U.S. Politics


Brendon Smialowski via Getty Images


New rules are supposed to help the markets work better even as Trump threatens to blow them up.

President Donald Trump’s administration has taken its first action to change the way the health insurance marketplaces created by the Affordable Care Act operate, aiming to shore them up for next year’s sign-up period.

The regulation published by the Centers for Medicare and Medicaid Services on Thursday is a response to insurers’ demands that federal authorities take steps to limit consumers’ ability to drop in and out of the insurance market. Such “gaming” of the system drives up costs for the carriers that must cover the consumers’ claims.

The overall consequence of the new rules is that health insurance will be harder to buy in 2018, especially for people whose circumstances change during the year, enabling them to buy policies outside the annual sign-up period. The length of that sign-up period is also cut in half.

Other aspects of the regulation could make coverage less comprehensive, reduce the value of the tax credit subsidies that make premiums more affordable for low- and middle-income people, and allow insurers to offer plans with fewer medical providers in their networks.

These new policies are intended to make the exchanges more attractive to insurance companies next year, after more insurers pulled out of the program this year. Consumers may be forced to endure more hassles in order to keep insurers in the fold because without the insurers, there’s no coverage to buy.

But the new rules are arguably more notable for what they don’t address: subsidies for so-called cost-sharing reductions, which are paid to insurers covering the poorest enrollees. Trump has threatened to cut off those payments and send the markets into a tailspin in an unorthodox bid to pressure Democrats into supporting his plan to repeal the Affordable Care Act.

That’s why even the insurance industry ― which got a lot of what it asked for from the Trump administration in this regulation ― isn’t satisfied. The cost-sharing reductions are the industry’s most pressing concern, and Trump’s comments Wednesday that he might end them have heightened anxiety about what the exchanges will look like next year.

Marilyn Tavenner, CEO of America’s Health Insurance Plans, praised the aspects of the regulation designed to ease regulatory burdens on insurers and impose stricter requirements on consumers.

But she said in a press release, “There is still too much instability and uncertainty in this market. Most urgently, health plans and the consumers they serve need to know that funding for cost-sharing reduction subsidies will continue uninterrupted.”

“Without funding, millions of Americans who buy their own plan will be harmed. Many plans will likely drop out of the market. Premiums will go up sharply ― nearly 20 percent ― across the market. Costs will go up for taxpayers. And doctors and hospitals will see even greater strains on their ability to care for people. We urge Congress and the administration to act now to guarantee funding for cost-sharing reduction subsidies,” said Tavenner, who previously ran the Centers for Medicare and Medicaid Services.

Under the Affordable Care Act, insurers are required to reduce deductibles, copayments and other forms of cost-sharing for the lowest-income enrollees who use the exchanges, and the federal government is supposed to reimburse them for the lost money. In 2014, however, House Republicans sued then-President Barack Obama’s administration, arguing that the federal government was making those payments without authorization from Congress. A federal judge last year agreed with the GOP lawmakers, and the Obama administration appealed. When Trump became president, his administration became the defendant in the case. The two sides soon obtained delays from the appeals court while they decided how to proceed.

For now, the Trump administration has continued making those payments. Some House Republicans have expressed support for keeping the money flowing or even authorizing the spending, which would resolve the legal dispute.

But Trump told The Wall Street Journal this week that he believes a threat to the viability of the insurance marketplaces could be leverage to force Democrats to the negotiating table. Democratic leaders have forcefully rejected this gambit and demanded that money for the cost-sharing subsidies be included in a pending federal spending bill.

Absent clarity on the subsidies, insurance companies may be reluctant to participate in the exchanges next year or, at a minimum, may request very high rate increases in order to cover their losses if the payments don’t continue. This could destabilize the troubled market just as analysts like Standard & Poor’s believe it may be righting itself.

The ways in which the regulation, which is little-changed from a proposed draft published in February, benefits insurers might not be enough.

“While [the Centers for Medicare and Medicaid Services] has taken steps to correct some of the current challenges in the marketplace, these changes likely are not significant enough to sway health plan decisions for the upcoming plan year,” Cara Kelly, vice president at Avalere Health, said in a press release. “Losing health plans from the exchanges is still a risk for 2018.”

