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Congressional Documents

GAO issues Medicaid report

Posted on February 17, 2015

The Government Accountability Office (GAO) issued a report examining (1) the extent to which Medicaid enrollees have private insurance, and (2) state and CMS initiatives to improve third-party liability (TPL) efforts. GAO found that 7.6 million Medicaid enrollees (13.4 percent) had private health insurance in 2012. Additionally, the number of Medicaid enrollees with private health insurance is expected to increase with the expansion of Medicaid. To combat this issue, GAO recommends that the Centers for Medicare and Medicaid Services (CMS) routinely monitor and share across all states information regarding key TPL efforts and challenges, as well as provide guidance on state oversight of TPL efforts conducted by Medicaid managed care plans.

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New CBO report estimates ACA costs

Posted on January 26, 2015

A new report released by the Congressional Budget Office (CBO) estimates that the coverage provisions of the Affordable Care Act (ACA) will result in $76 billion in net costs to the federal government in 2015 and $1,350 billion between 2016 and 2025. These costs come almost entirely from tax subsidies, accounting for $32 billion in 2015, and from the increase in spending from Medicaid expansions, $47 billion in 2015. CBO predicts that these costs will be offset slightly by an estimated $2 billion in penalties paid by the uninsured in 2015. This new CBO estimate of the ACA’s coverage provisions represents a 7 percent decline since their last estimate.

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GAO issues report on SHOP exchanges

Posted on November 14, 2014

A new Government Accountability Office (GAO) report reveals that only only 76,000 people enrolled in the 18 states running their own Small Business Health Options Program (SHOP) exchanges as of June 1. While GAO did not have data for the federal-run SHOP exchanges, CMS told the office that it expected similar enrollment trends for the small business marketplaces it is operating. A number of factors may be contributing to the low enrollment numbers such as a lack of interest in the Affordable Care Act’s (ACA) small business health tax credits, misconceptions about SHOP availability by employers, and the ability of employers to renew pre-ACA plans. GAO noted that these factors may also affect future growth.

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CRS publishes report on ACA repeal legislation

Posted on November 3, 2014

The Congressional Research Service issued a report summarizing legislative actions to repeal, defund, delay, or amend the Affordable Care Act (ACA). The report compiles legislation that has been approved by both chambers and enacted into law, legislation passed in the House not considered by the Senate, and ACA-related provisions in enacted annual appropriations acts for each of FY2011 through FY2014. Also included is a brief overview of all the ACA-related provisions added to appropriations bills considered, and in most cases reported, by the House and Senate Appropriations Committees since FY2011.

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GAO report finds insurers aren’t separating abortion funds

Posted on September 17, 2014

A new Government Accountability Office (GAO) report found that 15 insurers in a sample of 18 are selling Affordable Care Act (ACA) plans that do not segregate funds to cover abortion from their ACA subsidies, despite the ACA requirement  that insurers collect separate payments from customers for abortion coverage. The report was commissioned by House Republican leadership amid concerns that  customers were able to use federal health care subsidies on insurance policies that cover abortion procedures. However, about half of the states have passed laws forbidding exchange plans from covering abortion at all, so this issue may not be nationally pervasive.

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Report finds weaknesses in ACA enrollment controls

Posted on July 22, 2014

The Government Accountability Office (GAO) issued a preliminary report finding that fraud controls for enrollment in health care coverage and consumer subsidies under the Affordable Care Act (ACA) may be lacking. Congressional investigators using fake identities were able to obtain taxpayer-subsidized health insurance on Affordable Insurance Exchanges. The report’s findings were contained in testimony delivered at a House Ways and Means Committee hearing on July 23.

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Study assesses states’ Medicaid spending per enrollee

Posted on July 17, 2014

A new Government Accountability Office (GAO) report finds that eight states spent at least $10,500 per Medicaid recipient in 2008, while the majority of states were clustered in the $6,000-$8,000 range, per enrollee. For Fiscal Year (FY) 2013 Medicaid spending is estimated at $267 billion, a figure that is expected to nearly double by FY 2024. The GAO’s report assessed why there is so much variation in per-enrollee spending across states and how states account for those differences when setting Medicaid managed care rates.

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CBO and JCT revise mandate penalty estimation

Posted on June 5, 2014

An updated analysis released by the Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) estimates that 2 million fewer individuals are anticipated to pay the shared responsibility payment in 2016. Under the Affordable Care Act (ACA), most individuals not receiving minimum essential coverage through their insurance plans are expected to pay a fine for not complying with the individual mandate. The last estimate released by the analysts in 2012 postulated that 6 million individuals way pay the fine in 2016. CBO and JCT cite the expected increase in the number of individuals receiving exemptions from the individual mandate as the main reason for the estimated drop.

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CRS memo indicates number of missed ACA deadlines

Posted on April 23, 2014

An updated memo released from the Congressional Research Service (CRS) outlines the number of deadlines the federal government has missed during implementation of the Affordable Care Act (ACA). The memo consists of three tables, each representing a year after ACA enactment, with a list of the statutory tasks intended to have been achieved that year and the actions taken by the administration on that task as of April 15, 2014. According to Politico, the administration still has about 22 outstanding deadlines on ACA implementation.

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CBO lowers ACA cost estimate

Posted on April 14, 2014

The Congressional Budget Office (CBO) recently updated their cost estimate for the Affordable Care Act (ACA). The new estimate states that the ACA will cost $1.383 trillion over the next ten years, which is $104 billion less than the February estimate. The CBO states that the readjustment can be attributed to administrative changes, changes in the law, judicial decisions, new data (such as projected healthcare expenditures for both the private and public sectors), and changes in modeling.

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