CMS Announces Special Enrollment Period To Help Those Who Were Unaware Of Penalty

I recently discussed a flaw in the implementation of the Affordable Care Act in which people who were unaware of the penalties for failing to obtain health insurance might not become aware of this until April, after the closing of the open enrollment period. It would then have been too late for them to purchase insurance. Some Democratic members of Congress were urging the Obama administration to extend open enrollment. Today they have announced a special enrollment period from March 15 until April 30. There are also a number of events, such as loss of coverage, which allow individuals to purchase insurance outside of the usual open enrollment period. Following is the release from CMS:

The Centers for Medicare & Medicaid Services (CMS) announced today a special enrollment period (SEP) for individuals and families who did not have health coverage in 2014 and are subject to the fee or “shared responsibility payment” when they file their 2014 taxes in states which use the Federally-facilitated Marketplaces (FFM). This special enrollment period will allow those individuals and families who were unaware or didn’t understand the implications of this new requirement to enroll in 2015 health insurance coverage through the FFM.

For those who were unaware or didn’t understand the implications of the fee for not enrolling in coverage, CMS will provide consumers with an opportunity to purchase health insurance coverage from March 15 to April 30. If consumers do not purchase coverage for 2015 during this special enrollment period, they may have to pay a fee when they file their 2015 income taxes.

Those eligible for this special enrollment period live in states with a Federally-facilitated Marketplace and:

 Currently are not enrolled in coverage through the FFM for 2015,

  • Attest that when they filed their 2014 tax return they paid the fee for not having health coverage in 2014, and
  • Attest that they first became aware of, or understood the implications of, the Shared Responsibility Payment after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 taxes.

The special enrollment period announced today will begin on March 15, 2015 and end at 11:59 pm E.S.T. on April 30, 2015. If a consumer enrolls in coverage before the 15th of the month, coverage will be effective on the first day of the following month.

This year’s tax season is the first time individuals and families will be asked to provide basic information regarding their health coverage on their tax returns. Individuals who could not afford coverage or met other conditions may be eligible to receive an exemption for 2014. To help consumers who did not have insurance last year determine if they qualify for an exemption, CMS also launched a health coverage tax exemption tool today on HealthCare.gov and CuidadodeSalud.gov.

“We recognize that this is the first tax filing season where consumers may have to pay a fee or claim an exemption for not having health insurance coverage,” said CMS Administrator Marilyn Tavenner. “Our priority is to make sure consumers understand the new requirement to enroll in health coverage and to provide those who were not aware or did not understand the requirement with an opportunity to enroll in affordable coverage this year.”

Most taxpayers, about three quarters, will only need to check a box when they file their taxes to indicate that they had health coverage in 2014 through their employer, Medicare, Medicaid, veterans care or other qualified health coverage that qualifies as “minimum essential coverage.” The remaining taxpayers – about one-quarter – will take different steps. It is expected that 10 to 20 percent of taxpayers who were uninsured for all or part of 2014 will qualify for an exemption from the requirement to have coverage. A much smaller fraction of taxpayers, an estimated 2 to 4 percent, will pay a fee because they made a choice to not obtain coverage and are not eligible for an exemption.

Americans who do not qualify for an exemption and went without health coverage in 2014 will have to pay a fee – $95 per adult or 1 percent of their income, whichever is greater – when they file their taxes this year. The fee increases to $325 per adult or 2% of income for 2015. Individuals taking advantage of this special enrollment period will still owe a fee for the months they were uninsured and did not receive an exemption in 2014 and 2015. This special enrollment period is designed to allow such individuals the opportunity to get covered for the remainder of the year and avoid additional fees for 2015.

 The Administration is committed to providing the information and tools tax filers need to understand the new requirements. Part of this outreach effort involves coordinating efforts with nonprofit organizations and tax preparers who provide resources to consumers and offer on the ground support. If consumers have questions about their taxes, need to download forms, or want to learn more about the fee for not having insurance, they can find information and resources at www.HealthCare.gov/Taxes or www.IRS.gov. Consumers can also call the Marketplace Call Center at 1-800-318-2596. Consumers who need assistance filing their taxes can visit IRS.gov/VITA or IRS.gov/freefile

Consumers seeking to take advantage of the special enrollment period can find out if they are eligible by visiting https://www.healthcare.gov/get-coverage Consumers can find local help at: Localhelp.healthcare.gov or call the Federally-facilitated Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. Assistance is available in 150 languages. The call is free.

