Tuesday, August 13, 2013

ObamaCare, Waivers, Exemptions, Delays, Postponements, Suspensions, Affordable Care Act, Deadlines, Timeline

The Obama Administration acknowledges that a Long-Term Care provision in the health care law championed by the late Sen. Ted Kennedy is financially unsustainable.
Secretary of the Department of Health and Human Services Kathleen Sebelius wrote a letter to Congress that a 19-month “comprehensive analysis” of the Community Living Assistance Services and Supports (CLASS) program indicated that it is not viable.

Section 10407(d) mandate that the Secretary of Health and Human Services is required to “submit to Congress a report on the appropriate level of diabetes medical education.” This report has not been located as of 8/2013.
Also due and missed, the Secretary is required to “implement a 5-year national public education campaign on oral health care prevention and education.”
A requirement for the Secretary to “develop requirements for health plans to report on their efforts to improve health outcomes,” also due on March 23, 2012, has not been met

U.S. Government Accountability Office report: Obama administration is spending $8.35 billion to postpone Obamacare’s cuts to the market-oriented Medicare Advantage program.

Announces a one-year delay in issuing rules to states for putting in place a “Basic Health Program,” a Medicaid-like plan for low-income adults who don’t qualify for Medicaid and may not be eligible for insurance subsidies.

Congressional Research Service (CRS) report:  As of May 31, 2013 of 82 deadlines that the Affordable Care Act mandates upon the first three years of its own implementation, the administration has failed to meet 41.  White House had yet to meet 9 of 12 deadlines from the first year after the Affordable Care Act was enacted. It failed to meet 22 of 53 deadlines in the second year; another 8 became moot after Congress did not appropriate funds to complete the assigned tasks. In year three, the administration missed 10 out of 17 deadlines. That’s a total of 41 out of 82 deadlines missed.

Obama administration delays implementation of Obamacare’s employer mandate—the requirement that all firms with 50 or more employees offer health coverage, or pay steep fines—until 2015. The mandate was supposed to go into effect on 1/1/2014 with retroactive enforcement starting 7/1/2013.

Obama administration announces that it will significantly scale back the health law’s requirements that new insurance marketplaces verify consumers’ income and health insurance status.  Instead, the federal government will rely more heavily on consumers’ self-reported information ("the honor system") until 2015, when it plans to have stronger verification systems in place.

Department of Health and Human Services' inspector general report:  Centers for Medicare & Medicaid Services (CMS) - the agency within HHS that is running Obamacare - had set a May 13 deadline to deliver a plan to test the security of the crucial information technology component.
A test scheduled between June 3 and 7 was postponed and the delivery deadline and the test - assessing firewalls and other security elements - was re-set for August.
The delays in personal data security in the ACA exchanges mean that CMS's security certification of the Obamacare IT system will be pushed back from September 4 to September 30, a day before enrollment under the law is supposed to start.

Obama administration exempts Congress from being required to purchase health insurance from ACA exchanges. 
Under the law, they would not have qualified for government subsidies because of their high salaries. 
The Office of Personnel Management (OPM) will now pay 75% of the health insurance premium costs for Congressional staff.

A costly provision of the Affordable Care Act — its caps on out-of-pocket insurance costs, such as co-pays and deductibles — will be delayed for one more year.
The grace period has been outlined on the Labor Department’s Web site since February, but was obscured in a maze of legal and bureaucratic language that went largely unnoticed. When asked in recent days about the language, department officials confirmed the policy.

The Obama administration delays a step crucial to the launch of the new healthcare law, the signing of final agreements with insurance plans to be sold on federal health insurance exchanges starting October 1.
The U.S. Department of Health and Human Services (HHS) notifies insurance companies that it would not sign final agreements with the plans between September 5 and 9, as originally anticipated, but would wait until mid-September instead, according to insurance industry sources.
The reason for the hold-up is unclear. Sources attributed it to technology problems involving the display of insurance products within the federal information technology system.

SHOP Exchange—the small business exchange where small business owners will be able to compare plans side-by-side.
Health and Human Services Secretary Kathleen Sebelius confirms that while rates will be available to view on Oct. 1, when the exchanges are set to open, small businesses will not be able to buy insurance for another month.
Small businesses looking to enroll in coverage on so-called SHOP exchanges run by the federal government will be able to submit a paper application on Oct. 1 – they just won’t be able to enroll online.

“Healthcare.gov was initially going to include an option to browse before registering,” report Christopher Weaver and Louise Radnofsky in the Wall Street Journal. “But that tool was delayed, people familiar with the situation said.” Why was it delayed? “An HHS spokeswoman said the agency wanted to ensure that users were aware of their eligibility for subsidies that could help pay for coverage, before they started seeing the prices of policies.”

Healthcare.gov website opens as the portal for the ACA marketplace and is completely non-functional.

Obama administration grants a six-week extension from Feb 15 until March 31, 2014 for Americans to sign up for coverage next year and avoid new tax penalties under the president's health care overhaul law because of the non-functional healthcare.gov website.

Asks insurers to reinstate plans being canceled because they do not comply with minimum coverage requirements of the law.

The Obama administration plans to push back by a month the second-year start of enrollment in its health program to give insurers more time to adjust to growing pains in the law, a move that may stave off higher premiums before the 2014 congressional elections.
The enrollment period, previously scheduled to begin Oct. 15, 2014, will now start Nov. 15.
The decision means that sign-ups for the 2015 plan year would begin on Nov. 15, 2014 and end on Jan. 15, 2015 instead of the Oct. 15-Dec. 7 window previously announced.

