(CBS News) WASHINGTON -- CBS News has learned that the project manager in charge of building the federal health care website was apparently kept in the dark about serious failures in the website's security. Those failures could lead to identity theft among buying insurance. The project manager testified to congressional investigators behind closed doors, but CBS News has obtained the first look at a partial transcript of his testimony.
Henry Chao, HealthCare.gov's chief project manager at the Centers for Medicare and Medicaid Services (CMS), gave nine hours of closed-door testimony to the House Oversight Committee in advance of this week's hearing. In excerpts CBS News has obtained, Chao was asked about a memo that outlined important security risks discovered in the insurance system.
Chao said he was unaware of a Sept. 3 government memo written by another senior official at CMS. It found two high-risk issues, which are redacted for security reasons. The memo said "the threat and risk potential (to the system) is limitless." The memo shows CMS gave deadlines of mid-2014 and early 2015 to address them.
But Chao testified he'd been told the opposite.
"What I recall is what the team told me, is that there were no high findings," he said.
Chao testified security gaps could lead to identity theft, unauthorized access and misrouted data.
According to federal guidelines, high risk means "the vulnerability could be expected to have a severe or catastrophic adverse affect on organizational operations ... assets or individuals."
Watch: HealthCare.gov never received top-to-bottom security test, below.
It was Chao who recommended it was safe to launch the website Oct. 1. When shown the security risk memo, Chao said, "I just want to say that I haven't seen this before."
A Republican staff lawyer asked, "Do you find it surprising that you haven't seen this before?"
Chao replied, "Yeah ... I mean, wouldn't you be surprised if you were me?" He later added: "It is disturbing. I mean, I don't deny that this is ... a fairly nonstandard way" to proceed. http://www.cbsnews.com/video/watch/?id=50158504n
Late Monday, Health and Human Services told CBS News the privacy and security of consumers' personal information are at op priority, and consumers can trust their information is protected by stringent security standards. The author of the security memo, Tony Trenkle, retired from CMS last week; no reason was given.
Though a sideshow throughout Obamacare’s passage and litigation, Medicaid’s pivotal role in President Obama’s health care reform effort has become apparent following the law’s October 1 implementation. In many states, Medicaid enrollment through the Healthcare.gov portal is dwarfing the number of “private” insurance plan purchases.
While this development represents a major financial threat to the survival of Obamacare, new regulations established by Obamacare to cover Medicaid enrollment have created a major threat to the United States’ ability to administrate that far larger benefit program.
Following is a summary of the problem:
Non-citizens are eligible for Medicaid and CHIP (Children’s Health Insurance Program). This is not a new development. However, the documentation and verification process for such enrollments was significantly eased by regulations in the Affordable Care Act.
Getting fraudulent applications for Medicaid or CHIP approved is now easier, and thus more likely.
While troubling, final approval of fraudulent applications represents a lesser element of the problem regarding non-citizen enrollment. The greater concern is initial approval:
Applicants attempting to register for Medicaid as non-citizens by using Healthcare.gov will have their identification checked in real-time by the SAVE (Systematic Alien Verification for Entitlements) database. But if SAVE verification fails, the applicant is not prevented from enrolling in Medicaid/CHIP.
In fact, the opposite occurs: the applicant is likely enrolled in Medicaid immediately.
The applicant is then given a 90-day period to clear up the identification problem.
This “enroll first, confirm later” regulation, combined with the ACA’s easing of verification requirements, allows anyone, from a computer anywhere in the world, to successfully auto-enroll for 90 days of Medicaid by entering fraudulent information about being a certain category of legal alien living in the United States.
There is no guarantee that state governments will take action to cancel these enrollments at the end of each application’s 90-day period if identification is never provided. The cancellation of unverified enrollments is left to each state’s available manpower and political will.
At the end of the 90-day period, if states do indeed ask the applicant to produce identification or to have the enrollment canceled, the applicant is allowed to ask for an extension of the 90-day period. The applicant can get the period extended for significantly longer.
Obamacare does not allow any information entered into Healthcare.gov to be used for legal action against illegal immigrants. Like “catch and release,” an applicant could attempt to fraudulently enroll repeatedly.
Foreign entities looking to flood the Medicaid rolls with fraudulent auto-enrollments are, of course, beyond U.S. prosecution and able to cause such chaos.
An organized effort by domestic or foreign entities to create countless numbers of these fraudulent enrollments could challenge Medicaid with an unsolvable administrative situation.
In February of this year, James Edwards of the Center for Immigration Studies published a report titled “Immigration and Obamacare: Proposed Medicaid Rules for Verifying Status.” His report summarized the federal government’s January publication of such rules being proposed by the Health and Human Services Department and the Centers for Medicare and Medicaid Services. These proposed rules were later finalized on July 15 (click https://www.federalregister.gov/arti...native-benefit for the 164-page “Final Rule” document).
Edwards’ report documented the security flaws developing as a result of the Obama administration’s political goal of enrolling as many people as possible in some sort of health care coverage.
Following are highlights from Edwards’ report, focusing on the easing of the non-citizen application process and the removal of safeguards:
Two, down from three, documents are to be required to establish one’s status. Attestation made about someone’s citizenship status in a single affidavit counts as one of the accepted forms of identity.
This means that a signed document from a second individual which simply states that the applicant is who he says is will be an accepted form of identification.
Electronic documentation begins to overtake presentation of authentic identification documents. Similarly, a record of identity or status verification is regarded as more important than having authenticated copies of valid, legitimate documents on record.
States do not need to file copies of the documents. They are only required to keep track of whether or not the documents were accepted. No paper trail.
If electronic verification of citizenship or immigration status fails or is delayed, applicants for health benefits must have a “reasonable opportunity period” in which to confirm their status.
If otherwise eligible for Medicaid, states must grant Medicaid enrollment to unverified persons during this period. … “Reasonable opportunity” even applies, under this rule, to persons “unable to provide a SSN [Social Security number]“ — a rather glaring loophole for frauds to exploit.