 

For more information about Health Insurance Marketplaces, visit: www.healthcare.gov/marketplace

CMS Blog: http://blog.cms.gov/2015/02/20/what-consumers-need-to-know-about-corrected-form-1095-as/

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Bloomberg News Shows That Obamacare Is Not A Job-Killer As Republicans Claim

I’ve discussed many times, most recently yesterday, how the conservative arguments against the Affordable Care Act don’t hold up. Their predictions of doom have also consistently failed to come about. Bloomberg News looked at the effect of Obamacare on corporate profits, finding only a small effect, debunking the conservative claims that Obamacare is a job killer. It also helps that one of the benefits of the Affordable Care Act has a lower increase in premiums than has been seen in the past:

The biggest entitlement legislation in a generation is causing barely a ripple in corporate America.

The Patient Protection and Affordable Care Act — otherwise known as Obamacare — is putting such a small dent in the profits of U.S. companies that many refer to its impact as “not material” or “not significant,” according to a Bloomberg review of conference-call transcripts and interviews with major U.S. employers.

That’s even after a provision went into effect this year requiring companies with 50 or more full-time workers to provide coverage, and after more workers are choosing to enroll in existing company coverage because of another requirement that all Americans get insured.

“It’s just part of doing business,” said Bob Shearer, chief financial officer of VF Corp., which owns the North Face and Vans apparel brands. “Obamacare has added costs, but not so much that we felt we had to talk about it specifically.”

The collective shrug from the nation’s biggest employers undermines the arguments of Republicans, who call the law a job-killer as they seek its repeal.

While U.S. health-care costs continued to rise faster than inflation in the five years since the law was passed, their rate of growth has slowed. Employers spent an average of $11,204 per worker for health benefits in 2014, up 4.6 percent from a year earlier, according to Mercer LLC. That growth rate was 6.1 percent or more each year from 1998 to 2011.

Enrollment in insurance policies purchased on the exchanges has also beaten expectations. The Hill reports, “The administration announced on Tuesday that 11.4 million people had signed up ahead of Sunday’s deadline, a figure that puts the administration on track to beat its goal of 9.1 million enrollees. Republicans have been largely silent on the numbers.”

Taken together, these two reports are further evidence that the Affordable Care Act is helping to both increase the number of people insured and restrain health care costs.

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A Day In Conservative Stupidity: Three Examples

palin-finger-two

The conservative movement has become totally divorced from reality, often denying science and facts to make their positions. Here’s just three examples from the past day.

Conservatives Hate Historical Facts

Conservatives hate actual American history as the facts contradict so many of their claims. As Joseph Ellis has explained, the Founding Fathers established a secular state with overlapping sources of authority and a blurring of jurisdiction between federal and state power. Conservative claims of states’ rights and claims that the United States was founded as a Christian nation do not hold up. Oklahoma has a unique answer to teaching all those inconvenient facts in Advanced Placement History classes. Republicans there want to eliminate the AP classes and replace them classes which include the Ten Commandments and three speeches by Ronald Reagan.

Some Conservatives Still Think Obama Is A Muslim

The American Thinker is still making the conservative claim that Obama is a Muslim. Their evidence is a picture of Obama with a raised finger:

Is President Obama a Muslim?  A lot has been written about this, but if photographs speak louder than words, then a photo taken at last August’s U.S.-African Leaders’ Summit in Washington D.C. might shed considerable light.

It shows Barack Hussein Obama flashing the one-finger affirmation of Islamic faith to dozens of African delegates.

Steve M. gathered pictures of several other people who are also Muslims by this logic. The pictures include: Sarah Palin, Rush Limbaugh, Ben Carson, Scott Walker, Sean Hannity, Newt Gingrich, Andrew Breitbart, and Pam Geller. Who knew that the conservative movement was infiltrated by Muslims to this degree.

