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The Senate Goes to Work on ObamaCare

Posted By Administration, Monday, June 12, 2017

The U.S. Senate is now going to work on the repeal and replacement — maybe — of the Affordable Care Act. The House’s American Health Care Act (AHCA) is pretty much dead on arrival. While some parts of the House plan will survive, a lot of it will have to change.

Republicans also must find a way around a potential — but very likely — filibuster.

And while both political parties pose and posture, insurance commissioners in state after state are doing all they can to keep the few insurers participating in the ObamaCare exchanges in the game. To do it they are offering new — and never heard of before — incentives to stick with it for another year.

Insurers meanwhile continue to look to Washington and at Congress and the Trump administration for some sign of what they should do. They’re not sure if the Trump administration is going to continue to subsidize the out-of-pocket costs for lower-income households.

That’s a deal-breaker for most.

On the table is $7 billion that will help keep insurers participating. The president has said yes to the money but has made no move in that direction. That has insurance commissioners extending rating filing deadlines and giving other concessions that would not be the normal order of business.

John Franchini is the insurance commissioner of the PIA Western Alliance state of New Mexico. He said, “As a regulator, instead of being rigid on timelines, the type of pricing I’m going to want, I’m being more open about this. I’m trying to be more flexible to give them confidence that if things change, we as regulators will be flexible with them.”

In California — also a PIA Western Alliance state — commissioner Dave Jones has let insurers submit two different sets of rate requests. One is if ObamaCare continues and the other if it goes away. “Based on what we were hearing from insurers, we anticipated Trump rates would be double-digit increases over the past year. I wanted to give insurers the opportunity to file rates based on Trump,” Jones said.

In the PIA Western Alliance state of Washington Insurance Commissioner Mike Kreidler said he’s thinking of following Alaska’s lead and developing a reinsurance program that is a mix of state and federal money to help subsidize insurers. However, Kreidler said, “I don’t have any leverage to tell a health insurer they have to stay in the market. The GOP is scaring the bejesus out of them, and I’m trying to calm things down and work it out.”

House Ways and Means Chairman and Texas Republican Rep. Kevin Brady said the administration needs to make those payments to keep insurers involved. “We should act within our constitutional authority now to temporarily and legally fund Cost Sharing Reduction payments as we move away from ObamaCare and toward a patient-centered system that truly works for the American people,” Brady said.

Republicans — upon the election of Donald Trump — said they’d immediately repeal and replace ObamaCare. The self-imposed deadline at that time passed about two months ago. In other words, it’s kind of a mess.

Senate Majority Leader Mitch McConnell has vowed to take a vote on something by the end of July before the annual August recess but what that something will look like is anybody’s guess. And McConnell and others in Republican leadership admit that it is going to be hard to get enough votes to pass reforms.

A sort of a plan was put forth last week and it is already raising hackles on hardcore conservative Republicans and on the more moderate of the party. The issues range from preexisting conditions to essential health benefits and a plan to let states dump them to allowing states to repeal all ObamaCare regulations.

And then there’s Medicaid and what to do with it.

Part of the problem is there are four groups vying for control. A task force of 13 men started the process but criticism that no women are involved led the group to open its planning to any senators wanting to come.

Then there’s the group led by Louisiana Republican Sen. Bill Cassidy and Maine Republican Sen. Susan Collins. They have blasted the House’s American Health Care Act and crafted a plan of their own called the Patient Freedom Act.

 

A conservative group led by Ohio Republican Sen. Rob Portman is completely focused on Medicaid expansion.

The last group is made up of ultra-conservatives led by Texas Republican Sen. Ted Cruz and Utah Republican Sen. Mike Lee. They want whatever the Senate does to be as close as possible to the House bill.

In what may be bad news for employers, some Republicans want to tax employer-sponsored health insurance plans to help support and stabilize the public health insurance market. As it stands today, those plans aren’t taxed but the tax-favored status of employer-sponsored insurance cost the federal government $250 million in 2016.

Taxing that insurance could affect 177 million employees around the country.

Joel Wood does government affairs for the Council of Insurance Agents & Brokers (CIAB). His group is totally opposed to the idea. “I’m not saying we feel naked, but we feel vulnerable. All we are trying to do is keep that drumbeat going on whatever Congress decides to do to resolve issues associated with exchanges, high risk pools, Medicaid. [We want to ensure that Congress does not] solve those problems at the expense of the employer-provided system,” he said.

Nevada is a PIA Western Alliance state. Sen. Dead Heller is that state’s Republican in the Senate and he thinks in the end the Senate will move more in the direction of preserving much of what is good about ObamaCare.

Dan Holler of the group Heritage Action for America said that kind of talk is going to make it difficult for the party’s very conservative Senators to vote in favor. “There has to be a give and take, and right now it seems like conservatives are being told just to take it all and not get anything,” he said.

And while the Republicans in the Senate can’t quite figure out what they want to do, President Trump took to criticizing Democrats. “We're having no help; it's only obstruction from the Democrats. The Democrats are destroying health care in this country. If we gave you the greatest health plan in the world we would get no votes. The Democrats are really in our way,” the president said.


