Health Care Challenges Could Lock States Into Current Medicaid Spending

By: Friday July 20, 2012 4:39 pm

It looks like the sloppy wording in the Affordable Care Act cuts both ways.

We’ve been talking about the various challenges to the law arising out of drafting errors, in particular the vagaries of whether individuals seeking coverage on federally-run exchanges substitutes for state exchanges if the state refuses to implement one, can qualify for coverage subsidies. But there’s another drafting issue that could lock states which choose not to expand Medicaid into maintaining their current level of coverage and not cutting it further. The Hill explains.

 

Conservatives Raise Court Challenge on Allowing Insurance Subsidies on Federally-Run Exchanges

By: Sunday July 8, 2012 12:48 pm

Robert Pear today writes about an emerging lawsuit over the health care law that I touched on Thursday. The language around the insurance exchanges and whether the state or federal government runs them is sufficiently vague that conservative legal functionaries think they can exploit it.

States Opting Out of Medicaid Expansion Could Reduce Their Rolls Without Consequences

By: Thursday July 5, 2012 6:48 am

Phil Galewitz of Kaiser Health News sketches out a terrifying scenario for Medicaid in states that opt out of the expansion. Not only could they refuse to cover low-income adults up to 133% of the federal poverty line, but they could actually roll back their current Medicaid plans without any consequence.

Non-Trivial Number of Poor People Would Be Ineligible for Insurance Subsidies if Their State Denies Medicaid Expansion

By: Thursday June 28, 2012 3:32 pm

Because the authors of the Affordable Care Act saw no issue with the expansion of Medicaid and presumably found it constitutional, they wrote the exchange subsidies as affecting everyone above the rate of Medicaid, specifically about the federal poverty level (FPL). But what about people who make below the poverty level? They may be ineligible for subsidies, but that’s OK, because they can always hook up with Medicaid, which is now expanded to 133% FPL. However, if the part of the ruling reducing the leverage for the federal government to extend this Medicaid expansion to the states winds up in big fights among red-state governors, those under 100% FPL could find themselves out of luck.

House GOP Year-End Bill a Christmas Tree of Ideology

By: Sunday December 11, 2011 7:40 am

The House released their version of a year-end bill to extend unemployment benefits, a payroll tax cut and a “doc fix” to avoid a 27% cut in Medicare reimbursement. A look at the various elements of the bill make clear that Republicans have little interest in passing anything through Congress.

New Health Care Regulations Close Exchanges to Many Offered Unaffordable Employer Coverage

By: Monday August 15, 2011 3:00 pm

The somewhat good news here is that the seamless coverage regulations proposed by the Department of Health and Human Services have been widely praised. They are designed to do all those calculations backstage, so that the consumer need only to visit one portal to figure out which program they slot into. And it sets up a process for annual eligibility review, so individuals are not responsible for flagging their increase in income. Individuals who end up making too much for Medicaid will get to keep their coverage until they get a new plan on the exchange.

The somewhat bad news is that because of the new rules, the tax credits just got less affordable.

Community Health Centers Threatened With Funding Cuts From Debt Limit Deal Fallout

By: Tuesday August 9, 2011 2:30 pm

I thought the President was pretty clear yesterday – he thinks we’ve cut the domestic and defense budgets to the bone, and any future savings must come out of a combination of tax revenues and so-called “modest adjustments” to health care programs. So you can forget about that defense-heavy trigger being fired, and even if it is, the defense lobby will have all of 2012 to come up with a substitute for the cuts. And some of the potential areas for cuts in that trigger include some of the best spending in the Affordable Care Act, for community health centers.

Exchange Subsidies Threatened; Part of the Automatic Trigger in the Debt Limit Deal

By: Thursday August 4, 2011 5:30 am

Some Democrats took a look at the automatic cuts and thought they were tough, but probably better than a bad agreement that would slash the safety net and in all likelihood do little on revenues. After all, Medicaid, Social Security and programs for the poor were protected in the agreement, and Medicare would only see a provider haircut. And half of the automatic cuts would hit the Pentagon. What’s the forcing mechanism for the left?

Turns out, that would be the exchange subsidies from the Affordable Care Act:

Senate Likely to Repeal Health Care 1099 Provision Today

By: Tuesday April 5, 2011 8:43 am

The Senate has passed this bill a half-dozen times, sometimes attached to other bills, and more recently as a standalone. The pay-for that the Senate uses differs from the House’s. But instead of a House-Senate conference, the Senate, unbelievably, will vote on the House bill today.

Judge Health Reform on Care it Delivers to People, not Subsidies it Passes to Private Insurers

By: Tuesday January 5, 2010 6:01 am

There’s a lot I object to in Hendrik Hertzberg’s judgment of those opposed to the Senate health bill as “pathetic.”

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