recent West Health-NORC survey.
Further, from the mid-2000s to the passage of the Affordable Care Act, there was virtually no movement in Gallup’s survey results on this question. Only after Obamacare was instituted did significantly more Americans begin to claim they had to stay away from their doctors, even while sick, because health care had become too expensive.
The sharp increase in the number of people avoiding their doctors is almost certainly the result of the increasing health insurance costs that have occurred in the wake of the Affordable Care Act’s passage. In 2018 alone, health care premiums for Silver Plans — the benchmark ACA insurance plan — sold on an Obamacare exchange increased by a shocking 31 percent, according to an analysis by Health Pocket. Health Pocket also reports the average Obamacare Silver Plan premium is now $477 for a 30-year-old and greater than $1,100 for 60-year-olds.
Premiums are just the tip of the Obamacare iceberg, however, especially because many people who purchase their insurance plans on Obamacare exchanges receive government subsidies. Deductibles — the total amount that must be paid out of pocket for many services before a health insurer picks up the full cost of a service — are a much better indicator of just how bad the Obamacare crisis has become.
The average deductible for a family purchasing a Bronze Plan on an Obamacare exchange is now $12,186. The average family Silver Plan deductible is $8,292, although the average maximum annual out-of-pocket cost for Silver Plan families is greater than $13,700.
With deductibles this high, health insurance for most lower- and middle-income individuals and families becomes useless, even if they are eligible to receive subsidies that help offset higher health insurance premiums.
The problem isn’t limited to Obamacare, either. The ACA imposed significant regulations, fines, and mandates that distorted the entire health insurance marketplace, causing health care costs to rise for everyone, regardless of whether they receive health insurance from an employer or from an Obamacare exchange.
It’s true that people enrolled in Medicare or Medicaid are partially immune to some of these health insurance cost increases, but they face plenty of unique health care challenges of their own. For instance, about 30 percent of doctors don’t accept new Medicaid patients, in large part because reimbursement rates are so low. In some states, such as New Jersey, research has shown a majority of doctors refuse to see new Medicaid patients. In many cases, finding a good specialist is particularly difficult for Medicaid recipients.
America’s health care system has had numerous problems for many decades, but Obamacare did nothing to fix them. Instead, it created an even more dysfunctional, bloated, bureaucratic model and forced everyone to join it or be greatly affected by it. Obamacare has been a complete and utter disaster, and without significant reforms, it will only get worse in the coming years.
Justin Haskins (Jhaskins@heartland.org) is executive editor and a research fellow at The Heartland Institute
On – 10 Apr, 2018 By Justin Haskins
The budget, which faces long — if not impossible odds — of getting through Congress in its current form, also seeks to slash spending on Medicare.
The Trump budget calls for cutting $237 billion to Medicare, the huge federally run program that provides health coverage to primarily older Americans. When he ran for office, Trump told voters that he would not cut Medicare or Medicaid.
Trump, since being sworn in as president last year, has repeatedly tried and failed to get the Republican-controlled Congress to repeal the Affordable Care Act, as Obamacare is formally known.
His new budget proposal invokes the ghost of one of those doomed repeal bills, calling for “a two-step approach to repealing and replacing Obamacare, starting with the enactment of legislation modeled closely after the Graham-Cassidy-Heller-Johnson bill, as soon as possible,” according to a summary released by the U.S. Health and Human Services Department.
Under that proposal, tax credits that help most Obamacare customers purchase health insurance coverage would be eliminated.
In their place, the federal government would give states health-care grants that the states then would have the option of using to subsidize the purchase of insurance by customers on the individual insurance market.
In another echo of Graham-Cassidy, the new budget proposal also would seek a rollback of Obamacare’s expansion of Medicaid benefits to poor adults. Medicaid offers health coverage to primarily low-income people. Before Obamacare, most states either denied Medicaid coverage to people who did not have dependent children or set very low limits on how much a person could earn and still qualify for coverage.
HHS said that the Obamacare repeal provisions contained in the budget would save almost $680 billion over the next decade. While those savings might look attractive, some other costs associated with Graham-Cassidy could doom Trump’s latest effort to kill Obamacare.
A vote on Graham-Cassidy was canceled last September after it became clear that Republicans, who hold a slim majority in the Senate, would not get “yes” votes from several GOP members.
