June 1, 2013 Legislation





For the 37th time the GOP has voted to repeal Obamacare.  For the 37th time the vote was meaningless.

Sarah Hall Ingram was the commissioner of the IRS during the beginning of the targeting of Tea Party groups for auditing.  She left that part of the IRS in 2012 and her successor has taken the fall.  Where is Ms. Ingram now?  She is the head of the IRS section responsible for the taxing for Obamacare.

A loophole in Obamacare has surfaced.  This one may stick the physicians with no payments for several months of work.  According to the Democratic legislation which they admit they never read, once a family pays one month of a premium they get a three month grace period before they get dinged.  The insurance company is only responsible for the first month and the physicians have to eat any money expended during the next two months.  Think about chemo and how much the oncologist might have to absorb for those two months.  This may keep some physicians from going into the insurance unless they are employed and not responsible.  There is no wiggle room due to the way the law is written.  California law obligates physicians to provide care during the two month of no coverage.  

The CBO has evaluated the Obama budget on Medicare and agrees that it would save $360 Billion over 10 years.  This would mean the Medicare Parts A and B would become one and some seniors would buy meds at wholesale and not Medicare prices.  They did not look at in this report any other of Obama's budget.

Another loophole in Obamacare has come to light.  It is possible for employers to only provide bare bone medical coverage under the law.  Hospitalization is not required.  All that is required is preventative services.  This is great for small companies with low pay people.  They won't leave the companies medical plan to purchase the exchange plan because they can not afford it.  This means the business will not have to pay the $3000 penalty for those who opt out of employer coverage for exchange coverage. Several companies have already opted for this.  Another reason people should have read the law before enacting it.

Sebelius has reached out to the private sector to help fund the Obamacare sign up.  Enroll America, a non profit, asked her to help get money for their organization.  Sebelius called the Robert Wood Johnson Foundation who gave millions to the cause and H&R Block who gave $500,000.  She also called 18 other organizations for help but could not ask directly for money since they are controlled by HHS.  Sebelius contends this is legal and the GOP are not as sure.  The people to be hired are called navigators.  (See next story)

HHS is paying minimal money in the 36 states that have opted out of doing their own exchanges for "navigators".  These are people who are not required to have background checks or to even graduate high school but will help the poor not only pick an exchange but also help them apply for financial assistance.  Some of the states are worried about this lack of ability and are requiring the navigators to be licensed with testing. 

Several large health insurers have decided not to participate in the initial California state insurance exchange.  Cigna, Aetna and UnitedHealth said they will wait at least one year before considering joining. These are small insurers in the individual and small group markets.  Kaiser, Blue Cross and Blue Shield will participate and they hold about 87% of the business.  Covered California, the name of the state exchange, has also named prices.  The prices depend on the type of coverage and are not yet final since they must be reviewed by the state regulators.  The average amount for low income people will be about $300 per month.

Ex-House speaker Pelosi has stated that illegal immigrants even those on the path to citizenship will be not allowed to be on Obamacare or Medicaid.  Either by accident or on purpose, she did not mention Medicare or CHIP.

The Obama administration has just issued new rules that give employers with wellness programs the ability to either penalize or reward employees that quit smoking or get their cholesterol down or other good things.  The employer could charge the employee extra if they smoke but would have to offer the employee an alternative such as participating in a smoking cessation program even if they don't quit.  The maximum reduction in premiums will be 30% and 50% if the wellness program is to quit smoking.

The feds have said that Medicare will remain solvent until 2028, two whole years more than before Obamacare.  Nothing will help Social Security that will go belly up in 2033. The Medicare outlook is due to decreased health care spending especially in the realm of skilled nursing care.

Vermont has become the fourth state to legalize "death with dignity".  Physicians may now prescribe legally lethal doses of meds to help patients pass away on their own terms.  The patient must be at least 18, a Vermont resident, have less than six months to live and have an incurable and irreversible disease.  The patient must ask several times, at least once in writing. The patient must be told of the options as well.   

Sometimes California legislators are harder to understand than usual.  The Democratic controlled legislature has passed a bill and sent it to the Democratic controlled Senate to use federal funds given to the state for payments for Medicaid to interpreters for those who do not speak English.  They will use this money that was intended to pay providers.  The interpreters will be state employees and be allowed to join a union so the Dems will get their payments.     Top  


Cal/OSHA has fined Alta Bates $142.970 for safety violations due to not isolating patients with airborne diseases.  The hospital did not put these patients in state required negative pressure isolation rooms.  The announcement comes in the middle of a strike by the California Nurses Assn. who have it in for Sutter since they will not kow tow to the CNA.  

Hospitals and other businesses have had problems with the left leaning NLRB.  This board is the final arbitor of problems between labor and management.  The problem is the board was appointed by Obama illegally as twice pronounced from the DC Circuit Court.  The board has ignored the legal pronouncements and stated they will continue to operate as legal until the Supreme Court rules.  The administration, which lost twice in the Circuit Court will not take the case to the Supremes.  The Circuit court has now been asked by Cablevision to issue a writ of mandate forbidding the board from enacting an unfair labor practice against it.  The board to date wants management to expend huge amounts of money litigating before the illegal board and then take the decision to the courts to get it overturned.        Top 


 Republican Congressman and Dr. Scott DesJarlais of Tennessee was reprimanded and fined $500 for having a sexual relationship with two patients in 2000.  He also has to pay the state for the cost of the investigation.  His license to practice was not suspended nor revoked.  He has won his last re-election campaign when the incident was at issue.        Top


DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.