While Republicans are playing a game of chicken with the Democrats, that may mean America will not be able to pay their bills, they have once again tried to pull the “wool over the eyes” of the American people with two new myths about the Affordable Care Act. These myths are at the center of the debate of keeping the government shut down as well as whether to default on our debt. The House Republicans refuse to sign a clean Continuing Resolution which would insure our government is reopened and more important we do not default on our debts. As many of you know, most of the time when we write a blog, we go through a long process of verifying the information we put in this blog stating the source so anyone can re-check the facts. However, in order to get you information in real time, today we are simply going to tell you the issues the Republicans have indicated are “bad for the public”, worthy of keeping the government closed and possibly defaulting on the country’s debt to “save the American people” from ACA law and then counter these issues with the truth. There will be no rhetoric. The information contained in this blog is just the facts. As author’s of this blog, we recognize changes need to be made to ACA, however these are minor changes and easily fixed by the Congress or administrative modifications, if they just do their job, instead of playing politics with the well-being of the American public. The Republicans, especially those in the Tea Party, are reporting to the American people that they are trying to “save them” from the Affordable Care Act. That is simply untrue, rather they are trying to “save face” and be able to say they won out against big government and out of control spending. Being correct on the ACA is very important to them, even though, polls indicate the Congressional Republicans approval rating is less than 5%. The Republican stubborness reminds me of the last election when these same Republicans, supported by FOX news denied that President Obama was elected. They were sure, that their polls were correct, stating Nate Silver’s 535 predictions were wrong and numbers coming from the voting precincts along with the pundits who declared President Obama the “winner” were just plain wrong. Of course, in the end the polls cited by the Republicans were wrong and President Obama was re-elected. However, this proved just how out of touch these Republicans are with the reality of how Americans feel in this country. Now, they are exhibiting the same denial of truth, as moderate Republicans and Speaker Boehner are over-ruled by about 40 members, primarily of the Tea Party who seem to care very little about the impact shutting our government down and/or defaulting on our debt could have on the American people and the world economy. The two newly reported major myths being spread by the Republicans, in a desperate attempt to have some concessions, surround verifying a person’s income to “make sure” they are eligible for subsidies and/or cost sharing, as well as forcing ONLY members of Congress to buy insurance from the exchange, effectively exempting their staff from participating. While they are manipulating the data with regard to many issues, what they are saying about the ACA, in this case, is simply categorically untrue. Let’s begin with the issue of verifying income. As one of the writer’s of this blog, I can assure you from personal experience that income is verified when applying for coverage through the healthcare.gov website. I have recently finished signing up for a policy through the health care exchange and my income was verified immediately within the process. In fact, during the sign-up process, I was asked to project what income I thought I would have in 2014, Now, based on recent information, I have determined my income in 2014 will be greater than it was in 2012. So, I declared what my best guess is of what my income will be and clicked on enter. After a small waiting period, I received a message indicating that my stated anticipated income did not match income previously declared on my tax returns. I was asked to review my information and then asked again if this was my anticipated income for 2014. I clicked yes, and received a message, that I needed to submit documents to verify my income. Now, in my case, I could submit a written document by me describing why my income would be increasing. I was offered many choices on how to verify income, including pay stubs, prior tax returns, etc. While I was able to continue in the enrollment process and see what subsidies and cost-sharing if any, I was entitled to, based on the income I submitted, I had to electronically agree that the information I was giving was true and correct to the best of my belief and indicate I understood I had to submit documented evidence prior to a certain date to actually get the insurance. The exchanges do verify income. This has been a part of the Affordable Care Act from the beginning. Any information to suggest otherwise is simply false. Why are the Republicans making this demand about insuring people are truthful about their anticipated income suddenly? It is part of the same tired strategy and stereotype they have used to demean and embarrass anyone who participate in what they perceive is an entitlement program. They are trying to make people believe that by nature, Americans will lie about their income and be “given” a handout by the federal government in the form of undeserved subsidies and/or cost sharing. Americans, who would accept a tax incentive or subsidy must be a “shady” kind of person. Remember. these are also the folks who say millions of people apply for food stamps when they aren’t “truly” needy. The studies show however that less than three percent of food stamp recipients lie in order to get food stamps. They also ignore the fact, that not only do people have to verify their income at the time of application, but also have to electronically sign a document indicating they know that if their income is proven to be greater in 2014 than stated on their application, they will be liable to return the money on their tax return when they file in April of 2015. Income is verified then at two points, both prior to obtaining insurance and on their 2014 (filed 4/2015) tax return to validate they told the truth on their application. This is simply another untruth promoted by the Republicans to make ACA is a “hot button” issue. The second issue that the Republicans are “taking a stand” on involves whether they and their staff should enroll in the federal exchange. Initially, they tried saying Congress was exempt from the Affordable Care Act and that wasn’t fair to the average American. They tried to make it seem as if they had been exempted from a “terrible program”. First of all, Congress and their Staff receive their insurance via the federal employee health insurance group. Anyone reviving their health insurance from a large employer are not allowed to shop for insurance in the exchanges. So, by design, Congress and their Staff should not be eligible to get their insurance in the ACA exchanges. While the ACA was in bill form, Senator Grassley (R) submitted an amendment