Fox News

Fox News Tries And Fails To Get Any Details About The GOP’s Obamacare Replacement

Sen. Rob Portman (R) on Fox

Think Progress

Sen. Rob Portman (R-OH) struggled to articulate a credible GOP alternative to the Affordable Care Act during an appearance on Fox News Monday morning, promising only to replace President Obama’s health care reform with “legislation that does give people more opportunities” and “better ideas.”

But pressed by host Bill Hemmer about how Obamacare would “change” should Republicans reclaim the Senate majority after the midterm elections, Portman could only offer a critique of the existing law. He argued that reform does not cover enough Americans or allow people to keep their existing health care plans. “I personally think it is a failed model. We have to put in place better policies that allow people to keep what they have and allow people to get coverage who can’t afford it.”

Asked again, how the GOP would go about changing the existing law or which provisions it would keep in place, Portman mostly demurred, highlighting “wellness” provisions and expanding health savings accounts. Watch the exchange:

Earlier this month, House Budget Chairman Paul Ryan (R-WI) admitted that Republicans would not be able to preserve the most popular elements of Obamacare if they repeal the law as a whole.

“If you look at these kinds of reforms, where they’ve been tried before — say the state of Kentucky, for example — you basically make it impossible to underwrite insurance,” Ryan told Bloomberg’s Al Hunt when asked if Republicans would maintain the pre-existing conditions regulations, dependent coverage extension, and other rate requirements. “You dramatically crank up the cost. And you make it hard for people to get affordable health care,” Ryan insisted.

House Republican leadership has pledged to unveil a unified replacement plan for Obamacare but has yet to release any details about the proposal.



West Wing Week

West Wing Week: 12/20/13 or “26 Candles”

The White House

This week, the White House honored those lost at Sandy Hook on the one year anniversary. The President met with newly elected mayors and executives from America’s leading technology companies, discussed the benefits of health care reform with a group of moms, and celebrated the holidays with Christmas in Washington.



Affordable Care Act · Obama Administration

Obama Administration Making New Exemption For Individuals With Canceled Health Care Policies

health care exemption

H/t: TW – who writes,  this change should help a lot of people and diffuse much of the GOP’s anti-ACA talking points (‘bitching points’).

The Huffington Post

The Obama administration announced Thursday that it will allow individuals whose health care policies were canceled under the Affordable Care Act’s new rules to qualify for a hardship exemption, meaning they are not required to purchase a plan under the new law.

In a letter to six Democratic senators who had requested the change, Health and Human Services Secretary Kathleen Sebelius said that those who had their plans canceled under the law are now eligible for “catastrophic,” or bare-bones plans. As The Hill notes, those plans were previously intended for individuals under age 30 and others who qualify for a hardship exemption.

“I agree with you that these consumers should qualify for this temporary hardship exemption and I can assure you that the exemption will be available to them,”Sebelius wrote in the letter. “As a result, in addition to their existing options these individuals will also be able to buy a catastrophic plan to smooth their transition to coverage through the Marketplace.”

The letter was sent to Democratic Sens. Mark Warner (Va.), Tim Kaine (Va.), Angus King (Maine), Jeanne Shaheen (N.H.), Mary Landrieu (La.) and Heidi Heitkamp (N.D.).

“This is a common-sense clarification of the law. For the limited number of consumers whose plans have been cancelled and are seeking coverage, this is one more option,” Department of Health and Human Services spokeswoman Joanne Peters said of the exemption.

The announcement comes just four days ahead of the December 23 deadline by which individuals must select a plan to ensure no lapse in coverage.

Earlier Thursday, the administration projected fewer than 500,000 individuals whose plans had been canceled would enter 2014 without coverage.

The Huffington Post’s Sam Stein reported:

The officials at the briefing said that it was impossible to know the exact number impacted. But, they argued, the group was smaller than what has been reported because many of these individuals were being auto-enrolled into new plans.All told, the officials projected that fewer than 500,000 people would enter the New Year having had their insurance policy cancelled and not purchased a new plan.