Source links: The Hill — link 1, link 2, link 3, link 4, The Washington Post, Employee Benefit Advisor

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance news  ObamaCare  The Affordable Care Act  The Senate Goes to Work on ObamaCare  Weekly Industry News 

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UnitedHealth Group May be in Trouble with Feds

Posted By Administration, Tuesday, June 6, 2017

The Department of Justice has filed charges against UnitedHealth Group for overcharging the federal government more than $1 billion through its Medicare Advantage packages.

The suit — filed in a Los Angeles court — said UnitedHealth made patients appear to be much more infirm than they actually were so they could collect higher Medicare payments.

A report from Salon.com said the federal government’s conservative estimate is that UnitedHealth “knowingly and improperly avoided repaying Medicare” for the more than $1 billion in overcharges during the decade ending in 2016.

U.S Attorney Sandra Brown said, “To ensure that the program remains viable for all beneficiaries, the Justice Department remains tireless in its pursuit of Medicare fraud perpetrated by healthcare providers and insurers. The primary goal of publicly funded health care programs like Medicare is to provide high quality services to those in need — not to line the pockets of participants willing to abuse the system,” she said.

This is the second time UnitedHealth has been under Justice Department scrutiny under the False Claims Act. In 2011 a similar complaint was filed by the firm’s former finance director.

UnitedHealth is the nation’s biggest Medicare Advantage participant and in 2016 it covered 3.6 million policyholders. The price tag for that insurance was $56 billion.

The company denies any wrongdoing and spokesman Matt Burns said it will go to battle over the accusations. “We are confident our company and our employees complied with the government’s Medicare Advantage program rules, and we have been transparent with (Centers for Medicare and Medicaid Services) about our approach under its unclear policies.”

CMS declined to comment.

 

Source link: Insurance Business America

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  The Affordable Care Act  UnitedHealth Group May be in Trouble with Feds  Weekly Industry News 

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ObamaCare Repeal & Replace: The Usual Confusion

Posted By Administration, Tuesday, June 6, 2017

The Senate is back in session. They’ll go to work on the repeal and replacement of the Affordable Care Act. Or we should say, Republicans will go to work. Democrats will sit on the sidelines and complain.

Most Republican leaders are skeptical that anything can get done before the July 4th break or even before August’s month-long recess. The Trump administration — and in particular Vice President Mike Pence — wants it done and done quickly. Several things will make that difficult starting with the enormous unpopularity of the bill Republicans in the House sent over a few weeks ago.

The unpopularity is with many moderate Republicans in the Senate and with many consumers. A tracking poll released by the Kaiser Family Foundation’s Kaiser Health says 55% of Americans have a negative view of the House bill. And equal number want the Senate to dump it or make major changes. Just 8% of those polled want the House version passed.

Breaking it down by political party:

  66% of Republicans want the Senate to pass the House bill

  78% of Democrats view the Affordable Care Act positively

  48% of Independents like the ACA

  30% of Independents like the House bill

Kaiser also looked at the popularity numbers for ObamaCare and found 49% view it positively compared to just 42% with a negative view. Spokesman Drew Altman said, “There is nothing in this poll, that if you were in the Senate, would cause you to rush out and pass the House bill.”

One of the biggest problems facing Republicans in the Senate is the whether to keep the House’s $664 billion in tax cuts that are repealed in the House bill. They stretch from the Cadillac tax to investment income.

Senate Finance Committee Chairman Orrin Hatch of Utah laughed at the reluctance of some of his Republican colleagues. He says those taxes all must go and they have to go soon or the party will be very embarrassed. Why? The party has spent a better part of the last seven years trying to get it repealed.

“We should not be treating the Obamacare taxes as a smorgasbord, picking and choosing which ones to keep and which to discard. I don’t think there is a single tax increase in Obamacare that has enjoyed support on this Republican side,” Hatch said.

Republican Sen. Bill Cassidy of Louisiana — who along with Maine Republican Sen. Susan Collins — has authored the Patient Freedom Act. It’s an alternative that’s more or less in the middle between the Draconian House bill and ObamaCare. He and Collins think President Trump’s pledge to give the American people a healthcare plan to be proud of ought to be honored. 

President Trump’s contract with the voter, when he was running, was that he would continue coverage caring for pre-existing conditions, eliminating mandates but also lowering premiums. If we think that Trump’s contract with the voters is important to us, then the fiscally conservative thing to do is to pay for it,” Cassidy said in a statement.

To keep Collins in the fold and to placate Alaska Republican Sen. Lisa Murkowski, Sen. Mitch McConnell and the other very conservative Republicans are going to have to keep some of those taxes to pay for a better repeal and replacement plan. 

As for the president? These days it’s hard to figure out where Trump stands on the issue.

Stan Collender is the executive vice president Qorvis MSL Group. He is also a former congressional budget aide. He said, “This is undoubtedly one of the things that has to be driving Mitch McConnell crazy. It’s the key difference between the House and Senate Republicans. Tea Party members of the House want to cut taxes all the time, any way they can on any legislation. The Senate is willing to be more moderate and almost has to be, given its constituency.”

As to what direction all this will go? We’ll keep you posted.

 

Source links: The Washington Post, Insurance Business America

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance news  ObamaCare  ObamaCare Repeal & Replace: The Usual Confusion  The Affordable Care Act  Weekly Industry News 

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Huge: California’s Single Payer System Price Tag

Posted By Administration, Tuesday, May 30, 2017

Democratic California Sen. Ricardo Lara — Bell Gardens — wants California to do away with health insurance companies and put together a government-run health care system. He proposed it a few weeks ago and it is being pushed by the California Nurses Association.