The Obama administration is extending the date for individuals to enroll in health care plans.
As things stood prior to the announcement, individuals who wanted to be covered by Jan. 1 had to pick a plan by Dec. 15. That date has now been pushed back to Dec. 23

Extends the deadline to sign up for health coverage that takes effect on Jan. 1 by eight days (to Dec. 23) and delays the 2015 insurance enrollment period by a month, to Nov. 15, 2014, after the midterm elections.

Union-managed multi-employer health insurance plans are getting a special exemption from an Affordable Care Act tax. To make up for the lost revenue, taxes are going up on other plans.
The rules change exempts self-administered, self-insured group health plans from the law's reinsurance fee.

Spanish language version of Healthcare.gov...

Small business exchange...

Democratic Senate Majority Leader Harry Reid, one of Obamacare's architects and staunchest supporters, is also the only top congressional leader to exempt some of Reid's staff from having to buy insurance through the law's new exchanges.

Regarding the deadline to receive insurance coverage on January 1,  if an individual tries to sign up by December 23 but experiences an issue with the marketplace, they qualify for a special enrollment period and gain coverage as soon as possible.

The Pre-Existing Condition Insurance Program — which was supposed to expire at the end of this year — will continue through the end of January.

Announces that people whose policies have been canceled will be allowed to buy catastrophic coverage and will be exempt from tax penalties for not having insurance in 2014. It also extends for one month an expiring federal program for people with cancer, heart disease and other serious illnesses.

People whose health plans are being canceled because their coverage doesn’t meet Obamacare rules will be exempt next year from the mandate that all Americans carry medical insurance.
People losing coverage will now be allowed to buy bare-bones “catastrophic” insurance that the law usually limits to those younger than age 30.  Others can opt out completely without the threat of the fines being imposed next year on the uninsured as part of the Patient Protection and Affordable Care Act.

The deadline to sign up for Obamacare (scheduled for 11:59PM December 23 for January 1 coverage) has been pushed back 24 hours...

Announces that if people could show that they missed the deadline for coverage beginning Jan. 1 because of problems with Healthcare.gov, they might qualify for “a special enrollment period.” The administration did not say how long the period would last, but a spokeswoman said it was not providing “a blanket extension,” but was offering to provide “assistance to individuals on a case-by-case basis.”

Supreme Court Justice Sotomayor issues a temporary injunction barring the administration from enforcing the birth control requirement against an order of Colorado nuns, the Little Sisters of the Poor, and related groups.
After the brief is filed, Justice Sotomayor or the full court could extend or dissolve this temporary injunction while litigation moves forward in the lower courts. It is also possible that the Supreme Court would agree to hear the case immediately.
The 30,000 people with a history of serious illnesses who are enrolled in high-risk insurance pools created under the health care law in 2010 will have an additional two months -- until March 31 -- before they lose that coverage.
Late last month federal officials announced that they would extend the Pre-Existing Condition Insurance Plan (PCIP) — scheduled to close 12/31/2013 — until the end of this month to give people more time to enroll in health plans through state and federal insurance enrollment websites, many of which have been riddled with problems.
Enrollees in the high-risk pools must select a new plan by March 15 to avoid a gap in coverage. 

The Obama administration announced it will give medium-sized employers (between 50 and 99 employees) an extra year, until 2016, before they must offer health insurance to their full-time workers.
Firms with at least 100 employees will have to start offering this coverage in 2015.
These new Treasury Department regulations allow the nation’s largest employers avoid a fine by offering coverage to 70 percent of their full-time employees in 2015 and 95 percent starting in 2016.
Under an earlier proposal, employers with at least 50 employees would have been required to offer insurance, beginning 2015, to 95 percent of those who work 30 hours or more a week, along with their dependents.

The Massachusetts Obamacare exchange is awarded a three-month extension from the Obama administration to fix its broken website and get customers enrolled

Department of Health and Human Services announces that the supposedly temporary “fix” that President Obama announced in November to address the problem of the millions of Americans who lost coverage as a result of his health care law's minimum coverage requirements has now been extended through Oct. 1, 2016.

"Hard Luck" claims can be used to circumvent individual insurance mandates. 

In an attempt to limit the disruption to the insurance industry that would be caused by the move, HHS also announced that the “risk corridor” program (which has been described as a “bailout” to insurers; a means for shifting money from insurers who fare better under the new system to those who fare worse) would be further modified to funnel more money to insurers in states affected by the change.  Specifically, HHS would raise the administrative cost ceiling from 20 percent to 22 percent, and increase the risk corridors' profit margin floor from 3 percent to 5 percent.

Federal officials: all consumers who have begun to apply for coverage on HealthCare.gov, but who do not finish by March 31, will have until about mid-April to ask for an extension.
Under the new rules, people will be able to qualify for an extension by checking a blue box on HealthCare.gov to indicate that they tried to enroll before the deadline. This method will rely on an honor system; the government will not try to determine whether the person is telling the truth.
The rules, which will apply to the federal exchanges operating in three dozen states, will essentially create a large loophole even as White House officials have repeatedly said that the March 31 deadline was firm.

Administrative delay that will allow 18 states not to implement SHOP (Small Business Health Options Program).

Federal extension of 2015 enrollment period two additional months.

Six month delay in IRS enforcing financial penalty on small businesses providing Health Reimbursement Arrangements. 
HRA's do not comply with Obamacare and is therefore subject to a $100 fine per employee.