The last Republican to come out against the bill, Sen. Susan Collins of Maine, did so right after the Congressional Budget Office said the number of people with health insurance that covers “high-cost medical events would be reduced by millions” if the bill became law.
Collins, in announcing her opposition, said the bill would have opened the door to states rolling back Obamacare protections for people with pre-existing health conditions, who before the ACA became law could be charged higher insurance premiums than healthy people.
The CBO earlier had said that repealing Obamacare could lead to 20 million or more Americans becoming uninsured.
Brad Woodhouse, director of the Obamacare advocacy group Protect Our Care Campaign, said the Trump administration’s budget “is doubling down on its relentless war on American health care.”
“By asking Congress to revive the deeply unpopular Graham-Cassidy repeal bill that ended protections for Americans with pre-existing conditions, gutted Medicaid, ripped away coverage from millions, and raised costs for millions more, while also proposing drastic cuts to Medicare,” Woodhouse said.
On – 12 Feb, 2018 By Dan Mangan
|Friday, February 01, 2013
by Mike Adams, the Health Ranger
Editor of NaturalNews.com (See all articles…)
Tags: Obamacare, health insurance, mandate
(NaturalNews) Under Obamacare, American families are forced to buy conventional health insurance that primarily benefits the pharmaceutical industry. By 2016 — just three years from now — the cheapest health insurance plan available will cost a typical American family $20,000 a year, the IRS has now announced.
Here’s the news: The IRS just published descriptions of the financial penalties American taxpayers will pay if they fail to purchase the rip-off health insurance mandated under Obamacare.
“The examples point to families of four and families of five, both of which the IRS expects in its assumptions to pay a minimum of $20,000 per year for a bronze plan,” reports CNS News.
It goes on to report, “The IRS’s assumption that the cheapest plan for family will cost $20,000 per year is found in examples the IRS gives to help people understand how to calculate the penalty they will need to pay the government if they do not buy a mandated health plan.”
For the record, we here at Natural News repeatedly warned people about the Obamacare scam, describing how it was a forced taxpayer handout to Big Pharma and the dangerous sick-care industry which kills 783,000 Americans a year.
See my articles on the subject at:
Over the last few years, critics of my reporting on this subject insisted we were “conspiracy theorists” and that Obamacare would offer free health care to nearly everyone! Those who still had to buy health insurance would see rates go down, we were told by hypnotized, Kool-Aid-drinking Obama supporters. That’s why Obamacare is called the “Affordable Care Act,” after all.
How could it be called the “Affordable Care Act” if it wasn’t going to be affordable, they insisted.
So now the truth comes out. Obamacare is a total scam, a complete rip-off, a massive handout to Big Pharma and a disaster to the U.S. wage earner. Obamacare is going to bankrupt America. Every family, small business owner and corporations is going to be financially suffocated under this burden, to the point where tens of millions simply surrender to the system, get on welfare, and become lifelong Democrats voting for larger and larger handouts.
I hate to say it, but once again I told ya so. Did you really think Obama was going to save money for the voters and make Big Pharma’s profits go down? Seriously? (Don’t be so gullible…)
Obamacare was always designed, from the very start, to loot the American taxpayer and put government in a position of monopolistic power over your health care decisions. This is the move toward fascism that’s going to absolutely gut America and put millions of people on the street, homeless, jobless and diseased.
Like everything else Obama has tried to shoved down America’s throat, the Affordable Care Act is an outright catastrophe. It funnels hundreds of billions of dollars into the coffers of health insurance companies, vaccine manufacturers and drug companies, but it does absolutely NOTHING to help the American people.
Obamacare is, ultimately, nothing more than a financial racket enforced at gunpoint by the government itself. It’s Big Pharma looting your pockets while an armed government IRS agent stands by and nods approval.
Obamacare is institutionalized looting of the paychecks and bank accounts of the American people. It is the equivalent of being mugged at knifepoint with the demand, “Your wallet or your life.” In the case of Obamacare, however, you lose both your wallet and your life!
It’s time those of us who stand for true liberty and justice in America stopped playing so nice. The people who are pushing Obamacare, the NDAA, citizen disarmament and other similar schemes are traitors to America. They need to be removed from power immediately.