Edwards’ use of the phrase “otherwise eligible” raises the issue of the expansion and easing of the verification process for Medicaid and CHIP under President Obama. For example, eligibility for CHIP was expanded during President Obama’s first term, and the necessary documentation was decreased.
So: how simple is it to fraudulently enroll for Medicaid under the rules governing Obamacare?
Submit electronic copies of a false affidavit and a false work document while claiming to be a member of the “presumed eligible” populations, and you are required to get at least 90 days.
Most troubling, the establishment of Healthcare.gov and the other state-run exchanges allows this fraud to be perpetrated from anywhere on the planet. I asked Edwards:
PJM: “Based on the HHS/CMMS rules, couldn’t, say, al-Zawahiri get himself auto-enrolled with a “reasonable opportunity period” from a laptop in Pakistan?”
In addition to the economic risk of millions arriving at domestic health care providers with fraudulent approvals and Medicaid ID numbers, Medicaid databases could be so overwhelmed with fraudulent information so as to be rendered administratively unmanageable and unreliable.
Effectively, the databases would be useless and pointless. An organized entity could, rather simply, employ this tactic to economically damage and humiliate the United States.
Ironically, the massive failure of the exchange websites has postponed the risk until the websites are functioning properly.
"HOUSTON, October 25, 2013 — President Obama’s legacy may include a stake in the heart of a cherished dream of the progressive left: complete government control of healthcare in America."
."..If Obamacare dies an early and spectacular failure, it will be at least another 100 years before the American people will consider government-run healthcare again. This is why Obama will fight tooth and nail to impose this lead balloon on the American people.
Obama’s progressive “fundamental transformation” of this country was to revolve around a single-payer, government run and controlled healthcare system. He realized that he would have to sell a Trojan Horse to the American people; America would not stand for an immediate and open takeover of 1/6th of the economy.
"The rollout and website were such huge failures up front that even the old and sick who will tolerate the massive inconvenience of dealing with bureaucrats for endless hours can’t buy coverage. Private insurers will only go out of business if the sick can sign up and the healthy don’t.
More importantly, the American people were always supposed to blame this catastrophe on the private insurers, not the government. The problem is that the American people are not stupid: they see that a $634 million website run by the government that cannot even link a consumer to a private insurer’s webpage is the fault of the government."
"...The rollout has been such a magnificent failure that every Democratic senator up for re-election in 2014 has demanded a full one year delay of the heart and soul of the law, the individual mandate.
...President Obama may have just done what Republicans and constitutionalists have been unable to do for over a century: break the back of the progressive dream of socialized medicine in America for good.
Yes, the lobster makes sense, I’ll explain in a minute…
We now have seen a list of 465 Obamacare navigators. What can this list tell us about the program?
1. Millions and millions of dollars It is important to understand that all the navigators listed are not just helping steer people through the Obamacare maze out of the goodness of their hearts. Each group/person listed has been awarded a grant (translate: tax payer dollars) to “navigate” people through the process.
For example, the Community Action Network of Nebraska (CAN) which has a few chapters amongst the listings, was awarded a grant for $562, 457. There are 454 listings other than CAN.
While the grants are variable in amount, imagine the math on this, and how much has been spent-millions upon millions.
2. Where are the young people?
If you scan the navigators, one thing becomes clear. It is geared toward minority and low income populations, the people who often do not have insurance. From that perspective, it makes a certain amount of sense. But low income is going to get subsidies or Medicaid. In order to sustain the system, you need the young healthy folks who don’t already have insurance to sign up to be able to pay into the system so it doesn’t collapse on itself.
Apart from a few college-oriented listings, the search for those people seems to be lacking in the make-up of the navigators.
3. Why these guys?
Who made the selection of these people and how were they vetted? We already have been told they received no background checks, which in and of itself, is a bit frightening, considering the sensitive nature of the information with which they will be dealing. What accounting do they have to make, if they received a grant? Generally, a grant would require a full accounting of the expenditures. Who will be looking to make sure the money is spent correctly?
While there are healthcare providers amongst the navigators, there are others who have no relation to healthcare at all, and others whose selection is perhaps in accord with this administration’s political inclinations.
We reported last night the controversial choice of 14 Planned Parenthood chapters. There is also the Arab Community Center for Economic and Social Services in Dearborn, as well as multiple agencies directed at immigrant workers and Native Americans.
There’s even the “National Tongan America Society”. I don’t mean to be insulting in saying that I don’t think Tongans are a huge drain on our economy.
My personal favorite is the Maine Lobsterman’s Association. That seems a bit strange, but actually I can see where it might make sense-fishermen, who do not have employer insurance, who might actually make some money, and who often haven’t secured insurance. Any navigator reaching out to those who could actually pay into the system would be more likely to sustain the system.
There are also multiple “community action” groups, many of which sound like ACORN reborn. Amongst those, there is Seedco. Seedco has a “seedy” past. Seedco was under investigation by both NY State and the Federal government for fraud for falsely reporting jobs they supposedly had obtained for workers pursuant to a grant. The U.S. Attorney brought a civil fraud charge against them and they paid $1.725 million in a settlement in December 2012. Despite this, President Obama gave them a multi-million dollar contract for Obamacare.
Or should I say, we paid the settlement at least in some measure, since they received more tax dollars for training for Obamacare. “As a result of these and other operational changes, we strongly believe that Seedco has the experience, integrity and commitment to carry out this work,” a Seedco statement said when queried about their involvement in Obamacare.
Perhaps the most clearly political choice is South Carolina Progressive Network. Really? Here’s a picture from their network: ["If socialism were a respectable affiliation, Progressives would probably call themselves “democratic socialists.”]
The referenced navigator list doesn’t seem to be the complete list as there are other individuals and organizations I have heard of that don’t seem to be listed.
Questions need to be asked and need to continue to come to make sure that this doesn’t become even more of a money pit than it already is.
