In the continued efforts by the Federal government to “DO ANYTHING,” “SPEND ANYTHING,” “REWRITE ANYTHING,” as long as we stick with Obamacare, we’ve seen the frightening capability of lawmakers to make something “WORK” at all costs, frequently in defiance of its own government-created provisions.
Based on available research that I’ve referred to before, there have been 42 changes to Obamacare neatly cited by the Galen Institute on 7/18/2014, “42 Changes to ObamaCare…So Far.”
All citizens lose when we have laws enforced, followed and implemented in the way in which Obamacare is being enforced, followed and implemented.
Uncertainty not only invites overstepping of authority by governments but the flipside of selective non-enforcement of laws by government. It invites governmental waste as the flipside of governmental generosity in paying entitlements as procedures and provisions are sporadically, unevenly, or inaccurately carried out by our public employees and invites wasteful, haphazard spending and shifting of our money being used by a federal government that simply rewrites why it’s justified in doing whatever it decides to do with our money. This is the Obamacare today.
This behavior is encouraged by media angling to interpret Obamacare as more “reform” than repackaging, more compassion than chaos, more public-interest centered than political. But this angling to make it work will likely only generate more wasted money, wasted time, and a complex, disorganized, uneven system of paying and collecting by the government that will likely leave all consumers paying for a program with the simple political goal of getting people to have insurance…no matter how bad that insurance coverage is in order for politicians to claim that people have insurance.
Yesterday I addressed the alleged "issue" regarding federal subsidies to people enrolled in Obamacare through the Federal Exchange. There’s no argument that the language of the Act does NOT include subsidies for people enrolling for Obamacare on the Federal Exchanges.
However, we had two court decisions, one honoring the law and the other “interpreting” that such subsidies were available for federal-exchange enrollees based on “intent.” Naturally, a whole slew of Obamacare fans defended the interpretation angle by misstating or partially stating legislative intent that supported their position.
In my post yesterday, “Jeffrey Toobin’s Interpretation, HELP Health Reform Legislation-Section by Section Narrative,” I quoted the legislative intent expressed in the 2009 document from 7/15/09 describing that intent where it states that “Until a state becomes either an establishing or participating state, the residents of that state will not be eligible for premium credits, an expanded Medicaid match, or small business credits,” “HELP,” 2009. Not really seeing the “INTENT” for us to pay to cover subsidies by expanding the entitlements.
Today there are headlines such as the “LA Times,” announcing, “Many May lose Obamacare coverage because of missing paperwork,” by Noam N. Levey, http://www.latimes.com/nation/healthcare/la-na-obamacare-terminations-20140916-story.html. But should they have had Obamacare to begin with?
Neatly omitted in the article about unverified immigration status and missing “forms proving their income,” is the question of whether these individuals should have ever had Obamacare to lose if they didn’t provide the necessary or accurate paperwork.
The law provides in PPACA Sec. 1412 under its heading: “Advance determination and payment of premium reductions” that The Secretary, in consultation with the Secretary of the Treasury, shall establish a program under which—
(1) upon request of an Exchange, advance determinations are made under section 1411 with respect to the income eligibility of individuals enrolling in a qualified health plan in the individual market through the Exchange for the premium tax credit allowable under section 36B of the Internal Revenue Code of 1986 and the cost-sharing reductions under section 1402, https://sites.google.com/site/healthreformnavigator/ppaca-sec-1412. (emphasis added)
Section “1411(e) (2) VERIFICATION” continues:
“(A) ELIGIBILITY FOR ENROLLMENT AND PREMIUM TAX CREDITS AND COST-SHARING REDUCTIONS.—If information provided by an applicant under paragraphs (1), (2), (3), and (4) of subsection (b) is verified under subsections (c) and (d)—
(i) the individual’s eligibility to enroll through the Exchange and to apply for premium tax credits and cost-sharing reductions shall be satisfied
The language is UNEQUIVOCAL. IF INFORMATION IS VERIFIED THEN ELIGIBILITY SHALL BE SATISFIED.
Section 1411(e)(4) “INCONSISTENCIES INVOLVING OTHER INFORMATION” provides for (i) REASONABLE EFFORT.—The Exchange shall make a reasonable effort to identify and address the causes of such inconsistency, including through typographical or other clerical errors, by contacting the applicant to confirm the accuracy of the information, and by taking such additional actions as the Secretary, through regulation or other guidance, may identify and provide “(ii) NOTICE AND OPPORTUNITY TO CORRECT.—In the case the inconsistency or inability to verify is not resolved under subparagraph (A), the Exchange shall—
(I) notify the applicant of such fact;
(II) provide the applicant an opportunity to either present satisfactory documentary evidence or resolve the inconsistency with the person verifying the information under subsection (c) or
(d) during the 90-day period beginning the date on which the notice required under subclause (I) is sent to the applicant.
The Secretary may extend the 90-day period under subclause (II) for enrollments occurring during 2014.”
SHOULD THESE PEOPLE IN JEOPARDY OF ‘LOSING’ THEIR COVERAGE EVER HAD IT TO BEGIN WITH OR WAS THIS JUST ANOTHER FAST-AND-LOOSE APPROACH TO PUMP UP ENROLLMENT NUMBERS?
The Affordable Care Act sensibly requires VERIFICATION of eligibility BEFORE the federal government starts using its mad money, which obviously was NOT done.
While the author Noam Levey worries about the “backlash from consumers who be asked to repay hundreds or thousands of dollars in subsidies,” I don’t see any worry about the fact that these subsidies should never have been paid to begin with and that in many cases these sums may be unrecoverable.
