POLICY BRIEFINGS


Punch and Counterpunch on PPACA


In addition to this week’s oversight hearings, House Republicans are ramping up their anti-Obamacare playbook to highlight the problems individuals are experiencing with the health law. Democrats have responded with their own message which cites Patient Protection and Affordable Care Act (PPACA) success stories. Republican members of the House Ways and Means Committee also sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius requesting information on whether the Secretary has “certified” under the PPACA that the subsidy verification process is working properly. They said they doubt this is the case and want to know when the Secretary will inform Congress either way. They said that eligible individuals need to know whether they will actually get their subsidies beginning on January 1, 2014. Also, ten Senate Republicans, including Senate Minority Leader Mitch McConnell (R-KY), introduced legislation to protect self-insured employers and plans from being kept from buying “stop-loss” insurance as a result of federal regulations. Senator John Thune (R-SD) also introduced legislation, S. 1724, which would prevent HHS from exempting Taft-Hartley union-negotiated multiemployer health plans from having to pay the PPACA’s reinsurance fees (regulations indicated that such an exemption would be soon promulgated for self-insured, self-administered plans). Touting the positive effects of the PPACA, the White House Council of Economic Advisers released a report stating that the lower than average 1.3% increase in real per capital health spending over the last three years may be partially attributable to the provisions of the health law.


HHS Announces Relief from PPACA Deadlines


Because of the problems individuals are having in accessing the HealthCare.gov website to enroll for health coverage, HHS announced that persons enrolling by December 23 (previously December 15) will have their coverage begin on January 1, 2014. The White House press spokesman also confirmed that the 2015 open enrollment period will be pushed back to November 15, 2014 from October 15, 2014 to give insurers more time to set their 2015 rates based on the claims experience of those enrolling as late as March 2014. Republicans were quick to point out that the new enrollment period will begin after the 2014 mid-term elections, thus delaying the disclosure of possible rate increases before the election. The move will also shorten open enrollment to two months. The HealthCare.gov consultant, Jeffrey Zients, also announced that the website’s capacity should increase from 25,000 users to 50,000 by November 30th. CMS also said that HealthCare.gov has been improved to allow insurers to process their “834” eligibility verification forms faster. To better address potential enrollee needs to obtain health insurance coverage, CMS said that efforts are underway to allow health insurers to directly enroll participants through their own health plan websites. CMS also issued guidance that includes standard notice requirements for insurers who elect to continue offering non-PPACA compliant health plans pursuant to the President’s transitional relief for individuals and small businesses receiving cancellation notices from their insurers. Insurers must tell policyholders what PPACA-mandated benefits are not included in their old plans and what other options are available through online marketplaces, including potential tax credits.


Republicans Skewer PPACA Website Functionality and Security


At a House Space, Science and Technology Committee hearing, when four information technology experts were asked whether they think the HealthCare.gov website is secure or will be by the Administration’s self-imposed deadline for a complete fix (November 30th), they all said “no”. Also, at a House E&C Subcommittee on Oversight and Investigations hearing, Chairman Tim Murphy (R-PA) said “Right now, healthcare.gov screams to crooks, ‘If you like my health care info, you can steal it.’” Nonetheless Henry Chao, the CMS Deputy Chief Information Officer testified that the website is 60-70% complete and employs stringent privacy security controls to safeguard consumer data. He also admitted that personal information was released in a number of instances, but that the software problem allowing this has been fixed. He also said a full, system-wide security control assessment has not been concluded, but will be sometime in December. Republican members also highlighted a March report by McKinsey & Co. that warned HHS about thirteen serious risks to the website and the lack of a reliable decision-making structure within CMS to address the problems. Rep. Steve Scalise (R-LA) said that either the President didn’t know about the website problems, which meant his staff was keeping information from him, or he did know and thus deliberately misled the public about the operability of the website. Curiously, Henry Chao testified that he had not seen the full report until the committee released it earlier in the week. In perhaps a forecast of future criticism of the law’s implementation, Mr. Chao said “I think there’s still a lot of moving parts and it wouldn’t be prudent to give 100 percent guarantees to where we’ll be at….” The Democrat Chair of the Senate Committee on Small Business and Entrepreneurship, Sen. Mary Landrieu (D-LA), tried to shift the blame on the federal exchange problems during a hearing on small business health issues. She said that Republican led states had every opportunity to set up an exchange for their small businesses, but they “defaulted” to let the federal government operate the exchanges in their states.



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