that would require Congress and their staff to be receive their health insurance from the ACA federal exchange like all individuals, families, and smaller businesses in this country. According to some Republicans he added this amendment as a “poison pill”, thinking that it would cause the bill to not be passed even by its supporters in Congress. To Senator Grassley’s surprise, the ACA bill passed and became a law, with the Grassley amendment, meaning that all of Congress and their staff would receive their insurance via the ACA exchanges. So, because of the Grassley Amendment, Congressional Republicans found themselves in the position of having to use the federal health exchange. However, the executive branch and their staff will continue getting their employer sponsored insurance and rightly so because ACA was passed to insure people with out insurance, those who could not afford insurance, those who had pre-existing illnesses and young adults under the age of 26 would have a cost effective means of obtaining insurance. Since the inception of the Affordable Care Act, Congress and their staff have known they would be required to be a part of the exchange beginning in 2014. In fact, over the past two years, the Government Insurance Health Administration (GIHA) has coordinated the Pre-Existing Condition Insurance Plan (PCIP), that provided insurance to thousands of people, like me, with pre-existing conditions beginning in 2011. However, the Affordable Care Act is not perfect and there are things that should have been “tweaked” in terms of the law. One of the tweaks needed involved how members of Congress and their staff, would be able to use their “employer contribution” when purchasing plans. In the last two years, Republicans in the Congress have flat out refused to fix any issues associated with ACA, instead they appealed the law to the Supreme Court and made over 44 attempts to repeal or defund the law in Congress. In response to Republicans continuous refusal to “tweak” the bill, President Obama signed an executive order indicating that all federal employees who were staff members or Congressman could use their “employer” contribution to pay for all or part of their insurance through the federal health exchange and still be eligible for subsidies and cost-sharing. In a move that is so hypocritical, it is hard to believe, the Tea Party specifically, and Congressional Republicans have added the Vitter amendment to the Continuing Resolution which will take away the employer contribution to the healthcare plan for all of congress and their staffs. This represents a income reduction for everyone in Congress as well as their staff. This does not effect the actual members of Congress to a great degree because due to their salary, they will not be eligible for tax incentives or cost-sharing. But their staff, is a different story. Staff members may earn $40,000 to as high as $175,000 per year. Taking away the employee benefit which pays for part of their healthcare insurance premium from these employees is simply unfair. They should not be used as a political pawn just to prove a point by Congressional Republicans. They are punishing the very people who help them do their job. Why would they take away the possibility of their own staff members or others who work in the Capital from getting subsidies or cost sharing? It makes absolutely no sense. They are not doing the right thing and protecting their employees. In essence, they are denying them tax cuts or tax incentives that everyone else in the country in the exchanges receive. The Republicans proclaims that they want more money going to the average American and yet, they want to deny their staffs the ability to get health insurance for less money so they can say they got a “concession” and declare victory to their constituents. This is just plain cruel and clearly supports that these Republicans care very little about the people around them or their constituents. A third issue that is being considered in closing a deal to re-open the government and increase the debt limit is to remove the medical device tax. Again this is being considered as a concession to the Republicans and the Tea Party. The Medical Device Tax is one source of funding the ACA and removing this tax will require congress to find alternative funding. The reason there is so much pressure to remove this tax is because the medical device manufactures (ie: GE, Seimons, J&J, etc) have been spending millions of dollars lobbying congress to remove this tax. So you understand, this is a tax on the artificial hip that costs $350 to manufacture and ultimately costs over $30,000. The margins in these products are huge and they can well afford this tax. Many of these companies do not pay any income taxes currently (ie: GE) because of tax loopholes. Removal of this medical device tax will cause us to have to pay for it somewhere else. Watch our blog and we will let you know they want to replace these funds. Once again we have proven that the “concessions” or major issues associated with ACA are manipulations and/or just plain lies being spread by the Republicans in Congress. If Republicans and/or Tea Party Republicans were educated about ACA, and they should be because that is their responsibility and their job, they would know one of their “demands” may actually financially harm members of their own staff and the other demand to verify income is already a part of the law. That is why we have decided to award Republican members of Congress and specifically the Tea Party our first “stupid and you know it” award. Call your Representative and Senators today and tell them to stop these ridiculous demands. Let them know you are educated about the issues and you want truth as opposed to dishonest rhetoric.They need to re-open the government and not allow the United States to default on it’s debt for their own political gain. About the Authors: By: Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO and Lynne Smith, MSSW. Barbara is an industrial engineer with an MBA. She worked in the pharmaceutical industry for many years before moving into the healthcare industry where she had a company where she provided top quality coding, compliance and revenue cycle management services for physicians. She has since moved into full time consulting for physicians. Barbara is a nationally known expert known for her education, consulting and expert witness services. Lynne has dedicated her career to helping others. She has experience as a social worker in a rural county, an administrator in a large hospital network and as a College Professor. She uses the skills she developed over the years as an advocate in a variety of areas including her most recent venture serving as a Healthcare Advocate. Together, Lynne and Barbara own the ACA Healthcare Advocates consulting firm and are available to individuals, families and businesses to help them meet the requirements of the Affordable Care Act in order to meet the specific needs of the client while optimizing the fiscal considerations. Please direct your questions and/or inquiries to askcobuzzi@gmail.com.
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