In a 6-3 decision Thursday morning, the Supreme Court found that the Affordable Care Act
has a permanent place in American government allows the federal government to give subsidies to states without a state-run healthcare exchange, including Georgia. Our elected officials had some words. Read more
There were a number of moments during Tuesday’s House Oversight and Government Reform Committee hearing on the transparency failures of ObamaCare. Republican members took turns grilling Jonathan Gruber, the economist who worked with the Obama administration to craft the law, and Centers for Medicare and Medicaid Services Administration Marilyn Tavenner.
Toward the end of the hearing, Rep. Doug Collins (R-GA) got his chance to question Gruber, who has come under fire in recent weeks for calling voters “stupid” on a few different occasions. Unlike many of colleagues, Collins didn’t spend much his limited time grilling him. Instead, he spent under a minute with a short but pointed statement to Gruber.
Yeah, Michelle Nunn is the presumptive Democratic nominee for U.S. Senate, so why would she put herself on the same stage as three “also-rans” when it could only hurt her in a general election?
But Nunn isn’t just missing in action from debates. She’s also avoided talking about big issues that concern voters in competitive races, including Georgia. Politico, for example, released a poll this morning showing that Obamacare remains a toxic issue for Democrats — oh, and Nunn is in a Democrat, in case you couldn’t tell from watching her ads.
If you believe the numbers coming out of the Obama administration, some 222,000 Georgia “enrolled” into health plans on the federal Obamacare exchange. Only they didn’t. Turns out that about half of those people have actually paid their insurance premiums:
Georgia insurers received more than 220,000 applications for health coverage in the Affordable Care Act’s exchange as of the official federal deadline of March 31, state officials said Wednesday.
Insurance Commissioner Ralph Hudgens, though, said premiums have been received for only 107,581 of those policies, which cover 149,465 people.
“Many Georgians completed the application process by the deadline, but have yet to pay for the coverage,” Hudgens said in a statement Wednesday.
March 31 was the official deadline for individuals to get insurance coverage or face a financial penalty under the ACA. Yet because of the deluge of last-minute shoppers, federal officials relaxed the rules for those who reported having trouble with the exchange, and gave them into this week to sign up.
Given that extra time, there have presumably been more Georgians both signing up and paying for their premiums in April. They would not be included in the figures released Wednesday.
Jim Galloway reports that the Georgia Health Care Freedom Act (HB 707) may hit the state House floor for a vote on Monday, citing state Rep. Ed Lindsey (R-Atlanta) as his source.
“Lindsey specifically named HB 707 and HB 990 [as measures he’ll be pushing on Monday], which are not yet on the House calendar,” Galloway reported yesterday. “Lindsey is either misinformed, which is unlikely, or just spilled the beans, our AJC colleague Aaron Gould Sheinin informed us.”
Georgia Health Care Freedom Act, introduced by state Rep. Jason Spencer (R-Woodbine), is based on model legislation written by the Tenth Amendment Center, an organization that offers legislators solutions on how to push back against the federal government on issues like Obamacare and the NSA’s domestic surveillance programs on the state level.
The measure would prohibit Georgia as well as any counties and cities from establishing a health insurance exchange. It also bars state department and agencies from providing support to implementing provisions of the law.
“Atlanta Mayor Kasim Reed, for instance,” Galloway explains, “would be barred from hosting a health fair that helped his residents sign up for insurance offered by federal Obamacare exchanges.”
In order for HB 707 to have a chance to become law this year, barring an unlikely suspension of the rules, it has to clear the House by the end of legislative business on Monday, which is Crossover Day.
The legislation is co-sponsored by state Reps. David Stover (R-Newnan), Scot Turner (R-Holly Springs), Michael Caldwell (R-Woodstock), and Kevin Cooke (R-Carrollton). Lindsey is also a signer to the bill.
On Monday, the Department of Health and Human Services (HHS) finally shed some light on the age demographics of those who have selected health plans on the state and federal Obamacare exchanges.
While much attention has been paid to the overall numbers, the age demographics — specifically, the number of 18 to 34 year-olds — of those who are signing up for health insurance coverage may be more important.
Last summer, before the launch of the exchanges, HHS Secretary Kathleen Sebelius said that the goal was to enroll 7 million people into health plans, of which 3.3 million were expected by the end of 2013. That overall open enrollment goal includes 2.7 million people (or 38% of all enrollments) needed to come from the 18 to 34 year-old age demographic, sometimes called “young invincibles.”