The goal is to reduce that number as much as possible. And to encourage sign-ups after the New Year, the White House is planning a more aggressive public relations campaign. The docket includes cabinet-level visits to targeted districts, more community outreach through administration allies (churches, races and farmer markets were listed as venues where the ACA would be pitched) and paid media. 

Continue reading here…

Budget Deficit · U.S. Politics

Fox’s Hume Details How Right Wing Media Push GOP To Extremes

Media Matters

HUME: I’m not sure they’re calling the shots but make no mistake about it, Bill. These — some of these radio talk show hosts have real influence. They have a huge following, particularly in very conservative areas where they are most popular and where the many members of congress who inhabit those areas are not worried about being reelected if they can get nominated. But they are worried about a primary challenge that could deny them the nomination.

O’REILLY: And that happened —


HUME: So they’ll go a long way to avoid it and keeping radio talk show hosts off their back is one way of doing that.


O’REILLY: That happened in Indiana to Lugar. He was a very well thought of senator, moderate. And then a more conservative guy got the nomination. He lost in the general race. So you believe that in Congress, if somebody has to run every two years as they do, and they get on the wrong side of a powerful radio voice, that’s beamed into their district, because the guys are national, they can really do them bad damage if they promote the other guy?


HUME:  Well, look, it’s not controlling but it’s a factor. I mean, if you’re a pragmatic politician up for reelection, you’re looking at the landscape and you don’t want to a lot of problems. And you don’t — and in many of these districts the Democrats can’t cause you any problems. There are just not enough of them. What there are enough of is conservative Republicans and conservative Republicans around the country today are very disappointed in their party and its leadership. And they think that the control of the House of Representatives should have been able to give them much more leverage than they seem to have been able to demonstrate and they should have been able to do more with it. And so if you’re sitting over in the House of Representatives and some measures of defund Obamacare comes along and you think it’s a suicide mission because it might involve a government shutdown you’re going to be hesitant to oppose it anyway because you don’t want the most conservative — you don’t want the tea party and you don’t want the conservative radio talk show hosts on your back. That doesn’t mean they can defeat you but it means you don’t want it.

See video here…

Affordable Care Act

Tom Cole: ‘It’s Awfully Hard To Repeal Obamacare When A Guy Named Obama Is President’

Rep. Tom Cole (R-OK)

Now there’s a sensible GOP politician on the issue of Obamacare

The Huffington Post

On the same day that the House voted for a 42nd time to repeal Obamacare, comments emerged from one GOP rep about the difficulty his party faces in repealing President Barack Obama’s signature law.

In an interview with the New York Times published Friday, Rep. Tom Cole (R-Okla.) leveled about how realistic a chance there is for Republicans to erase the Affordable Care Act.

“It’s awfully hard to repeal Obamacare when a guy named Obama is president of the United States,” Cole said.

Cole was among the 230 members of Congress who voted on Friday to pass a continuing resolution that funds the government through Dec. 15, while defunding Obamacare in the process. But in an interview with the Norman (Okla.) Transcript,Cole explained that he saw Friday’s vote as just the first of many steps in reaching an agreement.

“We expect this will get kicked back to the House, but maybe we can come up with something that delays this for another year,” Cole said. “I’m not naive. I don’t think this will be easy or quick.”

Among the steps that Cole does not support is shutting down the government. Back in July, he publicly voiced his reservations, telling MSNBC that it was a “suicidal political tactic.” In his interview with the Transcript, Cole stood true to that belief, calling the House CR “the opening volley in a long tennis match.”


Bill Clinton · MOW 2013

Bill Clinton Explains The Real Way To Honor King’s Dream

Bill Clinton Thumbs Up (Featured)

Think Progress

President Bill Clinton connected Dr. Martin Luther King Jr.’s historic “I have a dream” speech to the struggles still facing the nation during a speech on Wednesday commemorating the 50th anniversary of the historic address.

