Monday, October 28, 2013

New lawsuit will wipe the Obamacare law from the books! Then after that let’s just fix the existing system!


Did anyone involved with Obamacare proof read this law when it was a bill. America's health system isn't broken! It's being broken! 

All would agree our Healthcare delivery system could use a little fine-tuning on an ongoing basis!

This over all will be devastating for years to come for everyone!

Bombshell: Federal judge suddenly green-lights lawsuit that could stop Obamacare in its tracks

  • Small-business plaintiffs say the government is treating all 50 states the same even though Congress allowed them to opt out – and 36 did
  • The IRS is granting insurance subsidies to taxpayers in the 'refusenik' states, even though the text of the Obamacare law doesn't allow it
  • A federal judge denied the government's motion to dismiss the case on Tuesday
  • He also refused, however, to issue an injunction barring the Obama administration from implementing the law while the case moves forward


PUBLISHED: 14:27 EST, 22 October 2013 | UPDATED: 15:05 EST, 22 October 2013

 

A federal judge on Tuesday refused to dismiss a case that could fatally cripple the Obamacare health insurance law.

The Affordable Care Act forbids the federal government from enforcing the law in any state that opted out of setting up its own health care exchange, according to a group of small businesses whose lawsuit got a key hearing Monday in federal court.

The Obama administration, according to their lawsuit, has ignored that language in the law, enforcing all of its provisions even in states where the federal government is operating the insurance marketplaces on the error-plagued Healthcare.gov website.

Thirty-six states chose not to set up their exchanges, a move that effectively froze Washington, D.C. out of the authority to pay subsidies and other pot-sweeteners to convince citizens in those states to buy medical insurance.

But the IRS overstepped its authority by paying subsidies in those states anyway, say the businesses and their lawyers.

 

 

The subsidies serve as a trigger that determines who has to comply with the now-famous individual and employer mandates. So, the lawsuit claims, the Obama administration illegally enforced the Affordable Care Act – suddenly making millions of taxpayers and small employers subject to paying fines if they don't play ball.

The Affordable Care Act authorizes subsidies only for policies purchased 'through an Exchange established by the State.'

A different section of the law empowers the federal government to set up its own exchanges for each state that chose not establish one.

 

But government lawyers have argued that 'Congress made clear that an exchange established by the federal government stands in the shoes of the exchange that a state chooses not to establish.'

The Treasury Department, they contend, 'has reasonably interpreted the Act to provide for eligibility for the premium tax credits for individuals in every state, regardless of which entity operates the exchange.'

But that amounts to the federal government ignoring the letter of the law, lawyer Sam Kazman says.

And 'without those subsidies, the employer mandate isn't triggered,' he told MailOnline.

And that could make the entire Obamacare system unsustainable.

 

 

Kazman is general counsel for the Competitive Enterprise Institute, a free-market think tank that is coordinating the case.

 

'The IRS cannot rewrite the law that Congress passed,' said Tom Miller, resident fellow at another think, the tank American Enterprise Institute.

'Its regulation expressly flouts the statutory text of the Affordable Care Act, the intent of Congress and the reasoned choices of [36] states.'

'The fiscal impact' of denying the Obamacare system millions of dollars in lost fines, 'while sizable, wouldn't be large enough to bring down the house,' Kazman added. The poltical one, however, is.'

'You'd have 34 "refusenik" states exempting their employers and many of their citizens from the employer mandate and portions of the individual mandate,' he explained.

'You'd have companies in participating states considering whether to move their operations' to states where they don't have to obey the Affordable Care Act. 'And you might even have some of those states seeking to undo their choice to participate.'

 

The Competitive Enterprise Institute said in a statement that the IRS and the Department of Health and Human Services have pushed regulations that Congress didn't authorize, forcing some employers 'to cut back employees' hours' in order to dodge Obamacare's more economically challenging requirements, 'even though they are located in states that have refused to set up their own insurance exchanges.'

U.S. District Judge Paul Friedman refused to dismiss the case, as the government requested, but also denied the plaintiffs' request for a preliminary injunction that would prohibit the IRS and HHS from granting subsidies in what lawyer Kazman calls 'refusenik' states.

Judge Friedman said Tuesday that he will rule on the merits of the case by February 15.

By then the Obamacare law will be in full swing, nearing the end of its open enrollment period and providing health care services to Americans who sign up for coverage by December 15.

Kazman said his organization would 'take an immediate appeal to the U.S. Court of Appeals' in order to get a re-hearing on the motion for an injunction to stop the clock on Obamacare while the larger legal issues are worked out.

At the lawsuit's heart is a set of distinctions that Congress drew between the 14 states – 15 including the District of Columbia – that chose to establish health insurance exchanges and the 36 that opted out.

The plaintiffs, who all hail from 'refusenik' states, say the federal government has invalidated their state governments' choices.

Kazman said that the Obamacare statute does not empower the IRS or HHS to 'give subsidy funding to people in states not authorized by Congress to receive it. That move, he agreed, had he effect of 'gutting a choice – to participate in the exchange program or not – that states were given by Congress.'

The government is 'asking you to interpret "north" to mean "south,"' plaintiffs’ attorney Michael Carvin told Judge Friedman on Monday.

The White House referred questions about the lawsuit to the Health and Human Services Department, which declined requests for comment and passed the buck to the Justice Department. The DOJ didn't respond to emails seeking a position on the lawsuit, which its lawyers are defending.

