Just What is an ACO?: A Brief Introduction to Accountable Care Organizations

"The accountable care organization is like a unicorn, a fantastic creature that is vested with mythical powers. But no one has actually seen one."

A mere six pages of Obamacare legislation delegated broad jurisdiction to the Secretary of Health and Human Services (HHS) to establish an Accountable Care Organization (ACO) program. The term “Accountable Care Organization” was coined in 2006. And there has been a couple of federal pilot program testing the idea. Yet without a regulation defining and establishing ACOs, most could only speculate on what one is.

But, on April 7, 2011, HHS took their six-page directive from Congress and turned it into a 127-page proposed regulation. We now have a better idea of what an ACO is and is not.

Here is our brief summary. Read more »

Christie Administration Harshly Criticizes Obamacare Rate Review Regulation

From time to time we check back on Obamacare regulations after their comment periods have closed to see what others are telling the Obama Administration about these regulations.

Thomas Considine, Commissioner of New Jersey’s Department of Banking and Insurance under Governor Chris Christie, submitted a comment to the Department of Health and Human Services (HHS) on February 14, 2011 soundly criticizing HHS's insurance rate review regulation. Read more »

1,147,271 Words of Obamacare Regulations Published So Far—270% as Long as the Text of the Statute.

Last year Congress passed the 906-page “Patient Protection and Affordable Care Act” followed by the 55-page “Health Care and Education Reconciliation Act of 2010.” Together, they form what is better known as Obamacare.

If you thought that Obamacare was long, it is only a fraction of the length of the regulations. Read more »

Obamacare would kill student health insurance plans; HHS solution?—Waiver Magic.

In order to avoid the fallout from the real potential that the Administration’s signature piece of legislation could lead to the collapse of the college health insurance system, the Obama Administration worked some rhetorical magic to give themselves the power to issue a regulatory waiver. Then, to add insult to injury, HHS issued the proposed regulation during the period when the federal government was under a court order to cease implementation of Obamacare. Read more »

Obamacare Waivers for States

Imagine a future Congress passing a law that would prohibit citizens from driving any vehicles except motor scooters. Then imagine that within the law there is a waiver provision to give “flexibility” to individuals who want to use other vehicles. With a waiver from the Department of Transportation, you could drive a convertible, a pickup, a sports car, or even a semi. To get this waiver you would have to apply to the Department of Transportation and six months later they would let you know if your request has been granted. Your waiver would only be good for five years and there would be no guarantee that it would be renewed.

Oh, and one more thing—no waiver would be granted if your vehicle is not at least as fuel efficient as a motor scooter.

How excited would you be that the government was offering “flexibility” through these waivers?

You can imagine, then, the response of some state governors at the White House’s announcement that Obamacare allows states "flexibility" if they want to opt-out of certain of Obamacare’s provisions. Read more »

Implementing Obamacare: A Pattern of Disregard for the Law and the Constitution

Not only is Obamacare itself unconstitutional, the Obama administration has been implementing it in an unconstitutional manner.

We have found three instances where the Department of Health and Human Services (HHS) has violated the separation of powers by writing regulations that exceed the authority granted to it by Congress in the implementation of Obamacare. Read more »

State Insurance Commissioners Consider Amendment to and Waiver from Obamacare's Medical Loss Ratio

In order to prevent the destruction of the health insurance agent profession, state insurance commissioners are considering asking Congress to amend to Obamacare and asking HHS for a waiver. Read more »

White House Gives Example of Alternative to Individual Mandate for States

Today, President Obama announced that he supports a bill by Senators Wyden and Brown which would move up the date states would become eligible to receive the so-called "state innovation waiver. State innovation waivers would be granted by the Department of Health and Human Services (HHS) and would waive some of the requirements of Obamacare.

HHS Offers Grants to Force States to Follow Federal Rate Review Regulations

Last year, the Department of Health and Human Services (HHS) released Cycle I of a grant program designed to force states to follow a federal regulation that requires review of health insurance rate increases deemed by HHS to be unreasonable. Read more »

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