Late last week the price tag became clear. It’s $400 billion a year.

Lara says the plan is to have much of that cost to be offset by state, federal and private spending but the rest will have to come via significant tax increases. And then there’s the prediction of annual health care costs jumping by $50 billion to $100 billion a year. These figures are massive and the task daunting when you consider the yearly California state budget for the entire general fund is $125 billion.

Here’s how Lara’s plan works. Health coverage with absolutely no out-of-pocket costs will be provided to all living in California and that’s including those here illegally. The state then contracts with doctors, hospitals and other health care providers for prices and then pays all the bills.

This is much how the federal government does Medicare.

All public money spent on healthcare — from Medicare, Medicaid and other federal public health funds and ObamaCare subsidy dollars will go into the pot to pay the bills.

The current estimate is that’s about half of what is needed to support Lara’s single payer system. The rest will have to come from higher taxes on business and a 15% payroll tax.

Tax increases? No problem Lara said. He, the California Nurses Association and other liberal supporters are totally energized by the idea and a tax plan to pay for the system is currently on the drawing board. The good news — they say — is we’ll be doing away with insurance company profits and the administrative costs of insurers. That will mean more money can be spent on the care of patients.

Republicans like Sen. Jim Nielsen of Gerber and business groups and health insurers aren’t too keen on the idea. “The impact on employers I think is going to be absolutely astounding. How can you possibly say this is going to be fiscally prudent for the state of California, not a burden for the state?” Nielsen said.

Businesses say — if this passes and is enacted — it will be much harder to expand their workforce.

For the tax increases to be implemented, two-thirds of the Assembly and two-thirds of the Senate must approve. That’s a daunting task. Even if it does pass, it must pass muster with Governor Jerry Brown. He’s a Democrat but has expressed skepticism at the logistics of the plan and the high cost.

Then if by some miracle the Legislature gets the two-thirds vote and Brown signs it into law, California will need to convince the Trump administration to waive the rules about how Medicaid and Medicare dollars are spent in California.

By the way, if you’re curious, Lara’s bill is SB562.

 

Source link: Insurance Journal

Tags:  Healthcare  HealthCare.gov  Huge: California’s Single Payer System Price Tag  Insurance Content  Insurance Industry  Insurance News  ObamaCare  The Affordable Care Act  Weekly Industry News 

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Keeping Up with ObamaCare Repeal & Replace

Posted By Administration, Tuesday, May 30, 2017

It used to be we tried to keep up with the Joneses. These days it’s trying to keep up with the latest developments in the Republican attempt to repeal the Affordable Care Act and replace it with something “better” is a much harder task.

Senate Majority Leader Mitch McConnell said he’s being pressured by Department of Health and Human Services Secretary Tom Price and leaders in the House to get something done by the end of summer. They at least want something to consider by the end of July when Congress goes on its annual August recess.

Apparently both fail to remember how slow the U.S. Senate moves. All McConnell would say is the Senate is “all about healthcare these days ... which we will move forward sometime in the near future.”

Others in Senate leadership think they’ll have something by then.

Meanwhile, while most of us took the Memorial Day weekend off, Senate staff began — says Sen. Ron Johnson of Wisconsin — drafting a bill.

 

Source links: The Hill — link 1, link 2

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  Keeping Up with ObamaCare Repeal & Replace  ObamaCare  The Affordable Care Act  Weekly Industry News 

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The Drama Continues: Last Week in ObamaCare

Posted By Administration, Wednesday, May 24, 2017

Most of what is happening on ObamaCare replace and repeal is happening behind the scenes. The House — because of soon to come numbers from the Congressional Budget Office (CBO) — may have to vote on it again and make some changes. If it doesn’t save at least $2 billion then there’s no point sending it to the Senate.

Rep. Greg Walden’s House Energy and Commerce Committee put most of the Republican repeal language together. He said, “We’ve got to wait for the CBO score to prove that you meet the reconciliation test.”

Some are wondering why it is taking the CBO so long to come forth with the numbers. It is assumed the CBO can’t quite figure out what the states will do with all that flexibility.

Another wrinkle? The attorneys general of 15 states and the District of Columbia have filed suit to get involved in the suit over the payments to insurers so they can stay involved in the exchanges of the Affordable Care Act. The original suit challenges how money is paid to insurers.

The governors of those states say they can’t trust the Trump administration.

For months insurers say they’ve been trying to get answers from Congress and now from the Trump administration about the future of those payments that help lower the co-pays and deductibles of the poorest among us.

Among the states involved are the PIA Western Alliance states of California who — along with New York — filed the main motion. They were then joined by PIA Western Alliance states of Washington and New Mexico as well as Connecticut, Delaware, Hawaii, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Minnesota, Pennsylvania, Vermont and the District of Columbia.

“The President has increasingly made clear that he views decisions about providing access to health insurance for millions of Americans — including the decision whether to continue defending this appeal — as little more than political bargaining chips. The number of uninsured Americans would go back up, hurting vulnerable individuals and directly burdening the States. The wrong decision could trigger the very systemwide 'death spirals' that central ACA features, such as stable financing, were designed to avoid,” the attorneys general contend.

