Larry Kocot Quoted in “New Glitch with ObamaCare Website Could Squeeze Consumers”


Larry Kocot, a Member of the Firm in the Health Care and Life Sciences practice, in the Washington, DC, office was quoted in an article titled "New Glitch with ObamaCare Website Could Squeeze Consumers."

Following is an excerpt: may be working better and somewhat faster for consumers attempting to enroll in plans, but a new wrinkle has emerged: there is no payment mechanism for insurers to get cash from the federal government subsidies.

The Centers for Medicare and Medicaid Services (CMS) confirmed the problem Tuesday night. The mechanism would enable the government to pay billions of dollars to insurance companies for subsidized and cost-shared plans has yet to be built—and experts say consumers may get squeezed in the meantime. ?...

The real sticking point here is cost-sharing, says Larry Kocot, Brookings Institution visiting fellow, in which consumers have portions of their medical bills subsidized.

"If cost-sharing is prepaid and the estimate is wrong, let's say the insurance company miscalculated the amount they are owed in subsidies, that is where it gets more complicated," Kocot says. "This is difficult, because there are more entities involved than just the beneficiaries and providers," he says, referring to the government and the physicians who would be entangled in the billing process.

He adds that it is in everyone's best interest to move in a timely fashion to resolve the payment issue. "There is the potential for the consumer to get squeezed in the middle if either party isn't holding up their end of the bargain."