Obamacare Ensures Parent’s Insurance Covers Children up to 26, But Not Their Pregnancies

One of the more popular aspects of the Affordable Care Act allows parents to cover their children under their health insurance plans until they reach age 26, but one thing that that aspect of the bill fails to do is to ensure that their parents’ plan will cover their daughter’s pregnancies.

Group health plans with 15 or more workers are required to provide maternity benefits for employees and their spouses under the Pregnancy Discrimination Act of 1978, but other dependents of employees aren’t covered by the law, so companies don’t have to provide maternity coverage for them.

There is no data on how many companies fail to provide dependent maternity benefits but Dania Palanker, a senior health policy adviser at the National Women’s Law Center says it’s common and that the number may grow with the expansion of coverage to children up to age 26.

According to Dan Priga, roughly 70 percent of companies that pay their employees’ health-care costs choose not to provide dependent maternity benefits. Priga, is the head of the performance audit group for Mercer, a human resources consulting company.

In some states, pregnant woman may qualify for Medicaid, the federal-state health-care program, but eligibility is based on household income and mainly reserved for low income individuals.

According to the March of Dimes, the average cost for uncomplicated maternity care was $10,652 in 2007. That includes prenatal care, a routine delivery and three months postpartum care.

Under the health insurance overhaul, preventive health benefits that are recommended by the U.S. Preventive Services Task Force, a federal agency, must be covered by new plans and by plans that have changed enough to lose their status of being grandfathered under the law. The recommended services include a range of screenings for pregnant women.

Starting in 2014, maternity and newborn care is one of 10 essential health benefits that must be offered by all health plans in the individual, small-group market and  state-based health insurance exchanges.

Large-group plans, however, are exempt from the requirement to provide the essential health benefits, now or in 2014.


Papa John’s Pizza Raising Prices Because Of Obamacare

After President Obama’s health care law takes full effect, Papa John’s CEO John Schnatter says that the new law will result in a $0.11 to $0.14 price increase per pizza, or $0.15 to $0.20 cents per order.

The company, which is the third-largest pizza takeout and delivery chain in the United States, will have to offer health care coverage to more of its16,500 total employees or pay a penalty to the government under Obamacare.

One Papa John’s franchise owner in Texas, Judy Nichols, says the law could interfere with her ability to open more restaurants.

“I have two options, I can stop offering coverage and pay the $2,000 fine, or I could keep my number of staff under 50 so the mandate doesn’t apply,” she told Legal Newsline. Nichols added that the law may cost her between $20,000 to $30,000 extra in taxes. “Obamacare is making me think about cutting jobs instead,” she said.

With strong sales and more than 1,500 new retail locations planned in the near future, Schnatter doesn’t seem all that bothered, probably because he intends to pass those health care costs on to customers.

“We’re not supportive of Obamacare, like most businesses in our industry,” Schnatter was quoted as saying in Politico. “But our business model and unit economics are about as ideal as you can get for a food company to absorb Obamacare.”

McDonald’s also expects Obamacare to cost each of its 14,000 franchises between $10,000 and $30,000 annually, according to Businessweek. Like Schnatter, the company believes it is well placed to handle the extra costs.

Representatives from other restaurant chains may be less hopeful, however, including Burger King, Quiznos and Dunkin’ Donuts, all which have expressed concern the law may hurt business, according to the Wall Street Journal.

Obamacare Provision Allows States to Deny Some Existing Medicaid Recipients Benefits

It appears that President Obama’s health insurance law, designed to provide coverage to 30 million Americans, in part by adding 17 million people to Medicaid has hit yet another snag. There is a provision in the law that the Supreme court justices chose to leave intact when they upheld the law last week that could have a very negative impact on the poor.

Starting in 2014, states will no longer be barred from making it harder for poor adults to qualify for Medicaid, including those who are already receiving benefits.

States could throw some low-income adults “into a black hole with nowhere to turn for coverage,” said Deborah Bachrach, who was New York’s Medicaid director until 2010 and is currently special counsel at Manatt, Phelps & Phillips, a New York law firm.

If a state opts out of the 2014 expansion of Medicaid, poor childless adults wouldn’t gain coverage in that state, but at the same time, the state could roll back eligibility for parents with children who are currently enrolled, reducing the number of participants in the program.