Based on the HHS numbers, Georgia isn’t on pace to meet its overall enrollment goal. Per an August 2013 memo, the Centers for Medicare and Medicaid Services (CMS) anticipated that 144,840 enrollments in Georgia by year’s end and 204,000 through March 31, 2014.
In reality, however, just 58,611 individuals from the state have selected a health plan, of which 26% are from the coveted 18 to 34 age demographic. Thirty percent (30%) of Georgians who selected a plan were 34 and under.
Many will say that this is a byproduct of a glitchy website. Others will surmise that it’s a lack of interest. Some will suggest that it’s some combination of the two. Whatever the reason, the actual numbers haven’t met expectations. The silver-lining for supporters of the law is that the numbers did jump in Georgia.
Now, a couple of things to keep in mind. HHS is using the “selected plan” term as some sort of a substitute for enrollment. But before anyone can be counted as an enrollment, they have to pay their first premium. There is no indication of how many of these “selected plans” are translating into actual enrollments in Georgia.
Another point is that, though Georgia is performing slightly better than the national average, the number of 18 to 34 year-olds is still relatively low.
Insurers need a large, diverse risk pool with young and healthy people to pick-up the costs of older and sicker enrollees. If insurers don’t meet target age demographic number, they could be forced to raise premiums for plans available on the exchanges before the 2015 open enrollment period.
It’s unclear what percentage of the market share the administration expected this age demographic to compromise of enrollments in Georgia, but the HHS numbers are concerning, although not necessarily an indication that the state’s insurance market is headed for the dreaded “death spiral.” For example, Bill Custer, a professor at Georgia State University, told GPB News that the 30% market share of those 34 and under is consistent with past rates.
In December, however, the Kaiser Family Foundation — which supports Obamacare — estimated that missing the 38% to 40% age demographic target (it varies by estimate) would lead to premium hikes, presenting two different scenarios.
“Under [the first] scenario, young adults would represent 33% of individual market enrollees instead of 40% as in the potential market,” wrote Larry Levitt, Gary Claxton and Anthony Damico. “Taking into account the allowed three-to-one variation in premiums due to age, we find that costs (health care expenses plus overhead and profits) would be about 1.1% higher than premium revenues.”
“Under [the second] scenario, young adults would represent 25% of enrollees, substantially less than their share of the potential market,” they continued. “[T]his is likely a worst-case scenario, since the expectation is that older and sicker individuals are more likely to buy first and that younger and healthier people will tend to wait until towards the end of the open enrollment period (which concludes March 31, 2014).”
Though they dismissed the prospect of a “death spiral,” the three researchers did concede that insurers would “likely raise premiums in 2015 to make up the shortfall.”
As noted by Kaiser, the line is that young and health people will enroll in droves toward the end of the open enrollment period. But, as Philip Klein explained, they’ll have represent a significant portion of enrollments over the next three months to hit the expected share.
Now, some health policy analysts, including those at the Kaiser Family Foundation, have dismissed the demographic numbers in recent days. Conveniently, they now claim that the worst-case scenario isn’t a big deal.
Obviously, it remains to be seen whether the “selected plan” numbers translate into enrollments and what percentage of them are young people. But the early warning signs of higher premiums in 2015, though perhaps not a “death spiral,” are there.
Fox News just teased an appearance by Rep. John Barrow (D-GA) on Your World w/ Neil Cavuto (4pm EST) to discuss his support for a delay of Obamacare’s individual mandate.
“Since October 1st, millions of Americans have attempted to access healthcare.gov to try to learn about the health insurance coverage they’re required to buy. And every day, we’re learning more and more about the problems they’re facing,” Barrow said on the House floor last week. “Folks are frustrated, and rightfully so.”
“Earlier this year, the Administration delayed the employer mandate, because businesses across the country just weren’t ready. But not the individual mandate. At the very least, our constituents deserve the same relief that businesses got,” he noted. “This isn’t about pointing fingers. This is about providing some relief to the folks we represent who are facing serious uncertainty because they’re being forced to buy something that’s not ready.”
“I urge my colleagues and the Administration to delay the individual mandate. It’s not only the right thing to do, it’s the only practical thing to do,” he added.
Barrow introduced legislation at the beginning of the year that would repeal a few of the most controversial provisions in the law, including the individual and employer mandates and the Independent Payment Advisory Board (IPAB). He has also co-sponsored a measure introduced by Rep. Charles Boustany (R-LA) to repeal the employer mandate.
