A new fight is brewing over health insurance companies letting millions of Americans renew their current coverage for another year ”” and thereby avoid changes under the federal healthcare law.

That may offer a short-term benefit for certain consumers and shield some of those individual policyholders from potentially steep rate increases. But critics say this maneuver could undermine government efforts to remake the insurance market next year and keep premiums affordable overall.

At issue is a little-known loophole in President Obama’s landmark legislation that enables health insurers to extend existing policies for nearly all of 2014. This runs contrary to the widespread belief that all health insurance must immediately comply with new federal rules starting Jan. 1, when most provisions of the law take effect.

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Unable to meet tight deadlines in the new health care law, the Obama administration is delaying parts of a program intended to provide affordable health insurance to small businesses and their employees ”” a major selling point for the health care legislation.

The law calls for a new insurance marketplace specifically for small businesses, starting next year. But in most states, employers will not be able to get what Congress intended: the option to provide workers with a choice of health plans. They will instead be limited to a single plan.

This choice option, already available to many big businesses, was supposed to become available to small employers in January. But administration officials said they would delay it to 2015 in the 33 states where the federal government will be running insurance markets known as exchanges. And they will delay the requirement for other states as well.

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On Jan. 30, the Obama administration unveiled a long list of exemptions from the ObamaCare insurance mandate. Flaws and contradictions in the law will cause millions of people to be uninsured. The administration also estimated that the cheapest family plan will cost $20,000 by 2016. This new information indicates that the Affordable Care Act is failing in both goals: making insurance affordable and covering the uninsured.

Children are the biggest victims. The hastily drafted law, passed before it was read, overlooked them.

The law says that beginning in 2014, employers with 50 or more full-time employees must offer coverage or pay a penalty. The law’s sloppy drafting left it unclear whether that meant worker’s coverage or family coverage.

Read it all from IBD.

Thus far, courts have avoided the issue of a corporation’s religious rights, Friedman says. In some cases, judges have ruled that plaintiffs have not demonstrated “substantial burden,” simply because it’s easier than weighing in on the First Amendment and RFRA rights of companies, he said.

If one or more of the cases against the employer contraceptive mandate is successfully appealed to the U.S. Supreme Court, justices will face a tricky set of intertwined issues: whether or not a corporation can practice religion; whether or not a corporation has the same religious freedom as its owners; and whether or not being required to cover contraceptives violates a corporation’s””or its owners’””religious freedom.

“It’s one of the most difficult legal questions I’ve seen, in terms of all the issues that are intertwined,” said Friedman, who runs the Religion Clause blog and wrote about the issue last month. “There really haven’t been any [courts] that have said corporations themselves have religious rights. They’ve either avoided the issue [by finding no substantial burden] or said the corporation can assert the owners’ rights.”

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Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers’ filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.

In other states, like Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.

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It is time, instead, to address one aspect of American exceptionalism of which I am not proud. We are the only advanced nation where medical bankruptcies are routine – as are deaths due to lack of access to proper health care.

And the worst part of the latter is the fact that mental health care is particularly unavailable to anyone who is not wealthy, or lucky enough to have mental health coverage through her or his insurance.

Persons with mental health problems need to be identified and helped….

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Your medical plan is facing an unexpected expense, so you probably are, too. It’s a new, $63-per-head fee to cushion the cost of covering people with pre-existing conditions under President Barack Obama’s health care overhaul.

The charge, buried in a recent regulation, works out to tens of millions of dollars for the largest companies, employers say. Most of that is likely to be passed on to workers.

Employee benefits lawyer Chantel Sheaks calls it a “sleeper issue” with significant financial consequences, particularly for large employers.

Read it all from the front page of yesterday’s local paper.

For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.

The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.

Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.

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For decades, doctors in picturesque Boise, Idaho, were part of a tight-knit community, freely referring patients to the specialists or hospitals of their choice and exchanging information about the latest medical treatments.

But that began to change a few years ago, when the city’s largest hospital, St. Luke’s Health System, began rapidly buying physician practices all over town, from general practitioners to cardiologists to orthopedic surgeons.

Today, Boise is a medical battleground….

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For the first time in its nearly 100-year history, Orlando Health is reducing its workforce by up to 400 positions starting immediately, hospital officials announced this morning.

The elimination of 300 to 400 jobs will occur in two phases, and represents a 2- to 3-percent decrease in the system’s 16,000 employees, said Orlando Health spokeswoman Kena Lewis. The reductions affect all departments and all eight of its hospitals, including Orlando Regional Medical Center and Arnold Palmer Hospital for Children.

The first wave of employees affected by the “labor expense reduction” portion of the initiative received their notices Friday, said Lewis. The next wave of downsizing will happen after the first of the year.