In the last several years, many states have sought to reduce the cost of the program by cutting providers’ rates and contracting with private managed-care companies, among other strategies.

“It’s a perfectly reasonable concern” that states might make it more difficult for adults to qualify, said Sara Rosenbaum, a health policy professor at George Washington University.

In 2009, when Congress approved the federal economic-stimulus law, which included additional Medicaid funding, states were prohibited from reducing eligibility or increasing the cost-sharing requirement for people enrolled in Medicaid. The health insurance law extended that ban until 2014, with the expectation that every state would have a new online insurance market and would have expanded Medicaid to everyone whose income is less than 133 percent of the federal poverty level, but the high court struck down the penalty for states that didn’t expand, saying the threatened loss of their existing federal Medicaid dollars was “coercive.”

Republican governors in at least seven states have indicated that they’re unlikely to expand Medicaid even though the federal government will pay all the costs from 2014 to 2017 and at least 90 percent of the costs after that. States have until next year to decide on the expansion, and some are expected to negotiate their own terms with the Obama administration before signing on.






Florida Gov. Rick Scott Says He Won’t Implement Obamacare

Florida Gov. Rick Scott says that his state will not implement the federal health care law because it’s bad policy and cost too much.

The governor told Fox News he thinks the law should be repealed, hopefully by Mitt Romney in November. But in the case that President Obama wins a second term he said Florida will not be setting up a health-insurance exchange nor will they expand Medicaid.

“We’re not going to implement Obamacare in Florida,” Scott told Fox News anchor Greta Van Susteren on Friday night. “We’re not going to expand Medicaid because we’re going to do the right thing. We’re not going to do the exchange.”

State Rep. Mark Pafford, the ranking Democrat on the Florida House committee that handles health care funding, said he was not surprised.

“This is a guy who was in the private sector. He created an organization to fight the Affordable Care Act,” said Pafford, of West Palm Beach. “He then was so upset that he became governor using his own money. So it wouldn’t make sense that he would do anything else.”

Under the Affordable Care Act law, states must implement a health insurance exchange by 2014, a Web-based marketplace where people can shop for insurance, or defer to a federal program. States need to submit plans to the federal government that demonstrate their readiness to launch health exchanges by Nov. 16. States also must decide whether to move forward with an expansion of Medicaid to reduce the number of uninsured residents.

In Florida about 3.8 million people, or 21 percent, are uninsured.

The Supreme Court ruling made it clear that states can not be financially penalized for non-compliance. The federal government has promised to cover nearly all of the costs of the Medicaid expansion in the early years, but Scott said Medicaid is already too expensive and the expansion would put further strain on the state budget.

“We care about having a health care safety net for the vulnerable Floridians,” Scott said on Fox. “But this is an expansion that just doesn’t make any sense.”

Many of the most popular aspects of the Affordable Care Act are already in effect and do not require state involvement. That includes provisions like prescription drug discounts for seniors, allowing young adults to remain on parents’ insurance plans and free preventative care.

Scott said other Republican governors agreed their focus should be fighting the law and supporting Romney, including Rick Perry of Texas, Bobby Jindal of Louisiana and Scott Walker of Wisconsin.

“Here in Louisiana, look, we refused to set up the exchange. We’re not going to start implementing Obamacare,” Jindal told POLITICO. “We have not applied for the grants, we have not accepted many of these dollars, we are not implementing the exchanges, we don’t think it makes any sense to implement Obamacare in Louisiana.”

Scott said the governors arrived at the same conclusion that expanding Medicaid and creating exchanges are not good for taxpayers.

“We care about the citizens of our state,” he said. “We know this will be bad for our health care. We want jobs in our state. This is going to put American businesses at an unbelievable disadvantage as compared to businesses around the world.”

Scott cited the law’s requirement for businesses to offer insurance to employees. He told Van Susteren a story about a Florida business owner who said he may have to shut his doors.

“They walked up to me and they said, ‘Governor, is this really going to become the law? Because if it does, we’re out of business,’ ” Scott said. “ ‘We have 20 employees; we know we won’t be able to buy any health care for anybody.’ ”

The law actually grants companies with fewer than 50 employees an exemption from any requirement to buy insurance.

