Wednesday, April 30, 2014

Michelle Obama 2-Day Hotel Stay in China Costs $222K

    Michelle Obama wrapped up her March visit to China with a stop in Chengdu, arriving on Tuesday, March 25 and departing for the United States on the following day.  But that one leg of the trip alone required about 900 room nights, ranging from 21 rooms beginning on March 13 for the advance team to a peak of 144 rooms when the first lady herself was at the hotel.
    The documents prepared in support of the stay estimated the cost at around 1,393,500 yuan (RMB), or $222,000 at current exchange rates:

    According to the documents, one of the factors in choosing the Shangri-La Hotel was a security consideration that "will allow party to occupy the entire top two floors for the visit."
    The documents also state that the local Ritz-Carlton had expressed interest in hosting the first lady, but...
in preliminary price comparisons, the cost was sufficiently more than the Shangri-La. We requested a price reduction but a great cost difference remained for the both the Executive Junior Suites, that will serve as control rooms, and the Presidential Suite.
    The cost of the first lady's hotel room for the Beijing portion of her trip, reportedly $8,400/night, raised some eyebrows at the time.  As THE WEEKLY STANDARD reported, the prices of the Westin Chaoyang Hotel where Mrs. Obama and her group stayed had been deemed "prohibitive" for Vice President Biden's trip to China in December 2013.
    So far, the documents for the Chengdu portion of Mrs. Obama's trip are the only ones that have been posted online by the State Department.  Mrs. Obama was in China March 19-26.

Note: A version of this post first appeared at The Weekly Standard.

President Obama's Japan Trip Hotel Bill: $635K

    President Obama spent only one night in Japan last week on his current swing through the Far East, but the State Department estimated total "lodging nights" required by the president and his entourage could run around 2,172, and the use of "functional rooms" (presumably conference rooms and the like) could last up to 29 days.  The total cost was estimated at a maximum of $635,261.92:

    The cost of lodging is not what makes this contract posting notable or unique, however (the cost of a recent presidential trip to Brussels came to about $1.5 million for just one of the hotels used for the visit); rather, the speed with which this contract was posted online makes it stand out.  The time from the president's departure from Japan to the posting of the contract was barely three days. Such contracts can sometimes take months to appear on fbo.gov, the federal government's contracting website.
    The visit was so recent, in fact, that as of Monday morning, the hotel where the president and his team stayed (Hotel Okura Tokyo) still had a message posted on its website thanking other guests for their patience with the inconveniences caused by the "foreign delegations's stay."

    Although the Justification and Approval document pictured above refers to a "Vice President visit," the State Department confirmed via email that the document pictured above was indeed for the president's recent visit.  The State Department said the reference to the Vice President was a typo left over from a prior document, but was corrected in the final contract.  The last time Vice President Biden visited Japan was in December 2013.  The estimated cost of lodging for that visit was $420,000.

Note: A version of this post first appeared at The Weekly Standard.

Wednesday, April 23, 2014

Biden In Ukraine: "Thank You For Making Me Feel Relevant Again"

    Vice President Biden addressed Ukrainian legislators Tuesday in a committee room of the Rada, the Ukrainian parliament, where he began his remarks by thanking the legislators for "making me feel relevant again." Biden is in Ukraine to show support for the Ukrainian government as that country faces continued pressure and threats from Russia.  Biden's "relevant" comments were a reference to his time as a legislator in the United States:
I want to thank my colleagues for bringing me back home. For 36 years I sat in our legislature, and I used to actually have this seat in our -- I was the chairman of our committee. Thank you for making me feel relevant again, back in a legislative body.
He went on to encourage the Ukrainians to continue to strive for energy independence with the goal of being able to tell Russia to "keep your gas":
And as you attempt to pursue energy security, there’s no reason why you cannot be energy secure. I mean there isn’t. It will take time. It takes some difficult decisions, but it’s collectively within your power and the power of Europe and the United States. And we stand ready to assist you in reaching that. Imagine where you’d be today if you were able to tell Russia: Keep your gas. It would be a very different world you’d be facing today. It’s within our power to alter that.
Biden is well known for his colorful comments throughout his career in public service, and his remarks to the Ukrainians are no exception.  Some additional excerpts:
I signed the book in the hotel as I was leaving today. The management asked me to sign their book, and I signed, “Ukraine united, Joe Biden.” 
I’ve been around, literally met every major leader in the world in the last 40 years... 
[A]n expert is anyone from out of town with a briefcase. Well, I don't have a briefcase, and I’m not an expert. 
I have an expression I use as I’ve gone around the world through my career is you never tell another man or woman what’s in their interest. 
Also to be very blunt about it, and this is a delicate thing to say to a group of leaders in their house of parliament, but you have to fight the cancer of corruption that is endemic in your system right now. It’s not just the United States. You need a court system that not only you and your people, but the rest of the world assumes can actually adjudicate fairly disputes among people. But you have a chance. You have a chance. 
And you may have different traditions. It’s not quite the same, but we understand different traditions in our country -- not as deeply as you do, but we are the most heterogeneous democracy in the world. We’re soon going to get the point where over 50 percent of the United States of America is made up of people of non-European stock; the majority of the American people are not of European origin in 2020. We understand. We have millions of Muslims. We have hundreds -- but it’s not quite the same. We’re not up against a border. We’re not sitting against a border of another powerful nation.
    The Vice President's complete comments are available here.

