Free Republic

The inspector general for the Department of Health and Human Services released a report highlighting problems verifying eligibility for federal health insurance subsidies under the Affordable Care Act.Here are five issues the IG found in place as of Feb. 23:1. Fraud could be significant. The audit found the federal government has been unable to resolve 2.6 million out of 2.9 million “inconsistencies” in the information provided by people who applied for health care subsidies. In other words, it could not verify the data provided by people seeking subsidies.2. Most inconsistencies were about citizenship and income. The vast majority of the...

BeneStream, created and backed by labor experts, is looking capitalize on an "intentional crack" in Affordable Care Act language by helping companies enroll low-income workers on Medicaid. BeneStream will capitalize on a subscription service to employers that will analyze the pay of every employee, and then offer to enroll low-income candidates into Medicaid. Between 20% and 40% of employees at companies in industries like hospitality and home health care will qualify for Medicaid enrollment. "It's both good policy and good business," said Andy Stern, a BeneStream board member and a former president of the Service Employees International Union. Both Messrs....

I need help and advice from my fellow freepers. The situation is this: recently, son and wife had a baby. Her health care covered their family and all expenses, but they couldn't afford a baby sitter, even on their combined salaries so she had to quit, so son quit a job which he loved and they moved to be near us, He lined up a job relatively quickly, but it is seasonal and no benefits. It's meant to tide them over until he gets a better job. Baby is past due for her checkups (thank goodness she's healthy). So son...

The Government Accountability Office has released a shocking report on Medicaid waste. They found that $14 billion had been improperly paid to managed care organizations (MCO's) who work with state Medicaid agencies to service eligible clients. Washington Examiner: The "size and diversity" of the MCOs have put both state and federal governments at odds on how to oversee the payments, the report said. Specifically, the wrong payments made were for treatments or services not covered, not necessary, or billed for but never provided, GAO found. States that expand Medicaid programs under Obamacare will receive a 100 percent reimbursement from...

The White House will be so disappointed. Obama officials were really counting on McAuliffe to make this Medicaid expansion happen in good time, and McAuliffe in turn was really counting on his boozing-and-schmoozing skills to translate into his own made-up version of bipartisan governance. He has so far been remarkably unsuccessful at persuading either Republican legislators or Virginian voters to come around to his way of thinking on the proposed expansion, and there’s been some speculation that McAuliffe might keep up a budget standoff that could lead to the shutdown of the Virginia state government this summer — but...

RICHMOND— Gov. Terry McAuliffe plans to expand Medicaid by executive action, he said Friday, sidestepping a Republican-controlled General Assembly that has blocked expansion through legislative action. McAuliffe also said he will veto sections of the state budget, including language meant to block expansion by fiat. His administration is looking at a number of options - which the governor did not detail - and expects to have a formal plan by September. The move leads Virginia into complex legal ground on arguably the most divisive political issue in the state. The governor said he'll allow most the spending plan to become...

irginia Governor Terry McAuliffe (D) on Friday said he would sign the state’s two-year budget but veto an amendment that would prevent him from expanding Medicaid under ObamaCare. McAuliffe plans to move forward with an expansion of Medicaid in his state under the new healthcare law. He also will scrap a proposed legislative commission on Medicaid reform, according to the Richmond Times-Dispatch. The Virginia Democrat has ordered Secretary of Health and Human Resources Bill Hazel to propose a Medicaid expansion plan by Sept. 1. McAuliffe promised he would expand Medicaid when he was running for governor. “We have the right...

Republican U.S. Sen. David Vitter, running to be Louisiana's next governor, is leaving the door open to a possible expansion of the state's Medicaid program to cover more of the working poor, as allowed under the federal health care law. Vitter said Monday that he's not opposed to the expansion if Louisiana can improve the performance of its Medicaid program and if the expansion doesn't draw state resources away from other spending priorities like higher education.