He has voted for delays of the various provisions of the law, but has voted against full repeal on three separate occasions (Roll Call #14, H.R. 2, 1/19/11; Roll Call #460, H.R. 6079, 7/11/12; and Roll Call #154, H.R. 45, 5/16/13) Richard Carbo, a spokesman for Barrow, told me back during the summer that the Congressman supports repeal, but agrees with Republicans on the need to “replace” the law.
To date, Republicans have not coalesced around any proposals to achieve that end, though Reps. Tom Price (R-GA) and Paul Broun (R-GA) have separately introduced healthcare policy alternatives.
Georgia Attorney General Sam Olens will be representing the great state of Georgia before the Supreme Court of the United States. He’ll be one of the 25 state attorneys general (in addition to other interested parties) who will be delivering oral arguments before the nine justices against Obamacare. From Attorney General Olens:
I am pleased to represent Georgia on Monday as the entire nation watches this historic healthcare reform suit reach the highest court of our country. I, along with 25 other attorneys general, the National Federation of Independent Business and four individual plaintiffs will begin oral arguments to defend Americans’ individual liberty before the U.S. Supreme Court. The Supreme Court has allotted an unprecedented six hours of time for oral argument, which will conclude on Wednesday, March 28. Paul Clement, former U.S. Solicitor General, will argue on behalf of the states. I have the honor of being only one of six attorneys general present for Monday’s argument.
This case raises the most consequential Constitutional question of our lifetime: whether or not the Congress has the power to force individuals to purchase a product. The Constitution clearly places limits on the authority of the federal government, and the Patient Protection and Affordable Care Act flagrantly exceeds that authority.
Today [March 23rd] marks the second anniversary of President Obama signing the healthcare bill into law. This case will determine if the federalist system, as envisioned by our Founding Fathers, remains intact or if there is no limit to the power of the federal government to regulate personal decisions of citizens, such as healthcare.
There were 90 minutes worth of oral arguments on the Anti-Injunction Act this morning, tomorrow will be 2-hours worth of arguments on the constitutionality of the individual mandate of Obamacare, and Wednesday will have 2 argument segments: 1.) 90-minutes worth on the “severability” (e.g., what parts of Obamacare be able to survive on their own if the individual mandate is invalidated) and 2.) 1-hour worth on whether or not Congress has the authority to force States to expand their Medicaid programs by threatening to withhold federal funds.
The Supreme Court will be making a decision at the end of June. For more updates on the case, you can point your browser to Healthcarelawsuit.us
AG Olens sent out this update tonight recapping the first day of arguments:
I was honored to be present today as the U.S. Supreme Court heard the first of three days of oral arguments on the constitutionality of the Patient Protection and Affordability Care Act.
The topic of today’s argument was the federal Anti-Injunction Act and whether or not it prohibits the plaintiffs from bringing a challenge to the individual mandate at this time. Georgia, the fellow plaintiff states, and the National Federation of Independent Business contend that the individual mandate issue may be resolved now without having to await the assessment of penalties under the Act.
We do not need not wait until 2014 when the penalties mandated by the President’s federal healthcare plan begin to take effect. The issues at stake are too significant to delay a decision from our Nation’s highest Court.
Click here for a transcript of today’s argument.
Attorney General Sam Olens’ office released this statement this morning:
The State of Georgia, together with 25 sister states, the NFIB and two individuals, today filed a Petition for Writ of Certiorari with the Supreme Court of the United States in the multi-state challenge to federal healthcare reform. Attorney General Olens released the following statement:
“We have said all along that this is a case that must ultimately be resolved by the Supreme Court, and that time is finally here,” said Olens. “Federal healthcare reform grossly exceeds the enumerated powers of Congress, and the Court now has the opportunity to restore Constitutional balance to a federal government of limited powers. We are hopeful that the Court will grant cert quickly and strike down the law.”
If you recall, a three-judge panel from the Eleventh Circuit Court of Appeals ruled that the individual mandate — a central piece of ObamaCare — was an unconstitutional use of the Commerce Clause. The Obama Administration has passed up its right to appeal to the full appellate court and have opted to have the case heard by the Supreme Court.
As you likely already know, a three-judge panel from the Eleventh Circuit Court of Appeals, which is based here in Atlanta, struck down the requirement on Americans to purchase health insurance, the central part of ObamaCare:
President Barack Obama’s signature healthcare law suffered a setback on Friday when an appeals court ruled that it was unconstitutional to require all Americans to buy insurance or face a penalty.
The U.S. Appeals Court for the 11th Circuit, based in Atlanta, ruled 2 to 1 that Congress exceeded its authority by requiring Americans to buy coverage, but it unanimously reversed a lower court decision that threw out the entire law.