But that’s only the beginning: Why doesn’t the FTC investigate the pharmaceutical monopoly enforced by the FDA in which drug companies earn 60,000% profit markups on their FDA-approved drugs?
State medical boards need to be entirely disbanded, as they criminalize alternative medicine, holistic medicine, acupuncture, chiropractic and other forms of healing.
The health insurance scam needs to be eviscerated. Its only purpose is to earn more money for health insurance companies and pharmaceutical interests. The system cares nothing for the American people, and it is based entirely on profit, not compassion or human dignity.
The cancer industry, with all its corrupt nonprofits, is a criminal racket that’s operated much like a mafia. Under the RICO Act, much of modern medicine could be shut down, unleashing the free market forces of alternative and complementary medicine which can provide safe, effective and low-cost health care to the entire nation.
But this is not allowed by Obama. Nor was it allowed under Bush, who conspired with Big Pharma to keep drug prices ridiculously high, soaking Medicare for hundreds of billions of dollars. Time and time again, every U.S. President is a health care sellout, and no one sold it out more completely than Obama.
The more this man does, the worse it gets. Let me ask you this: How are you going to come up with $20,000 a year to pay for health insurance?
Oh wait, let me guess: You think your job is going to buy it for you? Think again: U.S. employers are increasingly offshoring jobs precisely to avoid these costs. So you’re more likely than ever to find yourself unemployed by 2016. All across America, employers are responding to Obamacare mandates by slashing the weekly work hours of employees. U.S. businesses that used to thrive at full production are now experiencing severe shortages because they simply can’t afford to cover Obamacare costs for full-time employees.
Obamacare is absolutely gutting America’s economy it is must be repealed as soon as possible to stop the hemorrhaging of U.S. jobs.
You want a real health care solution? Here are 10 commonsense points:
1) Arrest all Big Pharma CEOs and top executives who have been involved in felony crimes, price fixing, doctor bribery, experiments on children and so on.
2) Outlaw vaccines additives such as mercury, aluminum, MSG and formaldehyde.
3) Decriminalize natural medicine and stop prosecuting alternative cancer doctors.
4) Abolish the FDA and end the drug monopoly cartel. Restore the free market to medicine.
5) Halt all Medicare and Medicaid payments to drug companies, hospitals and health insurance companies. Instead, issue patients VOUCHERS that they can spend in any way they wish, to receive whatever form of care works for them. This would restore the free market to medicine, where competition would drive down prices and spur improved patient outcomes.
6) End all intellectual property claims on genes and medicines. Break Big Pharma’s insidious cycle of inventing fictitious diseases and then marketing those fake diseases in order to sell deadly chemicals to a gullible public. Medicine belongs in the public domain, not in the hands of the greedy few.
7) Break the chain of influence between drug companies and medical journals, medical schools and the media. Outlaw drug money influence over all these institutions. Prosecute doctors for bribery if they have accepted money, gifts or free vacations from Big Pharma.
8) Decriminalize free speech about nutritional supplements, herbal remedies and natural therapies. Allow makers of natural products to tell the truth about the healing benefits of their products.
9) Encourage states to pass “medical freedom zone” laws that nullify federal laws concerning health care in their particular states. Openly allow the practice of alternative cancer therapies, nutritional therapies, etc. Turn your state into a medical tourism destination for all Americans!
10) End the artificial legal protections of Big Pharma and the vaccine industry. Restore due process rights to patients who have been harmed by drugs or vaccines. Only through this will drug companies clean up their act and stop killing to many people.
About the author:Mike Adams (aka the “Health Ranger“) is a best selling author (#1 best selling science book on Amazon.com) and a globally recognized scientific researcher in clean foods. He serves as the founding editor of NaturalNews.com and the lab science director of an internationally accredited (ISO 17025) analytical laboratory known as CWC Labs. There, he was awarded a Certificate of Excellence for achieving extremely high accuracy in the analysis of toxic elements in unknown water samples using ICP-MS instrumentation. Adams is also highly proficient in running liquid chromatography, ion chromatography and mass spectrometry time-of-flight analytical instrumentation.
