Obamacare Pledge: Info on Applications 'Won’t Be Used For Immigration Enforcement Purposes'

    Beginning with a speech last Thursday, President Obama is seeking to rejuvenate his administration's push to reform immigration laws and perhaps draw some attention away from the Obamacare launch debacle that has been dominating the headlines for much of October.  The day following the speech, a new topic appeared on the Healthcare.gov website entitled "What do immigrant families need to know about the Marketplace?"  While a previous entry listed the various immigration statuses that qualified for Marketplace coverage, the new entry is an extended discussion of the questions immigrants, regardless of status, might have about the insurance exchanges.  Among the subtopics discussed are: "Lawfully present immigrants and private insurance," "Immigrant access to Medicaid and CHIP," and "Disclosure of immigration status."
    Under "Disclosure of immigration status," the site goes to great lengths to explain that Marketplaces, whether federal or state, are not permitted to ask for the immigration status of family members who are not applying for coverage or benefits.  "States can’t deny benefits because the applicant doesn’t provide the SSNs of people who aren’t applicants for benefits or recipients of Medicaid or CHIP benefits, or those not required to provide SSNs," the site explains.  After describing how government agencies, including marketplaces, use the federal "data hub" to verify application information, the site notes that "[p]eople who aren’t seeking coverage for themselves won’t be asked about their immigration status."  If an application or the subsequent verification process does reveal problems with immigration status, the site goes on to assure applicants that "[i]nformation provided by applicants or beneficiaries won’t be used for immigration enforcement purposes."
    Elsewhere on the site, users are told that the "U.S. Department of Homeland Security [DHS] may verify your immigration status and/or naturalized citizenship status." But the new statement above suggests that if DHS is unable to verify legal status or the process reveals a possible violation, no action will be taken relative to immigration laws.  However, any false statements on applications may be pursued by law enforcement according to the individual privacy statement on the Healthcare.gov site, which includes the following caution:

If you don’t provide correct information on this form or knowingly and willfully provide false or fraudulent information, you may be subject to a penalty and other law enforcement action.

    As THE WEEKLY STANDARD reported early in October, the privacy policies of the exchanges for at least some states (Maryland, for one) include statements that they "may share information provided in your application with the appropriate authorities for law enforcement and audit activities."  But based on the above language at the Healthcare.gov site, possible violations of immigration laws will not trigger the "law enforcement action" threatened in other cases.


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

Obamacare Website Admits: You May Not Be Able to Keep Your Plan

    On the very day the Obamacare insurance marketplaces opened for business, a new topic appeared on the HealthCare.gov website:

    Although the topic was just added, it is already listed as "most popular":

    The write up on this new topic begins:

Starting 2014, most individual plans must offer new benefits and protections. Some plans will be changed or replaced with plans that offer these protections. 

If this happens, you can choose to buy a plan in the Health Insurance Marketplace instead. If you switch to a Marketplace plan, you may qualify for lower costs based on your income.

    Further down, the post states:

Your plan or choices may change
Given the changes required in 2014, insurance companies offering individual plans have two choices:

• They can make changes to your plan to provide these benefits. If they do, you’ll see these changes to your plan by the time you renew during 2014. For example, if your renewal date is in July 2014, you’ll see the changes no later than July.

• Your insurance company may decide to offer you other individual plans rather than renew the particular plan that you have today.

    While the post says that "insurance companies offering individual plans have two choices," this does not take into account that some insurance companies will simply choose to cancel the plan and not offer any alternatives, as some have already done.
    President Obama and his supporters have been insisting since before the Affordable Care Act was signed into law that if "you like your plan", you can keep it.  Now that the Marketplaces are open, the administration is finally acknowledging that that will not always be the case.
 

Note: A version of this article first appeared at The Weekly Standard under the headline "New Topic on HealthCare.gov: What If My Plan is Not Offered in 2014?" 

To Avoid 'Severe Consequences' From Delays, HHS Awards No-Bid Contract for Marketplace

    In August, the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services (HHS/CMS) quietly awarded a $11.6 million contract (maximum) to Novitas Solutions of Camp Hill, PA, already a CMS contractor, for financial management services related to the agency's implementation of the new Health Insurance Marketplace, due to open on October 1.
    The contract was awarded without competition to the firm as "an interim, transitory solution to meet the Agency's immediate and urgent need" because development and testing of the financial management services system "is already minimally two months overdue."  The documents accompanying the contract award notice state the reasons for the no-bid contract in rather dire terms [emphasis added]:

With the impending and mandated October 1, 2013, Marketplace enrollment and January 1, 2014 go-live deadlines nearing, CMS' need for contractor-provided financial management services has reached an unusual and compelling level of urgency. The prospect of a delay in implementing the Marketplace by the operational date of January 1, 2014, even for a few days, would result in severe consequences, financial and other. The effect of those consequences would most importantly be measured by the impact to the estimated millions of Americans and small businesses that have no health care today or access to affordable health care. Furthermore, if payments are not made and debts are not collected, with critical consideration given to timeliness, accuracy and integrity, the Agency's implementation and operation of the Marketplace and the Affordable Care Act will certainly be jeopardized.

    HHS explains in the Justification and Approval document that CMS recently realized that "specialized financial management services and expertise are needed beyond what was initially anticipated and beyond CMS' currently available resources."  The description of the services required include:

• accounting
• printing and mailing
• tracking of accounts receivable and accounts payable
• documenting funds collected by CMS
• data validation
• activity reporting
• debt management functions
• application of receipts to appropriate transactions
• referral of debt to the Department of the Treasury
• specified batch payment functions in HIGLAS [Healthcare Integrated General Ledger Accounting System]
• systems interface testing and support for HIGLAS functionality.

    The agency said the awarding of this contract is a temporary measure and stated its intention for "full and open competition and to award a resulting contract no later than July 2014."  The paperwork approving the awarding of the emergency interim contract was signed by several HHS employees in the chain of command, up to and including CMS Chief Operating Officer A. Michelle Snyder.
    With more than three years having passed since the Affordable Care Act was signed into law, it is unclear why HHS did not recognize this need until less than two months before the launch of the Marketplace.


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

Part of Obamacare's Health Insurance Marketplace Taken Offline

    With the launch of the Obamacare Health Insurance Marketplace less than three weeks ago, one of the only functions consumers were already able to access, creating an account, has been taken "offline" for "upgrading."
    In 2010, after Obamacare was signed into law, the Department of Health and Human Services (HHS) created Healthcare.gov, a website designated to answer questions about the new law and eventually serve as the portal for the new health insurance "marketplace" or "exchange" that are a fundamental part of Obamacare.  This summer, the website was relaunched in anticipation of the October 1 opening of the marketplace.  One of the feature added was the ability to create an account to prepare for the open enrollment period that begins at that date:

    However, the link provided now merely takes users back to the main page for individuals.  The reason for this is that on Wednesday, September 11, HHS took the "create an account" feature offline, as the website explains:

Creating an account and logging in: Temporarily off-line 

To get everything ready for Open Enrollment, we’re upgrading the Marketplace account service. You won’t be able to create an account or log in to one you’ve created until Tuesday, October 1.
If you’ve already created a Marketplace account, great! You’ll be able to log in again starting October 1 and start your application for coverage.
If you haven’t created a Marketplace account yet, that’s okay. You’ll be able to do that starting October 1 and get going on your application too.

     There have been reports of technical glitches, delays, and security concerns with the new Marketplaces.  It is unclear of this latest move by HHS is a reflection of those issues.


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