Conservatives Still Lack Any Actual Facts To Support Their Arguments Against Obamacare

Bill Maher called them Zombie Lies. Conservatives lack any real facts to dispute what a tremendous success Obamacare has become so they tell the same lies over and over, even when repeatedly proven to be lies. They are lies which just don’t die, because conservatives don’t care about facts. Jonathan Chait reviewed the latest claims from Stephen Moore, chief economist at the Heritage Foundation. See the full article to see how Chait shows that Moore’s claims are demonstrably wrong and that, “There is not a single substantive claim in this column that appears to be true.”

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Democrats Seek To Fix Bug In Obamacare Deadline

The Affordable Care Act has been a tremendous success in increasing the number of people insured, reducing the cost of health care coverage, and eliminating the ability of insurance companies to deny coverage to those who develop medical problems. However it is not surprising that a law of its complexity does get some details wrong. When I first heard that open enrollment would end in mid-February I thought this was a mistake.

Some of those who failed to purchase coverage last year might not realize that they risk paying penalties, and they might not realize this until around April 15 if they wait until the last minute to complete their taxes. If the goal of the mandate is to encourage people to sign up to avoid penalties, enrollment should extend through April 15. That way people could sign up for insurance to avoid the mandate.

I was glad to see that some Democrats have realized this and are working to fix the problem by urging the Obama administration to have a special enrollment period:

Three senior House members told The Associated Press that they plan to strongly urge the administration to grant a special sign-up opportunity for uninsured taxpayers who will be facing fines under the law for the first time this year.

The three are Michigan’s Sander Levin, the ranking Democrat on the Ways and Means Committee, and Democratic Reps. Jim McDermott of Washington, and Lloyd Doggett of Texas. All worked to help steer Obama’s law through rancorous congressional debates from 2009-2010.

The lawmakers say they are concerned that many of their constituents will find out about the penalties after it’s already too late for them to sign up for coverage, since open enrollment ended Sunday.

That means they could wind up uninsured for another year, only to owe substantially higher fines in 2016. The fines are collected through the income tax system.

This year is the first time ordinary Americans will experience the complicated interactions between the health care law and taxes. Based on congressional analysis, tax preparation giant H&R Block says roughly 4 million uninsured people will pay penalties.

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Republicans Plan To Impose Huge Tax Increase On Middle Class In Opposing Obamacare Fix

Republicans are increasingly seeing King v. Burwell as a way to do what they couldn’t accomplish in over fifty votes–repeal the Affordable Care Act. While it defies logic, the Supreme Court could conceivably rule that the Affordable Care Act only provides subsidies for plans purchased on state exchanges but not on the federal exchange.

A majority of people want Congress to pass a simple legislative fix should this occur, guaranteeing a continuation of the subsidies for those who purchase plans over the federal exchange. The health care and insurance industries also support such a fix.

This does not mean that the Republican Party will take the rational path. The Wall Street Journal reports:

Congressional Republicans say they won’t move to preserve consumers’ health insurance tax credits if the Supreme Court strikes them down, raising the stakes in the latest legal challenge to the Affordable Care Act…

Leaders in the GOP-controlled House and Senate see the court challenge as their best hope for tearing apart a law they have long opposed. If the court strikes down the subsidies, Democrats are expected to clamor for lawmakers to pass a measure correcting the language in the law to revive them. Congressional Republicans say there is no possibility they would allow that.

“No, no, no, no,” said Sen. Dan Coats (R., Indiana). “Even Democrats have acknowledged that this needs fixing.”

That position would force lawmakers to confront people in as many as 37 states where the federal government is currently running some or all of the exchange where consumers buy plans and tap the tax credits. There are 6.1 million people in those states who have the credits for 2015, according to federal data released this week. The average tax credit this year is $4,330, the Congressional Budget Office said this week.

Eleven of the states where the federal government has a hand in running the insurance exchange – including seven with Republican governors – signed onto a brief submitted late Wednesday asking the Supreme Court to uphold their tax credits. The brief said the loss of the credits “would deprive millions of low-and moderate-income Americans of billions of dollars in federal premium assistance essential to buy health insurance, thereby disrupting state insurance markets throughout the United States.”