HT: Dapandico for SC Progressive pic
WebMD paid for support of ObamaCare
Health and Human Services Secretary Kathleen Sebelius nor WebMD mentioned at the time was that the company, which millions of Americans regularly read for health news, also stood to earn millions of dollars from a federal contract to teach doctors about Obamacare.
The contract documents, reviewed by The Washington Times, reward WebMD handsomely. For instance, the fee schedule offers dozens of products, including: • As much as $126,826 for a single 5,000-word review article on scientific advances in a clinical topic. • Up to $68,916 for a four-minute video from an opinion specialist. • More than $140,000 for an eight-question online quiz. WebMD says it doesn’t believe it had an obligation to disclose to its broad consumer base its $4.8 million contract with the government.
No, your information is not safe under ObamaCare…at least not in Texas. Earlier this year, a left-wing group of organizers and operatives formed a group called Battleground Texas.
Headed by a former field director of Obama for America, Battleground Texas’ sole aim is to turn Texas from a so-called “red state” to another California–that is, almost singularly controlled by liberal Democrats.
The organization, dubbed “Battleground Texas,” plans to engage the state’s rapidly growing Latino population, as well as African-American voters and other Democratic-leaning constituencies that have been underrepresented at the ballot box in recent cycles. Two sources said the contemplated budget would run into the tens of millions of dollars over several years – a project Democrats hope has enough heft to help turn what has long been an electoral pipe dream into reality.
Now, however, a video released by James O’Keefe’s Project Veritas over the last few days has revealed that Battleground Texas may actually be gathering data on ObamaCare enrollees from one of the groups enlisted to enroll ObamaCare enrollees.
According to O’Keefe’s video, Enroll America, a “501(c)(3) organization whose mission is to maximize the number of uninsured Americans who enroll in health coverage made available by the Affordable Care Act” is sharing data with Battleground Texas.
Clarence Landry, an organizer with Enroll America, Texas, is seen on the video talking about working with, and cross-pollinating the same data with Battleground Texas.
A moment later, a woman named Adrian Bell [sic], a field director with Battleground Texas explains that Battleground Texas is a “Democratic organization.”
Another individual, Bill Hunn, explains that Battleground Texas is a “political action committee.”
If Battleground Texas is a Democratic political action committee as is stated in the video, why is Enroll America sharing data with them?
According to the Enroll America’s website, the Department of Health & Human Services (HHS) awarded health centers in Texas a total of $9,907,738 to provide outreach and enrollment assistance and HHS is planning to provide another $8,151,185 to organizations in Texas to serve as navigators.
That a portion of this money (how much is unknown) is being used to share data sharing between a political action group like Battleground Texas, which states it is “a Democratic organization” is highly questionable. Whether it is illegal, is another matter entirely.
The fact is, if Battleground Texas is gathering data from ObamaCare enrollees that will be later used for political purposes, there is a fatal flaw in the enrollment process.
Union bosses were for it before they were against it. They sold their members on a President who told them they would get better healthcare at lower cost when the exact opposite is occurring–and even though they are still pushing for nationalized healthcare.
We knew all along its consequences would be disastrous. Now, we are all paying the price.
For additional information about the Affordable Care Act, please visit www.iamempowered.org
Democratic Socialists of America 2013 Awards Reception
DATE: Friday, June 7: 6:00 pm Social, 7:00 pm Program PLACE: 58 Berkeley Street, SomervilleBoston DSA is proud to honor three of Boston’s best activists: » Jennifer Doeretiring from Jobs with Justice » Shelagh ForemanProgram Director of Massachusetts Peace Action » Andi Mullin,Director of the Campaign for Our Communities
Honorary Event Chairs: Brian Corr, Cambridge Peace Commission* Harris Gruman, SEIU* Rep. Denise Provost Rand Wilson, SEIU Local 888*
Computer Security Expert McAfee: Obamacare a Hacker's Dream
By Greg Richter -- Thursday, 03 Oct 2013
Saying "somebody made a grave error," McAfee Antivirus founder John McAfee says millions of Americans could have their identities stolen as people sign up for Obamacare.
Appearing on Fox Business Network's "Cavuto" on Wednesday, the eccentric tech magnate warned that anyone can put up a fake Obamacare web page and claim to be a broker for the system. There is no central government-operated website to point people to legitimate brokers.
"Instead, any hacker can put a website up, make it look extremely competitive, and because of the nature of the system, this is healthcare after all, they can ask you the most intimate questions, and you're freely going to answer them," McAfee said. An unsuspecting user might give up his Social Security number, date of birth or share any mental health issues, he said.
Though he announced this past weekend development of software that can hide users from the NSA's prying eyes, McAfee said the hacker issue isn't a problem software can solve.
"What idiot put this system out there and did not create a central depository?" he asked. "This is insane. I will predict that the loss of income for the millions of Americans that are going to lose their identities … "
More than 700 fake or misleading websites playing off of the new federal Healthcare.gov site and the word Obamacare have been created on the Internet by so-called cyber-squatters looking to steal personal information from individuals trying to get healthcare coverage.
According to The Washington Examiner, many of the sites are considered legal, though they have nothing to do with the government or the Obamacare program.
One website, the Examiner noted, has even branded itself as part of the "Obamacare enrollment team" and directs people to enter their name, address, Social Security number, and more on an enrollment form. But the site — www.obama-care.us, which is registered through GoDaddy.com and is owned by a Georgia company that also runs 167 other squatter sites — doesn't enroll anybody in anything. It just takes the information.
Cyber-squatting is nothing new. Many companies set up websites with names similar to high-profile pages to either draw traffic away from their competitors or to share information collected with other companies. But identity thieves also use fake squatter websites to gather information that ends up being used or sold to someone else.
Earlier this month, McAfee Antivirus founder John McAfee described the Obamacare website as a hacker's dream because millions of Americans could have their identities stolen. He warned that anyone could put up a fake page and claim to be a healthcare insurance broker affiliated with the federal program.
"Any hacker can put a website up, make it look extremely competitive, and because of the nature of the system, this is healthcare after all, they can ask you the most intimate questions, and you're freely going to answer them," McAfee said.
