California Legislature Votes to Restore Tax on People Without Health Insurance

The California Legislature voted Monday to tax people Updatewho refuse to buy health insurance, bringing back a key part of former President Barack Obama’s health care law in the country’s most populous state after it was eliminated by Republicans in Congress.

The tax now heads to Democratic Gov. Gavin Newsom, who proposed a similar plan in January — an indication he will likely approve it.

California Legislature Votes to Restore Tax on People Without Health Insurance

POSTED 3:59 PM, JUNE 24, 2019, BY UPDATED AT 06:04PM, JUNE 24, 2019

HHS offers another Obamacare extension to avoid ‘canceled’ health plans

ImageThe Obama administration will   allow some health plans that fall short of Obamacare coverage requirements to   continue past the November elections and through most of President Barack   Obama’s second term.

 The decision, announced   Wednesday by federal health officials, extends for two years an earlier   decision by the White House to let people keep their existing health plans   through 2014, even if those plans fell short of Affordable Care Act   requirements. Under the new policy, some people could renew plans in 2016,   meaning they’d be covered into 2017.

Without the change, Democrats   worried that another wave of canceled health policies would hit just weeks   before the November 2014 midterm elections, setting off more recriminations   over Obama’s earlier pledge that people can keep their plans if they like   them. 

The new policy could have a   limited practical impact. The extension is optional for both states and the   health plans themselves. To date, only about half the states have allowed the   older, often skimpier, plans to continue. And some insurers want to scrap   them to maximize enrollment in the new health insurance exchanges. And   officials predict more Americans will migrate to the new plans, particularly   if they qualify for subsidies.

One official said the number of   people in plans that have been extended is “falling quite rapidly.”

Republicans quickly lambasted   the move as blatant 2014 politics and another sign that the administration   just can’t get the law to work.

“The Obama   administration’s announcement today that it will continue to allow insurers   to sell health care plans that don’t meet Obamacare minimum coverage   requirements is not only another reminder of the president’s broken promise   that you can keep your plan if you like it but represents a desperate move to   protect vulnerable Democrats in national elections later this year,”   Senate Minority Leader Mitch McConnell said in a statement.

The Obama administration said   the move, revealed in a conference call with senior administration officials,   isn’t politics. “The goal is to implement the Affordable Care Act in a   common-sense way and to try to provide a smooth transition for consumers and   employers,” an official said on the call.

Documents accompanying the   announcement reveal that the changes were crafted “in close   consultation” with a large contingent of vulnerable Democrats, including   Sens. Mark Warner, Mary Landrieu, Jeanne Shaheen and Mark Udall as well as   Reps. Tim Bishop, Elizabeth Esty, Carol Shea-Porter, Gary Peters, Scott   Peters, Ann McLane Kuster, Kyrsten Sinema, Ann Kirkpatrick and Ron Barber.

The changes, part of new   regulations and guidance issued by the Department of Health and Human   Services, will give some consumers an extra two years to remain on health   plans that would otherwise be canceled for failing to meet Obamacare’s   minimum coverage requirements. Many of those plans had already been given a   one-year reprieve in November 2013, but now they could be sold through 2016.   It also extends the offer to people in small group health insurance plans,   where small businesses could also have faced plan cancellations in the coming   year.

The insurance industry has   worried that the move to “un-cancel” plans could make it harder for   the new markets to succeed, and some strong backers of the law also worry.   Sen. Tom Harkin (D-Iowa), for instance, said in an interview that he’d rather   see people in the newer policies with stronger coverage.

“We’ve been through this   before. They made that decision – fine,” Harkin said. “A lot of   people say they have policies that they don’t pay very much for but I put it   this way: they’re great policies as long as you don’t get sick.”

A new rule also requires that   an Obamacare program intended to protect insurers from unexpected costs is   fully funded by the insurance industry, rather than by taxpayers. Republicans   have said that taxpayers could be on the hook for an insurance industry   “bailout” through these provisions.

The rule also outlines the   administration’s plan to implement SHOP exchanges for small businesses. The   federal one had been delayed a year. The Treasury Department also said it was   streamlining some of the paperwork for employers. 

Source: Kyle Cheney, Politico   Pro

United States: “Skinny” Plans Under PPACA: Are They a Solution?


We already understand that, after January 1, 2015, employers with the equivalent of 50 or more full-time workers to provide health insurance or else pay a $2,000 per employee fine.  We know that “full-time” means 30 or more hours per week over a measurement period.  But in the midst of discussion about who has to offer and who will get coverage, the question has arisen about what coverage will actually have to be offered by a large employer.  The concept of “skinny” plans has started to emerge as a possible option for large employers looking to keep coverage costs lower.