The brief was filed by a group of mostly Democratic attorneys general. The lone Republican, North Dakota’s Wayne Stenehjem, declined to comment…

Nobody in the Senate Republican caucus has said the party should tweak the law so it can continue as it is, particularly since such a move would preserve the unpopular requirement for people to buy coverage or pay a fine, said Don Stewart, a spokesman for Senate Majority Leader Mitch McConnell of Kentucky.

Republicans are also increasingly preparing to use the budget procedural tactic known as reconciliation to repeal large parts of the law and potentially enact alternative provisions after the court ruling, whatever the outcome. The reconciliation process allows party leaders to pass changes with a simple majority, rather than the 60 votes most bills need to clear procedural hurdles in the Senate.

A loss of the subsidies would amount to a tax increase on the middle class. Republicans tend to concentrate on lowering taxes for the wealthy, at the expense of the middle class, and therefore see no problem in this. They mistakenly believe this will not affect their more affluent supporters, who do not qualify for the subsidies. What they fail to realize is that reducing the number of people in the risk pool will result in higher premiums for everyone.

Republicans are again talking about proposing their own plan, but they have repeatedly failed at doing so. The last time the Republicans did propose a plan it was remarkably similar to Obamacare, except then it was proposed as the conservative alternative to Hillarycare.

Any Republican plan which avoids harming millions of people will not only have to provide a mechanism for assisting those who cannot afford insurance coverage. Any plan must also ensure that insurance companies could not return to denying coverage to those who have medical problems. Republicans will find that this is not so simple, and will require the type of compromises seen in the Affordable Care Act.

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Kaiser Health Tracking Poll Shows Most Support Fix For Subsidies Under Affordable Care Act

While you can never be certain as to what the Supreme Court would do, I’ve always felt that it is most likely that they would ultimately find that King v. Burwell is a frivolous case. (In other words, the most conservative justices might accept it, but John Roberts will cast the deciding vote against it if needed). This case is the latest Republican attempt to overturn the Affordable Care Act in the courts because of some language in the law, contradicting other portions, which could be taken to mean that subsidies are only available to those who obtain coverage through state exchanges, and not the federal exchange.

As I’ve pointed out in the past, it would politically be bad for Republicans if the court ruled against the Obama administration in this case. If the Supreme Court does accept the absurd argument that subsidies should only be available under the law for policies purchased on state exchanges, the simplest solution would be for Congress to revise a few words in the law to fix the problem. It is rather common for Congress to pass laws after major legislation to fix minor problems, except in this case Republicans in Congress are more interested in repeated, futile efforts to repeal ObamaCare as opposed to making such fixes–with yet another repeal vote now planned.

The Kaiser Health Tracking Poll for January finds that relatively few people are now aware of King v. Burwell, but most people do think that Congress should fix the problem. Among total voters, passing a law to fix this is supported 64 percent to 27 percent. There is similar support among independents, greater support among Democrats, and even a substantial number of Republicans (40 percent) would support such a fix:

King v Burell

If this is not fixed by Congress passing such a law, the second solution would be for states to start their own exchanges. A majority would also support this in affected states. Even Republicans support this, although at lower levels than Democrats and independents:

King v Burell2

I suspect that Republican leaders would much prefer to see the Supreme Court not put them in a position to have to take such action, either in Congress or at a state level. Failure to take such action would make displease the majority of voters, while taking such action would displease their base, who might take revenge in primaries where they dominate.

Update: Hospitals and insurance companies also lose if the subsidies are not continued, and are therefore also defending the subsidies before the Supreme Court.

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CBO Shows ObamaCare Costing Less Than Projected–Ignore Conservative Attempts To Distort The Data

There was more good news from the Congressional Budget Office today regarding the Affordable Care Act. The latest’s estimates significantly reduce the costs of expanding medical care under the law:

 The Congressional Budget Office on Monday significantly lowered its estimate of the cost of providing health insurance coverage to millions of Americans under the Affordable Care Act.

Douglas W. Elmendorf, the director of the budget office, said the changes resulted from many factors, including a general “slowdown in the growth of health care costs” and lower projections of insurance premiums that are subsidized by the federal government.