The National Association of Insurance Commissioners (NAIC) agree. It sent a letter to all members of the Senate and to White House Budget Director Mick Mulvaney. The letter said those payments are critical. “This is not a theoretical argument — carriers have already left the individual market in several states, and too many counties have only one carrier remaining. The one concern carriers consistently raise as they consider whether to participate and how much to charge in 2018 is the uncertainty surrounding the federal cost-sharing reduction payments.”

Meanwhile in the slow-moving Senate, Finance Committee Chairman and Utah Republican Orrin Hatch says he is open to a delay in doing away with the individual mandate — a key ObamaCare policy that originally irked the Republican Party leadership.

Hatch said he’s open to letting it stay until 2020 or even permanently, “I don't mind the individual mandate being expanded. But it all comes down to budgetary concerns and how it's going to be written.”

Other rebels in the Senate are Republicans Sen. Susan Collins of Maine and Sen. Bill Cassidy of Louisiana. They have introduced the Patient Freedom Act of 2017. It is appealing to many Democrats — including Democratic Party Whip Sen. Dick Durbin of Illinois.

The Collins-Cassidy bill returns health care and health insurance power to the states while keeping important consumer protections. It does away with some of the controversial mandates the two consider burdensome. They are the individual mandate and employer mandate and requirements that all health insurance plans be in one of four groups.

The bill keeps prohibitions on lifetime limits and the preexisting conditions rules of ObamaCare as well as letting young adults stay on their parents’ plans until age 26. Money for mental health and substance abuse disorders are also kept.

Collins said, “The ACA has been in full effect for three years, yet nearly 30 million people still do not have health insurance coverage. Those who do have coverage are experiencing huge spikes in premium costs, deductibles, and co-pays. Simply put, doing nothing is not an option.”

To solve that problem, all citizens are automatically enrolled whether they want to be enrolled or not.

Cassidy — who is a doctor — agrees. “We have been stressing the importance of making sure we have a replacement plan ready to go with the repeal of Obamacare, in order to ensure that no one sees a gap in their health care coverage. With the introduction of the Patient Freedom Act of 2017, I believe we now have that plan.”

Durbin likes the idea of working with Collins and Cassidy. “I think Collins and Cassidy have shown more good faith than most when it comes to that very issue. I’ve talked to both of them privately and I want to continue that dialogue because I think they're beyond repeal; they're talking about making it stronger,” he said.

The last two items that stood out last week. Many Senate Republicans aren’t happy with the — described as skimpy — subsidies for lower income, middle income and older people in the House bill.

Republican Sen. Bob Corker of Tennessee said, “What I want to ensure is that the subsidies or tax credits are enough so that lower-income, middle-income people have the ability to actually purchase healthcare. The way the subsidies were in the House bill, it really wasn’t enough to help people who were on the lower end of the economic spectrum to be able to actually purchase it.”

The House plan has $2,000 to $4,000 credits based on age and not income.

The last — and maybe most shocking — item in the evolution of U.S. health care comes from Aetna President and CEO Mark Bertolini. He said it’s time to look at a single-payer system and start the debate. His concept is a single-payer system has insurers administering the program.

“If the government wants to pay all the bills, and employers want to stop offering coverage, and we can be there in a public-private partnership to do the work we do today with Medicare and Medicaid at every state level — we run the Medicaid programs for them — then let’s have that conversation,” Bertolini said.

The reason for Bertolini’s push is because he thinks that’s where we’re headed so why wait? “We’re going to pay for it one way or another. What we have to do is we have to get the costs right. We have to get people healthy. It’s not about who is paying the bill. It’s about what we’re doing to get the costs down.”

 

Source links: The Hill — link 1, link 2, link 3, Insurance Business America — link 1, link 2, The Washington Post

Tags:  HealthCare.gov  Insurance Content  Insurance Industry  Insurance news  ObamaCare  The Affordable Care Act  The Drama Continues: Last Week in ObamaCare  Weekly Industry News 

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Trying to Explain Trump’s Tax Plan

Posted By Administration, Wednesday, May 3, 2017

PIA National — at its just held annual Federal Legislative Summit — said tax reform is a high priority of the association. The PIA supports the creation of a clear and simplified tax code that reduces tax rates for small businesses and opposes the creation of any tax provision or regulations that may impede small business growth.

In its white paper on taxes, PIA National said small business is the backbone of the nation’s economy and has been for 250 years. Small business creates jobs that stimulate the economy and has a history of pulling the country out of recessions.

But the white paper said small business is under duress. “Despite these significant contributions, they are hampered by overly burdensome laws and regulations. Taxes at the state and federal level represent a major cost of doing business and are especially harsh on small businesses.”

PIA Advocates for independent agents by:

  Supporting legislation in Congress to decrease the corporate income tax rate for small businesses.

  Working with Congress, the Small Business Administration (SBA) and the Internal Revenue Services (IRS) to create a simpler tax structure and eliminate unnecessary complexities to create a system that is clear and competitive.

  Monitoring the activities of the IRS and the SBA to ensure that the voices of small business owners are being heard before any changes are made to current tax code

Now President Trump — after hint after hint — has finally released his tax reform plan. Instantly pundits from both sides of the political aisle and financial and tax experts started dissecting the plan and now we’re all confused. ‘

After looking at stories from sources ranging from MSN to The Hill, we — too — are confused. So we’ll give you what we’ve found and let you decide.