Note: A version of this post first appeared at The Weekly Standard.

Wednesday, April 16, 2014

U.S. Cosponsors U.N. Resolution to Fight Texting and Driving

    While crises continue in Ukraine, Syria, Iran, and the Central African Republic, the United Nations turned its attention to a different kind of crisis on Thursday: the "global road safety crisis."  The U.N. General Assembly held a session on Improving Global Road Safety in which the United States cosponsored a resolution "which calls for laws to fight texting and driving."  Ambassador Samantha Power tweeted the following:
    In her remarks at the session, Power noted that although "improvements in road design, traffic management, safety equipment, and emergency response" could help reduce the 1.2 million annual worldwide traffic fatalities, "[m]ost important, however, is driver behavior." She continued:
Excessive speed and a failure to obey traffic rules are both killers. The role of alcohol in traffic fatalities is also well documented and should never be understated. In recent years, however, we have faced a new and deadly threat in the form of driving while texting or talking on the phone. Research shows that cell phone users are over 5 times more likely to get in an accident than undistracted drivers. And that texting while driving can delay a driver’s reactions as much as a 0.08 blood-alcohol level, the same as a drunk driver. Already, in the United States, more teenagers are killed while texting than because they have been drinking. But the problem is neither confined to teenagers nor to highly-industrialized countries; it is spreading as fast as technology.
    It is unclear how the push for such bans will fare, particularly in less developed countries where drivers routinely take shortcuts on sidewalks, and red lights and stop signs often seem optional. However, Power cited a new law just passed in Maryland that was named for Jake Owen, a five-year-old who was killed when a distracted driver rammed the boy's family's car.  The law increases penalties for drivers found responsible for causing an accident while talking on a cell phone or texting.

Note: A version of this post first appeared at The Weekly Standard.

Under Obamacare, HHS Begins Fingerprinting "High Risk" Medicare Providers and Suppliers

    Four years after Obamacare became law, the Department of Health and Human Services (HHS) is notifying Medicare providers and suppliers of new fingerprint-based background checks.  Eventually, all individuals who hold a five percent or greater stake in a Medicare supplier or provider that is categorized as "high risk" will be subject to the requirement.  The provision is part of the Medicare, Medicaid, and CHIP Program Integrity Provisions (Title E) of the Affordable Care Act, and gives the HHS secretary broad discretion in applying the background check requirements depending on the potential for abuse, fraud and/or waste.
    The new requirements are spelled out in a document posted online on the website of the Centers for Medicare and Medicaid Services (CMS) last Friday.  The new rules will apply to both current and future enrollees who are classified as "high risk," the stated purpose being to weed out "bad actors" in the Medicare program and prevent any more from enrolling.
    This particular document is a "News Flash" from CMS's Medicare Learning Network and is addressed to suppliers and providers who submit claims for "Durable Medical Equipment Medicare Administrative Contractors (DME MACs) and Home Health and Hospice (HH&H) MACs for services provided to Medicare beneficiaries."  There is no effective date or implementation date listed on the document; rather, the document states that "fingerprint-based background check implementation will be phased in beginning in 2014," and that those affected will receive letters after which the individuals will have thirty days to comply with the finger-printing requirement.  The fingerprints will be submitted to the FBI for a background check and will be stored by the government in accordance with federal requirements and FBI guidelines.
    Although initially the new regulations will only be applied to providers and suppliers of "Durable Medicare Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers or Home Health Agencies (HHA)," the "high risk" category is defined at the discretion of the HHS secretary and may be expanded in the future.