An unsuspecting user might give up his Social Security number, date of birth, or share any mental health issues, he said.
Adding to the confusion are legitimate sites that have similar names to the Heathcare.gov site. For example, healthcare.com was established in 1994 to help people shop for private health insurance. It offers quotes from different companies, but it has no affiliation with the federal Obamacare program.
To prevent cyber-squatting, security experts typically recommend that multiple domain names be purchased similar to the main website name.
The retired cyber security expert who spoke to the Examiner said he was "shocked" that the government had not picked up any other obvious domain names before cyber-squatters could purchase them.
The expert provided the Examiner with a list of 221 websites trying to take advantage of the Healthcare.gov name, and another 499 that are squatting on state healthcare exchange websites.
Posted by - CNN Investigative Correspondent Chris Frates
October 31st, 2013
Washington (CNN) - Senate Democrats voted unanimously three years ago to support the Obamacare rule that is largely responsible for some of the health insurance cancellation letters that are going out.
In September 2010, Senate Republicans brought a resolution to the floor to block implementation of the grandfather rule, warning that it would result in canceled policies and violate President Barack Obama’s promise that people could keep their insurance if they liked it.
The District of Columbia is an island surrounded by reality. Only in the District of Columbia could you get away with telling the people if you like what you have you can keep it, and then pass regulations six months later that do just the opposite and figure that people are going to ignore it. But common sense is eventually going to prevail in this town and common sense is going to have to prevail on this piece of legislation as well,” Iowa Sen. Chuck Grassley said at the time.
“The administration's own regulations prove this is not the case. Under the grandfathering regulation, according to the White House's own economic impact analysis, as many as 69 percent of businesses will lose their grandfathered status by 2013 and be forced to buy government-approved plans,” the Iowa Republican said.
On a party line vote, Democrats killed the resolution, which could come back to haunt vulnerable Democrats up for re-election this year.
Senate Democrats like Mary Landrieu, Jeanne Shaheen, Mark Pryor, Kay Hagan and Mark Begich – all of whom voted against stopping the rule from going into effect and have since supported delaying parts of Obamacare.
The rule set up the criteria for what insurance plans would be grandfathered, or exempted, from the new Obamacare requirements. Democrats argued then that the rule was necessary to insure that insurance companies weren’t able to drastically change their plans and still remain exempt from Obamacare.
Republicans are “saying that basically we will grandfather it in, but the insurance companies can change it however they want, and you are stuck with it,” Democratic Sen. Tom Harkin of Iowa said in 2010.
The rule essentially prevents insurance companies from keeping their grandfathered status if they make changes to their plans. In practice, insurance companies are loath to leave their plans unchanged so grandfathered plans are disappearing, and people are being forced to change their plans to meet Obamacare’s more robust coverage requirements.
Hatch to Unions: Join GOP in Calling for Health Law Delay.By Kris Maher -- Washington WirePolitical Insight and Analysis From The Wall Street Journal's Capital Bureau Search Washington Wire1 July 18, 2013
The Affordable Care Act is upsetting some political alliances and inspiring a flurry of letter-writing among politicians.
Last week, three union presidents wrote a letter to Congress’s top Democrats, Senate Majority Leader Harry Reid of Nevada and House Minority leader Rep. Nancy Pelosi of California, sharply criticizing the Obama administration and the law’s impact on union-run health plans. Today, the unions got a response of sorts — from Republican Sen. Orrin Hatch.
The Utah Republican wrote to James Hoffa, president of the International Brotherhood of Teamsters, and two other union presidents, asking them to join Republicans in calling for a “permanent delay” of the law “until we are able to come up with a plan that will achieve the law’s stated goals.” In the meantime, he argued, the law would drive up costs while failing to cover as many people as once promised.
Since last year, union leaders have complained that many of the law’s requirements will drive up costs for union-sponsored health-care plans that are managed jointly by unions and mostly small employers, potentially causing unionized employers to drop the plans that cover more than 20 million people.
In a letter dated July 11 to Sen. Reid and Rep. Pelosi, the union presidents said that without changes the Affordable Care Act will devastate union-sponsored health-insurance plans. Union officials have also been upset that the Obama administration listened to employer requests to delay a provision requiring bigger companies to provide insurance coverage or pay a penalty. That rule, which had been scheduled to take effect in early 2014, has been pushed back a year.
The union officials called the delay “disconcerting.” They also said union arguments have been “disregarded and met with a stone wall by the White House.”
“Since your activities to encourage changes to the law have, to date, been unsuccessful,” Sen. Hatch wrote, “I want to invite you to join me in an effort to help the Obama Administration and Congress understand the full impact the law has had and will continue to have.”
The Utah Republican told the labor leaders that he agreed with their assessment that the law is motivating employers to cut workers’ hours and “destroy the foundation” of the 40 hour work week.
“My colleagues here in Congress – members of both parties – have highlighted similar concerns with the law,” Sen. Hatch wrote. Last week, he and fellow Republicans sent a separate letter to the White House calling for delaying the law’s implementation indefinitely.
It’s not clear whether the Teamsters, the United Food and Commercial Workers and Unite Here, a union that represents hotel and laundry workers, would ever consider joining forces with Republicans on the issue. Leigh Strope, a spokeswoman for the Teamsters, said the union declined to comment on Sen. Hatch’s letter. A Unite Here spokeswoman also declined to comment.
Tim Schlittner, a UFCW spokesman, said he viewed Sen. Hatch’s invitation as being insincere because he believed the lawmaker had previously recommended that the White House ignore the union’s concerns about the law.
“As much as Senator Hatch wants to make this about scoring political points against the Affordable Care Act, our motivation is preserving the best health care possible for our members,” Mr. Schlittner said.
Sen. Hatch, who once worked as a construction worker in the Wood, Wire and Metal Lathers Union, typically opposes union-backed legislation. But Julia Lawless, his press secretary, held out hope that unions would accept the invitation.
