Rationing the MVNHS©

In response to yesterday's post on the apparent death-spiral of the Much Vaunted National Health System©, frequent (and valued) commenter John Fembup observed that this is not really news; in fact, Dr David Owens (former chief of the Service) noted the likely future 40 years ago:

"The National Health Service is a rationed service. There will never be a government or a country that has enough resources to meet all the demands any nation will make on a national health service."

That quote, by the way, comes from a report of the annual meeting of the National Academy of Sciences in DC in 1976.

It should come as no surprise to regular IB readers that what Dr Owens observed must, in fact, be the case. Almost 6 years ago, co-blogger Bob explained it in easily understandable economic terms:

"The economics of goods and services can be reduced to simple demand and supply. Health care is no different. It follows economic theory just like every other consumer good.At either extreme you have inelastic price curves and elastic curves. Most consumer items track a bell curve but some things are totally elastic or totally inelastic."

That is, health care is, in fact, a good and a service (depending on whether you're talking about a cast, or the orthopedist affixing it to your arm). Regardless, there is only so much of it at any given time (there's not an endless supply of cardiologists, for example). And folks who deliver health care expect to be paid for their services, as those who supply bandages and syringes expect to be paid for their products. How much we're willing to throw at a given patient then becomes an issue.

When the cost of health care is perceived to be free (as in a nationalized scheme), the demand is going to go up. But from where do the funds come to pay for unlimited services and supplies?

One could ask Venezuela about that, no?

MVNHS© Circling the Drain?

While prognosticators opine breathlessly on the potential Halbig/King/Burwell fallout, it may be instructive to cast our eyes eastward to see how Britain's Much Vaunted National Health System© is faring:

"NHS may be forced to abandon free healthcare for all, says Britain's top doctor"

Wait, what?

That can't be good.

Surely he's overstating the case, right?

Not so much:

"If the NHS continues to function as it does now, it’s going to really struggle to cope because the model of delivery and service that we have at the moment is not fit for the future."

Turns out, if something's "free" it's likely to be much in demand, and you know the old saw: "You can have it fast. You can have it cheap. You can have it good. Pick two."

Under a nationalized health are scheme such as the MVNHS©, it's readily apparent that the folks in charge have long opted for the first two. Now, they're even failing at least one of those, which does not bode well for the average Brit.

Interestingly, the good doctor is calling for a more holistic delivery approach, with services more centrally located and delivered. Now, how - or even if - that can be accomplished becomes the next big challenge.

Health Wonk Review: Decade edition

The venerable Health Wonk Review celebrates its 10th anniversary, and I can think of no one more fitting to present it than David Williams. His own blog also turns 10 this weekend (we beat him by a month), so he's a natural to host this very special 'Review.

Gruberized

This just in ........

Massachusetts' governor has fired Obamacare architect Jonathan Gruber from a board that oversees the state's health insurance exchange, a source confirmed to the Washington Examiner.

Gruber ignited a controversy last December when a series of videos surfaced where the Massachusetts Institute of Technology professor discussed the “stupidity of the American voter” was vital to passing the 2010 Affordable Care Act. - Washington Examiner

I guess he feels really stupid now.

Biting the Hand .......

In a recent campaign speech to participants of the Council on Aging the Arrogant One let his feelings be

known with regard to financial planners.

President Obama made only one reference to any insurance-related product today at an AARP event in Washington. He thanked AARP for helping the White House organize the aging conference, and then used the rest of the appearance to blast financial advisors who "receive backdoor payments or hidden fees for steering people into bad retirement investments that have high fees and low returns." - Life Health Pro

Either El Presidente is unaware that AARP would not exist if not for fee's and commissions paid by carriers in exchange for an endorsement, or he knows but fails to connect the dots.

Can you say backdoor payments to AARP?

Oh, and speaking of low return retirement investments, how is Social Security doing these days? Let's consider those that work until their 65th birthday and then drop dead the day after they retire.

What kind of ROI do they get?

#AARP

No fees, please

Over at LifeHealthPro, Craig Gottwals has a very interesting take on the role of fees in the age of MLR (Medical Loss Ratio). Craig's an attorney specializing in health care law, so what he says has a lot of credibility.