Skinny plans are essentially an outgrowth of “mini-med” plans that are set to be phased out.  Mini-meds offered very limited coverage, but they also were very affordable.  Some companies offered mini-meds to their part-time employees as an option to provide at least some coverage when they were not eligible for the plans offered to full-time employees.  The theory is that, unlike the exchange plans, large-employer plans that are sponsored by an employer do not have to cover the 10 categories of services in the health care law’s essential health benefits.  Thus, they are less expensive, but they provide a lower benefit that an exchange plan.  Click Here for Full Story…

Could the Obamacare Dream Turn Into a Nightmare for This Industry? By Keith Speights | More Articles | Save For Later July 20, 2013 | Comments (24)

If we were to draw two columns — one for winners from the Patient Protection and Affordable Care Act, or PPACA, and another for losers — the word “hospitals” would probably be listed near the top in the winner’s column. Large hospital chains Health Management Association (NYSE: HMA  ) and Tenet Healthcare (NYSE: THC  ) , have seen their stocks more than double over the past year, whileCommunity Health Systems (NYSE: CYH  ) is up around 75%.

Investors flocked to hospital stocks in anticipation of the full implementation of PPACA, commonly referred to as Obamacare. In the minds of many, Obamacare presented a dream come true for helping hospitals to flourish. But could that dream now be turning into a nightmare for the industry?  Click Here for the rest of the story….

It’s Only Fair to Protect All Americans from ObamaCare

Published on Jul 16, 2013
In a “speaker’s minute” speech on the House floor today, Speaker John Boehner talked about the Republican plan for economic growth and jobs, and previewed tomorrow’s votes on legislation by Reps. Tim Griffin (R-AR) and Todd Young (R-IN) to give all Americans “the same break from ObamaCare that the president wants for big businesses.”
News & Politics
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California’s health exchange to serve as voter registration hub

May 17, 2013:Image

Millions of Californians who contact the state’s new health exchange to buy insurance will be given the opportunity to register to vote, too, a move that some Republicans fear could benefit Democrats.

Secretary of State Debra Bowen made California the first state to designate its health exchange as a voter registration agency Wednesday, but others are expected to follow suit, said Shannan Velayas, Bowen’s spokeswoman.

“This is about making sure that all eligible Californians are offered the chance to register to vote,” Velayas said Thursday.

A 1993 federal law requires states to designate their agencies and offices that provide public assistance or disability services as voter registration agencies, Velayas said.

The federal law commonly is known as “motor voter” because it ensured that applicants for drivers’ licenses nationwide would be asked if they wanted to register to vote.

Public agencies in California that currently serve as voter registration outlets include the Department of Motor Vehicles and offices overseeing the state’s welfare, tax collection and in-home supportive services.

California’s health care exchange, Covered California, is creating a marketplace for millions of uninsured Californians to compare prices and buy health insurance policies this fall to take effect Jan. 1.

Many of Covered California’s clients are expected to be families of low and moderate incomes. Some will be eligible for taxpayer-subsidized policies, and others will have incomes low enough to qualify for Medi-Cal.

Senate GOP leader Bob Huff said he supports the notion of all Californians registering to vote but that targeting specific populations of people creates the possibility of partisan advantage.

“It does beg the question about whether it’s a systematic attempt to try to empower people more predisposed to vote their way,” Huff said of the designation by Bowen, a Democrat. “And that would be concerning to us.”

When the state launched an online system of voter registration two months before last year’s November election, the new voters who signed up were more Democratic than the voting population as a whole, according to an analysis by the California Civic Engagement Project at UC Davis.

Democratic Sen. Lou Correa of Santa Ana, chairman of the Senate elections committee, said he was not aware of Bowen’s designation of Covered California this week but supports the concept.

“I believe the foundation of democracy is voters,” he said. “More voter participation means greater democracy in our country.”

Lori Shellenberger, director of the Voting Rights Project of the American Civil Liberties Union of California, characterized Bowen’s designation as “one of the most significant voter registration policy decisions in the state’s history.”

PPACA’s Impact on Insurance Premiums: Actuarial Study Predicts 32% Increase in Costs Over Next Five Years

ImageA new report by the Independent Society of Actuaries predicts that individual market health insurers could experience as much as a 32% increase on average in health care costs from 2014 through 2017 due to changes brought on by the Patient Protection and Affordable Care Act (PPACA). This would result in higher premiums as the increased costs are passed on to those who purchase health insurance in the individual markets. 