In March 2010, when President Obama signed the health care law, the Congressional Budget Office estimated that the expansion of coverage would cost the federal government $710 billion in the fiscal years 2015 through 2019, Mr. Elmendorf said.

“The newest projections indicate that those provisions will cost $571 billion over that same period, a reduction of 20 percent,” he said. The Affordable Care Act not only subsidized the purchase of private insurance, but also authorized a major expansion of Medicaid, the federal-state program for low-income people.

As usual, conservatives are cherry picking and distorting the numbers to portray this as a negative. Among other distortions of the facts, they fail to take into account the fact that having a substantial portion of the country be uninsured results in higher costs for both government programs, as well as costs which are passed on to those who do pay for insurance. The bottom line is that, even before these more favorable numbers, the CBO found that the Affordable Care Act results in a reduction in the deficit. Strange that conservatives who place such a high priority on reducing the deficit (which was run up by Republicans during the Bush years) oppose a program which will help reduce the deficit.

Of course if conservatives are unhappy with the cost of the Affordable Care Act, they should keep in mind the fact that costs are much higher due than they otherwise might be due to providing coverage through private insurance companies rather than through a single-payer system modeled on Medicare. Somehow I doubt many conservatives would go for the far more cost effective single-payer model.

Conservatives are also attacking the law because, while reducing the number of uninsured by 27 million people, there will still be 31 million uninsured in 2025. However, when looking at who will remain uninsured, I wonder which group conservatives are complaining about. Of this 31 million, 30 percent are illegal aliens and conservatives would sure protest if health care coverage were extended to them. Another 1o percent are ineligible for coverage because of living in states which did not expand Medicaid–a decision which conservatives support. The remainder are people who will qualify for coverage but choose not to purchase it.

The number of uninsured might fall as more red states go along with the expanded Medicaid program. It was just announced that Indiana is the latest to offer the expanded Medicaid program.

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Conservative Argues That It Is Not A Bad Thing If People Die Due To Repealing Obamacare

If the Affordable Care Act were to be repealed, as most Republicans are calling for, we would see millions of Americans lose their insurance. We would return to past problems, including people being denied insurance when they have medical problems, people once again being forced to declare bankruptcy due to medical costs, and we would see many more deaths than we will otherwise see.  Michael R. Strain of the American Enterprise Institute has an op-ed in The Washington Post under the headline, End Obamacare, and people could die. That’s okay.

Note again that the author is from the American Enterprise Institute and this is published in The Washington Post. This is not just some isolated blogger or conservative shouting out their personal opinion.

Strain’s logic is that “We make such trade-offs all the time.” For example, “Consider, for example, speed limits. By allowing people to drive their cars at speeds at which collisions result in death, our government has decided that the socially optimal number of traffic fatalities is not zero.”

He has other such examples, but they do not apply to the type of trade-off he is advocating. There are good reasons for having a society in which people can drive, and it is an unavoidable fact that this will lead to a certain number of traffic fatalities. The types of trade offs he discussed are not analogous to taking away health care coverage.

While there are reasons for having a society in which people can drive, despite traffic fatalities,  there is no good reason for either having people uninsured or for a system in which insurance companies are allowed to profit by denying coverage to those who become sick.

Strain argues that, “In a world of scarce resources, a slightly higher mortality rate is an acceptable price to pay for certain goals.” This falsely assumes that health care coverage is something which we cannot afford to provide. However every other industrialized nation on the planet, existing in the same “world of scarce resources,” is able to provide health care coverage to its citizens. The Affordable Care Act is a valuable step in the right direction, but it is an incremental step which still falls short of what is provided in the rest of the industrialized world.

There is no good reason why the United States cannot provide the same level of health care coverage as is seen in the rest of the industrialized world. One reason why we have been unable to do this is the unnecessary middleman–private insurance companies making huge profits while making health care more expensive than elsewhere. Perhaps the answer is that in a world of scarce resources, a system of private insurance is an unacceptable price to pay, and we should be thinking in terms of conversion to a far more cost-effective single payer system.

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Will The State Of The Union Address Matter After This Week?

