Medical Billing Blog

Obamacare is about to collide with the U.S. tax-filing season, adding frustration for millions of taxpayers trying to figure out how to comply and how much they will owe the government.

About 10.3 million Americans have gained insurance coverage since the full implementation of Obamacare last year, according to an analysis published Wednesday in the New England Journal of Medicine. The study, done by Harvard researchers and published by the NEJM, was based on Gallup polling and data from the Department of Health and Human Services. It also estimated that the uninsured rate declined by 5.2 percentage points in the second quarter of 2014, or from 21 percent in September 2013 to 16.3 percent in April 2014. In particular, it found jumps in the insurance rates for Hispanics, blacks and young adults.

The Internal Revenue Service (IRS) has issued final regulations on the small business health care tax credit under Health Care Reform, which include information on the requirement to purchase health insurance coverage through the Small Business Health Options Program (SHOP) Marketplace. 

President Barack Obama celebrated the end of the Affordable Care Act’s first open enrollment period by announcing that at least 7.1 million Americans have signed up for insurance through exchanges. "No, the Affordable Care Act hasn’t fixed our long broken health care system, but this law has made our broken system a lot better," Obama said before a large and happy crowd Tuesday afternoon in the Rose Garden. The tally is based on the number of people who enrolled for coverage by Monday’s deadline through the new federal insurance marketplace operating in three dozen states. It also includes people who enrolled in 14 state-run marketplaces as of the deadline or, in the case of a few states, by last weekend. The Census Bureau estimates that 47 million Americans went without health insurance last year, more than 15 percent of the population. White House press secretary Jay Carney said Tuesday that the administration expects that the final numbers will also show sharply higher enrollment by young adults, though demographic breakdowns by race or age will not be available for days or weeks, and he was unable to say how many of the enrollees were previously uninsured. The law’s impact on the uninsured, he said, was intended to be measured over three years.

Kathleen Sebelius, the secretary of health and human services, said Wednesday that the Obama administration would not extend the deadline for people to sign up for health insurance or delay the requirement for most Americans to have coverage. There will also be no delay in the penalty most Americans face under President Barack Obama's healthcare reform law if they fail to obtain health coverage this year. Last year, embracing nonpartisan estimates for the Affordable Care Act, Health and Human Services Secretary Kathleen Sebelius set a benchmark for the new insurance marketplaces: "Success looks like at least 7 million people having signed up by the end of March 2014," she said to NBC. Enrollment, however, began at a terribly slow pace in October because of all the technical problems with HealthCare.gov, the federal health exchange website serving 36 states. Some state-run health exchange websites have had their own problems as well. Within that context, Sebelius on Wednesday redefined what success looks like: "Success looks like millions of people with affordable health coverage, which we will have by the end of March," she told the House Ways and Means Committee. The administration released the latest enrollment figures on Tuesday—revealing that some 4.2 million Americans have signed up for coverage on the new exchanges. However, that figure does not include how many people have actually paid for their plans—a metric that could make the actual number of enrollees significantly lower.

The Obama administration announced Wednesday that it has rewritten an array of far-reaching rules under the Affordable Care Act, the most significant of which will let people keep bare-bones health insurance policies for three more years. Americans with health insurance policies that don't meet consumer standards set by the president's healthcare law would be allowed to keep their plans into 2017, three years later than originally envisioned, so that people can buy these noncompliant plans through October 2016 and be covered by them until the following September, when Obama’s tenure in the White House will have ended. The healthcare law was designed to phase out health insurance plans in 2014 if they did not include a basic set of benefits and limits on how much consumers can be required to pay out of pocket for their medical care. After the controversy broke, the administration announced in November that state regulators could allow insurers to renew old policies in 2014. Only about half the states have agreed to the extensions. Some, particularly those with liberal, Democratic insurance regulators, have balked at allowing what they consider substandard plans to remain on the market.

The federal government may not completely finish the automated payment system for Healthcare.gov for “several months,” White House spokesman Jay Carney said Friday. Until that system is fully running, the administration won’t be able to verify how many of the consumers who signed up for through the health insurance website are, in fact, paying their premiums and are hence truly enrolled. The administration reported earlier in the week that nearly 3.3 million people have selected plans on through the marketplace as of Feb. 1. However, insurance companies are saying that about 20 percent of those people failed to pay their premiums on time and consequently didn’t receive coverage in January, the New York Times reports. Paying the first month’s premium is the final step in completing an enrollment. Under federal rules, people must pay the initial premium to have coverage take effect. In view of the chaotic debut of the federal marketplace and many state exchanges, the White House urged insurers to give people more time, and many agreed to do so. But, insurers said, some people missed even the extended deadlines.

The Obama administration announced Monday it would give medium-sized employers an extra year, until 2016, before they must offer health insurance to their full-time workers. Firms with at least 100 employees will have to start offering this coverage in 2015. Small businesses with fewer than 50 workers have always been exempt from the new coverage requirements but the law originally required all other businesses to start covering their workers for face penalties beginning Jan. 1, 2014. Under the Affordable Care Act, larger employers are generally subject to tax penalties if they fail to offer "minimum essential coverage" to full-time employees and their dependents. The administration laid out a three-tier approach. For larger employers with 100 or more employees (about 2 percent of employers): Seventy percent of employees must be offered coverage in 2015, and in later years at least 95 percent of employees must be offer coverage. Employers that do not meet these standards will be subject to tax penalties. For employers with 50 to 99 employees (about 2 percent of employers): Companies with 50 to 99 employees will have an extra year, until 2016, to provide coverage or pay tax penalties. For small businesses with fewer than 50 employees (about 96 percent of all employers): These companies will not be required to provide coverage or fill out any forms in any year. Officials Monday said that the delay in the Affordable Care Act mandate will affect 50 percent of the businesses that were supposed to be complying by 2015. About 7.8 million workers are employed by the affected businesses. However, those officials also took pains to note that the so-called employer mandate to offer affordable health insurance to workers does not affect 96 percent of the employers in the U.S., because they have fewer than 50 full-time employees.