Right out of the chute the president radically changed the individual and married couple deduction:

  For individuals, the deduction will go from $6,300 to $12,600

  Married couples will see an increase from $12,700 to $24,000

Individuals will be helped but a huge part of the plan is aimed at business and small business in particular.  

MSN’s report says the Trump plan cuts the corporate tax rate — and many small businesses are corporations — from 35% to 15%. That means small businesses with creative accountants will do well. Those receiving business income via an LLC or other pass-through entities instead of wages could find this a nice loophole.

But that depends on how the bill is eventually crafted. But they could end up being taxes at that 15% rate instead of the top individual income rate of 35% which the Trump plan has cut from 39.6% to 35%.

The 15% corporate tax has some concerned that the rich will take advantage of this and drop their rate from the 35% proposed to 15%. Treasury Secretary Steven Mnuchin said that the administration is aware of that possibility and “will make sure that there are rules in place so that wealthy people can’t create pass-throughs and use that as a mechanism to avoid paying the tax rate that they should be on the personal side.”

What he didn’t specify is what those rules will look like.

Those currently paying the 39.6% rate — as you may or may not know — are those with incomes of $470,000 or more annually. By the way, the plan also drops that 3.8% ObamaCare tax for couples making over $250,000 a year.

The individual tax rates will look like this:

  10%

  25%

  35%

The tax brackets are 10%, 25% and 35% but there is no detail as to the income levels that accompany those brackets. It says tax watchers like the Tax Foundation and the Tax Policy Center are going to find it hard to predict revenue.

Scott Greenberg of the Tax Foundation said, “In order to know how much revenue something will raise, you need to know what it’s taxing.”

And with that he noted the plan also has a child care tax break but no specifics. You also — much to the relief of retailers — won’t see a border excise tax.

The plan also dumps the estate tax for estates valued at $5.5 million or for couples with estates valued at $11 million or more.

Controversially, Trump wants to dump the deduction for state and local income taxes. So, if you live in a state where those costs are high — like just about every state — then it’s a concern.

A story from The Hill said the plan does away with all individual deductions except mortgage interest and charitable giving. And it quotes Ernst & Young’s Mark Weinberger who heads the Business Roundtable Tax and Fiscal Policy Committee as saying it will make business more competitive.

“In calling for competitive tax rates and moving toward a modern international tax system, the President’s proposal reflects the most important elements that must belong to any pro-growth reform,” he said.

A second MSN story outlines the small business plan a bit deeper:

The Home Office: Quoting the IRS, MSN said as long as it is used by professional purposes, you can deduct home office expenses like mortgage interest, insurance, utilities, repairs and depreciation.

“Generally, when using the regular method, deductions for a home office are based on the percentage of your home devoted to business use. So, if you use a whole room or part of a room for conducting your business, you need to figure out the percentage of your home devoted to your business activities,” the IRS told MSN.

But there are changes as noted by MSN MarketWatch’s Tax Guy Bill Bischoff. “Such expenses are classified as miscellaneous itemized deduction items, and you can only deduct them to the extent they exceed 2% of your adjusted gross income or AGI. AGI is the number at the bottom of page 1 of your Form 1040. It includes all taxable income items and is reduced by selected write-offs, such as the ones for self-employed retirement plan contributions and alimony paid,” he said.

Employee Business Expenses: Job expenses will be impacted. For the employee, these are items not already reimbursed by your employer. This includes:

  Business travel away from home

  Business use of the personal vehicle

  Business meals and entertainment

  Business travel

  Use of your home

  Education

  Supplies

  Tools of the trade

  Miscellaneous expenses like home office deductions

 

Bischoff said the changes are probably needed because employees have been fairly creative with these items in the past.

“In a 2015 decision, the Tax Court allowed the taxpayer to claim a home office deduction for legal expenses incurred in a cause of action against her condo homeowners’ association (HOA) and to defend herself against related misdemeanor criminal charges. The taxpayer operated her unincorporated IT business out of a home office in her condo. She deducted 50% of various condo expenditures as home office expenses on her Schedule C (Profit or Loss from Business) for the IT business,” Bischoff said.

While much of this looks pretty good, a story from The Hill says the Trump plan came on a one page document with a series of bullet points but is seriously lacking in detail and that could be problematic.

The article points out some unanswered questions. One is capital investments. Republicans want businesses to be able to immediately deduct those investments. The concept is called full expensing and Republicans — and some conservative financial experts — say this could be a major player in economic growth.

Questions have also risen over what tax breaks will go away. And these are breaks that benefit the wealthy and special interests. House Republicans want to drop tax preferences for business except those doing research and development.

The Trump plan leaves that out though he mentioned it during the campaign.

Democrats — predictably — call it a giveaway to the wealthy and a plan that will add to the deficit. Massachusetts Democrat Rep. Richard Neal is the top Democrat on the House Ways and Means Committee. He said, “President Trump’s tax proposal does not do nearly enough for working families and small businesses in this country.”

