Beware the word Entitlement. In Washington-World “entitlement” is a magic and dreaded word. For those receiving the particularly unfortunate monies designated as entitlement it’s a sure sign that the money is on the chopping block.
For those in Washington posturing about being anti-waste and anti-big government it’s a means of trimming Washington’s expenses without affecting themselves, sort of a macrocosm of the Congressional gym remaining open during the “shutdown.”
With the agreement on a debt ceiling provision, known currently as the “Default Prevention Act of 2013,” you can read about the entitlement of those qualifying for health exchange enrollment to a free pass on healthcare premiums, with governments and insurance companies advertising ways that individuals can obtain health insurance for a cost of $0.
What about the rest of us? The new Act has no impact on us. The unemployed poor left out of the entitlement to credits and rebates available on exchanges since only the employed can use exchanges, those who obtain health insurance from their employers who are facing higher premiums because, hey, insurance companies need to make up their money somewhere, and dependents, like spouses, who formerly could be covered by a head-of-household who can no longer afford their insurance who will not qualify to use health exchanges because other insurance is available to them even if it’s at price-gouging levels.
The premium credits and rebates, and cost-sharing provisions of Obamacare are an entitlement, rewarding some citizens with low to no premiums through federal funding. Yet, the word entitlement is not attached to the rebates and credits in Obamacare.
Today, a big deal is being made that the income verification provisions of the Obamacare credits and rebates entitlement have been resurrected by yesterday’s “Default Prevention Act of 2013.”
While already this morning politicians are talking about dismantling “entitlements “such as Social Security and Medicare, you know, those programs we’ve paid into all our lives, the only change to Obamacare entitlements of rebates and credits is a return to a former timeline for income verification.
Under the Act, “Division B-Other Matters,” income verification is addressed, and it’s essentially nothing but a resurrection of the plan to verify income of those receiving credits and reductions available requiring the Secretary to “…certify to the Congress that the Exchanges verify such eligibility…”
Income verification is back on beginning in January, 2014. Under the heading “(b) Report by Secretary-Not later than January 1, 2014, the Secretary shall submit a report to the Congress that details the procedures employed by the…Health Benefit Exchanges to verify eligibility for credits and cost-sharing.” In the next section “(c) Report by Inspector General,” it is provided that a “…report regarding the effectiveness of the procedures and safeguards…for preventing the submission of inaccurate or fraudulent information,” will be submitted to Congress “…not later than July 1, 2014.”
A few interesting aspects of this provision come into play. First, what are we resurrecting? If you look at the CBO.gov website and search for the July 30th 2013 to Paul Ryan as Chairman of the Committee on the Budget from the Director of the CBO, Douglas Elmendorf, notes that income verification under the PPACA is going to be conducted by HHS for “…a statistically valid sample of applicants in 2014, as expected.” In July, the only suspension of the income verification was this step of taking a statistically valid sample and verifying income by HHS for state-run exchanges until 2015.
Under yesterday’s Act, presumably the state-run exchanges will also be subject to the “rigors” of having “a statistically valid sample” of individuals getting rebates and credits subjected to governmental follow-up. For a gambler, it comes to weighing the odds before cheating, and determining whether they believe they’ll be part of the sampling.
There were already stiff penalties in the PPACA for defrauding the government in obtaining subsidies and credits under Obamacare which provides a band of workers with the Obamacare entitlement in the form of virtually free premiums for healthcare.
There’s also the issue of why the extension of the income verification provision was put off to begin with, presumably because HHS couldn’t manage it, in the letter above only explained by noting that “…the final regulations indicate that HHS will not conduct follow-up verification on behalf of the state-run exchanges until January 1, 2015.”
Two choices on this one, either there was no reason to extend the provision in the first place OR there is no way HHS will be able to implement the provision by January 1, meaning that the extension will be reincorporated into law.