Adams is a person of color whose ancestors include Africans and Native American Indians. He’s also of Native American heritage, which he credits as inspiring his “Health Ranger” passion for protecting life and nature against the destruction caused by chemicals, heavy metals and other forms of pollution.
Adams is the founder and publisher of the open source science journal Natural Science Journal, the author of numerous peer-reviewed science papers published by the journal, and the author of the world’s first book that published ICP-MS heavy metals analysis results for foods, dietary supplements, pet food, spices and fast food. The book is entitled Food Forensics and is published by BenBella Books.
In his laboratory research, Adams has made numerous food safety breakthroughs such as revealing rice protein products imported from Asia to be contaminated with toxic heavy metals like lead, cadmium and tungsten. Adams was the first food science researcher to document high levels of tungsten in superfoods. He also discovered over 11 ppm lead in imported mangosteen powder, and led an industry-wide voluntary agreement to limit heavy metals in rice protein products.
In addition to his lab work, Adams is also the (non-paid) executive director of the non-profit Consumer Wellness Center (CWC), an organization that redirects 100% of its donations receipts to grant programs that teach children and women how to grow their own food or vastly improve their nutrition. Through the non-profit CWC, Adams also launched Nutrition Rescue, a program that donates essential vitamins to people in need. Click here to see some of the CWC success stories.
With a background in science and software technology, Adams is the original founder of the email newsletter technology company known as Arial Software. Using his technical experience combined with his love for natural health, Adams developed and deployed the content management system currently driving NaturalNews.com. He also engineered the high-level statistical algorithms that power SCIENCE.naturalnews.com, a massive research resource featuring over 10 million scientific studies.
Adams is well known for his incredibly popular consumer activism video blowing the lid on fake blueberries used throughout the food supply. He has also exposed “strange fibers” found in Chicken McNuggets, fake academic credentials of so-called health “gurus,” dangerous “detox” products imported as battery acid and sold for oral consumption, fake acai berry scams, the California raw milk raids, the vaccine research fraud revealed by industry whistleblowers and many other topics.
Adams has also helped defend the rights of home gardeners and protect the medical freedom rights of parents. Adams is widely recognized to have made a remarkable global impact on issues like GMOs, vaccines, nutrition therapies, human consciousness.
In addition to his activism, Adams is an accomplished musician who has released over a dozen popular songs covering a variety of activism topics.
Click here to read a more detailed bio on Mike Adams, the Health Ranger, at HealthRanger.com.
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On – By Mike Adams
A fraud-infested Obamacare “outreach” program will get an astounding $1.2 billion from American taxpayers if legislation introduced by a veteran congresswoman becomes law. The preposterous measure, introduced by California Democrat Maxine Waters a few week ago, aims to recruit customers for the health insurance exchanges set up under Obama’s disastrous healthcare overhaul. The 14-term congresswoman, investigated by the House Ethics Committee for steering federal funds to her husband’s failing Massachusetts bank, crafted the law because the Trump administration slashed Obamacare outreach funding by more than 90%.
“Our health care system is under attack by a president, administration, and Republican-controlled Congress that – after numerous failed attempts to repeal Obamacare – are sabotaging it for political gain,” Waters said in a statement. “My legislation seeks to reverse their vindictive efforts to undermine and de-stabilize our health care system by ensuring that all consumers are provided with the information they need to make timely and well-informed decisions when purchasing health coverage through the federal and state-run marketplaces.” The bill, Affordable Care Act (ACA) Outreach for the Uninsured, Transformative Recruitment, and Enrollment Action for Compassionate Healthcare (ACA OUTREACH) Act, is cosponsored by 36 other lawmakers. If it passes, the Department of Health and Human Services (HHS) would dole out $300 million annually through 2021 for “navigator” grants. Minority and underserved communities would be especially targeted, according to language in the bill’s text.
The Obamacare navigator program was rife with fraud and corruption and Judicial Watch sued HHS back in 2014 to obtain records that the agency refused to provide under the Freedom of Information Act (FOIA). In 2013, the Obama administration gave dozens of leftists organizations a whopping $67 million to help people “navigate” health insurance exchanges that weren’t even fully established. In a “culturally competent manner” the so-called navigators were tasked with helping people shop for and enroll in plans that would eventually be available on the federal government market places. The money was divided between 105 mostly leftist groups that assisted and recruited the uninsured to sign up for coverage and understand their options.