Wednesday, October 16, 2013

Obamacare causing recession and layoffs in Hospitals. Doctors, Nurses hit hard…The sick hit harder!


Obamacare reduces reimbursements…so Nurses, Administration, Physicians are losing their jobs. Ah…I was wondering just who will be taking care of the sick?

A job engine sputters as hospitals cut staff

Paul Davidson and Barbara Hansen, USA TODAY 8 a.m. EDT October 13, 2013

Hospitals are cutting thousands of jobs, undercutting a sector that was a reliable source of job growth, even through the recession.

Hospitals are reducing payrolls in the face of declining revenue even as the new health care law expands health insurance to more Americans.

Story Highlights

  • Hospitals face lower insurance reimbursement
  • New health care law encourages fewer hospital stays
  • Twenty-six states rejected expanding Medicaid, a revenue source for hospitals

Hospitals, a reliable source of employment growth in the recession and its aftermath, are starting to cut thousands of jobs amid falling insurance payments and in-patient visits.

The payroll cuts are surprising because the Affordable Care Act (ACA), whose implementation took a big step forward this month, is eventually expected to provide health coverage to as many as 30 million additional Americans.

"While the rest of the U.S. economy is stabilizing or improving, health care is entering into a recession," says John Howser, assistant vice chancellor of Vanderbilt University Medical Center.

Health care providers announced more layoffs than any other industry last month — 8,128 — mostly because of reductions by hospitals, according to outplacement firm Challenger, Gray and Christmas. So far this year, the health care sector has announced 41,085 layoffs, the third-most behind financial and industrial companies.

Total private hospital employment is still up by 36,000 over the past 12 months, but it's down by 8,000 since April and more staff reductions are expected into next year.

This month, Indiana University Health laid off about 900 workers as part of a move to trim its budget by $1 billion over five years. Vanderbilt plans to eliminate 1,000 jobs by year-end to help shave operating costs 8% a year. And the Cleveland Clinic is offering buyouts to 3,000 employees as it shaves its annual operating costs by $330 million.

"This is a challenging time for the health care industry," says Jim Terwilliger, president of two of Indiana health's hospitals. "The pace of change is far greater than any time in recent history."

There are myriad reasons for the cuts, which are affecting administrative staff as well as nurses and doctors:

• Medicare, Medicaid and private insurance companies are all reducing reimbursement to hospitals. The federal budget cuts known as sequestration have cut Medicare reimbursement by 2%, the American Hospital Association says.

• The health care law has further reduced the Medicare payments to hospitals that provide lower-quality service or have high readmission rates.

• The National Institutes of Health reduced funding to hospitals by 5% as part of sequestration, forcing hospitals to trim research staff.

• The number of inpatient hospital days fell 4% from 2007 to 2011, in part because of the economic downturn, the hospital association says.

• As more Baby Boomers turn 65, their services will be reimbursed at Medicare rates that are lower than those of private payers, putting further pressure on hospital revenue.

The new health care law was supposed to ease the burden on hospitals by expanding Medicaid coverage to more low-income Americans, who often use hospital services in emergencies then don't pay their bills. But 26 states, including Tennessee, rejected ACA's offer of federal funding to expand Medicaid. That decision led to about a third of the job cuts by Nashville-based Vanderbilt, Howser says.

Still, J.P. Fingado, CEO of API Healthcare, a consulting firm for hospitals, says the layoffs are shortsighted because the providers likely will have to add staff as soon as next year to handle increased patient volumes resulting from the health care law.

"The cuts are a particularly short-term reaction," he says.

 

Thursday, October 3, 2013

The Affordable Care Act cuts federal funding for hospitals that care for the poor!



The Affordable Care Act cuts federal funding for hospitals that care for the poor!
Health care law leaves Grady $45 million short

ATLANTA —

In an ironic twist, Grady Memorial Hospital faces a $45 million funding loss directly related to a new health care law designed to benefit the hospital.

The result could mean major cuts at Georgia's largest trauma center, according to Channel 2’s Lori Geary.

Danielle Words is an uninsured hospital patient who uses Grady as a safety net because it cares for thousands of uninsured Georgians.

“If I didn’t have this resource, I’d really be in big trouble,” Words said. “It’s very important to me.”

Words plans to sign up for health insurance under the Affordable Care Act because she qualifies in the insurance exchange.

Thousands more who are treated at Grady would have qualified for Medicaid, but Georgia chose not to expand the health care program.

“If Georgia were to expand, we estimate we'd have an additional 40,000 patients that would be eligible under the new rolled out expansion of Medicaid," Grady President and CEO John Haupert told Geary.

The Affordable Care Act also cut federal funding for hospitals that care for the poor, like Grady. The intent of the law was to expand Medicaid to offset those losses.

However, the U.S. Supreme Court left Medicaid expansion up to the states and Gov. Nathan Deal decided Georgia could not afford it.

"The impact to Grady when it's fully implemented will be a loss of $45 million a year in funding,” Haupert said.
  
The loss of funding means the hospital must prepare to cut clinical services.

“(It’s) obviously more than a haircut, right?” Haupert said.

Republican and Democratic lawmakers at the state Capitol are aware of the funding issues and are trying to work on solutions, according to Haupert.