Late-Nite Short Cuts

Obamacare’s individual mandate is beginning to creep into outreach about signing up for health insurance this year.

The message is coming from two directions. Some outreach groups will move in the coming weeks to clearly mention the risk of rising penalties as they urge people to get covered before the enrollment season ends Feb. 15. And people who are getting an early start on their 2014 taxes — tax preparers say they expect the year’s first big surge in early February — will get a reminder of fines they may face for being uninsured last year and how much larger those fines could be one year from now if they say “No thanks” to Obamacare.

...But the mandate fines are going to start hitting home. As people start working on their 2014 tax forms, they will be able to see precisely how much they could pay in penalties for being uninsured last year. And it’s often more than the $95 they heard about.

The law puts the penalty at “the greater of $95 or 1 percent of household income” for 2014. It gets larger for being uninsured this year — $325 or 2 percent of household income. That could be a catalyst for people to sign up fast.

For all the handwringing about what the new Republican-controlled Congress could to do Obamacare, another health insurance program could be dropped entirely if lawmakers don't take action this year: the Children's Health Insurance Program.

The program covers an estimated 8 million children in low- and middle-income families that earn too much to qualify for Medicaid. Funding is set to expire in September, and it's not clear yet if the new Congress will extend CHIP or scale it back. Those who get dropped will probably have to go on to the new health insurance exchanges for coverage, but one estimate found as many as 2.7 million children could still lose health insurance if CHIP goes away this year.

In Washington, D.C., there's been little consensus on modifying the health care law. But in state capitals around the country, from Albany and Columbia to Austin and Sacramento, lawmakers have been mulling over hundreds of proposals that reflect many starkly different views on Obamacare as settled law.

A Center for Public Integrity review found that more than 700 Obamacare-related bills were filed in the states during 2014 or carried over from 2013 in states where legislatures allow that.

The Supreme Court is hearing arguments in a case that will have big consequences for how an estimated 68 million Americans get health care. More specifically, the case involves whether or not doctors and hospitals can sue states if they feel the rates they get paid by Medicaid, the public insurance program for low-income Americans, are too low.

State Medicaid programs typically pay poorly. On average, reimbursements are one-third lower than those for Medicare, the federal health insurance for older Americans, according to the Kaiser Family Foundation. Both pay less than commercial health plans. And that's a growing challenge for providers: The Affordable Care Act (ACA) widened eligibility for Medicaid to cover more low-income adults, adding 9.7 million people to the program since 2013.

More than five years after the single-payer system was scrapped from ObamaCare policy debates, just over 50 percent of people say they still support the idea, including one-quarter of Republicans, according to a new poll.

The single-payer option – also known as Medicare for all – would create a new, government-run insurance program to replace private coverage. The system, once backed by President Obama, became one of the biggest casualties of the divisive healthcare debates of 2009.

At first glance, Colorado would seem to be one of the federal health law’s clearest success stories, offering nearly 200 plans and average premiums nearly unchanged in the coming year.

But zoom in closer, and it is clear that a kind of pricing pandemonium is underway, one that offers a case study of the ambitions and limits of the Affordable Care Act during this second year of enrollment.

By the end of 2014, 27 states and the District of Columbia had expanded Medicaid eligibility to adults with incomes up to 133% of the Federal Poverty Level (FPL).1 And, governors in Indiana, Montana, Tennessee, Utah and Wyoming had put forward proposals to implement expansion in 2015. The opportunity to extend health coverage to tens of thousands–in some states hundreds of thousands–of low-income adults2 and at the same time inject billions of federal dollars into state economies are powerful motivators.

States that have expanded their Medicaid programs are seeing significant benefits for residents, providers, payers and their economies. With data still coming in, here are some early results from 2014.

Single payer might be off the table, but health care still topped the agenda in Gov. Peter Shumlin’s third-term budget address Thursday.

The governor is proposing a 0.7 percent payroll tax, which would generate roughly $86 million a year, in order to increase Medicaid payments to doctors and hospitals. The boost would push reimbursements up to the level of Medicare, which pays at a higher rate, and to pay for other initiatives intended to strengthen Vermont’s health care system.