The report refers to an “average” increase in costs, but the actual increase in “per member per month” (pmpm) claims expenses will vary from state to state.  

According to the report, some states could experience dramatic increases. By 2017, the study estimates the pmpm increases will be 62% for California, 67% for Maryland and over 80% for Ohio and Wisconsin.  Other states will see less dramatic increases. Colorado, for example, could experience a 39.6% higher pmpm; Florida 26.5%; and Texas 33.8%. The higher claims costs would primarily be due to the increased level of health care services required by new entries to the insurance market.

However, some states that already have imposed extensive mandated benefits and community rating provisions could see a decrease in pmpm anticipated average claims, including Massachusetts (-12.8%), New Jersey (-1.4%), New York, (-13.9%), and Rhode Island (-6.6%).  

The report also includes two other major findings:

  • After three years of Exchanges and insurer restrictions, the percentage of uninsured nationally will decrease from 16.6% to between 6.8 and 6.6%, compared to pre-ACA projections.
  • Under PPACA , the individual non-group market will grow 115%, from11.9 million to 25.6 million lives; 80% of that enrollment will be in the Exchanges. (See report at, page 6.) 

The report does not address PPACA’s impact on large employer group health plans as the most affected will be individual and small employer group health benefits during this period.

The study immediately drew fire from the Obama Administration regarding the projected premium increases. The administration claims the analysis fails to consider cost relief strategies in the law, such as federal premium tax credits to make premiums more affordable, and the risk adjustment pools that would help subsidize health insurance carriers that attract a disproportionately higher share of those with expensive health conditions.  

However, insurance experts countered that neither of these mechanisms actually will cut the cost of the claims’ pmpm. These mechanisms will simply transfer funds from the federal budget to individuals, or shift funds generated by a premium tax on individual health insurance companies to plans with a disproportionate share of adverse actuarial risks.   

Rick Foster, former Medicare chief Actuary, says the report does “a credible job” of estimating potential enrollment and costs under the law “without trying to tilt the answers in any particular direction.” He further notes that “actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully.”

On a positive note, clearly PPACA will expand insurance coverage for many. However, the Democratic leadership promised that the passage of PPACA would save the country money. This Society of Actuaries study reminds us that this last promise is unlikely unless the Administration makes some modifications to the current reforms. 

Author: Michael Gomes
APRIL 19, 2013 – 9:53 AM

Study: Health Care Costs Higher for Young Adults Newly Covered by ACA

Friday, April 12, 2013

Study: Health Care Costs Higher for Young Adults Newly Covered by ACA

Young adults who enrolled in a parent’s employer-sponsored health plan after an Affordable Care Act provision took effect incurred about 15% more in health care costs than those who already were covered under their parents’ plans, according to a study by the Employee Benefits Research Institute, The Hill‘s “Healthwatch” reports.

The study notes that the newly insured young adults were more likely to use their coverage for mental health, substance use disorder or pregnancy care, (Viebeck, “Healthwatch,” The Hill, 4/11).

Under the Affordable Care Act, employers that offer insurance plans are required to allow workers to include their children on health plans up to age 26. According to Politico, about 3.1 million young adults nationwide have gained coverage under the provision, which went into full effect in 2011 (Smith, Politico, 4/12).

For the study, researchers examined insurance claims from 2010 and 2011 at one large U.S. employer to determine the effect of that ACA provision. The researchers compared insurance claims for nearly 700 young adults who enrolled in a parent’s health plan in 2011, under the ACA provision, with about 13,000 young adults who already were covered under a parent’s plan prior to the provision taking effect.

The study found that 60% of hospital claims for the newly enrolled young adults were for mental health, substance use disorder or pregnancy care, compared with just one-third of claims filed for young adults who were already receiving coverage under their parents’ plans.

Further, the findings showed that mental health and substance use disorder care accounted for 42% of newly enrolled young adults’ inpatient hospital visits. The study also showed that the group was nearly four times more likely to use their insurance for pregnancy-related care than those who were previously insured. Meanwhile, the majority of inpatient hospital claims for young adults who already were covered in 2011 were for miscellaneous problems (“Healthwatch,” The Hill, 4/11).

As a result, the study found that the newly enrolled young adults incurred $2,866 in health care costs per person, on average, compared with a $2,472 per-person average for young adults who already were covered by their parents’ plans (Radnofsky, “Washington Wire,” Wall Street Journal, 4/11).

According to “Healthwatch,” the figures could reflect the higher cost of treatment for conditions such as substance use disorders and pregnancy, compared with “miscellaneous” hospital visits (“Healthwatch,” The Hill, 4/11). The company studied by EBRI noted that the cost incurred by the newly enrolled young adults added just 0.2% to their overall health care costs (“Washington Wire,” Wall Street Journal, 4/11).