Oregon’s Sen. Ron Wyden agrees. He is the ranking member of the Senate Finance Committee and said, “Instead of focusing on lowering taxes for teachers, nurses and cops, Trump appears to be piling on the conflicts-of-interest by ensuring he himself will receive an elite giveaway. Yet another reason why it’s critical the American people see his tax returns.”

The president disagrees and told Fox News reporter Martha MacCallum that it’s a great plan that people will love. She then pointed out that it might benefit the rich more than the poor because his rate would likely go from 39.6% to 15%.

Trump disagrees. “I’m going to end up paying more than I pay right now in taxes, all right? I will pay more than I pay right now. The reason I’m going to pay more is because I lose all the deductions. They have deductions on top of deductions. They have hundreds and hundreds of pages of deductions, things that you’ve never heard of before. I have great accounting firms. I’m sure you do. They come in, ‘Well, you’re entitled to a deduction for geese flying over America, you’re entitled to this, you’re entitled to’ — by the time they give all these — all of that stuff goes away. All of it goes away, other than charitable deductions, which we think is important to keep, and interest deductions, which we think is important to keep. But all of the stuff goes away,” the president said.

 

Source links: The Hill — link 1, link 2, MSN Money — link 1, link 2

 

 

Tags:  Insurance Content  Insurance Industry  Insurance News  ObamaCare  taxes  The Affordable Care Act  Trying to Explain Trump’s Tax Plan  Weekly Industry News 

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The ObamaCare Saga Continues

Posted By Administration, Wednesday, May 3, 2017

At the time this is written things are in motion. Even if the Republicans pass something before this is published, once you get past the part of getting a vote, the story is still relevant and will give you perspective on what is happening with the bill.

Republicans are short of the votes to pass the repeal and replacement of the Affordable Care Act but they’re pushing to correct that says New York Congressman Peter King. He thinks it needs to be passed and then given to the Senate to correct.

“I would hope it gets changed over there,” he said.

Republican Sen. Roy Blunt of Missouri agrees. “If you’re in the House, what you should be thinking now is that if it doesn’t survive, it all comes back to you. I think what they should be focused on is getting the process moving and, frankly, passing the obligation over to the Senate.”

But Republicans are still battling those who promised to repeal ObamaCare and won’t stop until it’s done. And then there’s those like Missouri Rep. Billy Young who hates an amendment wanted by the Freedom Caucus.

“I have always stated that one of the few good things about Obamacare is that people with preexisting conditions would be covered. The MacArthur amendment strips away any guarantee that preexisting conditions would be covered and affordable,” Long said

The House Freedom Caucus said they like that revised version of the Republican plan and the one that deals with preexisting conditions. It will allow states to ask for the ability to opt out of that part of the plan if they establish a high-risk pool for people with preexisting conditions.

This is the part of the Affordable Care Act that opponents say drives up premiums. States — under this plan — could set up high risk pools for insurance. Those pools could charge more for insurance than those not in the high-risk categories.

Other than pressure to just pass something, none of this is going to move moderates in the party to support the plan and get the 216 votes needed to move it to the Senate.

In a statement the Freedom Caucus Members Rep. Tom MacArthur of New Jersey and Rep. Mark Meadows of North Carolina said, “While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower healthcare costs. We look forward to working with our Senate colleagues to improve the bill. Our work will continue until we fully repeal Obamacare.”

Meanwhile, the president continues to say whatever is passed will offer protections to those with preexisting conditions and calls the bill “beautiful” but hasn’t said exactly what “beautiful” looks like.

Nothing done these days — it seems — is done without controversy. In the acceptance of the bill and the amendments that won over the Freedom Caucus is a stipulation that exempts members of Congress and their staffs from the possibility of changes in preexisting conditions.

Immediately Democrats jumped on that one. Leslie Dach of the Protect Our Care Campaign said, “The best evidence yet that the new GOP repeal plan is a disaster for people’s health care is that the GOP exempted members of Congress from living under it.”

No. No. No. That’s not what this means says MacArthur’s aide Camille Gallow. “Congressman MacArthur does not believe Members of Congress or their staff should receive special treatment and is working with House Leadership to make absolutely clear that Members of Congress and staff are subject to the same rules, provisions, and protections as all other Americans,” she said.

Republicans keep trying to find a way to please the majority of the party’s conservatives and Democrats are opposing anything that has to do with repeal. It’s politics. And politics is fine but there are 10 patient advocacy groups that are screaming at the two parties and saying their political games are impacting REAL people.

The group includes the American Cancer Society Cancer Action Network, the American Heart Association and several others and all of them have pegged the American Health Care Act and the new modifications on preexisting conditions and the ObamaCare provision that mandates what insurers must cover as “inadequate” and “unaffordable.”

The group issued a statement saying, “As introduced, the bill would profoundly reduce coverage for millions of Americans — including many low-income and disabled individuals who rely on Medicaid — and increase out-of-pocket costs for the sickest and oldest among us. We are alarmed by recent harmful changes to the AHCA, including provisions that will weaken key consumer protections.”

The groups say these high-risk pools are just not a viable option. “Previous state high risk pools resulted in higher premiums, long waiting lists and inadequate coverage,” the groups said.

The problem is the high-risk pools let insurers charge people that are sicker more money for insurance. Some of them cannot afford those prices and what it does is return health care back to what it was before ObamaCare.