Note: A version of this post first appeared at The Weekly Standard.

Saturday, April 12, 2014

State Department Posts "Embargoed" Climate Change Press Release a Day Early

    Apparently someone at the State Department hit the "publish" button too soon.  This press release regarding the "Intergovernmental Panel on Climate Change Working Group 3 Report" appeared Saturday night on the State Department website, well ahead of its 5 AM Sunday scheduled release:

    No need to get up at 5 AM Sunday now. Whew!

Friday, April 11, 2014

White House Retweet: 'Kathleen Sebelius Is Resigning Because Obamacare Has Won'

    The first official word from the Obama administration on Kathleen Sebelius's resignation as secretary of health and human services is a retweet by the official White House Twitter account of a tweet by Vox.com's Ezra Klein:

    After news broke yesterday of Sebelius's imminent departure, Klein quickly posted an article entitled "Kathleen Sebelius is resigning because Obamacare has won."  The article was largely met with derision on the right, and even mainstream news reporting called into question the victorious characterization of Sebelius's exit.
    The president is set to speak at eleven o'clock Friday morning and is expected to announce that Sylvia Mathews Burwell, currently director of the Office of Management and Budget, will take Sebelius's place.

Note: A version of this post first appeared at The Weekly Standard.  Some nice coverage at Memeorandum, too.

Thursday, April 10, 2014

HHS Spending $800K on Studies to Help Family Planning Clinics Survive Obamacare

    Despite the Obama administration's insistence that everyone -- the government, insurance companies, doctors, medical providers, and consumers -- will reap benefits from Obamacare, a recent grant proposal by the Department of Health and Human Services (HHS) suggests that the agency does have concerns about the ongoing financial viability of one player in the health care market: so-called family planning centers.
    HHS intends to spend up to $800,000 to fund studies to "conduct data analysis and related research and evaluation on the impact of the Affordable Care Act (ACA) on Title X funded family planning centers." At least part of the concern centers on the ACA's provision that allows those 26 and under to stay on their parents' insurance, and how confidentiality considerations may impact the ability of Title X centers to cover their costs.
    The Title X program, which began in 1970 as part of the Public Service Health Act, is "the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services."  Included are contraceptives, breast and cervical cancer screening, pregnancy testing, screening/treatment for sexually transmitted infections (STIs), and HIV testing. Although Title X funds may not be used for abortion, many Title X centers provide abortions using funds from other sources. For instance, Planned Parenthood clinics perform over 300,000 abortions each year, and that organization is the only Title X provider actually listed by name on HHS's Title X website home page:
Services are provided through state, county, and local health departments; community health centers; Planned Parenthood centers; and hospital-based, school-based, faith-based, other private nonprofits.
     The studies that HHS's Orwellian-sounding Office of Population Affairs is soliciting fall into two categories.  The first seeks to assess the national impact, primarily financial, of Obamacare on Title X centers.  The second seeks a qualitative analysis on the impact of the Title X centers providing confidential services. Preserving confidentiality for Title X clients can hurt the centers' ability to be reimbursed for services due to the reporting requirements of state laws and regulations, as well as insurance company rules.  HHS is hoping to acquire case studies on how various Title X centers have managed to overcome this obstacle in order to share those techniques and strategies with other Title X providers.
    The financial concerns of family planning centers center on two areas.  First, HHS has been fielding complaints from family planning centers about "significant challenges" they are facing "negotiating adequate payment terms" with Marketplace private health plans.  On top of this are "continuing challenges" with Medicaid's "varying reimbursement policies around onsite dispensing of contraceptives and education and counseling[.]"  Mandated free contraceptives has been one of the highest profile and most controversial parts of Obamacare, but ironically that increased availability may end up financially harming the very family planning centers that are a significant provider of those contraceptives -- particularly to low income clients.
    The second category of studies looks for ways to mitigate the impacts of confidentiality requirements on family planning centers that can hamstring efforts to secure reimbursements, a problem that Obamacare will only exacerbate.  Since Obamacare aims to increase use of private insurance through the marketplaces, family planning centers will likely see an increase in difficulties obtaining reimbursements without the Explanations of Benefits (EOB) required by insurers.  Since claims details are available to the policy holders, clinics are often not able to file claims for family members wishing to keep their treatment at a family planning clinic private from a spouse or a parent.
    HHS says that "[f]ifty percent of family planning clients are under the age of 25," and under Obamacare, millions of young adults ages 19-25 are now able to remain on their parents' policies.  But along with that coverage comes a lack of privacy for those young adults who may not want their parents to know of their contraceptive use, HIV testing, or treatment for STIs.  HHS says that in "the long term, this practice [of not billing to maintain confidentiality] may result in unsustainable revenue losses for Title X centers."
    To help family planning centers, HHS would like these studies to find ways the clinics can deliver "services confidentially while being able to bill insurance for the visit," which would likely require suppression of EOBs and claims history:
Title X centers regularly forego billing for clients that request confidential services. They are generally unable to negotiate EOB and claims history suppression with issuers because of State laws and regulations. OPA [Office of Population Affairs] is requesting case studies and other qualitative data to identify mechanisms where Title X providers have successfully provided services confidentially while being able to bill insurance for the visit. The specific regulatory issues are not well understood and potential solutions have not been identified.
    HHS is also looking for these studies to provide the following:
  • An analysis of statutes, regulations, or other policies (such as issuer or provider policies) across the U.S. that affect the ability of Title X providers to bill insurance when services are requested confidentially. Such an analysis should discuss both challenges as well as potential policies that could serve as best practices. 
  • An analysis of successful business practices (such as contract negotiations) or issuer policies, business practices or other mechanisms that have resulted in the ability of centers to successfully bill insurance while maintaining client confidentiality. 
  • If “best practices” are located as part of the study, provide an evaluation of the impact to the Title X center’s revenue as a result of the practice. 
  • Based on the findings of the initial case studies, an intervention to test whether solutions (or “best practices”) can be implemented at other centers and an evaluation of such implementation in terms of the impact to revenue. Applicants should propose a methodology for an intervention.
    Grant applications from public or non-profit private entities interested in doing the studies are due by April 24, 2014.  Awards will be from $250,000 to $400,000 per year, and may be approved for a project extending up to three years, depending on the availability of grant funds in future years.