“We certainly hope these organizations join us in this effort,” said Ms. Lawless. “With each passing day we are watching ObamaCare unravel and it’s hard-working, middle-class families –including union families – that are being forced to pay the price.”
Resolution 54: AFL-CIO Convention Resolution on the Affordable Care Act
Submitted by the Building and Construction Trades Department, the International Union of Operating Engineers and the American Federation of Teachers
Referred to the Resolutions Committee Referred to the Executive Council by the Resolutions Committee with the Recommendation that It Be Sent to the Convention for Adoption Referred to the Convention by the Executive Council with a Recommendation for Adoption
WHEREAS, in 2009, the AFL-CIO Convention passed two health care resolutions—Health Care Reform Now and the Social Insurance Model for Health Care Reform—which reaffirmed the labor movement’s commitment to health care for all, ultimately through a single-payer system. In 2010, Congress passed the Affordable Care Act (ACA);
WHEREAS, the AFL-CIO continues to support the ACA’s goal of securing high-quality, affordable health coverage for all Americans; three years after the passage of the Affordable Care Act, we reaffirm our commitment to the goal of affordable, quality health care for all but recognize that the ACA remains a work in progress;
WHEREAS, the ACA’s expansion of comprehensive health insurance to 25 million more Americans, support for affordability through expanded Medicaid eligibility and premium subsidies and insurance market reforms are clear gains for working families. The new law also has eliminated some of the worst insurance company abuses, cut costs for seniors, and appears to be contributing to lower rates for individual coverage in states like California and New York;
WHEREAS, the federal agencies administering the ACA have interpreted the Act in ways that are threatening the ability of workers to keep health care coverage through some collectively bargained, non-profit health care funds. Republican governors in many states have refused to participate in implementing the Act and are even actively blocking efforts to provide health care to all through Medicaid expansion;
WHEREAS, for decades before the enactment of the Affordable Care Act, such quality, affordable health coverage has been provided to workers and their families through non-profit multiemployer health plans negotiated between unions and participating employers, including the approximately 20 million individuals covered by such plans today;
WHEREAS, the health coverage provided through multiemployer plans has met the goals of the Affordable Care Act by providing portable, affordable, high-quality coverage for workers who would otherwise be left out of typical employer plans, including participants in industries where employment is mobile or part-time;
WHEREAS, multiemployer health plans have been attractive to employers because they provide predictable, consistent and cost-effective long-term health coverage for workers;
WHEREAS, multiemployer health plans have been attractive to employees because they provide a consumer-oriented plan design, portability, stability and flexibility;
WHEREAS, contrary to the law’s intent, some workers might not be able to keep their coverage and their doctors because the federal agencies’ current implementation plans will be highly disruptive to the operation of Taft-Hartley multiemployer plans, substantially changing the coverage available for millions of covered employees and their families;
WHEREAS, the federal agencies tasked with implementing the law have unnecessarily imposed an interpretation of the Affordable Care Act which imposes additional costs and fees for which plan participants receive no benefit, unnecessarily driving coverage costs higher;
WHEREAS, in industries like construction, where 93 percent of employers are considered small under the ACA, the playing field is now even more tilted in favor of companies that shirk responsibility toward their workers;
WHEREAS, current negotiation of collective bargaining agreements setting the terms of health insurance coverage for plan participants are already demonstrating the adverse impact of the application of the Affordable Care Act to multiemployer plans;
WHEREAS, the multiemployer plan community, including the AFL-CIO and other labor organizations, has engaged the Administration since the passage of the Affordable Care Act to work toward a legally supportable regulatory approach that would enable multiemployer plans to continue to provide the valuable coverage they provide today and to allow participants to keep the coverage they have;
WHEREAS, unless changes are made, the ACA will effectively use taxpayer dollars to subsidize employers that refuse to take responsibility for providing their employees health care, placing more responsible employers at a competitive disadvantage, and destabilizing the employment-based health care system. At the same time, the ACA will be taxing non-profit worker health plans for the exclusive benefit of for-profit insurance companies. Employers will then have a financial incentive to drop coverage and force low-wage workers onto the exchanges, making it nearly impossible for those workers’ plans to continue. The end result will be that millions more workers and their families will be forced onto the exchanges, increasing the costs of the exchanges to the federal government and undermining the finances of the ACA;
WHEREAS, the labor movement has pushed for a requirement in the ACA that allemployers assume responsibility for contributing toward the cost of health care for their employees, either by offering health benefits or by making substantial contributions to a public fund to finance coverage for uninsured workers;
WHEREAS, the ACA includes a limited employer responsibility penalty that applies just to medium and large employers, and then only for employees who work 30 or more hours per week on average, it falls short of what is needed to prevent irresponsible employer behavior. Employers are preparing to avoid paying penalties by cutting workers’ hours and pay, thereby creating a new underclass of less-than-30-hour workers;
WHEREAS, we must not shift costs to working families and retirees or endanger the quality of care or limit access to care by underfunding urban, safety-net hospitals and other critical providers. ACA’s payment and delivery reforms are an important step toward lowering costs, but they should be implemented in a way that protects the availability of services for our communities. And the cuts in reimbursement to hospitals and other providers should be accompanied by stronger mechanisms to ensure the maintenance of safe staffing and effective care delivery;
WHEREAS, workers should not be penalized for negotiating good health care benefits by having them subjected to special taxation—particularly so long as the tax system as a whole is tilted so severely in the direction of the very rich;
WHEREAS, denying eligibility for health benefits to immigrants on the path to citizenship is not only cruel, but also short-sighted given the important connections between coverage expansion and controlling the growth of health costs;