Twenty-six states together had challenged the mandate, arguing that Congress had exceeded its authority by imposing such a requirement. But the Obama administration had argued it was legal under the Commerce Clause of the U.S. Constitution.
On Wednesday, June 8th, the Georgia chapter of Americans for Prosperity will hold the “Hands Off My Healthcare Rally” beginning at 9am at the Eleventh Circuit Court of Appeals in Atlanta as oral arguments are heard State of Florida v. Department of Health and Human Services; the lawsuit filed by Florida, which has since been joined by 25 other states, against the Obama Administration over the health care law passed last year.
Judge Roger Vinson ruled in a 78-page opinion that ObamaCare is unconstitutional because the individual mandate, the centerpiece of the law, violated the Commerce Clause. The Obama Administration appealed the ruling, which brought it to Atlanta. The next stop will be the Supreme Court.
Writing over at The Daily Caller, Gov. Nathan Deal explains why Congress should repeal ObamaCare, nothing that simply defunding the president’s signature legislation won’t be enough:
[I]t’s no surprise that I fully support congressional Republicans’ efforts to repeal Obamacare. But with that effort stalled in the Democratic Senate, some of my House GOP friends have discussed simply cutting off the money for its implementation. While I share their concerns about the disastrous effect Obamacare will have on our economy and personal freedoms, Washington cannot simply defund it without rescinding its crippling mandates. Otherwise, these mandates will be passed on to the states to become the most burdensome, suffocating taxes on the American public in the history of this country. Unlike the federal government, states are unable to print greenbacks or borrow money from the Chinese government to cover deficits. Most states, including mine, require balanced budgets.
The costs associated with implementation are enormous and difficult to gauge. The only way we can calculate the cost is to examine the requirements of the law and then look at how the federal and state governments are expected to divide the costs.
If federal taxes were raised to cover the true costs of new healthcare spending — one estimate has it at more than $82 billion — Georgians’ federal tax obligations would rise $2 billion a year. That’s $200 for every man, woman and child in the state (meaning the bill is actually much higher for the people who actually pay income taxes).
Georgians would see their state tax burdens rise significantly as well. Georgia taxpayers would have to fork over, at a minimum, an additional $465 million per year to pay for a dramatic expansion of our state Medicaid program that is required by the new law. For Georgia families, this translates to an annual increase of approximately $1,000 per household. With so many families struggling to make ends meet, these extra costs would be nothing short of debilitating.
To cover some of the costs of Medicaid expansion and the mandated insurance exchange, Obamacare reduces the rate of reimbursement to doctors and other providers significantly. This reduction in reimbursement may affect the number of doctors who accept Medicaid patients, seriously impacting patient access at a time when demand will skyrocket. In fact, the estimated 1.2 million Georgians who will become covered through Medicaid and insurance exchanges have been projected to generate an additional 1.2 to 2 million physicians visits per year. This translates into a shortfall of 300-400 providers in Georgia.
Not only will costs rise for individuals, families and physicians, but the State Health Benefit Plan will also take a hit. Because the health care law requires employers to cover dependents up to age 26, the state and its employees will share a 12 percent cost increase. Other mandates, such as having to re-insure retirees until they reach Medicare age, will put tens of millions of dollars of new costs on the state as an employer.
While I agree with Gov. Deal that ObamaCare should be repealed, I’m still waiting on word if Gov. Deal regrets his vote for Medicare Part D – unlike his former colleague Newt Gingrich, which added trillions in unfunded liabilities to an already fiscally troubled program.
A federal judge today dismissed your Justice Department’s motion to dismiss Virginia’s case against Obamacare.
Georgia is part of a 20 state lawsuit using a similar defense, that the federal government does not have the constitutional power to enact many if not most of the parts of Obama’s heath care reform initiatives. The judge rules that it is an open constitutional question:
While this case raises a host of complex constitutional issues, all seem to distill to the single question of whether or not Congress has the power to regulate – and tax – a citizen’s decision not to participate in interstate commerce. Neither the U.S. Supreme Court nor any circuit court of appeals has squarely addressed the issue.
If I did this correctly, you can read the decision here. For now, consider the constitutionality of Obamacare officially under review.
Well, that only took 14 months…
I am strongly in favor of reforming the health care system, but I don’t think this bill is going to do it, and therefore I can’t support it. It puts too much of the burden of paying for it on working folks who are already being overcharged, and that’s not fair. It threatens to overwhelm Medicaid in Georgia, and that’s not right. And it barely touches the insurance companies, and that’s not smart. We can do better and I’m ready to start.