“As Congress considers this legislation, we challenge lawmakers to remember their commitment to their constituents and the American people to protect lifesaving health care for millions of Americans, including those who struggle every day with chronic and other major health conditions,” the groups added.

In another odd twist, Democrats reached across the aisle and made a proposal to Republicans and said they’d agree to $15 billion in additional military spending in exchange for the funding of healthcare subsidies. These are $10 billion cost-sharing dollars that help the poor afford to purchase health insurance on the ObamaCare exchanges.

The Trump administration has since said it will continue to provide those funds. No word if this is part of the deal.

Meanwhile pressure continues on Republicans in the House who have promised for seven years to repeal and replace ObamaCare and who have over 40 times passed bills to do just that. And now they can’t pass anything.

Putting that in perspective is Louisiana Sen. Bill Cassidy who told CNN the House bill is a work in progress and some of what it eventually passes will be dumped when negotiations with the Senate starts.

His vision is a bill — and he’s written one — that looks a lot like the Affordable Care Act.

“The House has to pass a bill. It’ll go to conference committee. I’m sure the administration will be involved. There will be two other times when what the White House is advocating can be addressed,” he said.

Cassidy — though — like many others is not happy with the House Freedom Caucus preexisting condition compromise. “I suspect the advocates for the bill will say that’s their guarantee. I will insist that the president’s pledges be met. And the president pledged that he would take care of people with preexisting conditions,” Cassidy added.

Senate Texas Sen. Ted Cruz also gave perspective to what that body will have to do if the House ever passes a bill. “Legislating takes time. It’s worth remembering it took Obama 14 months to pass Obamacare. The House repeal bill was on the floor for 14 days. That’s not nearly long enough to draft legislation as consequential as this.”

That’s politics. That’s Washington. But what do the people think? An ABC/Washington Post poll conducted a couple of weeks ago suggests Congress and the president might want to consider fixing and not replacing ObamaCare.

  79% think President Trump should make ObamaCare work instead of letting it fail

  Overall 61% want it fixed not replaced

  88% of Democrats want it fixed

  21% of Republicans want it fixed

 

But whatever they do, large percentages in both parties want pre-existing conditions covered. Period. That depends on the poll but it runs around 70%.

Another poll by NBC News and The Wall Street Journal said 50% have no confidence the Republicans will put forth anything that will make health care better for the masses. That’s up 16% from a similar poll in February when just 34% said they had no confidence.

No one is sure what ought to be done though 47% think ObamaCare does need a major overhaul but doing away with it is a split along party lines:

  75% of Republicans say repeal and replace

  Just 13% of Democrats feel that way

 

Source links: The Hill — link 1, link 2, link 3, link 4, link 5, link 6, link 7, The Washington Post — link 1, link 2

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  The Affordable Care Act  The ObamaCare Saga Continues  Weekly Industry News 

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Republicans Plunge Ahead & Trump Pressures Insurance & Democrats

Posted By Administration, Tuesday, April 18, 2017

Rep. Greg Walden

Oregon Congressman Greg Walden is the chairman of the House Energy and Commerce Committee. It crafted most of the ObamaCare replacement plan — the American Health Care Act — that died an ignominious death a few weeks ago and didn’t even get a full House vote.

Efforts to get it passed — or even considered — before the current congressional recess also stalled and then died. Since it won’t likely get a vote, Walden said reforms may have to be attached to a future budget measure. “You could make an argument that says, ‘Okay, we couldn’t get it done now.’ We’ve had people tell us: ‘Why take this on first? You should have done infrastructure, you should have done tax reform. It may be where we end up,” he said in a recent interview.

Just after the failure to pass, President Trump said he’s moving on to other things and will let the Affordable Care Act implode. However, last week the president told Fox Business that ObamaCare has to happen first before he can do the rest of his agenda — an agenda that includes infrastructure repair to the tune of $1 trillion and tax reform.

“Health care is going to happen at some point. Now, if it doesn’t happen fast enough, I’ll start the taxes. But the tax reform and the tax cuts are better if I can do health care first,” Trump said.

And to up the ante to get Democrats to negotiate, Trump told The Wall Street Journal he might withhold the ObamaCare payments to insurers which hurts those getting cost-sharing insurance subsidies.

Democrats responded immediately via Senate Minority Leader Sen. Chuck Schumer.

“President Trump is threatening to hold hostage health care for millions of Americans, many of whom voted for him, to achieve a political goal of repeal that would take health care away from millions more. This cynical strategy will fail,” Schumer said.

Insurers and major medical groups aren’t that happy with the threat either. From the insurance perspective, this move could wreak havoc on the individual insurance markets.

The subsidies amount to about $7 billion a year and are paid directly to insurers who — along with major medical groups — dashed off a letter to the president urging him to not make that move.

Trump’s “maybe” decision also muddies up an already muddy situation. Republicans in the House sued President Obama over the payments and wanted them denied.

The president said he doesn’t want to deny those payments but indicated he feels forced to do something. “I don’t want people to get hurt. What I think should happen — and will happen — is the Democrats will start calling me and negotiating,” he told the WSJ.

As for Sen. Schumer and House Minority Leader Nancy Pelosi, Trump said, “Schumer should be calling me up and begging me to help him save Obamacare. He should be calling me and begging me to help him save Obamacare, along with Nancy Pelosi.”