Note: A version of this article first appeared at The Weekly Standard.

Sunday, April 6, 2014

$1.5M Hotel Contract for President's One-Day Visit to Brussels

    In late March, President Obama took a week-long trip through Europe which included a stop of less than 24 hours in Brussels, Belgium for meetings with the European Union and NATO.  The president stayed at The Hotel, a twenty-seven story hotel in the center of the city.  The estimated cost for the president's stay, including about two weeks for an advance team, was $1,522,646.36.

    Despite reports that the president travelled with an entourage of 900, the Justification and Approval documents only indicate a need for "283 Lodging Rooms."  However, sometimes more than one hotel is used during VIP trips.  For instance, when the president travelled to South Africa for Nelson Mandela's funeral, five different hotels were used.
    Contracts for lodging have not yet been posted for the president's other stops during his European trip which included the Netherlands and Rome, Italy.

Note: A version of this post first appeared at The Weekly Standard.

Friday, April 4, 2014

BLS: Percentage of Hourly Workers Earning Minimum Wage or Less in 2013 Falls to 4.3%

    In the midst of the Obama administration's latest push to increase the federal minimum wage from $7.25 to $10.10 an hour, the Bureau of Labor Statistics (BLS) had released an analysis showing the the percentage of hourly workers earning at or below the minimum wage is down to 4.3%, or 3.3 million workers.  The decrease continues a trend of more than three decades, beginning with a high of 15% back in the early 1980s.  The numbers have occasionally spiked in reaction to economic conditions, most recently in the so-called Great Recession from 2008 to 2010, but then resumed the downward direction.

    Women's gains in this area have been even more dramatic, falling from around 22% in the early 1980s to about 5% in 2013.  The percentage for men during the same time went from about 10% to about 3%.
    The largest segment of the workforce earning minimum wage or below is in food preparation and serving (21.7%) whose wages are often supplemented by tips.  Other industries represented in the survey include service occupations, such as healthcare and protective services (11.3%), and sales and related occupations (6.1%).
    A related report from the BLS includes other facts about minimum wage workers:
  • Minimum wage workers tend to be young. Although workers under age 25 represented only about one-fifth of hourly paid workers, they made up about half of those paid the federal minimum wage or less.
  • About 5 percent of Black workers, 4 percent of White workers and Hispanic or Latino workers, and 3 percent of Asian workers earned the federal minimum wage or less. 
  • Among hourly paid workers age 16 and older, about 10 percent of those without a high school diploma earned the federal minimum wage or less, compared with about 4 percent of those who had a high school diploma (with no college) and about 2 percent of college graduates. 