WHEREAS, it has been a common practice for public unions in New York and elsewhere to build a benefit structure through three different plans: 1) a comprehensive basic health plan negotiated with the employer, providing hospital, medical and related benefits; 2) a per-employee cash contribution to a union-sponsored welfare trust fund that is used to provide supplemental benefits such as prescription drugs and other health care benefits; and 3) voluntary member-paid benefits, sponsored by the union or union trust funds for insurances like umbrella policies that cover catastrophic health care claims. Under the current construction of the ACA, each separate insurer (or plan if the benefit is self-funded) will pay the Transitional Reinsurance (TR) and Patient Centered Outcomes Research Institute (PCORI) fees. This means that these fees will be levied three times on the same group of workers. These fees should only be charged once and only to the plan sponsor of the base health plan, as is the ACA rule for single employers;
WHEREAS, the ACA Excise Tax, Reinsurance Fee and other fees will drive the costs of collectively bargained, union administered plans, and other plans that cover unionized workers, to unsupportable levels, resulting in pressure to shift costs to workers, cut wages, and to agree to unacceptable high deductible plans;
WHEREAS, the federal agencies have not provided a regulatory approach that provides a positive environment for all of our plans, including multiemployer plans;
WHEREAS, this resolution is not meant to be a comprehensive list of the benefits and the problems of the ACA;
WHEREAS, because of these factors and the impact on our members, many unions have called for changes in the Affordable Care Act;
NOW, THEREFORE, BE IT RESOLVED, that the AFL-CIO reaffirms the health care resolutions adopted by the 2009 convention, including the commitment to pursue health care for all ultimately through a single-payer system;
BE IT FURTHER RESOLVED, that the ACA should be administered in a manner that preserves the high-quality health coverage multiemployer plans have provided to union families for decades and, if this is not possible, we will demand the ACA be amended by Congress;
BE IT FURTHER RESOLVED, that non-profit multiemployer plans should have access to the ACA’s premium tax credits and cost-sharing reductions on behalf of working families, just as for-profit insurance companies will;
BE IT FURTHER RESOLVED, that the employer responsibility rules should be fixed by applying a full employer penalty for failing to provide affordable comprehensive coverage to workers who average 20 or more hours per week and adding an employer penalty on a pro rata basis for employees who work fewer than 20 hours per week.
BE IT FURTHER RESOLVED, that the employer responsibility rules should be fixed further by extending employer responsibility requirements to more employers, especially to construction companies with five or more employees as was provided by the Merkley Amendment included in the Patient Protection and Affordable Care Act;
BE IT FURTHER RESOLVED, that employers that attempt to shirk their responsibility in its entirety by dumping low-income workers into Medicaid should be penalized;
BE IT FURTHER RESOLVED, that the AFL-CIO will strongly oppose taxing workers’ health benefits;
BE IT FURTHER RESOLVED, that the AFL-CIO supports the preservation of collectively bargained plans, union administered plans, and other plans that cover unionized workers, by eliminating the ACA Excise Tax, Reinsurance Fee and all other fees;
BE IT FURTHER RESOLVED, that we call on the federal agencies responsible for implementing the Act to exempt supplemental welfare benefit plans from the PCORI and reinsurance fees. http://www.aflcio.org/About/Exec-Council/Conventions/2013/Resolutions-and-Amendments/Resolution-54-AFL-CIO-Convention-Resolution-on-the-Affordable-Care-Act
Union Letter: Obamacare Will ‘Destroy The Very Health and Wellbeing’ of
Workers
The leaders of three major U.S. unions, including the highly influential
Teamsters, have sent a scathing letter to Democratic leaders in Congress,
warning that unless changes are made, President Obama’s health care reform plan
will “destroy the foundation of the 40 hour work week that is the backbone of
the American middle class.”
If that’s not bad enough, the Affordable Care Act, if not modified, will
“destroy the very health and wellbeing of our members along with millions of
other hardworking Americans,” the letter says.
The full letter, below:
Dear Leader Reid and Leader Pelosi:
When you and the President sought our support for the Affordable Care Act
(ACA), you pledged that if we liked the health plans we have now, we could keep
them. Sadly, that promise is under threat. Right now, unless you and the Obama
Administration enact an equitable fix, the ACA will shatter not only our
hard-earned health benefits, but destroy the foundation of the 40 hour work week
that is the backbone of the American middle class.
Like millions of other Americans, our members are front-line workers in the
American economy. We have been strong supporters of the notion that all
Americans should have access to quality, affordable health care. We have also
been strong supporters of you. In campaign after campaign we have put boots on
the ground, gone door-to-door to get out the vote, run phone banks and raised
money to secure this vision.
Now this vision has come back to haunt us.
Since the ACA was enacted, we have been bringing our deep concerns to the
Administration, seeking reasonable regulatory interpretations to the statute
that would help prevent the destruction of non-profit health plans. As you both
know first-hand, our persuasive arguments have been disregarded and met with a
stone wall by the White House and the pertinent agencies. This is especially
stinging because other stakeholders have repeatedly received successful
interpretations for their respective grievances. Most disconcerting of course is
last week’s huge accommodation for the employer community—extending the
statutorily mandated “December 31, 2013” deadline for the employer mandate and
penalties.
Time is running out: Congress wrote this law; we voted for you. We have a
problem; you need to fix it. The unintended consequences of the ACA are severe.
Perverse incentives are already creating nightmare scenarios:
First, the law creates an incentive for employers to keep employees’ work
hours below 30 hours a week. Numerous employers have begun to cut workers’ hours
to avoid this obligation, and many of them are doing so openly. The impact is
two-fold: fewer hours means less pay while also losing our current health
benefits.
Second, millions of Americans are covered by non-profit health
insurance plans like the ones in which most of our members participate. These
non-profit plans are governed jointly by unions and companies under
the Taft-Hartley Act. Our health plans have been built over decades by working
men and women. Under the ACA as interpreted by the Administration, our employees
will treated differently and not be eligible for subsidies afforded other
citizens. As such, many employees will be relegated to second-class status and
shut out of the help the law offers to for-profit insurance plans.
And finally, even though non-profit plans like ours won’t receive the same
subsidies as for-profit plans, they’ll be taxed to pay for those subsidies.
Taken together, these restrictions will make non-profit plans like ours
unsustainable, and will undermine the health-care market of viable alternatives
to the big health insurance companies.