U.S. Centers for Medicare and Medicaid Services disclosed that 6 million of the 8 million people who signed-up for the Patient Protection and Affordable Care Act (Obamacare) will be receiving healthcare from Medicaid that is so affordable it is free. The revelation that seventy-five percent of the expansion of health insurance is Medicaid comes just 48 hours after the Department of Health and Human Services said many of the other 2 million that had “purchased� insurance on HealthCare.gov“ may have received greater subsidies than merited or were allowed to purchase plans for which they were ineligible.� Given the huge influx...

WASHINGTON -- With Virginia Sen. Phil Puckett's resignation on Sunday tipping control of the chamber, state Republicans didn't waste any time. The Washington Post reports that Republicans on Monday have forced Democrats to agree to pass a state budget without accepting the federal government's offer of a Medicaid expansion, dealing a blow to one of Gov. Terry McAuliffe's signature initiatives.

Conservatives in the Ohio House this week blocked a move widely viewed as an attempt by Governor John Kasich to set aside money he could later spend on Medicaid expansion without legislative approval. The version of House Bill 483 (HB 483) passed by the Ohio Senate included a last-minute change to move as much as $300 million in surplus state revenue to the state Medicaid Reserve Fund. Legislators feared this was an effort by the Kasich Administration to circumvent the General Assembly for spending on the Obamacare Medicaid expansion when an existing appropriation expires in mid-2015. ... Kasich, a Republican,...

ALBANY, N.Y. (AP) — Two years after a 33-year-old mentally disabled man died at a state institution in Queens, and one year after his sister filed a lawsuit accusing the staff of killing him, New York officials have sent her an $11.67 million bill. The claim against Rasheen Rose's estate cited his total Medicaid assistance from Aug. 6, 2002, through Aug. 6, 2012, the day he died. A spokeswoman for the Office for People with Developmental Disabilities, which runs the center, said Wednesday officials were following federal Medicaid obligations in seeking reimbursement. "Not doing so would be a violation and...

Four years after its passage, Obamacare has now been largely implemented, and millions have had their coverage disrupted. For years, the administration has propagated a number of myths about Obamacare. Some have already crumbled, and others will fall as Obamacare continues to change the American health system.Myth No. 1: If you like your health plan, you can keep it. Despite President Obama’s promise that “If you like your plan, you can keep it,� about 6 million people have already been notified by insurance companies that their policies are being canceled. That number will grow. Currently, about 19 million people have...

Following the lead of Maryland, Oregon, and, most recently, Massachusetts, Nevada became the fourth state last week to drop its troubled health exchange website after facing serious technological issues and significantly missing the mark on enrollment predictions. Instead of the current enrollment system, Nevada’s Silver State Health Insurance Board unanimously voted to transition to the HealthCare.gov infrastructure for enrollment. This may not be a permanent transition, however, with the state planning to keep its options open for the future, possibly adopting enrollment software that was successful in other state-run exchanges.

From California to Rhode Island, states are confronting new concerns that their Medicaid costs will rise as a result of the federal health care law. That’s likely to revive the debate about how federal decisions can saddle states with unanticipated expenses. Before President Barack Obama’s law expanded Medicaid eligibility, millions of people who already were entitled to its safety-net coverage were not enrolled. Those same people are now signing up in unexpectedly high numbers, partly because of publicity about getting insured under the law. For states red or blue, the catch is that they must use more of their own...

Hospital systems around the country have started scaling back financial assistance for lower- and middle-income people without health insurance, hoping to push them into signing up for coverage through the new online marketplaces created under the Affordable Care Act. The trend is troubling to advocates for the uninsured, who say raising fees will inevitably cause some to skip care rather than buy insurance that they consider unaffordable. Though the number of hospitals tightening access to free or discounted care appears limited so far, many say they are considering doing so, and experts predict that stricter policies will become increasingly common....

HUNTSVILLE, TX, May 21, 2014 (LifeSiteNews.com) – A Planned Parenthood affiliate in Texas bilked state and federal taxpayers for 10 years by performing unnecessary medical procedures on incarcerated teens, most of whom are minorities, according to a lawsuit filed by a whistleblower. “Planned Parenthood targets an incarcerated population of minority youth exclusively for unnecessary testing and fraudulent claim billing,” according to a lawsuit filed by Patricia Carroll, an Accounts Receivable Manager at Planned Parenthood Gulf Coast (PPGC) from October 2007 until she resigned in October 2012.