Note: A version of this post first appeared at The Weekly Standard.

Thursday, April 3, 2014

Inspector General Uncovers 'High-Risk Security Vulnerabilities' in State Medicaid Systems

     The Office of the Inspector General (OIG) for the Department of Health and Human Services (HHS) has uncovered seventy-nine "high-risk security vulnerabilities" in the information processing systems of ten state Medicaid agencies that "raise concerns about the integrity of the systems used to process Medicaid claims."  While the ten states are not identified by name, the OIG said that the investigation "suggests that other State Medicaid information systems may be similarly vulnerable," though the results could not be conclusively applied to all fifty states.  Now that the expansion of Medicaid under the Affordable Care Act has taken effect in 2014, millions of new enrollees will be added to these same state systems, ready or not.
    While the number of findings range from a low of three in one state to a high of seventeen in another, a chart accompanying the report illustrates the pervasiveness of the problems throughout the states, as well as the widespread nature of the vulnerabilities:

    The OIG provided specific examples of the vulnerabilities exposed by the investigation:
  • one State agency had not encrypted the hard drives of 14 portable laptop computers, leaving them susceptible to unauthorized access.
  • one State agency had not established any type of formal agency-wide inventory mechanism to account for all information system components and devices and was unable to identify all workstations and servers that were authorized to access the secure network and so needed to be properly secured.
  • one State agency had not enabled the network user account lockout function after unsuccessful login attempts, an error that could have allowed intruders to successfully run automated login attack tools without detection. 
  • one State agency was using an insecure remote access method, which sent unencrypted data (including passwords) across the Internet, to perform system administration functions within its MMIS [Medicaid Management Information Systems].
  • one State agency’s physical access control policies and procedures did not address the review of electronic badge access rights; consequently, some terminated employees still had access to the datacenter housing the State agency’s MMIS.
  • one State agency had not established formal policies and procedures to address the antivirus software deployment and update requirements. In the absence of formal antivirus deployment policies and procedures, more than 1,000 workstations and 200 servers from the State agency’s network were not reporting to the antivirus software control console, which was used to track the antivirus deployment and update status. Without updated antivirus deployment, State agencies expose their networks to known vulnerabilities, which could leave sensitive systems and data susceptible to unauthorized access and exploitation. 
    In the report's conclusion, the OIG repeated the warning of the "serious vulnerabilities" found in the ten states studied.  The state Medicaid agencies told the OIG that the vulnerabilities were being addressed.  The OIG said that "management should make information system security a higher priority," and that the inspector general was continuing to investigate in this area.
    With full implementation of the Affordable Care Act (ACA) in 2014, Medicaid will see a massive increase in enrollment even with only about half of states participating in the ACA-related expansion. As many as 8.9 million low-income Americans will meet the revised income threshold for eligibility.  With the personal information of nearly 9 million more Americans running through state Medicaid systems, the increased strain on the system and workload of state personnel serve to increase the urgency of addressing these serious security shortcomings.

Note: A version of this post first appeared at The Weekly Standard.

Security Breaches of Personal Information at Federal Agencies More Than Double Since 2009

    Millions of individuals who recently entrusted personal, medical, and financial information to the federal government while enrolling in Obamacare via Healthcare.gov may find a recent trend reported by the Government Accountability Office (GAO) rather unsettling.  The number of security breaches involving Personally Identifiable Information (PII) at federal agencies more than doubled in recent years, increasing from 10,481 in 2009 to 25,566 in 2013.  Perhaps even more disturbing, the GOA found that "none of the seven agencies [in a related study] consistently documented lessons learned from PII breaches."
    A graph accompanying the GAO report illustrates the dramatic and consistent upward trend in PII-related breaches over the last several years:

    A data breach may consist of something as simple as mailing documents containing PII to the wrong recipient, but also includes incidents involving massive loss of sensitive data as illustrated by these examples in the report:
  • [I]n May 2006, the Department of Veterans Affairs (VA) reported that computer equipment containing PII on about 26.5 million veterans and active duty members of the military was stolen from the home of a VA employee. 
  • In July 2013, hackers stole a variety of PII on more than 104,000 individuals from a Department of Energy system. Types of data stolen included Social Security numbers, birth dates and locations, bank account numbers and security questions and answers...
  • In May 2012, the Federal Retirement Thrift Investment Board (FRTIB) reported a sophisticated cyber attack on the computer of a contractor that provided services to the Thrift Savings Plan. As a result of the attack, PII associated with approximately 123,000 plan participants was accessed. According to FRTIB, the information included 43,587 individuals' names, addresses, and Social Security numbers, and 79,614 individuals' Social Security numbers and other PII-related information. 
    While the increasing number of incidents is concerning, the GAO also found that "agencies have had mixed results in addressing" information security "and most agencies had weaknesses in implementing specific security controls."  An earlier GAO report in December 2013 covered the responses to PII data breaches of seven federal agencies, including the IRS; the Centers for Medicare and Medicaid Services (CMS), the agency charged with implementing and running Obamacare; and the Veterans Administration (VA).  That report found agency responses broadly inconsistent.  For example:
  • only one of seven agencies reviewed had documented both an assigned risk level and how that level was determined for PII data breaches
  • only two agencies documented the number of affected individuals for each incident 
  • only two agencies notified affected individuals for all high-risk breaches
  • the seven agencies did not consistently offer credit monitoring to affected individuals
  • none of the seven agencies consistently documented lessons learned from their breach responses
    The GAO report also gives a preview of an upcoming report specifically on cybersecurity at federal agencies, and preliminary results are not encouraging.  The GAO has found effective and consistent response to cyber incidents in only about 35% of cases:
While these results are still subject to revision, we estimate, based on a statistical sample of cyber incidents reported in fiscal year 2012, that the 24 major federal agencies did not effectively or consistently demonstrate actions taken in response to a detected cyber incident in about 65 percent of reported incidents.
    The full GAO report on cybersecurity will be completed and issued later this spring.

Note: A version of this post first appeared at The Weekly Standard.

HHS Creates Another Obamacare Hardship Waiver

    A few weeks ago during a Congressional hearing, Health and Human Services Secretary Kathleen Sebelius told Congress regarding Obamacare, “We have implemented a number of changes in the way the law was written to ease the transition into the marketplace...”  This week, her department has done the same thing once more, granting penalty exemptions for people who applied for Medicaid or CHIP (Children's Health Insurance Program) coverage before March 31 but who may experience a gap in coverage before their applications are processed and approved.  Guidance issued on March 31 declares that "HHS is exercising its authority to extend the hardship exemption" to individuals in this position.
    Back in October, the federal government recognized a flaw in the way the initial open enrollment period was set up.  Since the "shared responsibility payment" (penalty/tax) affects anyone who has a gap in coverage of more than three months, anyone who enrolled after February 16 would not have coverage until April 1, resulting in a penalty.  HHS issued guidance on October 28, 2013 that created a hardship exemption for anyone in this position whose private insurance coverage was obtained during the open enrollment period but was not effective until after March 31.
    In that October guidance, however, HHS apparently overlooked the fact that those applying for Medicaid or CHIP would face the same coverage gap, resulting in a violation of Obamacare's individual mandate.  HHS rectified the oversight in guidance issued on Monday.
    First, in regard to Medicaid, HHS says that since
the effective date of coverage for an individual who is determined eligible for Medicaid is the date of his or her application..., an individual who applies for coverage on or before March 31, 2014 and is found eligible for Medicaid based on that application will have Medicaid on or before March 31, 2014. Under these circumstances, even if such an individual did not have coverage before March 31st, he or she will qualify for a short coverage gap exemption for the period of time before his or her Medicaid coverage was not yet effective, back to January 1, 2014.
    Second, regarding CHIP coverage, HHS says that since
CHIP effective dates typically follow the same rules as private insurance (meaning that an application date of March 31st may not yield a March 31st effective date), HHS is exercising its authority to extend the hardship exemption described in the October 28, 2013 guidance, to include individuals who apply for coverage during the initial open enrollment period and are found eligible for CHIP based on that application. The IRS and Treasury Department intend to publish guidance allowing an individual to claim a hardship exemption from the individual shared responsibility payment for the months in 2014 prior to the effective date of the individual's CHIP coverage if the individual submits a coverage application prior to the close of the open enrollment period and is found eligible for CHIP. 
     There is still much to be learned about the hardship exemptions and how they will be granted and approved.  HHS has not responded to multiple emails inquiring about the number of exemptions filed so far, and how those whose exemptions are turned down after the close of open enrollment might avoid the penalty.  But with Monday's new guidance, the list of exemptions is growing, and HHS will need to clarify just how the process will work.

Note: A version of this post first appeared at The Weekly Standard.