In a nutshell, one of the challenges facing agents in the fully insured large group market (where most of the whole fee discussion takes place) is how employers and their agents deal with the annual rate increases. Traditionally, it's not been unusual for the employer to pay his agent a fee for procuring coverage, and the agent then negotiates with the carrier to deduct the cost of commissions from their premium calculations.

Alternately, the agent might agree to a simple commission reduction (although this might be classified as rebating, but that's another post).

Regardless, the goal is to find a way to lower premiums.

Craig asks a simple question: Will this strategy still work in the age of MLR?

The short is answer is "No," but I really recommend reading the whole thing. There's precious little insider lingo, and he does a great job of explaining why this arrangement is not only spinning wheels, it can actually put you in reverse.

Recommended.

Solyndra-care

If you liked Solyndra you are going to love the Obamacrack co-ops.

* Only one Obamacare co-op made money during the first three quarters of 2014.

* Taxpayers are set to lose more than $1 billion of the $2.4 billion loaned to the co-ops - nearly double the loss of Solyndra. - Insurance News Net

Reminds me of a line Gov. Romney used in one of the debates with Obama. It seems like Obama only picks losers.

According to S&P, almost a third of the co-ops received more than $20,000 in federal loans for each person covered in 2014:

*The Minuteman Health Inc. Co-op in Massachusetts got more than $156 million and covered only 1,822 people - nearly $86,000 per enrollee.

*The Land of Lincoln Mutual Health Insurance Co-op in Illinois got more than $160 million and covered only 3,428 people - nearly $47,000 per enrollee.

*Freelancers Co-op of Oregon (Health Republic of Oregon) got more than $60 million and covered only 1,279 people - more than $44,000 per enrollee.

The money would have been better spent on vouchers and let these people buy coverage from a real insurance carrier.

Where do I go to get my tax money back?

#co-op  #obamacare #acquisitioncost

The Obamatax Man Cometh

Obamacrack buyers. Did you get a government bailout last year? You might have a surprise when you file

your taxes.

The majority (52 percent) of Obamacare enrollees receiving an advance premium tax credit to purchase Obamacare insurance is facing the prospect of paying back $530 of that tax credit to the IRS, according to a new study from H&R Block.  This clawback is reducing the refunds for these taxpayers by 17 percent this filing season. - ATR

Obama giveth to buy votes and the IRS taketh away.

Gotcha!

UPDATE:

According to the UK Daily Mail the 52% figure translates to roughly 4.5M tax filers.

Now isn't that special?

Thanks to Henry Stern for the update info.

Green Mountain State gets $Grubered

Our old friend Jonathan Gruber just scored the equivalent of 64,000 cups of steaming hot, delicious coffee:

"In a 54-page memo, Vermont State Auditor Doug Hoffer confirms that embattled Obamacare architect Jonathan Gruber overbilled the state ...  Gruber himself apparently pocketed at least $48,000 of the $80,000 the state of Vermont has already paid"

Hope he also stocked up on some de-caf.

Pimping Medicare

Medicare fraud is back in the news and a carrier with a bulls eye on their back is Humana. A major player in

the Medicare Advantage business, Humana uniquely positions themselves in targeted markets to offer some of the most competitive plans in the area.

Are they smarter than their competitors or is something else afoot?

Humana, Inc. faces new scrutiny from the Justice Department over allegations it has overcharged the government by claiming some elderly patients enrolled in its popular Medicare plans are sicker than they actually are.

The privately run Medicare Advantage plans offer seniors an alternative to standard Medicare, which pays doctors for each service they render. By contrast, under Medicare Advantage, the health plans are paid a set fee monthly for each patient based on a complex formula known as a risk score. Essentially, the government pays higher rates for sicker patients and less for those in good health. - NPR

On the surface it may appear there is nothing wrong. The government taxpayer SHOULD pay more for sicker people.

But who defines "sicker" and how is that assessment made?

Therein lies the problem.