A third lawsuit has emerged accusing Planned Parenthood Gulf Coast of committing Medicaid fraud. Former PPGC accounts receivable manager Patricia Carroll is alleging her former employer falsified Medicaid claim forms and double billed. Carroll joins former Planned Parenthood Gulf Coast employee Karen Reynolds, who won her case in 2013 and received a $1.25 million bounty from the $4.3 million settlement paid by PPGC to Obama’s Department of Justice, and former PPGC employee Abby Johnson, whose lawsuit accusing PPGC of $6 million in fraud is still pending. Carroll originally filed a sealed whistleblower lawsuit in 2012, but at some point the...

A half-century ago, a governor named Brown persuaded the California Legislature to embark on what those involved thought would be a modest new program of health care for poor Californians. Medi-Cal, as it was dubbed, was California's version of the national Medicaid program that had been attached to the new Medicare system of health care for the elderly. At the time, California's poor obtained medical care, if they did, from either charity or county-owned hospitals, and Medi-Cal was seen as a way of easing the burden on the counties' taxpayers. But as one of the participants in the Medi-Cal legislation,...

More than one-fifth of the popu-lation of the United States was receiving Medicaid benefits before the passage of The Affordable Care Act (ACA). The ACA expanded eligibility to adults under the age of 65 who have income up to 138 percent of the federal poverty level. As originally written, the ACA relied on two provisions intended to entice and prod states to expand their Medicaid programs. So far, about half of the states have expanded their programs. The carrot enticing states to expand their programs is the generous federal participation. This year, the federal government will cover 100% of the...

WASHINGTON — Surgery patients covered by Medicaid arrive at the hospital in worse health, experience more complications, stay longer and cost more than patients with private insurance, a new study has found. The study, by researchers at the University of Michigan, may offer a preview of what to expect as millions of uninsured people qualify for Medicaid under the Affordable Care Act.

Indiana Gov. Mike Pence has joined a growing list of Republican governors using Obamacare as a way to expand Medicaid. Pence announced Thursday a blueprint of conservative reforms to extend health coverage to a larger share of low-income residents, some of which already have been adopted by other red states, Politico reports. Pence said his proposal was "the kind of health reform that puts working Hoosiers in the driver's seat," according to Politico. Urgent: Do You Approve Or Disapprove of President Obama's Job Performance? Vote Now in Urgent Poll The plan outlines a number of specific proposals including: placing enrollees...

NBER Report: Medicaid Expansion Reduces Incentives to Work Sean Riley | May 15, 2014 | Add a comment A working paper released this month from the National Bureau of Economic Research concludes that public insurance programs reduce incentives to work for low-income childless adults—precisely the population Medicaid expansion under the Affordable Care Act targets. The paper comes on the heels of the widely-cited February 2014 Congressional Budget Office report estimating that the ACA, including Medicaid expansion, would cause a decline of 2.5 million full-time-equivalent employees by 2024. In that case, proponents of the ACA defended the findings by arguing it...

OAKLAND, Calif. -- It's been two months since Rodrigo Salido left the maximum security wing at Santa Rita jail, and two months without pills for his bipolar disorder. Now Salido, who served two years for burglary, assault and gang involvement, has no health insurance and few options for refilling his medication. California and 25 other states, under a provision of President Obama’s health law, opened up Medicaid to single and so-called “childless” adults. The change in eligibility criteria will extend Medicaid coverage to vast numbers of ex-offenders whose incomes are below the federal poverty line. Men and women involved in...

It looks as if Indiana may soon join the list of red states signing up for the Affordable Care Act's Medicaid expansion. Republican Gov. Mike Pence, after months of discussions with the Obama administration, offered a plan Thursday to expand Medicaid coverage to low-income uninsured Hoosiers. About two dozen states still haven't joined the Affordable Care Act Medicaid expansion, which extends coverage to low-income adults earning up to 138 percent of the federal poverty level. Some states like Texas and Louisiana appear entrenched in their opposition to major elements of the health care law. Other Republican states, however, are still...