Read more:







Kathleen Sebelius: Obamacare Implementation May Cause Some Health Care Costs To Rise

* Sebelius says expects some shifting in the insurance markets

* Independent study sees 32 percent average rise in premium costs

* Key changes from Obama’s signature healthcare law coming next year

By Jeff Mason and David Morgan

WASHINGTON, March 26 (Reuters) – President Barack Obama’s top healthcare adviser acknowledged on Tuesday that costs could rise in the individual health insurance market, particularly for men and younger people, because of the landmark 2010 healthcare restructuring due to take effect next year.

U.S. Health and Human Services Secretary Kathleen Sebelius said definitive data on costs will not be available until later this year when private health plans become authorized to sell federally subsidized coverage on new state-based online marketplaces, known as exchanges.

“Everything is speculation. I think there’s likely to be some shifting in the markets,” she told reporters at the White House.

The law, also known as “Obamacare,” eliminates discriminatory market practices that have imposed higher rates on women and people with medical conditions.

It also limits how much insurers can charge older people. But while the changes are expected to lower costs for women, older beneficiaries and the sick, men and younger, healthier people will likely see higher rates as insurers try to hedge against continued risks.

“Women are going to see some lower costs, some men are going to see some higher costs. It’s sort of a one to one shift … some of the older customers may see a slight decline, and some of the younger ones are going to see a slight increase.”

Insurance premiums could rise for some with individual plans, she said, as Obama’s Patient Protection and Affordable Care Act enhances the level of coverage and either eliminates or reduces the rate of price discrimination against people who are older, female or have preexisting medical conditions.

“These folks will be moving into a really fully insured product for the first time, so there may be a higher cost associated with getting into that market,” Sebelius said.

But those who qualify for federal subsidies through state healthcare exchanges would still get a better deal, she said.

Her remarks coincide with growing uneasiness about possible cost increases among lawmakers and executives in the $2.8 trillion U.S. healthcare industry.

A new study released on Tuesday by the nonpartisan Society of Actuaries estimates that individual premiums will rise 32 percent on average nationwide within three years, partly as a result of higher risk pools. Changes would vary by state, from an 80 percent hike in Wisconsin to a 14 percent reduction in New York.

Obama’s healthcare restructuring, the signature domestic policy achievement of his first term, is expected to provide coverage to more than 30 million people beginning on Jan. 1, 2014, both through the state exchanges and a planned expansion of the government-run Medicaid program for the poor.

Subsidies in the form of premium tax credits, available on a sliding scale according to income, are expected to mitigate higher costs for many new beneficiaries.

But the insurance industry, which is set to gain millions of new customers under the law, is warning of soaring premium costs next year because of new regulations that include the need to offer a broader scale of health benefits than some insurers do now.

That has raised concerns about people with individual policies not subject to subsidies and the potential for cost spillovers into the market for employer-sponsored plans, which according to U.S. Census data, cover about half of U.S. workers.


Sebelius dismissed the idea of significant change for employer plans, saying that market segment was “likely to see very little impact.”

Separately, a Democratic U.S. senator on Tuesday said the federal government has limited scope to help millions of people likely to remain without affordable health insurance under the new law.

Senator Ron Wyden of Oregon, a member of the Senate Finance Committee, released a report submitted to the panel by the administration that outlines an “employee choice” policy that would allow some employers to offer a wider range of coverage choices to their workers at reduced rates for 2014.

But Wyden said the approach would not help many of the nearly 4 million worker dependents who may have to forego subsidized private health coverage as a result of an IRS ruling.

“Even in the states that allow for employee choice, it will be limited to a small number of workers,” Wyden said.

The law would have most people with employer insurance remain under their current plans. Workers can opt for subsidized coverage if their employer plan is unaffordable, but only according to a narrow definition of what is affordable.

The IRS ruled in January that the cost of insuring a worker’s family will be considered unaffordable if the employee’s contribution to an individual coverage plan exceeded 9.5 percent of that person’s income. That rule ignores the fact that family coverage is far more expensive than individual coverage.

As a result, the nonpartisan Kaiser Family Foundation estimates that 3.9 million family dependents could be left unable either to afford employer-sponsored family coverage or to obtain federally subsidized insurance through an exchange.

In its report to the Senate committee, Sebelius’ department said some employers could claim a tax credit in 2014 to make coverage more affordable and offer workers a range of coverage plans through state-based exchanges. (Writing by David Morgan; Editing by Fred Barbash and Paul Simaao)