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In an experiment apparently aimed at keeping down the cost of health-care reform, Orlando-based Darden Restaurants has stopped offering full-time schedules to many hourly workers in at least a few Olive Gardens, Red Lobsters and LongHorn Steakhouses…In an emailed statement, Darden said staffing changes are “just one of the many things we are evaluating to help us address the cost implications health care reform will have on our business. There are still many unanswered questions regarding the health care regulations and we simply do not have enough information to make any decisions at this time.”

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Estimates of the number of businesses eligible to take the tax credit have ranged from 1.4 million to 4 million companies, but in May, the Government Accountability Office reported that only 170,300 firms actually claimed the credit in 2010. Of these, only a small fraction, 17 percent, were able to claim the whole credit….

So why has the credit fallen short of expectations? The G.A.O. concluded that the credit was too small to sway business owners. Moreover, it said, claiming the credit is a task so complicated as to discourage many companies from trying.

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Saying there are “troubling signs” of abuse in the way hospitals use electronic records to bill for Medicare and Medicaid reimbursement, the Obama administration warned in a letter to hospital associations Monday that it would not tolerate what it called “gaming the system” and vowed to vigorously prosecute doctors and hospitals implicated in fraud.

The strongly worded letter, signed by Attorney General Eric H. Holder Jr. and Kathleen Sebelius, the secretary of health and human services, said that “electronic health records have the potential to save money and save lives.” But the letter continued: “There are troubling indications that some providers are using this technology to game the system, possibly to obtain payments to which they are not entitled. False documentation of care is not just bad patient care; it’s illegal.”

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Would an expansion of Medicaid under the federal health-care law help or hinder South Carolina’s finances? Depends who you ask.

Strains of disagreement are building against the backdrop of a campaign by Gov. Nikki Haley’s administration to build opposition to an expansion.
Generally opposed by Republicans and favored by Democrats, the debate over whether to expand the Medicaid program in the states is set to play out in many statehouses across the country. That’s because a June Supreme Court ruling made the extension of coverage optional.

In the Palmetto State, advocates for the expansion contend Haley’s administration is emphasizing the costs and underselling offsetting economic benefits of an expansion.

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The U.S. Supreme Court’s ruling upholding the Affordable Care Act””or “Obamacare,” as some have dubbed it””has advocates of faith-based nonprofits concerned about potential unintended “collateral damage” to their bottom lines.

The worry: Chief Justice John Roberts’s nod to lawmakers’ wide discretion to impose taxes””and to condition taxes to influence behavior””could pose threats both to charities’ tax exemptions and to donors’ tax deductions.

“It’s an issue that’s definitely on our radar,” said Rhett Butler, government liaison for the Association of Gospel Rescue Missions.

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As health care costs continue to increase, employers are looking for ways to cut costs, such as reducing spouse and dependent coverage in 2013, says a study out today.

While the total cost of health care is predicted to rise 5.3%, to $11,507 per employee in 2013, the increase is slowing, says the new Towers Watson survey of 440 midsize and large companies. This year, in comparison, the cost is expected to increase 5.9%.

“Recently employers have been increasing employee premiums, although they can only push the envelope so far,” says Paul Fronstin, director of the Health Research Program at the Employee Benefit Research Institute. If healthy workers drop out of the plan, self-insured employers might lose money, he says.

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Are you having trouble finding a doctor who will see you? If not, give it another year and a half. A doctor shortage is on its way.

Most provisions of the Obama health law kick in on Jan. 1, 2014. Within the decade after that, an additional 30 million people are expected to acquire health plans””and if the economic studies are correct, they will try to double their use of the health-care system.

Meanwhile, the administration never seems to tire of reminding seniors that they are entitled to a free annual checkup. Its new campaign is focused on women. Thanks to health reform, they are being told, they will have access to free breast and pelvic exams and even free contraceptives. Once ObamaCare fully takes effect, all of us will be entitled to a long list of preventive services””with no deductible or copayment.

Here is the problem: The health-care system can’t possibly deliver on the huge increase in demand for primary-care services.

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In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014. But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now.

Other places around the country, including the Mississippi Delta, Detroit and suburban Phoenix, face similar problems. The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care. Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.

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They kept their decision confidential. Not one leak, Not one semi-sliver of a little detail released prematurely. Lips sealed.

It has a role, and, yes, it can be done–even today. Confidentiality, secrets, limits that should not be breached–these things matter.

Hooray for them–it is one of the reasons there is so much surprise.

Say what you want about the actual decision, but this aspect of its handling deserves real praise–KSH.

For the roughly 50 million uninsured Americans, the court’s ruling has the biggest implications. For the majority of citizens who currently have insurance, the ruling could mean some important changes as well, such as to their health plans or their personal tax rates.

Many less affluent Americans who do not qualify for Medicaid may now gain health coverage as the program is expanded.