And Another Republican Governor Embraces ObamaCare's Medicaid Expansion Yesterday we covered how Arkansas Republicans went along with ObamaCare, today another GOP Governor drinks the Kool-Aid. Et tu, Mike Pence? More than a year in the making, HIP 2.0, as his staff has nicknamed it, would replace traditional Medicaid for all non-disabled Hoosiers ages 19 to 64 with incomes up to 138 percent of the federal poverty level. If accepted by the Obama administration, it would expand coverage to an additional 350,000 Hoosiers who now lack a viable health insurance option, the governor's staff estimates. ... If approved, the move could...

Nearly one-third of California’s total population -- roughly 11.5 million people -- will be enrolled in Medi-Cal next year.. Enrollment is expected to exceed previous estimates by 1.4 million, and administration officials said it would cost the state $1.2 billion more than originally thought.

The health care law has opened up an unusual opportunity for some mothers-to-be to save on medical bills for childbirth. Lower-income women who signed up for a private policy in the new insurance exchanges will have access to additional coverage from their state’s Medicaid program if they get pregnant. Some women could save hundreds of dollars on their share of hospital and doctor bills. Medicaid already pays for nearly half of U.S. births, but this would create a way for the safety-net program to supplement private insurance for many expectant mothers. Officials and advocates say the enhanced coverage will be...

A new report finds that Obamacare customers are in for sticker shock because, unlike many employer-sponsored insurance plans, the fine print in many Obamacare policies requires patients to meet their deductible before lower-cost prescription drug co-pays kick in. That means hefty out-of-pocket expenses for Obamacare plan holders, especially since Obamacare deductibles are "relatively high" as compared to employer-sponsored insurance plans. The report, which was conducted by the Robert Woods Johnson Foundation and Breakaway Policy, concludes that even Obamacare customers who receive taxpayer-funded subsidies will "find it difficult to afford the amounts they will have to pay out-of-pocket before their Exchange...

RICHMOND — Virginia Gov. Terry McAuliffe is considering expanding health coverage for the poor without the approval of the state legislature, a move that would muscle his top priority past Republican opponents but also throw his young administration into a partisan firestorm and uncertain legal territory. McAuliffe and his top advisers have consulted lawyers, health-care experts and legislators on how to bypass the GOP-dominated House of Delegates, according to three people familiar with the discussions. A fourth, who like the others spoke on the condition of anonymity because they were not authorized to reveal private strategy, said the office of...

Spending on health care grew an astounding 9.9% in the Bureau of Economic Analysis' advance estimate of first-quarter GDP. It's the biggest percent change in health-care spending since 1980, when health-care spending jumped 10% in the third quarter. Analysts said it's primarily due to a consumption boost from the implementation of the Affordable Care Act. Adjusted for inflation, America is spending more on health care than ever before.Personal consumption grew by 3.0%, about half of which was due to the growth in health-care spending, said Ian Shepherdson, chief economist for Pantheon Macroeconomics. "If health-care spending had been unchanged, the headline GDP growth number would have...

President Obama is doing his victory dance, telling us how his health care plan has become a success because his more than his targeted number (8 million) clicked their desire to have health insurance on a website. We will soon see how many are real policyholders, and later we will see their real costs as everything shakes out with co-pays and renewals next year. What we do know is that Medicaid is a pending disaster waiting to happen. When the Obamacare registration period started we were regularly hearing about all those new Medicaid sign-ups. Then we did not hear about...

Have you ever wondered why ObamaCare is burdened with so much complexity? Here's the answer: Barack Obama. Obama? Yes, the president himself. He campaigned on the promise that he would put partisanship aside and unite the country behind sensible answers to pressing problems. Then he didn't. How could that possibly have worked in health care? Easy. Obama could have adopted the approach taken by his 2008 opponent, John McCain. In fact we now know that Zeke Emanuel and others on the White House staff were urging him to do just that. Also, before he became the president's chief economic adviser,...