“I would respectfully suggest that Martin Luther King did not live and die to hear his heirs whine about political gridlock,” Clinton argued. “It is time to stop complaining and put our shoulders against the stubborn gates holding the american people back,” he said, laying out five ways Americans can improve the country:

Ensure equal access to education. “We cannot be disheartened by the forces of resistance to building modern economy of good jobs and rising incomes or to rebuilding our education system to give all our children a common core of knowledge necessary to ensure success. Or to give Americans of all ages access to affordable college and training programs. And we thank the president for his efforts in those regards.”

Implement Obamacare. “We cannot relax in our efforts to implement health care reform in a way that ends discrimination against those with pre-existing conditions, one of which is inadequate income to pay for rising health care. A health care reform that will lower cost and lengthen lives.”

Invest in science. “Nor can we stop investing in science and technology to train our young people of all races for the jobs of tomorrow and to act on what we learn about our bodies, our businesses, and our climate.”

Protect the vote. “We cannot be discouraged by a Supreme Court decision that said we don’t need this critical provision of the Voting Rights Act because look at the states. It made it harder for African-Americans and Hispanics and students and the elderly and the infirm and poor working folks to vote. What do you know? They showed up, stood in line for hours, and voted anyway, so obviously we don’t need any kind of law.”

Expand gun safety. “But a great democracy does not make it harder to vote than to buy an assault weapon.”

Watch it:


Five Myths About Obamacare You Shouldn’t Believe


Think Progress

With just over a month to go before Obamacare’s state-level marketplaces open for business, the rhetoric swirling around the implementation of the health reform law has intensified. And thanks to a mounting pile of media-manufactured “scandals” that Obamacare opponents claim will bring down the law, it can be difficult to separate the facts from the fiction.

Of course, implementing health reform won’t be flawless at every step of the way. But it’s also not exactly the train wreck that opponents claim. Here are five popular myths circulating about Obamacare’s presumed impact that you shouldn’t be so quick to believe:

1. Obamacare will cause young people’s insurance premiums to skyrocket.

Mainstream media outlets and conservative pundits have consistently speculated about impending “rate shock” under Obamacare, claiming that the young and healthy Americans who will be required to buy health insurance under the law will face very high premiums. As states finalize the plans that they will offer on Obamacare’s new insurance marketplaces, stories focusing on the “huge premium spikes” due to the health law have added fuel to the fire.

In reality, however, much of that coverage is sensationalized. It’s difficult to project generalities about how premiums will affect every American in a particular state, but it’s important to remember that many people will qualify for federal assistance to help them buy insurance. A recent study from the Commonwealth Fund estimates that more than 80 percent of the estimated 16 million young people who don’t currently have health care will qualify for some kind of subsidized coverage under Obamacare. They’ll either receive federal subsidies to help them buy insurance plans on the state-level marketplaces, or they’ll qualify for Medicaid coverage after the health law expands the public program’s enrollment pools.

Stories that focus on the “new” cost of premiums typically aren’t taking in account the fact that most young adults won’t be paying for that total cost on their own — or the fact that you can’t really compare the premiums for a bare-bones plan to the premiums for a plan that actually provides adequate coverage.

2. Obamacare is incredibly unpopular, so most Americans want to get rid of it and Congress wants to exempt itself from it.

One of the most widespread talking points against the health reform law is that no one actually likes it. Obamacare opponents consistently point to polls that say Americans want to repeal the law, and have recently claimed that the law is so distasteful that Congress is trying to exempt itself from it.

But that’s not actually the whole story. While it’s true that most Americans say they don’t like the health reform law as a whole, polling has repeatedly shown that’s largely because they don’t understand what it actually does. Thepoliticized battle over health care reform has taught Americans that “Obamacare” is a bad word, but they tend to like the law’s specific provisionswithout even realizing they’re part of Obamacare. Furthermore, even despite Americans’ tendency to react negatively to the law as the whole, they still don’t support defunding it.

That trend holds true even for the Republicans who have been crusading against Obamacare for the better part of the past three years. GOP lawmakers talk about repealing the whole law, but then concede they’d like to keep its most popular provisions intact. They badmouth the law in public, but take money from it in private.