(Dr.) Olivia Graves alleges that a Humana medical center had diagnosed abnormally high numbers of patients with diseases such as diabetes with complications that boosted Medicare payments — diagnoses that "were not supported by medical records." Graves alleges that Humana knew about the overcharges but took no action to stop them. Humana has denied the allegations.

And in early February, a federal grand jury in West Palm Beach, Fl. indicted Dr. Isaac Kojo Anakwah Thompson on eight counts of health care fraud. He's accused of cheating Medicare out of about $2.1 million by inflating risk scores of some Humana-enrolled patients. 

Regardless of who you believe, ultimately it is the taxpayer that loses.

hat tip to Holly Robinson for this find.

#Medicarefraud

Open Enrollment...yet again....

Like the Feds, Covered California has announced another special Open Enrollment period.  This one runs from today through April 30.  Eligible consumers must indicate on their application that they were unaware of the tax penalty for going without health insurance.  It doesn't appear to require that you were uninsured in 2014.  

Since the application also includes a statement about the accuracy of the submitted information, the applicant also certifies that he or she is a blithering idiot or doesn’t watch TV, listen to the radio or know how to read.

More Delays on HRAs

Technically, Health Reimbursement Arrangements (HRAs) aren't "insurance" at all, but a means to provide tax-advantaged financing of health care. Unlike Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs), HRAs are entirely employer-financed; they're like an employer-provided health care gift card.

Until the ObamaTax, HRAs were also quite flexible in how they were set up and for what they could be used. For example, pre-ACA, small employers could fund "standalone" HRAs that allowed employees to pay for privately purchased health insurance (among other things). This encouraged employees to buy the plan best suited to their needs, and employers could control costs because they weren't beholden to a group carrier's annual rate in creases.

Sadly, those days are gone.

One of the ways that these plans have been affected is increased taxation. Under the DC-enforced ObamaTax regulations, so-called "standalone" HRAs are subject to a pretty hefty excise tax. The good news (for certain values of "good") is that the IRS has graciously granted a (temporary) reprieve:

"The Treasury Department ... will delay enforcement of an Affordable Care Act prohibition relating to standalone health reimbursement arrangements until July 1"

Gee, how generous of them.

Oh, and that excise tax? $100 per employee per day (of non-compliance).

Ouch.

Naturally, I turned to our local Gurus of all things HRA (and FSA, and HSA), the folks at FlexBank, for their take:

"The deal is, the taxes are still coming, it’s just been delayed."

Pay me now, or pay me later. So sayeth DC.

Three Strikes...

Pamela Weldon played by the rules, and for her efforts, she's outta luck:

"[CoOpportunity]'s liquidation marked the third time she would lose her health insurance under Obamacare, the third time she would head to HealthCare.gov to shop for coverage, and the third time she would have to purchase a brand new plan."

On the bright side, she now has an extra coupla months to sign up (maybe), but woe unto her if she has any claims in the meantime. She believed the lie that if she liked her plan, she could keep it; suffering from carpal tunnel syndrome for over a dozen years, she was satisfied with her Humana plan, but was forced to find a new ObamaPlan when her plan was cancelled.

No problem, thought she, and headed to the 404Care.gov site, where she attempted - for two months! - to obtain coverage. She finally got coverage from CoOpportunity, and we all know how that turned out.

She also believed the lie that "if you like your doctor, you can keep your doctor:" as with all the ObamaTax promises, this one had an expiration date. Turns out, her regular physician wasn't in her new plan's network. Luckily for the 58 year old Ms Weldin, though, her plan did cover birth control convenience items.

It actually just goes from bad to worse: her plan of choice was no longer offered, then the carrier itself assumed room temp. She eventually found a plan that included her preferred doc, but at a much steeper rate.

But hey, that's the new paradigm, no?

You have GOT to be kidding me

Really? They're going to do this?

"The Obama administration will hold a second enrollment period for ObamaCare this year ... The enrollment period will run from March 15 to April 30."

They're just trolling us now.

Here's my question: why arbitrarily cut it off in April? Why not just open it year 'round? That way no one will have to pay any penalty fine tax. Better yet, it means that you can just wait to buy your insurance in the ambulance.

