Exemptions undermining ACA coverage mandate
The Paducah Sun
In 2012 the Obama administration argued before the U.S. Supreme Court that the Obamacare “individual mandate,” and more specifically the provision for a fine for those people who failed to sign up for insurance, was essential to the law’s survival. Without it, argued administration lawyers, the entire Affordable Care Act would collapse financially.
What to make, then, of a Congressional Budget Office analysis that finds almost 90 percent of the nation’s 30 million uninsured won’t pay a fine in 2016 under the ACA. The reason? A broad and growing list of exemptions being created by the administration.
Got a notice your electricity is going to be shut off? That qualifies for an exemption. Been the victim of domestic violence? You’re exempt. In the country illegally? You’re exempt. Belong to a faith-healing sect? If you’re not already exempt, you will be soon, and that includes Christian Scientists, for whom specific legislation is advancing through Congress even now.
In all the administration has come up - so far - with 14 hardships people can invoke and not be fined for not having insurance. Suffering fire or flood loss qualifies. So does the recent death of a close family member. Also, if you are being evicted or if you’ve had substantial medical expenses in the last 24 months that can’t be paid, you qualify for an exemption. There’s also a catch-all exemption for “people who experienced another hardship” obtaining health insurance.
There are beyond that broader exemptions built into the law. For instance, many people in the 21 states that opted not to expand Medicaid under Obamacare are exempt from the insurance requirement. So are all Native Americans.
And then there’s that broad group that got caught in the “if you like your insurance you can keep it” windmill. Many will recall the furor that erupted when millions of Americans had their insurance canceled last year because their policies did not meet the minimum coverage standards required by Obamacare. In an effort to save face, President Obama asked companies to rescind the cancellations. Not all of them could or did. So if you are one of the people who actually lost your insurance due to Obamacare, you too are exempt.
The problem with this development is that the administration’s lawyers were correct when they argued before the Supreme Court that the individual mandate is essential to the functioning of the law. The implications of 90 percent of the uninsured avoiding a penalty is ominous, particularly to the extent those who are exempted are younger, healthier individuals.
A lengthy Wall Street Journal article about the exemption statistics quotes insurance executives expressing deep concern about the impact on health insurance premiums if, as is now feared, their insurance pools are disproportionately filled with older people with more health problems. The article quotes a North Carolina insurance actuary as saying the number of more-expensive, older Americans in his company’s plans is greater than projected. He told the newspaper the penalty (currently a fine of the greater of $95 or 1 percent of family income) needs to be stronger and the exemptions fewer if the system is to work financially.
This latest troubling finding by the CBO is just one in a growing list of problems that seem to threaten the viability of the ACA. We’ve previously mentioned on this page concerns from another agency - the Health and Human Services Inspector General’s office - that millions of people receiving ACA subsidies are receiving incorrect amounts or aren’t entitled subsidies at all. Add it all up, and the finances of the ACA seem to be teetering on the brink.
Time will tell, but Sen. Max Baucus’ 2013 warning that implementation of the ACA was shaping up as a “huge train wreck” may yet prove prescient.
Darts and Laurels
A laurel to the CDC’s $1.8 million award to help fight drug overdose in Kentucky — put on your boxing mitts!
A dart to the life lost on an early morning ATV ride — tragic.
A laurel to BSACAP for assisting 17 students in their pursuit of higher education!
A dart to the end of summer break — it was sweet!
A laurel to new beginnings and a new school year — good luck, kids!
New nutrition guidelines;a healthy decision for students
By The Kentucky Standard
Anyone with children knows it can be difficult to get them to eat their vegetables.
School districts are now facing that same challenge, as new nutritional standards go into effect this year requiring schools to offer healthier lunches.
Approved by Congress in 2010, the lunch standards phase in requirements that schools increase offerings of fresh fruit, vegetables and whole grains while reducing sodium.
Schools have been moving along that path, but what they are finding is that kids are tossing the healthy foods and filling up by purchasing extra items a la carte, such as an extra helping of French fries.
That has led districts such as Nelson County Schools to limit students’ purchases of what are called “competitive foods,” like fries, and the hours of operation for vending machines.
The enforcement of the regulations comes through the U.S. Department of Agriculture, which administers food subsidies to schools for free and reduced lunches. If districts don’t want to comply, they don’t have to. They just won’t get the federal funds. For most cash-strapped schools, that’s really not an option.
One school district, Fort Thomas Independent Schools, announced this week it would forego the federal funding — costing it up to $200,000 this year — and develop its menu using its own standards.
It should be pointed out that while the federal rules are complex — what isn’t when it comes to regulations written in Washington? — schools still have a lot of flexibility in developing their menus. While the food on school lunch trays will be healthier than in the past, it is a long way from what most people would call health food.
Take the new limits on sodium. Starting this year, cafeterias can still serve meals with enough sodium in breakfast and lunch to add up to nearly 2,000 milligrams in a day, and that’s just two meals. The recommended intake for school-aged children is between 1,200 and 1,500.
Other limits include no trans fats, less than 10 percent of calories coming from saturated fat and keeping total calories at lunch below 650 for elementary students and 850 for high-schoolers.
Even in the highly partisan political atmosphere in which we find ourselves today, one could be excused for thinking making school lunches healthier a prime area for bipartisanship. Alas, such is not the case. The School Nutrition Association, which includes the food industry giants, spent $105,000 between April 1 and June 30 lobbying Congress to lessen or delay implementing the new standards, according to a report in USA Today. So far, the lobbying group has had some early success, convincing the House Appropriations Committee to allow some districts to obtain waivers to school lunch programs that have operated at a net loss over a six-month period. That measure has yet to be passed by the full House.
Opposition to the guidelines seems to revolve around two issues — that they cost too much and students are wasting the healthy food.
As for cost, there is money available. We are one of the richest countries in the world, and if we can’t find enough money to provide healthy meals for our students, then it is time for lawmakers to seriously examine their priorities. Childhood obesity is an epidemic in this country, and much of the problem lies with the food our children are eating. The long-term costs to this country in the form of health care spending treating obesity-related diseases eclipses the upfront costs of providing them healthy meals.
As to the waste, school officials can’t force students to eat. Much of the problem stems from the food they are used to eating at home. But that is no excuse for throwing in the towel. There are plenty of parents who are already familiar with this problem, and take the approach that if they are hungry, they will eat what’s on their plate.
Who knows, given the chance, they might even learn to like it.
And isn’t learning what school is all about?
Darts and Laurels
A laurel to the avoidance of a worker’s strike at HRMC — glad for a mutual agreement!
A dart to traffic accidents — slow down, don’t text and watch for the other guy!
A laurel to HRMC’s Cancer Survivors Day — very heartfelt and very heartwarming!
A dart to continued slagging employment — it’s a bit better, but only a bit!
A laurel to improved conditions at BSRDC — we know it comes with effort!
Darts and Laurels
A laurel to educational day camps that keep kids learning during summer break!
A dart to the destruction of Worldwide Equipment’s garage — a great loss.
A laurel to no lives lost in the Worldwide Equipment fire — trucks are replaceable, people are not.
A dart to Ronnie Blair’s retirement — we’ll miss him around town!
A laurel to SOAR sessions that seek public input — let your voice be heard!