And the controversy over Congress seeking an Obamacare exemption is entirely manufactured. In reality, the issue stems from a Republican-sponsored amendment to the health law requiring lawmakers to get their insurance on the new marketplaces, just like uninsured Americans. The GOP senator who offered the amendment expected Democrats to turn it down, but it made it into the final version of the law anyway. Now, the administration is simply trying to deal with the mess that created — since the marketplaces were always intended for uninsured people, not people who already have access to health care through their employers.

3. Obamacare is using taxpayer dollars to fund abortion.

Abortion coverage was a sticking point during the fight to pass the Affordable Care Act, and continues to stoke controversy three years later. Many anti-abortion lawmakers have seized on the opportunity to ban their state’s marketplaces from including any plans that cover abortion, which may give the impression that Obamacare would otherwise require abortion coverage. In reality, the health law simply left it up to each state to decide. Each state has the option of providing insurance plans that offer abortion coverage in their marketplaces, and must also offer at least one plan that doesn’t cover abortion services.

Making the situation more complicated still is the Republican-sponsored amendment that requires members of Congress to get their coverage through the marketplaces, which has raised questions about whether those lawmakers — who have been barred from receiving coverage for abortion services — willend up with plans that cover the procedure. Nonetheless, the federal government will not fund abortion under the health law. Obamacare stipulates that the insurers offering abortion coverage on the marketplaces must separate out federal money so it doesn’t go toward that type of reproductive care.

Another point of contention is the federal grants that the Department of Health and Human Services recently awarded to over 100 nonprofit organizations to assist in their efforts to enroll people in Obamacare. Abortion opponents are outraged that Planned Parenthood affiliates in Iowa, Montana, New Hampshire, and Washington, DC were among the grant recipients, and are now suggesting that these funds might go toward abortion services. But the Obamacare grant money has nothing whatsoever to do with abortion. “These grants will enable local Planned Parenthood affiliates to help people enroll in new, more affordable insurance plans that cover preventive care, maternity care, and emergency care,” a spokesperson for the organization explained.

4. Obamacare is forcing companies to slash employees’ hours and shorten the work week.

Over the past year, a growing list of large companies in the service sector have warned that Obamacare will force them to cut back their workers’ hours. The health law requires employers with 50 or more workers to provide adequate health benefits to anyone who works at least 30 hours a week — and CEOs are saying they can’t afford that, so they’ll need to make sure their employees don’t work more than 30 hours so they won’t qualify for coverage.

Large companies are blaming this move specifically on the health law. But in reality, Obamacare just serves as a convenient scapegoat for anti-labor practices. Employers have been attempting to shift more health costs onto workers for the past decade, and workers’ health care costs have beenskyrocketing as the same time as their wages have stagnated. Indeed, studies have shown that large employers were trying to slash workers’ hours long before Obamacare was around. Most large companies aren’t actually planning to slash their employees’ benefits specifically in response to health reform, despite the headlines proclaiming otherwise.

Nonetheless, the narrative that Obamacare is killing the business sector has persisted — and begun to devolve into pure nonsense. Crossroad GPS’ latest anti-Obamacare ad misleadingly claims that the health reform law now “redefines full-time as 30 hours a week,” which threatens jobs and wages for people who want to work more than that. Obamacare does no such thing. In reality, it simply hopes to protect 30-hour-a-week workers by making sure their employers are required to extend adequate health coverage to them. It’s not a particularly radical concept. Starbucks, for example, already provides health insurance to every employee who works at least 20 hours a week.

5. Obamacare is causing workers’ spouses to lose their health coverage.

Now that the myth about companies being forced to slash workers’ hours has been solidified, Obamacare opponents are onto a slightly modified version of the doomsday predictions about the health law’s impact on the business sector. After shipping company UPS announced that it would drop its employees’ spouses from its insurance coverage — specifically citing the health law — critics jumped on the news as evidence that Obamacare will be catastrophic for workers.

UPS cited increased costs under the health law to justify the move, but health insurance experts are skeptical that’s really the primary reason that the company decided to save money by eliminating spousal benefits. Instead, as aneditorial from Bloomberg suggested, UPS is likely “using the health-care law as a smokescreen for cutting costs it wanted to cut anyway.”