Makes sense to me.

Obamacrack Tax Headache

If you are one of the 11 million or so Obamacrack addicts that got subsidy money, you might want to delay your 2014 income tax filing.

If you have already filed, consider filing a corrected return.

The Obama administration says it sent about 800,000 HealthCare.gov customers the wrong tax information, and officials are asking those consumers to delay filing their 2014 taxes.

The tax error disclosed Friday is a self-inflicted injury that comes on the heels of what President Barack Obama had touted as a successful enrollment season, with about 11.4 million people signed up. - CNBC

Reportedly 89% of the 11+ million are on Medicaid.

That leaves roughly 2.5M that bought Obamacrack with subsidy money and presumably have or will file taxes. In round numbers, about a third of you got bad information from the government.

Co-Ops circling the drain?

Was Hawkeye state-based CoOpportunity Health's rapid growth - and even more rapid decline -  a harbinger of things to come? We've wondered about the Co-Op model for a while:

"The Freelancers Union, which provides health insurance to 25,000 of its members in New York State, is ending an experiment in providing low-cost insurance to independent workers"

That little "experiment" cost thee and me over $340 million. So, what does the future hold for these insurance company wannabe's?

Over at Forbes, Dr Scott Gottlieb posits that it's not likely to be very bright, and worrisome:

"The co-ops aren’t dying only because they were hastily constructed, or poorly managed. Their disaster is far more willful and deliberate. They meant to lose money."

Interesting take. But what possible motivation could there be to purposefully back a loser?

Well, if your actual end goal is single-payer (as we've maintained all along), then it begins to make sense.

A lot of sense.

Co-blogger Patrick adds:

This post from UPenn's Institute of Health Economics adds some financial perspective on the scope of the problem:

"The “combined ratio,” across all plans, is 116.8%, which corresponds to an underwriting loss of about $17 per $100 of premiums"

Hard to stay afloat when you're hemorrhaging cash. Or put another way:

Falling Dominoes

Have you ever watched someone stack dominoes then tap one and watch the rest fall? Some of these set ups are quite elaborate and took a long time to build only to collapse and fail in a matter of minutes.

This is what is happening to health insurance, and to an extent, health care as well, in the U.S. as a result of Obamacrack.

Assurant is a 100+ year old carrier that is losing money in the health insurance sector and will probably leave the market very soon. If not for the taxpayer funded "bail out money" (some might call it blood money) Assurant would have been gone long ago, or possibly never even entered the Obamacrack game.

The carrier lost $37M last quarter and losses would have been even greater if not for the government payola.

The health unit lost money even though it cut spending on expenses other than claims sharply, executives said.

Colberg said the biggest problem was last-minute moves the Obama administration made to let consumers hang on to "grandmothered policies," or policies purchased between the time PPACA became law and Jan. 1, 2014.

Health insurers had priced 2014 major medical coverage based on the assumption that most people who had coverage purchased before major new PPACA commercial health insurance requirements took effect in 2014 would have to replace the coverage.

The decision to allow grandmothering "dramatically altered the risk pool in 2014 and made the market much sicker than expected," Colberg said. - Life Health Pro

Political maneuvering and manipulation of the law led, at least in part, to unanticipated losses.

They must not have been paying attention when he said "If you like your plan you can keep your plan".

Looks like Assurant got Gruberized.

Imagine If You Will

A world in which almost anything can be considered a life qualifying event that allows you access to Obamacrack.

Under the new rules of engagement, you are not allowed to purchase health insurance anytime you want. That was the old way. Not any more.

Now you can only purchase when the government says you can purchase. During pre-determined open enrollment periods.

Or pre-defined life qualifying events.

If you get married (but not engaged), divorced (but not separated), lose your current health insurance (involuntarily of course) or deliver a baby you may then purchase health insurance.

But some groups are not happy with this arrangement. They believe you should be able to purchase health insurance when you become pregnant.

Groups such as Planned Parenthood, March of Dimes and Young Invincibles (whatever that is) want to change the rules making health insurance available as soon as you are impregnated.