Getting teens to sign up for the Affordable Care Act and learn how to obtain contraceptives through Obamacare, was the focus of an event hosted by the D.C. Campaign to Prevent Teen Pregnancy at the Church of Scientology’s National Affairs Office in Washington, D.C. on Thursday, a gathering that featured officials from the Health and Human Services Department and the Planned Parenthood Federation of America (PPFA) . Wilma Robinson, deputy director of the HHS Office of Adolescent Health, said she was attending to explain “the impact of the Affordable Care Act on adolescents,” which she defined as girls and boys...

Sen. Rand Paul (R-Ky.) admitted Friday it’s “difficult to turn the clock back” on ObamaCare, but proposed making the law voluntary as a possible fix for consumers. “I think it’s going to be difficult to turn the clock back. People get assumed and accustomed to receiving things, particularly things that they get for free,” he told a crowd of students at Harvard’s Institute of Politics on Friday. Paul’s comments echo those of other Republicans who have admitted it will be difficult to fully repeal the law after some of its more popular provisions took effect. The potential 2016 presidential candidate...

Earlier today, Oregon became the first state-run health exchange to adopt the federal HealthCare.gov exchange portal. After receiving more than $300 million dollars in federal grants, the state struggled to sign up private insurance enrollees through their own online portal, Cover Oregon. Due to these difficulties and the projected costs of fixing the exchange, a technological advisory committee recommended to Oregon’s exchange board on Thursday that the state transition to using the federal exchange, rather than attempt to fix its existing exchange. Today, state officials approved the advisory board’s recommendation. Examining the cost projections between the two options, state officials...

Millions of Americans fall into the 'coverage gap' where they do not get Medicaid, but are too poor to qualify for federal subsidies on the new insurance exchanges.

The Illinois Medicaid program paid an estimated $12 million for medical services for people listed as deceased in other state records, according to an internal state government memo. The memo dated Friday, which The Associated Press obtained through a Freedom of Information Act request, says the state auditor compared clients enrolled in the Medicaid database with state death records dating back to 1970. Auditors identified overpayments for services to roughly 2,900 people after the date of their deaths... Republicans have pressed for the state to use a private company to verify Medicaid eligibility. Maximus Health Services was hired to scrub...

Republicans “still can’t bring themselves to admit that the Affordable Care Act is working,” President Obama told a news conference on Thursday. He also took aim at states that have not expanded their Medicaid programs:“This does frustrate me—states that have chosen not to expand Medicaid for no other reason than political spite. You got 5 million people who could be having health insurance right now at no cost to these states—zero cost to these states—other than ideological reasons they have chosen not to provide health insurance for their citizens.”But some governors, pointing to President Obama’s own broken promises, simply don't...

Washington state has blown past its targets for signing up new Medicaid participants under the Affordable Care Act (ACA). The program’s ranks have grown roughly 25 percent in the past six months, helping fulfill one of the act’s key goals to provide health care to nearly all Americans. But with enrollment success comes the challenge of serving more people in a $10 billion program that’s already stretched thin in places. Some of the new enrollees haven’t seen a doctor in years and need help navigating the health-care morass. Medicaid patients already struggle to get care in parts of the state...

Four years after Obamacare became law, the Department of Health and Human Services (HHS) is notifying Medicare providers and suppliers of new fingerprint-based background checks. Eventually, all individuals who hold a five percent or greater stake in a Medicare supplier or provider that is categorized as "high risk" will be subject to the requirement. The provision is part of the Medicare, Medicaid, and CHIP Program Integrity Provisions (Title E) of the Affordable Care Act, and gives the HHS secretary broad discretion in applying the background check requirements depending on the potential for abuse, fraud, and/or waste. The new requirements are...

