Tag: "Health Reform"

Tax Credits Cure Food Sales Tax Complexity. Why Not Use Them in ObamaCare Reform?

California’s tax treatment of food and ObamaCare’s tax treatment of health insurance have something in common. Both sets of regulation are so bad that people buying the same product can be taxed or subsidized differently in ways that are almost impossible to decipher.

As Joe Eskenazi of SF Weekly explains, California taxes the same bunch of carrots differently depending on whether the “buyer is a homeless shelter (no), a racetrack (yes), an ostrich farm (no), or a zoo (maybe).”

Sold in combination, a cup of coffee and a cup of gazpacho are a taxable meal. Sold separately, they are not. Cream-filled donuts are not taxable, but a croissant sandwich is. A cold sandwich with hot gravy poured on it is taxable even if it is cooled to room temperature. So is a previously hot, but currently cold, soup.

At first, the state held that movie popcorn was heated food. The movie theaters disagreed. They claimed that the lights over the popcorn were dehumidifier lamps, not heating lamps. They hired popcorn experts to measure the internal heat of the popcorn piles. Multiple hearings and many dollars later, the California Board of Equalization ruled that the heat in the popcorn was indeed a by-product of those dehumidifier lamps. Movie popcorn became a tax exempt food.

For Opponents, ObamaCare’s “Bailout” of Insurers is a Richer Target than Ever

UntitledghgThe Administration continues to move the goalposts on its so-called “bailout” of insurers which lose money in ObamaCare’s exchanges. Formally, this is labelled “risk corridors”, and describes a process by which the Administration will take money from insurers which profit more than expected in the exchanges, and transfer it to those insurers which lose more money than expected.

Unfortunately, taxpayers are at risk because the revenue coming into the risk corridors is determined by premiums, whereas the payouts are determined by medical claims. If, overall, the insurers charged premium that are too low, the risk corridors will suffer deficits. This blog has covered the risk corridors thoroughly, and we expect that there will be a significant deficit. Our latest entry on the topic questioned the Administration’s assertion that the risk corridors would be budget neutral.

ObamaCare Subsidies Wrong for More Than One in Eight ObamaCare Beneficiaries

The government may be paying incorrect subsidies to more than 1 million Americans for their health plans in the new federal insurance marketplace and has been unable so far to fix the errors…

So piles of unprocessed “proof” documents are sitting in a federal contractor’s Kentucky office, and the government continues to pay insurance subsidies that may be too generous or too meager. Administration officials do not yet know what proportion are overpayments or underpayments. Under current rules, people receiving unwarranted subsidies will be required to return the excess next year.

The problem means that potentially hundreds of thousands of people are receiving bigger subsidies than they deserve. They are part of a large group of Americans who listed incomes on their insurance applications that differ significantly — either too low or too high — from those on file with the Internal Revenue Service, documents show.

The government has identified these discrepancies but is stuck at the moment. Under federal rules, consumers are notified if there is a problem with their application and asked to upload or mail in pay stubs or other proof of their income. Only a fraction have done so, according to the documents. And, even when they have, the federal computer system at the heart of the insurance marketplace cannot match this proof with the application because that capability has yet to be built, according to the three individuals.

Source: Washington Post.

Wellness Fails Again

UntitledPepsiCo is the latest large employer to report that its wellness program has a negative return on investment, returning $0.48 for every dollar invested.

A voluntary program to help people manage actual diseases returned $3.78 per dollar invested.

The authors note that the results likely overstate the return on investment because they did not include the cost of program staff or the cost of employee time.

Beginning this year, ObamaCare requires that the government spend $200 million on wellness grants for small businesses that did not have a program in place when the law passed in 2010.

Urban Institute: Kill the Employer Mandate

Caduceus with First-aid KitA new report from the Urban Institute urges the end of the employer mandate. The mandate has little effect on coverage: 251.1 million people would have health insurance if the employer mandate is fully implemented, versus 250.9 million if it were repealed. However, the mandate hurts low-income workers, by influencing some employer to cut back both hours and headcount:

Creating arbitrary thresholds (e.g., potential penalties for firms of 50 or more workers not providing coverage for employees typically working 30 or more hours per week) for financial requirements will change the employment decisions in some firms, and at least some workers will be adversely affected by them.

(Linda Blumberg, John Holahan, & Matthew Buettgens, Why Not Just Eliminate The Employer Mandate?)

Update: Federal Taxpayers Have Spent $655 Million on Three State Exchanges That Have Shut Down

Here’s the list:

Maryland                 $171,013,111

Massachusetts        $179,036,455

Oregon                    $305,206,587

Total                       $655,256,153

(Phil Kerpen, The Federalist). See previous posts here and here.

ObamaCare Will More than Double Profit Margins for Hospitals’ Emergency Departments

Think ObamaCare is all bad news for hospitals? Not according to a new study:

Physician and Nurse Pushing GurneyWe estimated that hospital revenue from ED care exceeded costs for that care by $6.1 billion in 2009, representing a profit margin of 7.8 percent (net revenue expressed as a percentage of total revenue). However, this is primarily because hospitals make enough profit on the privately insured ($17 billion) to cover underpayment from all other payer groups, such as Medicare, Medicaid, and unreimbursed care. Assuming current payer reimbursement rates, ACA reforms could result in an additional 4.4-percentage-point increase in profit margins for hospital-based EDs compared to what could be the case without the reforms.

(Michael Wilson & David Cutler, Health Affairs)

Only 25 Percent of Eligible, Unsubsidized, Applicants Selected a Policy

After five months of open enrollment, the final ObamaCare numbers are in:

  • Of 13.5 million eligible enrollees, 8 million (59 percent) “selected” policies on ObamaCare exchanges;
  • Of 4.8 million eligible enrollees who will not get subsidies, 1.2 million (25 percent) “selected” policies; and
  • Of 8.7 million eligible enrollees who will get subsidies, 6.8 million (77 percent) “selected” policies.

Although the report gives excruciating details of age, gender, and ethnic identities of the applicants, the Administration still declines to report how many of those who “selected” policies have paid premiums, claiming that only insurers themselves have this information.

Even If You Pay Your ObamaCare Fine, You Won’t Be Able To Choose Your Own Health Plan

According to Sarah Kliff, the Administration has made…”a decision that industry officials say could trigger yet another wave of cancellation notices.”

The administration is targeting a type of coverage called fixed benefit or indemnity insurance, which give patients a fixed sum of money whenever they visit the doctor or land in a hospital.

The new rule would mainly affect people who had chosen to pay the individual mandate, or who were exempt from the mandate, and who bought a fixed-benefit plan as a stopgap. The Obama administration is saying that they can’t do that unless they also buy a more comprehensive plan.

The Cost of Failure

American Commitment’s Phil Kerpen has calculated the cost in the five states that have closed or are at risk of closing their exchanges:

97