The Obama administration often touts the health benefits women have gained under the Affordable Care Act, including the option to sign up for coverage outside of open enrollment periods if they’re “having a baby.”

But advocates complain the special insurance enrollment period begins only after a birth. As a result, uninsured women who learn they are pregnant outside of the regular three-month open enrollment period, which this year ended Sunday, can get stuck paying thousands of dollars for prenatal care and a delivery — or worse, going without  care. - KHN

Kind of runs against the grain of "planned" parenthood, doesn't it?

It's a Trap!

The Pareto Trap (or Principle) is also known as the 80/20 Rule:

"[F]or many events, roughly 80% of the effects come from 20% of the causes"

In business, it's an aphorism that 20% of one's customers account for 80% of one's headaches.

Another way to look at it is that attempts to improve one thing (eg gas mileage) will also incur negative consequences (eg safety). And so it is with health care:

"A Pareto improvement was promised by the president at the launch of his signature reform. “If you like your doctor, you can keep your doctor” ... To lower costs, i.e. make health insurance more affordable, insurers limit the physicians in their network."

This is the trade-off for access to insurance versus access to care. It precisely exemplifies our longstanding meme here at IB: health care is not health insurance. I would add the following codicil:

"Making health insurance more available will, of necessity, make it more expensive."

The proof of this, of course, are the subsidy and cost-sharing schemes: if guaranteed issue insurance which immediately covered pre-existing conditions was "affordable" (as in PP"A"CA), then there would be no need for them.

Common sense, really.

Hidden Providers Still Exist

Hidden providers are not new to health insurance. They have been around as long as there has been

managed care. We have posted on the hidden provider issue here several times, but apparently we still need to get the word out.

Pam Durocher is a breast cancer survivor.

That's a good thing.

When looking for a surgeon for reconstructive work she used her carrier's provider search tool to look for par providers.

But she wasn't thorough in her search.

Like Durocher, many consumers who take pains to research which doctors and hospitals participate in their plans can still end up with huge bills. Sometimes, that’s because they got incorrect or incomplete information from their insurer or health-care provider. Sometimes, it’s because a physician has multiple offices, and not all are in network, as in Durocher’s case. Sometimes, it’s because a participating hospital relies on out-of-network doctors, including emergency room physicians, anesthesiologists and radiologists. 

Consumer advocates say the sheer scope of such problems undermine promises made by proponents of the Affordable Care Act that the law would protect against medical bankruptcy. - The Daily Beast

Consumer advocates need to stick with something they understand. Obamacrack did nothing to "protect consumers against medical bankruptcy."

If anything, it made it worse.

Because of cost constraints placed on carriers, shortened enrollment periods and planned obsolescence of existing health insurance policies it is more difficult for consumers to understand their options and how these new plans work.

Telling voters that buying health insurance will be as easy as purchasing an airline ticket online and allowing health insurance to be peddled by navigators and social workers has only made matters worse.

“It’s not fair and probably not legal that consumers be left holding the bag when an out-of-network doctor treats them,” said Timothy Jost, a law professor at Washington and Lee University.

One must assume that Prof. Jost has never practiced law in the real world.

Perhaps Jost should revisit contract law 101.

Efforts by doctors, hospitals and other health providers to charge patients for bills not covered by their insurers are called “balance billing.” The problem predates the federal health law and has long been among the top complaints filed with state insurance regulators.

The federal health law largely sidesteps the issue as well. It says insurers must include coverage for emergency care and not charge policyholders higher copayments for ER services at non-network hospitals, because patients can’t always choose where they go. While the insurer will pay a portion of the bill, in such cases, doctors or hospitals may still bill patients for the difference between that payment and their own charges.

Yes, and it has always been that way, even before Obamacrack.

No fear.

Legislators have a "fix" for these problems. Effectively eliminate managed care networks.

If regulators required them to fully cover charges by out-of-network doctors, that could reduce “incentives for providers to participate in networks” and make it harder to have adequate networks, America’s Health Insurance Plans, the insurers’ trade group, and the Blue Cross Blue Shield Association wrote in a joint letter to the NAIC.