Here are a few examples of the community organizations that received navigator grants from the government; an Arizona nonprofit called “Campesinos Sin Fronteras” that provides services to farm workers and low-income Hispanics; a south Florida legal group that provided navigators in “racially, ethnically, linguistically, culturally and socioeconomically diverse” communities; three Planned Parenthood branches—in Iowa, Montana and New Hampshire—got a combined $655,000 to serve as navigators. Others include; the Arab Community Center in Michigan, which got nearly $300,000 to reach out to and engage uninsured community members through “multicultural” media. A Black Chamber of Commerce in South Carolina received north of $230,000 to “provide outreach around new coverage options” and a Hispanic aging group in Texas got over $646,000 help members that are “socially isolated due to cultural and linguistic differences.”
Some of the navigator money went to a labor front group called Restaurant Opportunities Center of New York headed by an illegal immigrant activist named Maria Marroquin. The group received navigator funds shortly after Marroquin, an illegal alien from Peru, had been arrested for participating in disruptive demonstrations protesting the deportation of fellow undocumented immigrants and demanding amnesty.
Besides the outrage of hiring an illegal immigrant to promote a U.S. government program, it’s equally disturbing to know that navigators have access to the sensitive personal information of healthcare enrollees. This includes Social Security numbers, which can be used for identity theft, a rampant crime among illegal alien populations seeking to establish residency and land jobs in the U.S.
Navigator funds also went to a nonprofit (Association of Community Organizations for Reform Now (ACORN), with such a huge history of corruption that Congress issued a federal funding ban. As part of a broader investigation into ACORN Judicial Watch obtained records showing that HHS violated the congressional ACORN funding ban by awarding a Louisiana nonprofit called Southern United Neighborhoods (SUN) a $1.3 million Obamacare navigator grant to recruit customers. Headquartered in New Orleans, SUN is dedicated to combating poverty, discrimination and community deterioration that keep low-income people from taking advantage of their rights and opportunities, according to its website.
On – 01 Feb, 2018 By
Congress needs to finish the job of repealing and replacing Obamacare in 2018, Sen. Ted Cruz says.
Republicans in Congress last year failed to craft a comprehensive repeal-and-replace bill for Obamacare that both the House and the Senate could agree on.
“I think we got very close last time, and that’s something I’m continuing to devote a lot of time [to], trying to unite our fractious conference and build consensus, to get at least 50 Republicans on the same page,” Cruz, R-Texas, told the Washington Examiner this week.
The Texas senator says he has taken the time to sit down with Republicans who voted against the previous attempt to repeal Obamacare and is optimistic new legislation will pass.
Cruz is committed to the issue because he thinks the Republican Party needs to use the repeal-and-replace bill as a “last reconciliation” before the midterm elections in November. Cruz aims to get a bill passed with just 51 votes, getting around a Democratic filibuster.
Getting rid of Obamacare’s individual mandate was a great victory en route to repealing the law, he said, but it’s not enough.
“Since most of Obamacare remains the law, millions of Americans continue to suffer under Obamacare’s framework, with soaring health insurance costs and reduced choices. Many find that their health premiums cost more than their monthly housing costs,” said Marie Fishpaw, director of domestic policy at The Heritage Foundation. “It’s imperative that Congress undo Obamacare’s damage and ensure Americans have better choices for coverage options at more affordable prices.”
“To meet these goals, conservatives stand ready to offer solutions as described in a recent open letter from 13 conservative leaders,” she added.
Republicans have made the repeal and replacement of Obamacare a key campaign promise to voters for seven years now, Cruz said.
He said he supports a health care bill that starts small and builds up, instead of one that packs a lot of different, partisan ideas into it.
Cruz said the way to kick-start such a bill would be to begin by lowering premiums.
“I think lowering premiums is a win-win for everybody. It’s a win for conservatives, a win for moderates. The No. 1 reason people despise Obamacare is that premiums have skyrocketed,” he said.
It’s not going to be easy to get 50 votes, Cruz concedes, but adds that his fellow Republicans need to follow through on their promises as the midterm elections approach.
On – 26 Jan, 2018 By Chrissy Clark