A project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation

Congressional Documents

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.

Continue Reading "GAO report finds insurers aren’t separating abortion funds" »

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.

Continue Reading "Report finds weaknesses in ACA enrollment controls" »

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.

Continue Reading "Study assesses states’ Medicaid spending per enrollee" »

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.

Continue Reading "CBO and JCT revise mandate penalty estimation" »

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.

Continue Reading "CRS memo indicates number of missed ACA deadlines" »

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.

Continue Reading "CBO lowers ACA cost estimate" »

CRS memo explains premium subsidies for plans offered outside of Marketplaces

Posted on April 10, 2014

A memorandum from the Congressional Research Service (CRS) released by the House Energy and Commerce Committee states that a “literal application” of the law would prohibit premium subsidies to be offered for plans sold outside of the Affordable Care Act’s Marketplaces. The memo also provided means by which the administration could argue they possessed the authority to offer subsidies outside of the Marketplaces.

Continue Reading "CRS memo explains premium subsidies for plans offered outside of Marketplaces" »

CBO estimate indicates impact of repealing the individual mandate

Posted on March 13, 2014

The Congressional Budget Office (CBO) score of HR 4015 found that repealing the Affordable Care Act’s (ACA) individual mandate would save the government $169.5 billion over the next 10 years. Doing so would also result in 13 million fewer individuals having insurance by 2018, and those with insurance would pay more for their coverage. Lifting the individual mandate is the current pay-for for the House bill to reform the Sustainable Growth Rate (SGR). The savings from removing the mandate would arise from the decreased issuance of health insurance subsidies, or premium tax credits.

Continue Reading "CBO estimate indicates impact of repealing the individual mandate" »

GAO report finds states spend one-third of Medicaid dollars on few beneficiaries

Posted on February 20, 2014

The Government Accountability Office (GAO) released a new report citing how Medicaid spends a third of their funds on a small sect of high-expenditure Medicaid beneficiaries. The report, Medicaid: Demographics and Service Usage of Certain High-Expenditure Beneficiaries, found that states spent 31.6% of all Medicaid expenditures on 4.3% of the Medicaid population. Furthermore, the report stated that certain characteristics, such as residing in a long-term care facility, contributed to individuals being deemed high-expenditure Medicare beneficiaries.

Continue Reading "GAO report finds states spend one-third of Medicaid dollars on few beneficiaries" »

CBO FAQ clarifies recent report

Posted on February 10, 2014

A new set of frequently asked questions (FAQ) was published today by Douglas Elmendorf, the Director of the Congressional Budget Office (CBO), in an effort to clarify some of the misconceptions concerning CBO’s report released last week. The FAQ clarifies that 2.5 million Americans will not lose their jobs as a result of the Affordable Care Act (ACA), but will instead no longer feel forced to remain employed just to receive healthcare. The FAQ also addresses why CBO chose to revisit the labor market in their study.

Continue Reading "CBO FAQ clarifies recent report" »