It would also raise premiums.

Instead, AHIP says, states could require out-of-network doctors to accept a benchmark payment from insurers, perhaps what Medicare pays, rather than balance billing patients.

Yes, but Medicare almost always pays a lower reimbursement than private health insurance.

Ronald Reagan pegged it when he said "I'm from the government and I am here to help you.".

It used to be said the only thing the government can manage correctly is a war.

Now they can't even get that right.

Reality, what a concept

Schadenfreude, it's what's for dinner:

[click pic to embiggen]

IANAL but...

Consider this:

"[T]he Obama administration has gone to extraordinary lengths to partner with churches and other faith-based groups, even publishing sample church bulletin inserts, flyers, and scripts"

And for what purpose are they "partnering?"

Well, to push folks to sign up for ObamaPlans.

I am not a lawyer, but doesn't that conflict with this:

"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof"

What am I missing?

Paybacks are Hell

You've heard the expression before. Paybacks are hell. This applies to Obamacrack as well.

Filing your 2014 taxes? Did you make more than you told the government you would make? All that free government cheese isn't looking so good these days.

Jane Riddle of Los Angeles was unemployed in late 2013 when she applied for an Obamacrack policy. With $0 income her health insurance premium came out to be a quite affordable $1 per month.

Then she got a job.

Then she filed her taxes.

That's when the trouble began.

Riddle landed a job in early 2014 at a life insurance agency, but since her new employer didn't offer health benefits, she kept her Obamacare plan. However, she didn't update her income with the California exchange, which she acknowledges was her mistake.

Now, she has to pay back the entire subsidy, which is forcing her to dip into her savings. - Money CNN

Ouch.

How many Jane Riddles are out there?

Between 4.5 million and 7.5 million taxpayers received subsidies for insurance premiums when they signed up for coverage on Obamacare exchanges, federal officials said. These folks had to forecast their 2014 income when they applied. Those who underestimated their earnings either will receive smaller tax refunds or will owe the IRS money.

Doesn't the government know how many people got free cheese? They gave out so many Obamabucks they lost track?

Some 53% of Jackson Hewitt clients who received subsidies have to repay part or all of it, with the largest being $12,000, said Mark Steber, chief tax officer. 

Over half missed the mark in estimating their income.

In all fairness, that is not an indictment of J - H, but rather a slam against the people that designed this mess.

Tell us how much you will make next year and we will give you free cheese. Miss the mark and we will ask for some (or all) of it back.

And consider the case of Erica Cherington that bought an Obamacrack plan for 2014 and only paid $89 monthly because her low income entitled her to a $284 per month taxpayer funded subsidy.

Then she got a new job that paid more. As a result she had to pay back $600 of her subsidy (a little more than 2 months worth).

To avoid this happening again, Cherington called the federal exchange to update her income, which she hadn't done when she changed jobs. Her revised monthly premium: $156 a month.

A case manager who handles disability payments, Cherington is now considering dropping her coverage and paying the penalty instead.

"It's not really affordable," she said of her new premium. "I don't know if I'll be able to keep it."

Her new premium is $2/day more and she is earning more income than last year, but she can't afford the higher premium with her higher wage base.

Yeah, paybacks are hell.

Stupid Claims Rep Tricks

Over the years, our Stupid Carrier Tricks series has garnered quite a few eyeballs. The carriers, though, rely on individuals to carry out the work; in the P&C area, claims are generally handled by claims representatives (aka "adjusters"). Law-blogger (and longtime FoIB) Eric Turkewitz has a fascinating, frustrating post up about a weaselly Allstate Rep with a snarky attitude and faulty brain filter:

"A snarky email from an Allstate adjuster may cost the company $900,000 ... especially since the defendant had a problem with its expert."

Eric makes often complex legal issues easily understood, and you can't help but smile at his take on the adjuster.

Recommended.

Gaming Obamacare is Easy

Over at The Federalist I wrote an article showing five ways for individuals to legally game Obamacare. These loopholes show ways of saving money by simply using other people's money.