On behalf of the millions of working men and women we represent and the
families they support, we can no longer stand silent in the face of elements of
the Affordable Care Act that will destroy the very health and wellbeing of our
members along with millions of other hardworking Americans.
We believe that there are common-sense corrections that can be made within
the existing statute that will allow our members to continue to keep their
current health plans and benefits just as you and the President pledged. Unless
changes are made, however, that promise is hollow.
We continue to stand behind real health care reform, but the law as it stands
will hurt millions of Americans including the members of our respective
unions.
We are looking to you to make sure these changes are made.
James P. Hoffa General President International Brotherhood of
Teamsters
Joseph Hansen International President UFCW
D. Taylor President UNITE-HERE
The Wall Street Journal Monday, November 11, 2013 Washington WirePolitical Insight and Analysis From The Wall Street Journal's Capital Bureau
Union Fears ‘Destructive Consequences’ From Obamacare July 19, 2013 By Kris Maher
The laborers union has added to organized labor’s drumbeat of dissatisfaction with the Affordable Care Act.
In a letter sent to President Barack Obama on Thursday, Laborers International Union of North America President Terry O’Sullivan wrote that the law has “destructive consequences” for the types of health plans that cover millions of unionized construction workers and their family members.
Click on the image to start interactive tour.The letter follows a separate one written last week by the heads of the International Brotherhood of Teamsters, the United Food and Commercial Workers and Unite Here, expressing similar concerns to Congress’s top Democrats, Sen. Harry Reid and Rep. Nancy Pelosi. The International Brotherhood of Electrical Workers took out print ads raising alarms about the law last week as well.
Mr. O’Sullivan zeroed in on some factors that could directly impact unionized construction workers who are typically covered by multiemployer plans. He noted that costs are rising for such plans because of the law’s benefit mandates. Moreover, a tax under the law would cost such health plans $63 per covered individual, or $630,000 for a plan covering 10,000 people, he wrote. The proceeds of the tax will be used to subsidize insurance companies offering health plans in the Health Exchanges.
“In effect, ACA takes money from the pockets of each laborer covered by a health and welfare fund and gives it to for-profit insurance companies,” Mr. O’Sullivan wrote. Those added costs will eventually impact collective bargaining agreements, he said, making union construction companies less competitive than nonunion ones and resulting in less work for union laborers.
Mr. O’Sullivan concluded: “Approximately 3 million laborers, retirees, and their families now face the very real prospect of losing their health benefits. This, I must remind you, was something that you promised would not happen.”
The laborers union, with about 570,000 members, is one of a few major unions that didn’t support enactment of Affordable Care Act, Mr. O’Sullivan reminded Mr. Obama. “Now, we have watched as the implementation of the law has progressed, our fears have become reality,” he wrote.
The letter was copied to Vice President Joe Biden, as well as Sen. Reid and Rep. Pelosi.
"Three years later, union leaders say the bill they fought to pass now threatens to hurt their own members. At issue are the collectively bargained, multi-employer insurance plans that more than 15 million unionized workers access under the Taft-Hartley Act. Those plans currently allow workers like builders and electricians to change jobs among participating employers and stay in the same health-insurance plan. Because many of the jobs involve manual labor, the plans usually account for injuries and repetitive stresses, benefits that unions say their workers sought instead of higher wages.
But this could change. Under the Affordable Care Act, small companies could choose to stop covering workers through the union agreements and send their workers to the state-based exchanges instead. Through these exchanges, workers would pay lower premiums, thanks to federal government subsidies. But labor leaders fear that the workers who retain union plans will end up paying higher premiums, since there will be fewer people in the plans, and coverage could be less generous. No one knows for sure that this is how it will play out—companies could very well decide to continue in the union plans and keep the status quo—but unions are predicting the worst.
Republicans are saying “I told you so.” Democrats are saying that while they never meant to hurt their allies in organized labor, their hands are now tied by the House GOP. In a decision last week, the Obama administration said it can’t make the changes union leaders are looking for, either. Unions now are left in the middle of the roiling family feud that all agree has no easy answers.
The first public signs of trouble came in July, when union leaders including Teamsters’ president James Hoffa wrote a blistering letter to Democratic leaders Nancy Pelosi and Harry Reid warning of "nightmare scenarios" for millions of workers if the Affordable Care Act is not changed to accommodate labor health plans."
“Congress wrote this law; we voted for you,” they wrote. “We have a problem; you need to fix it.”
Scams sprout with rollout of Obamacare Amber Hunt, The Cincinnati Enquirer
November 11, 2013
Confusion over health insurance law opens floodgates for fraud.
CINCINNATI -- Ohio resident James Dick already had deleted an inbox's worth of bogus e-mails about the Affordable Care Act when his telephone rang. On the other end: a convincing-sounding man claiming to be from the national Medicare office. He told Dick that he was ready to send him a new Medicare card but first needed to verify the 69-year-old's identity -- by asking for his bank account number.
"I said, 'No, I don't think so,' " Dick told The Cincinnati Enquirer. The man insisted that he couldn't verify Dick's identity without the number and kept pressing for it until Dick hung up.
"It was a scam is what it was," Dick said. "I'm sure they've done it to other people. Most people don't realize what they're doing." According to computer security experts and government officials, Dick is right. Since the launch of Obamacare, residents nationwide are finding themselves targets of ACA scams. It's making the already-troubled debut of a controversial law even more confusing.
"It's an opportunity for scammers, and scammers very rarely leave an opportunity unfulfilled," said Mark Rasch, a former computer crime and fraud prosecutor with the U.S. Department of Justice. Schemes appear within days of enrollment opening The scams come in many forms -- as e-mails, phone calls and imposter websites. Some rely on ignorance about what the health-care law actually covers, such as one touting that recipients could qualify for cheaper auto insurance. (Hint: The ACA does not affect car coverage.)
Virginia Democrat Calls For Forcing Doctors To Accept Medicare And Medicaid Patients
November 02, 2013
You would think that when your party is digging a hole, that is getting harder and harder to get out of, you wouldn't want that hole to get deeper faster. But here is Kathleen Murphy, Democrat running for the House against Barbara Comstock, telling a forum in Great Falls that she believes it should law to force doctors to accept Medicare and Medicaid patients. Forced by government decree, mind you.