One of Scott’s biggest concerns is the cost of adding an estimated 1 million people to the Medicaid rolls.

“We can’t pay for that; there is no way Floridians can pay for that,” he said.

Democrat Rep. Pafford believes that Republican lawmakers should be embracing provisions that expand health care access, he said, and new revenue streams like a tax on internet commerce could help pay for it.

“We can afford it,” he said. “There are plenty of ways to do that. They just don’t want to afford it.”

The Legislature sets the budget, so it will ultimately decide whether or not to allocate money to implement provisions of the health care law.

Incoming Senate President Don Gaetz said he and incoming House Speaker Will Weatherford will work with the governor’s office in reaching a final decision. But for now, they are waiting on staff to digest what the court ruling means and its impact, Gaetz said.

“It’s not a matter of not having made up my mind yet, it’s a matter that this 110-page opinion, which is nearly as complex as the law itself, is not 48 hours old yet,” said Gaetz, R-Niceville. “I believe in ‘ready, aim, fire,’ not ‘ready, fire, aim.’ ”

Weatherford, R-Wesley Chapel, said there isn’t an immediate need to move forward on implementing the law. There is no harm in waiting a few months to see if the outcome of the November election changes the political climate, he said.

“There is an opportunity to bring new leadership to the United States of America,” he said, “and if that happens it’s going to change everything.”

Peter Schiff Explains Why Obamacare is Unconstitutional

Supreme Court Upholds Obamacare

In a clear cut victory for President Obama, the Supreme Court upheld his signature legislative achievement, the 2010 Affordable Care Act this Thursday.

Chief Justice Roberts wrote the majority opinion, who held that the law was a valid exercise of Congress’s power to tax. Congress, he said, is “increasing taxes” on those who choose to go uninsured.

The law requires non-exempted individuals to maintain a minimum level of health insurance or pay a tax penalty. Why certain individuals are exempt while others are not remains an issue of contention for many.

The essence of Roberts’s ruling was:

•       “The Affordable Care Act is constitutional in part and unconstitutional in part,”.

•       “The individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause. That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it.”

•       But “it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but (who) choose to go without health insurance. Such legislation is within Congress’s power to tax.”

The law, Roberts wrote, “makes going without insurance just another thing the Government taxes, like buying gasoline or earning income and if the mandate is in effect just a tax hike on certain taxpayers who do not have health insurance, it may be within Congress’s constitutional power to tax.”

He said “The question is not whether that is the most natural interpretation of the mandate, but only whether it is a ‘fairly possible’ one and that the Supreme Court precedent is that “every reasonable construction” of a law passed by Congress “must be resorted to, in order to save a statute from unconstitutionality.”

In 2005, then Senator Obama voted against confirming Roberts as chief justice, saying that Roberts lacked empathy for underdogs and “he has far more often used his formidable skills on behalf of the strong in opposition to the weak.”

Vice President Biden also voted against Roberts when he was a senator.

The four justices joining Roberts in upholding the law were Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan.

The dissenting justices were Justices Antonin Scalia, Anthony Kennedy, Clarence Thomas and Samuel Alito.

Individuals who choose to or can not afford health insurance, and are not eligible for subsidies, will be penalized by the government increasingly year after year starting at $95 in 2014, rising to $325 in 2015, and up to $695 in 2016. After 2016, that $695 amount is indexed to the consumer price index.

Congress specifically did not allow the use of liens and seizures of property as methods of enforcing the penalty nor is non-compliance with the mandate subject to criminal or civil penalties under the Tax Code. Interest does not accrue for failure to pay the penalty in a timely manner, according to the congressional Joint Committee on Taxation.

The court said that the Obama administration cannot coerce states to go along with the Medicaid insurance program for low-income people.

The financial pressure which the federal government puts on the states in the expansion of Medicaid “is a gun to the head,” Roberts wrote.

“A State that opts out of the Affordable Care Act’s expansion in health care coverage thus stands to lose not merely ‘a relatively small percentage’ of its existing Medicaid funding, but all of it,” Roberts said.

Congress cannot “penalize States that choose not to participate in that new program by taking away their existing Medicaid funding,” Roberts said.

The Medicaid provision is projected to add nearly 30 million more people to the insurance program for low-income Americans — but the court’s decision left states free to opt out of the expansion if they choose.