Be sure to check it out here.

404Care.gov Speedbump

So as Open Enrollment 2.0 winds down, this should come as no surprise to anyone that's been paying attention:

"A technical problem that had been interfering with sign-ups for [an ObamaPlan] has been fixed, officials say. Any consumer whose enrollment was hampered by the glitch will be provided with a special enrollment period."

Which is interesting, since the law recognizes only a few, specific situations that would trigger such an exception, and website "glitches" ain't one of them.

'Course, flouting the actual law hasn't seemed all that relevant to this crew in the first place (cf: subsidies in non-State-run exchanges).

Friday Afternoon Linkfest

■ If you're a current or former Anthem insured (or employee), the beleaguered carrier is offering a series of Town Hall meetings to "[t]o review what we know and share with you what we're doing at this point."

On hand will be Chief Info Officer Stacia Grosso and Ken Goulet, Commercial and Specialty Market honcho.

Aside from these Town Halls, Anthem's also arranging for complimenatry credit monitoring for those affected by the cyber attack. Click here for more on that.

■ Speaking of commercial business, employers will be delighted to learn that the IRS [ed: ever notice how, of you take out that space, it becomes theIRS?] is about to ship out the new Form 1094-C, which "employers are supposed to use to tell the IRS whether they offered workers minimum essential coverage (MEC), and Form 1095-C, which is the form employers are supposed to use to tell the workers themselves whether they had or were offered MEC."

Oh goody.

■ And finally, just in time for Valentine's Day, this reminder from Dame Nancy McBotox Pelosi that, in lieu of flowers or chocolate, one should instead urge loved one's to sign up for an ObamaPlan.

See, romance isn't dead (it is, apparently, quite under the weather).

Take a Number

The folks that created Obamacrack must have pieced the plan together in the

middle of the night, working by candlelight in between tequila shooters. Just when you think it can't get any worse .......... it does.

Comes now 2015 and time to file taxes based on your 2014 ACTUAL income. No more guessing. No liars poker. Time to show your hand.

Way back in 2013 if you needed health insurance and wanted the taxpayers to help you pay for the newly inflated premiums, you went to goodluck.gov and applied for Obamacrack.

The less income you PROJECTED, the bigger your subsidy.

Such a deal.

Keep in mind you didn't have to prove anything, not even citizenship. Just show up, claim you are poor, and you get free stuff.

Obamacrack was born.

The presidents signature legislation was prepared to create a nation of people addicted to the expectation of free, or almost free, health insurance and health care.

April 15th is upon us and time to settle up.

New forms. Higher tax prep fees. And questions. Lots and lots of questions.

Like this.

Enrolled and received subsidy for the first five months of 2014, then got a new job and enrolled in employer provided insurance.  I failed to report the household income change to Healthcare.gov and therefore received more subsidy than was due for those first five months.  I cannot find where to complete the Form 8962 in TurboTax.  How can I get that form incorporated into my TurboTax return?  I should only have to pay back the difference between the PTC based on current income figures versus the APTC which was based on estimated income figures.  TurboTax is calculating that I have to repay ALL of the subsidy and that appears to be incorrect.

I selected that we "had health insurance all year" and selected both "plan through work" and "plan through Healthcare.gov" since I had both in 2014. -TurboTax

Look at the date.

Question posed 19 days ago and there are 4 responses.

TaxguyBill seems to have an idea and actually is helpful.

Buffetmom wants more crack, or at least expected the crack to be free.

Now TurboTax tells us we have to repay some to the Marketplace through our taxes. This does not seem justified since during the time we benefited from the Marketplace plan we did not have the income. How do we handle this?

Pay the man, sweetie. There is no free lunch.

Turning Tables Again

Recently, an outfit in The Pelican State asked me to share my thoughts on the value of health insurance. I was one of a handful of industry experts who gave for our Top 3 Reasons for having health insurance.

As far as I could tell, I was the only actual insurance person included (there was a nurse and a journalist/author, for example), which I found quite interesting.

Anyway, some interesting answers and less overlap than I'd have expected.

[And Thanks! to Alex T]