FYI last night at the Great Falls Grange debate, Democrat delegate candidate Kathleen Murphy said that since many doctors are not accepting medicaid and medicare patients, she advocates making it a legal requirement for those people to be accepted.
She did not recognize that the payments are inadequate to cover the doctors' costs. She also did not recognize there is a shortage of over 45,000 physicians now and that it is forecast to be 90,000 in a few years.
Democrats appear to want to make physicians slaves of the state, but Democrats don't admit they would just drive more doctors out of practice into retirement and other occupations. The Obamacare law and regulations are causing millions of people to lose their health insurance, drop many doctors and hospitals. The HHS internal forecast is 93 million Americans would lose their health insurance due to the Obamacare law and rules about adequacy of insurance.
Many more people will be uninsured. The penalties for being uninsured start at $95 per year, but the penalties can't be collected by the IRS if a person does not have a tax refund to attach.
The out of pocket costs required by Obamacare's Silver Plan for a non-smoking mother and father with two children making a gross before income taxes of $50,000 (roughly average salary for VA) would be $13,765 per year including the deductible of $10,400. That's 28% of their gross income -- not very affordable and about the same as guidelines for a mortgage payment. For such a family making $100,000 of gross income, The cost would be $21,431 including the deductible of $12,700, or 21% of gross income.
With such high deductibles doctors are stuck with trying to collect cash from the patients, even at regulated charge structures. Thus is makes sense for primary care doctors not to participate in Obamacare, medicare and medicaid. They should encourage patients to participate in Concierge Care and insurance programs run by the doctors themselves with patients who can do simple math. Patients can take out catastrophic insurance with high deductibles for major surgeries. Tax deductability for individual medical savings accounts would make health care more affordable.
The head of Obamacare programs, Berwick, loves the socialized medical system in the UK, but never mentions that malpractice insurance is minimal. In the UK, panels of doctors review and approve malpractice awards, rather than emotional juries misled by trial lawyers. Malpractice reform like this with caps on malpractice awards would go a long way in making health care affordable.
I hope physicians rise up and speak out for common sense, protecting quality medical care in the US and giving patients freedom to choose
THIS along with the fact that Terry McAuliffe has already said he'd go to the government shutdown mat to get a state exchange in Virginia. Unbelievable. Combine the chaos of thousands of people across Virginia losing their health insurance, we are going to add to that on the state level by forcing doctors to accept patients they can't afford to help? Unbelievable. Dark days are ahead, but there is still time. Three days to make sure this does not happen.
Democrats in Virginia will drive up health care costs, drive doctors out of the state, and then drive health care costs up even more because there will not be enough doctors practicing in the state.
Kathleen Murphy, a Democrat who is running for the House of Delegates against Republican incumbent Barbara Comstock, told a forum in Great Falls on Saturday that doctors should be forced to accept Medicare and Medicaid patients:
FYI last night at the Great Falls Grange debate, Democrat delegate candidate Kathleen Murphy said that since many doctors are not accepting medicaid and medicare patients, she advocates making it a legal requirement for those people to be accepted.
She did not recognize that the payments are inadequate to cover the doctors' costs. She also did not recognize there is a shortage of over 45,000 physicians now and that it is forecast to be 90,000 in a few years.
Democrats appear to want to make physicians slaves of the state, but Democrats don't admit they would just drive more doctors out of practice into retirement and other occupations. The Obamacare law and regulations are causing millions of people to lose their health insurance, drop many doctors and hospitals. The HHS internal forecast is 93 million Americans would lose their health insurance due to the Obamacare law and rules about adequacy of insurance.
Many more people will be uninsured. The penalties for being uninsured start at $95 per year, but the penalties can't be collected by the IRS if a person does not have a tax refund to attach.
Democratic gubernatorial candidate Terry McAuliffe is promising to go toe to toe with the Republican state legislature to set up an Obamacare state exchange in Virginia. Additionally, McAuliffe is running on a campaign promise to expand Medicaid across the Commonwealth. However, according to the National Center for Policy Analysis, there are simply not enough doctors in Virginia to accommodate such an expansion under Obamacare:
Effect of the ACA on Virginia's Physician Supply.
As in other states, Virginia's physician supply is relatively "inelastic," meaning the number of physicians cannot increase quickly to accommodate the rising demand for medical services an influx of newly insured Medicaid enrollees would create. Virginia physicians have little if any capacity to expand the number of patients they treat. Currently, there are about 29,472 physicians in Virginia, of whom an estimated 22,215 are actively involved in patient care.12 About 85 percent of Virginia's active doctors work full time - so there is little excess capacity. http://www.dhp.virginia.gov/hwdc/docs/Medicaid%20Map%20Packet.pdf
According to the Virginia Department of Health Professions Healthcare Workforce Data Center, two-thirds of Virginia's active physicians are more than 44 years of age, while 20.1 percent are 60 or older.13 Thus, many of these physicians will retire in the next few years. A number of economic studies indicate the newly insured will nearly double their consumption of medical care.14 Yet the demand for health care will continue to rise. Furthermore, an aging population will require more medical care. Across the U.S. 78 million baby boomers are either retired or headed that way in the next decade.
The Virginia Department of Health Professions, through its Health Workforce Data Center, has published a report titled ‘Medicaid Workforce Map Packet.’ This report provides a series of maps displaying the distribution of physician and mid-level providers relative to the estimated number of uninsured adults age 19-64 with income up to 138% of the federal poverty level (the group that would be income-eligible for Medicaid if Virginia chooses to enact a Medicaid expansion.) The researchers used multiple methods to estimate the supply of willing Medicaid providers by city, county and local health district. The uninsured estimates were obtained from the Virginia Atlas of Community Health. This report should be of interest to anyone concerned about the supply of health care providers available to serve enrollees in an expanded Medicaid program. Click here to view the report.