For others among the ranks of some 50 million uninsured Americans, the law creates a system of tax subsidies ”“ designed to help more Americans afford health coverage ”“ plus the mandate to buy insurance or pay a fine.

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The debate over the federal contraceptive mandate and the fight for religious freedom is not about “a particular policy choice” but is “a debate over the role of religion in American society and the freedom and integrity of the Catholic Church’s mission,” the head of the Knights of Columbus said June 22.

“It’s not an ordinary national debate. There’s a great deal at stake here,” Supreme Knight Carl Anderson told Catholic News Service in an interview in Indianapolis. It is an attempt “to redefine the role of religion in America,” he added.

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If you thought Monday’s immigration decision was confusing, wait until the Supreme Court weighs in on health care Thursday. Court-watchers expect a flurry of opinions, dissents and concurring judgments ”” a confusing outcome for a complex law.

When that happens, all of Washington ”” and the law’s supporters and opponents throughout the country ”” will be scrambling for the quickest way to find out the law’s fate.

There are four questions before the court. They are….

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The Supreme Court is set this week to decide the politically charged constitutional clashes between President Obama and Republicans over his healthcare law and his immigration enforcement policy.

By most accounts, the justices must make a stark, clear choice either to endorse Obama’s policies ”” including the mandate for all to have health insurance ”” or to strike them down as flatly unconstitutional.

But the justices could rule in unexpected ways that would allow both sides to claim a victory.

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In a continuing study, an all-star group of researchers following Ms. [Wendy] Parris and tens of thousands of other Oregonians has found that gaining insurance makes people feel healthier, happier and more financially stable. The insured also spend more on health care, dashing some hopes of preventive-medicine advocates who have argued that coverage can save money ”” by keeping people out of emergency rooms, for instance. In Oregon, the newly insured spent an average of $778 a year, or 25 percent, more on health care than those who did not win insurance.

For the nation, the lesson appears to be mixed. Expanded coverage brings large benefits to many people, but it is also more likely to increase a stretched federal government’s long-term budget responsibilities.

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In an unexpected blow to the Obama administration and a major boon for America’s Catholic bishops, the influential Catholic Health Association on Friday (June 15) rejected White House proposals aimed at easing faith-based objections to the contraception mandate.

“The more we learn, the more it appears that the ”¦ approaches for both insured and self-insured plans would be unduly cumbersome and would be unlikely to adequately meet the religious liberty concerns of all of our members and other Church ministries,” Sister Carol Keehan and leaders of the CHA said in a five-page response to the Department of Health and Human Services.

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Last September, the U.S. bishops struggled to raise awareness about an “interim final rule” for co-pay-free contraception, approved by the Obama administration in August 2011.

Now, in the wake of 43 Catholic groups filing 12 lawsuits across the nation on May 21, recent polling confirms that the controversial federal rule, approved Jan. 20, has emerged as an election issue. Public opposition has mounted against the controversial rule, while partisan forces and their media allies argue that Catholic leaders are “carrying water” for the GOP.

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Steven Wagner, the president of QEV Analytics, a polling firm that recently conducted a survey for The Catholic Association, said religion could emerge as a sleeper issue in the election: “Everyone says this election is about the economy. I can see the issue of religious liberty being what decides the race. If Obama continues to lose Catholics by the margin the Pew poll suggests, that means he could lose the key swing states of Florida, Ohio, Colorado and Iowa.”

Losses in those states could cost Obama the White House, and the states are likely aware of that fact. Wagner noted the administration will likely try to be careful and avoid provoking Catholic activists before the election.

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I will admit that the HHS contraception rule does ask these Catholic clerics to sacrifice something. But what is this sacrifice? Simply to allow the women who work for their organizations to be offered contraceptive coverage by their insurers. To refuse this sacrifice is not to uphold civil society. It is to refuse to participate in it.

Toward the end of their statement, the 15 bishops who signed this statement called on every U.S. Catholic to join in a “great national campaign” on behalf of religious liberty. More specifically, they called for a “Fortnight for Freedom” concluding with the Fourth of July when U.S. dioceses can celebrate both religious liberty and martyrs who have died for the Catholic cause.

As Independence Day approaches, I have a prediction. I predict that rank-and-file American Catholics will ignore this call.

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Despite differences over contraception, evangelical leaders have fallen in step with Catholic bishops over what they see as federal compulsion to provide services against their conscience.

In 2011, the Obama administration ruled that religious institutions would be required to provide employees with free contraceptive coverage. President Obama said in February that insurers would be responsible for paying for the contraception, but those who opposed the new rule suggested insurers could simply raise premiums to cover the cost.

Searching for strategies, some evangelicals filed lawsuits. Others followed Catholic bishops’ lead, releasing letters to be read in churches.

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