Lost in the overall shuffle concerning the many problems with Obamacare’s exchanges is the central problem of enforcement of those aspects of the law the president hasn’t waived or delayed yet – including the particular challenge when it comes to verifying the immigration status of those applying for taxpayer subsidized insurance. On April 1st, the Centers for Medicare and Medicaid Services issued a new guidance document to health insurers. The CMS guidance says that people whose immigration status is uncertain will be presumed eligible for subsidized coverage in Obamacare’s marketplaces while a further review is pending. Emphasis mine: If there...

It may be water over the dam, but one report on the potential impact to employers if Michigan did not adopt the Obamacare Medicaid expansion has been exposed as being essentially bunk due to flagrant misuse or misrepresentation of the data it cited. This is worth noting because the claims from Jackson Hewitt were widely cited by Republican lawmakers here who supported the expansion, and probably tilted others into that camp. Its conclusion was that "employers may pay substantially higher federal tax penalties under the ACA (Affordable Care Act) in states that do not expand Medicaid." Jackson Hewitt estimated Michigan...

Millions of Americans who didn't have health insurance last year now do, as a result of the Affordable Care Act. In Lane County, Oregon, Trillium Community Health Plan is struggling to deal with a huge influx of new patients. CEO Terry Coplin says they expected 26,000 people to sign up in the first few years. Instead, about that many signed up in the first few months. "We weren't expecting to get such a large assignment of patients in the first two months," says Coplin. "These patients who are coming onto the program, many have not seen a physician for years....

Sally Kohn, a “progressive” homosexual activist and writer at the Daily Beast, makes some mighty tall claims in her column from Tuesday, “New Poll Shows Voters in Red States Want to Expand Medicaid.” Citing several polls, including one from NPR and one commissioned by MoveOn from Public Policy Polling, she claims that the popularity of Medicaid expansion in conservative states is now soaring. The leftist polling also indicates that 75 percent of Americans nationwide support the expansion of Medicaid, and the claim is that the “overall” popularity of Obamacare is rising. But, Kohn insists that Republicans are desperate to create...

Vance McAllister, the Louisiana Republican who got elected to Congress on Saturday after being endorsed by Duck Dynasty's Willie Robertson, supports amnesty for all of the country's illegal immigrants. “We have to secure the borders, but (citizenship) has to be attainable for those people already here,” he told Thetowntalk.com before the election. “It has to be a tough path, but it has to be attainable.”

The number of Americans who were enrolled in Medicaid at any time during fiscal 2013 exceeded the entire population of the United Kingdom, according to new data published by the federal government’s Medicaid and CHIP Payment Access Commission (MACPAC). Were Medicaid a nation instead of a U.S. entitlement program it would be the 20th most populous country on earth. …

And here I bet some of you thought the 2013 elections were over, didn’t you? Well, they were for the most part, but given the variations in election laws and special circumstances from state to state, there’s always some action brewing someplace. In this case, the congressional seat in Louisiana’s 5th district was open due to Republican Rodney Alexander’s resignation earlier this year to take a job with the Jindal administration. That required a special election, which began earlier this fall. Because of Louisiana’s somewhat unique election structure and the fact that nobody got more than 50% of the vote,...

Mr. McAuliffe stated,point blank,he would not engage in partisan skullduggery to affect the expansion of Medicaid under Obamacare at the expense of the Virginia State budget, yet that is exactly what he is doing. Less than six months after taking office, Mr. McAuliffe is not only doing “a 180” on his campaign promise not to hold the budget hostage to his whim, but doing so at the expense of the State budget and the well-being of State government. So what does it mean when we say Gov. McAuliffe and his Progressive and Democrat stooges will hold the budget hostage in...

WASHINGTON – The Obama administration often touts that people with pre-existing conditions and countless others can now get covered under ObamaCare. But there's another group that's starting to benefit from the law -- prison inmates. Cash-strapped state and local prisons increasingly are using the Affordable Care Act to pay for their inmates' medical costs, taking advantage of a little-known provision that lets them shift some of those expenses to the federal government. Ohio, Illinois and Iowa are among the states trying to offload the rising costs of health care – which include mental health programs – by enrolling inmates into...