Former CBO Chief: Congress Never Meant to Limit Obamacare Subsidies
A Supreme Court ruling expected this summer will determine whether the federal government can subsidize the insurance costs of individuals in states that did not establish their own health care exchanges under the Affordable Care Act.
Douglas Elmendorf was the director of the Congressional Budget Office when Congress debated the bill, and on Tuesday he provided some ammunition to backers of the law who insist that that Congress did not intend to prevent payments of subsidies to consumers in states using the federal exchange.
Related: How Obamacare Could Be Squeezing Consumer Spending
In an interview with CNBC’s John Harwood at the Peter G. Peterson Foundation’s 2015 Fiscal Summit*, Elmendorf said that before the ACA passed, the CBO analyzed the bill for members of Congress, many of whom were powerfully opposed to it. At the time, he said, there was a common understanding on Capitol Hill that the subsidies would be available to states regardless of the status of their exchanges.
“That analysis was subject to a lot of very intense scrutiny and a lot of questions,” he said. “My colleagues and I can remember no occasion on which anybody asked why we were expecting subsidies to be paid in all states regardless of whether they established exchanges or not. And if people had not had this common understanding…then I’m sure we would have had a lot of questions about that.”
Pressed by Harwood, Elmendorf added, “My colleagues and I talked to a lot of people, with a lot of questions about nearly every aspect of the analysis that we did…and we could not remember anybody asking us any questions about what would happen in the federal exchange different from what would happen in the state exchanges.”
Even so, the language of the law states that the subsidies would apply to exchanges “established by the State” and the Supreme Court will decide how literally those words must be interpreted.
*Pete Peterson also funds The Fiscal Times.
Increasing Number of Americans Delay Medical Care Due to Cost: Gallup
From Gallup: “A record 25% of Americans say they or a family member put off treatment for a serious medical condition in the past year because of the cost, up from 19% a year ago and the highest in Gallup's trend. Another 8% said they or a family member put off treatment for a less serious condition, bringing the total percentage of households delaying care due to costs to 33%, tying the high from 2014.”
Number of the Day: $213 Million
That’s how much the private debt collection program at the IRS collected in the 2019 fiscal year. In the black for the second year in a row, the program cleared nearly $148 million after commissions and administrative costs.
The controversial program, which empowers private firms to go after delinquent taxpayers, began in 2004 and ran for five years before the IRS ended it following a review. It was restarted in 2015 and ran at a loss for the next two years.
Senate Finance Chairman Chuck Grassley (R-IA), who played a central role in establishing the program, said Monday that the net proceeds are currently being used to hire 200 special compliance personnel at the IRS.
US Deficit Up 12% to $342 Billion for First Two Months of Fiscal 2020: CBO
The federal budget deficit for October and November was $342 billion, up $36 billion or 12% from the same period last year, the Congressional Budget Office estimated on Monday. Revenues were up 3% while outlays rose by 6%, CBO said.
Hospitals Sue to Protect Secret Prices
As expected, groups representing hospitals sued the Trump administration Wednesday to stop a new regulation would require them to make public the prices for services they negotiate with insurers. Claiming the rule “is unlawful, several times over,” the industry groups, which include the American Hospital Association, say the rule violates their First Amendment rights, among other issues.
"The burden of compliance with the rule is enormous, and way out of line with any projected benefits associated with the rule," the suit says. In response, a spokesperson for the Department of Health and Human Services said that hospitals “should be ashamed that they aren’t willing to provide American patients the cost of a service before they purchase it.”
See the lawsuit here, or read more at The New York Times.
A Decline in Medicaid and CHIP Enrollment
Between December 2017 and July 2019, enrollment in Medicaid and the Children's Health Insurance Program (CHIP) fell by 1.9 million, or 2.6%. The Kaiser Family Foundation provided an analysis of that drop Monday, saying that while some of it was likely caused by enrollees finding jobs that offer private insurance, a significant portion is related to enrollees losing health insurance of any kind. “Experiences in some states suggest that some eligible people may be losing coverage due to barriers maintaining coverage associated with renewal processes and periodic eligibility checks,” Kaiser said.