A Pelosi aide pooh-poohed the president’s comments and said it “will increase costs, is a threat to the good health of the American people and a threat to keeping government open.”

Oregon Sen. Ron Wyden agreed. He’s the top Democrat on the Senate Finance Committee and said the Democrats will not negotiate with a hostage taker.

“There is no outcome in which the administration sabotaging insurance markets persuades Democrats to pass Trumpcare, a disastrous proposal which would only make our health care system worse. When the president drops his threats on Americans’ health care — including the latest threat to withhold insurance payments, which he clearly understands puts people’s care in danger — Democrats will be prepared to work on bipartisan improvements to the Affordable Care Act,” Wyden said.

California Insurance Commissioner Dave Jones almost instantly responded to Trump’s statement. He said, “The cost-sharing subsidies, an important part of the Affordable Care Act, lower deductibles and other out-of-pocket costs to make healthcare more affordable. President Trump's threats to withhold the cost-sharing assistance create fear among consumers and instability in the health insurance market. President Trump's stated intention to hold hostage for political gain the healthcare of millions of Americans who rely on cost-sharing assistance is outrageous. We can expect rates to increase and insurers to leave the market because of President Trump's actions undermining the Affordable Care Act.”

Meanwhile, Democrats say they’ll try to secure those payments as part of the negotiations for a new spending bill. It’s the same bill Oregon’s Rep. Walden says the Republicans are going to try to put their plan into.

Stay tuned. This will continue to stay interesting.

 

Source links: The Washington Post — link 1, link 2, link 3, Insurance Business America, Insurance Journal, MSN

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  Republicans Plunge Ahead & Trump Pressures Insuran  The Affordable Care Act  Weekly Industry News 

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Update: California Single Payer & ObamaCare Repeal & Replace Still Stalled

Posted By Administration, Tuesday, April 11, 2017
Sen. Ricardo Lara

California Democrat Sen. Ricardo Lara thinks Congress and the Trump administration have failed the people. His solution is a single payer health care system for the Golden State. Lara introduced a bill to set one up.

Under his proposal, the state will negotiate with providers, carriers, medical suppliers, and pharmaceuticals on prices for policyholders.

Lara’s office told The Sacramento Bee that all California residents will be required to sign up. Insurers will not be allowed to offer coverage that is outside of what the state authorizes.

“With Republicans’ failure to repeal the Affordable Care Act, Californians really get what is at stake with their healthcare. We have the chance to make universal healthcare a reality now. It’s time to talk about how we get to healthcare for all that covers more and costs less,” Lara told the newspaper.

He’s named Senate Bill 562 The Healthy California Act and its comprehensive covering:

  All medical care — inpatient, outpatient

  Emergency care

  Dental

  Vision

  Mental health

  Nursing home care

In addition, the bill does away with co-pays and insurance deductibles. It allows members — which in this case is all Californians — to choose their doctor or doctors.

Governor Jerry Brown — when he heard about the bill — did some head scratching. “This is called ‘the unknown by means of the more unknown.’ In other words, you take a problem, and say “I am going to solve it by something that’s…a bigger problem,’ which makes no sense,” Brown said.

What Lara didn’t say is how he’d pay for it.

As for the rest of us. Congress is in recess and will be for another week. It adjourned without being able to take any action on the repeal and replacement of the Affordable Care Act. And it wasn’t as if no one tried. The effort to come up with an agreement was Herculean.

The recess doesn’t mean a deal can’t be done before the return of Congress. House Majority Leader — and California Republican — Kevin McCarthy said if a deal gets done members will be expected to return.

“Should we be prepared to advance our bill through the House in the coming two weeks, we will advise Members immediately and give you sufficient time to return to Washington,” McCarthy wrote in a memo to House members just before the adjournment.

Most think that’s wishful thinking. Leaders of the repeal and replace movement from Vice President Mike Pence and House Speaker Paul Ryan on down failed last week in negotiations. Divisions within the Republican Party and with the president are so deep that no deal is going to be forthcoming anytime soon.

Pence offered to do away with three huge ObamaCare regulations:

  The requirement to cover people with pre-existing conditions

  The requirement that makes it illegal for insurers to charge sick people more for coverage

  The mandates that say what insurers must cover

In the House, the Rules Committee considered finding ways to subsidize those with high health care costs. It would give $15 billion over nine years to help insurers afford to pay the costs of sick patients with high expenses.

Meanwhile, as talks continue insurers have about six-weeks to decide what to do for 2018. Rate concerns or whether to leave the exchanges altogether are on the mind of executives. The ticking insurer clock isn’t helped much when President Trump says, “I’ve been saying for the last year and a half that the best thing we could do, politically speaking, is let ObamaCare explode. It’s exploding right now.”

Cynthia Cox of the Kaiser Family Foundation says that’s not what insurers or even the majority of the people want to hear. “It’s not sending them the message that the Trump administration is going to try to stabilize the market. ObamaCare or the marketplaces are not going to explode on their own. To hear the Trump administration say it’s going to explode may suggest they’re going to take some action to weaken the market,” she said.

 

Source links: Insurance Business America, The Washington Post, The Hill — link 1, link 2

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  The Affordable Care Act  Update: California Single Payer & ObamaCare Repeal  Weekly Industry News 

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