Obama’s Assault on Charity Payments for Premiums


January 9, 2014
**To receive this commentary directly to your email, click the "subscribe to the Health Freedom eNews" button above.


The sick are getting a reality check. It’s 2014, the first year of full Obamacare implementation and taxation…but Obama is focused on the well and the healthy, not the poor and the sick. An article in Inside Health Insurance Exchanges (HEX) tells the tale, “HHS Warns Hospitals, Providers Not to Cover Patient Premiums.”

A Los Angeles non-profit, called A Better LA, plans to donate the $50 to $100 per month share of 50 people’s Obamacare premiums not financed by federal subsidies. In addition, some hospitals want to pay the premiums for their most frequent patients so their costs can be reimbursed. (WSJ, 12/17/13, p A6).
Obama is not pleased. First, such ‘premium charity’ makes his “affordable” premiums look bad. Second, he desperately needs the well, not the sick, enrolled in government exchanges (aka “Marketplaces”). Therefore, his health officials released the following statement on charitable payment of premiums:
“The Department of Health and Human Services (HHS) has broad authority to regulate the Federal and State Marketplaces (e.g., section 1321 (a) of the Affordable Care Act). It has been suggested that hospitals, other healthcare providers, and other commercial entities may be considering supporting premium payments and cost-sharing obligations with respect to qualified health plans purchased by patients in the Marketplaces. HHS has significant concerns with this practice because it could skew the insurance risk pool and create an unlevel field in the Marketplaces. HHS discourages this practice and encourages issuers to reject such third party payments. HHS intends to monitor this practice and to take appropriate action, if necessary.” [Emphasis added.]
In other words, too many sick people in the exchanges without enough well people to cover their costs will destabilize the exchanges.
Tim Jost, legal scholar at Washington and Lee University, doubts HHS has authority to prohibit such charity. He told HEX: “I haven’t seen anything in the regs that specifically prohibits it…If they had some specific authority to prevent it, you’d think they would have mentioned it.” They didn’t. The Administration is throwing its weight around trying to plug any legal hole where the freedom to be charitable might get through.
Hospitals are not being charitable. Hospital payments for patient premiums may sound laudable, but their intent is to open the door to taxpayer dollars for hospital reimbursement. Obamacare has already cut $18.1 billion in federal Medicaid “disproportionate share hospital” (DSH) payments, which cover the hospital’s uncompensated care costs, including charity care and bad debt.
Insurers oppose ‘premium charity.’ They want the taxpayer-funded federal premium subsidies from Obamacare enrollment but they don’t want a deluge of the high-risk or sick patients. As The Wall Street Journal reports,
“[I]nsurers say they can’t make a profit unless the health insurance exchanges created by the Affordable Care Act draw a balanced mix of healthy and sicker customers…Help from nonprofits or hospitals could speed the arrival of less healthy customers into the exchanges, outpacing the arrival of younger, healthier people who might not cross paths with hospitals.”
SCOTUS upset the Obamacare applecart. Obama intended to impose a national wage and wealth redistribution scheme primarily on the backs of the young and healthy and the wallets of the working. It includes 20 new or higher taxes, two coverage mandates, expansion of Medicaid, a ban on pre-existing condition exclusions, and higher prices for care and coverage. No one, including the hospitals and insurers now on the hook for providing care and coverage to millions more enrollees, expected the Medicaid expansion and individual mandate to be ruled unconstitutional, thus leaving insurers and hospitals in the lurch as the sick sign up and the young and healthy stay away.
But who’s to blame? Not the young or the healthy. Hospitals and insurers are reaping the consequences of their own complicity. If health plans and hospitals had not supported Obamacare, the “Affordable Care Act” would not be law.
2014 is a critical year.  We can stop Obamacare this year. Federal funding for operating Obama’s exchanges – federal takeover centers -- runs out December 31, 2014. Exchanges need enrollees to fund their multi-million dollar operations in 2015. Stop the exchanges from being successful in 2014: Donate to CCHF & Opt-Out of Obamacare & Refuse to Enroll.
Committed to patient-centered health freedom,
Twila Brase, RN, PHN
President and Co-founder
CORRECTION – In the December 18 Commentary, the Halbig vs. Sebelius lawsuit was incorrectly cited as originating in Oklahoma. There are four similar lawsuits. Pruitt vs. Sebelius is the lawsuit filed by Oklahoma’s Attorney General, Scott Pruitt.