Obama SOTU

I certainly liked Obama’s State of the Union Address while listening to it. In a room dominated by Republicans, Obama was once again the adult in the room–the sensible one interested in governing and not bogged down in extremist ideology. His economic numbers provided real evidence of success, despite Republican obstructionism, and Obama was right in addressing the need to extend the benefits of economic recovery to more in the middle class.

The question is whether the speech, and Obama’s aggressiveness on policy matters, will make a difference matters beyond this week. David Corn summed up some of my concerns:

Barack Obama is very good at getting elected president (two for two!) and pretty darn good at policy (Obamacare; the stimulus; the auto industry rescue; Wall Street reform; ending Don’t Ask, Don’t Tell; Cuba; immigration reform executive action; dumping DOMA; middle-class tax cuts; new EPA limits on emissions that cause climate change; banning torture; downsizing the wars in Iraq and Afghanistan, and killing Osama bin Laden). But there’s one key piece of the job description where he’s fallen short: shaping the ongoing political narrative of the nation.

The president is the country’s storyteller in chief. And despite his inspiring powers of oratory (see Campaign 2008) and his savvy understanding of the importance of values in political salesmanship (see Campaign 2012), Obama, as his aides concede, has not effectively sold the nation on his own accomplishments, and, simultaneously, he has failed to establish an overarching public plot line that explains the gridlock in Washington as the result of GOP obstructionists blocking him on important issues where public opinion is in his favor. With his State of the Union speech Tuesday night, Obama had one last chance to take a swing at forging this narrative. Though he did adopt a muscular stance in presenting a forceful and vigorous vision—going on offense in the fourth quarter of his presidency, as his advisers have put it—the president let the Republicans off easy.

Throughout his presidency, as the GOP has consistently sought to block him, Obama has responded inconsistently. He often has pleaded for reason and looked to craft a deal—frequently (and justifiably) to prevent a hit to the economy. (This was the adult-in-the-room strategy.) At times, he has praised House Speaker John Boehner, while pointing to Boehner’s tea party wing as the cause of the partisan paralysis. And then he has occasionally—but not too often—flashed anger and slammed Republicans for being irresponsible and reckless (the debt ceiling scuffle, the assorted government shutdown showdowns). He has not presented a steady and stark tale in which he stars as the fighter for the middle- and lower-income Americans who are stymied repeatedly by always-say-no Republicans aligned with plutocrats, the gun lobby, corporate polluters, and other foes of progress. Consequently, he has often borne blame for the sluggish economy and the mess in Washington, with the Democratic Party paying the price for the dips in his approval rating.

For this to have meaning, Obama must stick to pushing his views, and the Democratic Party must be there behind him. The reaction of the Democratic Party has been even more inconsistent than Obama’s. Here’s what I thought during the speech:

Of course the general election is an entirely different ballgame than the midterms, and Democrats who thought there was benefit in running as Republican-lite in a midterm election where the big contests were in the red states might act more boldly. Or maybe not.

On the other hand, maybe we should just be happy that Obama had a good speech, the positive results from his policies are real, and that the speech was well accepted. Beyond that, I’m not sure that a State of the Union address ever really matters all that much.

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Commonwealth Fund Shows That Obamacare Has Made Health Care More Affordable

Another study has shown that the Affordable Care Act is exceeding expectations in increasing access to health care to Americans. A Commonwealth Fund survey has found that Obamacare has resulted in a reduction in the number of working-age adults without insurance from 20 percent of the population in 2010 to 16 percent in 2014 (the first year insurance was available through the exchanges) with further reductions in uninsured expected this year. Even more significantly, the number of adults who did not get needed health care because of cost decreased from 80 million people (43 percent) in 2012 to 66 million (36 percent) in 2014.

The percentage who reported problems paying medical bills in the previous 12 months decreased from 30 percent to 23 percent.

The percentage who did not fill a prescription fell from 27 percent to 19 percent. The percentage who did not get needed specialist care decreased from 20 percent to 13 percent.

“These declines are remarkable and unprecedented in the survey’s history,” said Sara Collins, the study’s lead author. “They indicate that the Affordable Care Act is beginning to help people afford the healthcare they need.”

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