It makes sense that companies would be looking to trim their health costs, and shifting spousal coverage is one way to do it. But the media coverage of UPS’ move has largely left out the fact that Obamacare actually makes it much easier for the company to consider the move in the first place. Thanks to the health reform law, the spouses of UPS employees won’t be left out in the cold without any options to get insurance. They’ll be able to get it through their own employers — who will now be required to provide it — or through Obamacare’s new state-level insurance marketplaces.


Meet The Press · President Barack Obama

Obama To Appear Sunday On ‘Meet The Press’

Obama Meet The Press

This will be a rare occasion for the POTUS…

The Huffington Post

President Barack Obama will appear Sunday for an exclusive interview on “Meet the Press,” as fiscal cliff negotiations come down to the wire before the Dec. 31 deadline.

Obama didn’t sit for interviews on any of the Sunday public affairs shows while running for reelection in 2012. He last made the Sunday show rounds when pushing for health care reform in Sept. 2009.

“Meet the Press” host David Gregory, who sparked controversy and prompted a D.C. police investigation after holding up an empty gun magazine during last Sunday’s interview with National Rifle Association executive Wayne LaPierre, will return from vacation to conduct the interview with the president. NBC News has not commented on the police investigation.

Obama’s Sunday appearance will be his 11th on “Meet the Press” and second as president.

U.S. Politics

David Gregory on “Obamacare”: “Nobody’s really been given anything yet.” Oh really?

In my opinion David Gregory still has a lot to learn about “Obamacare”…

The Political Carnival

I was barely awake when the news was blasted loud and clear about the Supreme Court upholding the individual mandate. That woke me up pretty quickly. But you know what really opened my eyes? This quote by MSNBC’s David Gregory (host of NBC’s Meet the Press”) when he was asked to comment about how Republicans would respond to the president’s victory:

“Nobody’s really been given anything yet.”

He said that to buttress the idea that the voting public wouldn’t be swayed by the decision because, see, they haven’t “benefited yet,” so they still won’t support the plan.

Yes, he said that. Yes he’s uninformed and unqualified to work in the news media.

So none of this happened, David?

  • Providing Small Business Health Insurance Tax Credits Effective Jan. 1, 2010
  • Allowing States to Cover More People on Medicaid Effective April 1, 2010
  • Relief for Four Million Seniors Who Hit the Medicare Prescription Drug “Donut Hole” Program applied only on 2010.
  • Cracking Down on Health Care Fraud Many provisions effective now
  • Expanding Coverage for Early Retirees Applications for employers to participate in the program available June 1, 2010.
  • Providing Access to Insurance for Uninsured Americans with Pre-Existing Conditions National program established July 1, 2010
  • Putting Information Online Effective July 1, 2010
  • Extending Coverage for Young Adults Effective for health plan years beginning on or after September 23, 2010 Under the new law, young adults are allowed to stay on their parent’s plan until they turn 26 years old.
  • Providing Free Preventive Care Effective for health plan years beginning on or after September 23, 2010
  • Prohibiting Insurance Companies from Rescinding Coverage  Effective for health plan years beginning on or after September 23, 2010
  • Appealing Insurance Company Decisions  Effective for new plans beginning on or after September 23, 2010
  • Eliminating Lifetime Limits on Insurance Coverage Effective for health plan years beginning on or after September 23, 2010
  • Regulating Annual Limits on Insurance Coverage Effective for health plan years beginning on or after September 23, 2010
  • Prohibiting Denying Coverage of Children Based on Pre-Existing Conditions Effective for health plan years beginning on or after September 23, 2010 for new plans and existing group plans
  • Holding Insurance Companies Accountable for Unreasonable Rate Hikes Grants will be awarded beginning in 2010
  • Holding Insurance Companies Accountable for Unreasonable Rate Hikes Grants will be awarded beginning in 2010
  • Prescription Drug Discounts Effective January 1, 2011
  • Free Preventive Care for Seniors Effective January 1, 2011
  • Improving Care for Seniors after They Leave the Hospital Effective January 1, 2011

Oh, and there was this: Damn that “Obamacare” and its $1.1 billion in rebates!