Category: New Health Care Law

Obamacare Might Have Enrolled Only 2.3 Million; Spent $73 Billion to Save Less than $6 Billion in Uncompensated Care

Things change fast in Obamacare. Just yesterday, I discussed evidence that Obamacare had enrolled only 6 million people in subsidized, private plans on exchanges. Having read the U.S. Department of Health & Human Services’ (HHS’) latest report, it looks like the figure is only 2.3 million: “Based on an estimated 10.3 million decrease in the total number of uninsured and an estimated 8 million increase in the number covered by Medicaid, ASPE estimates that hospital uncompensated care costs will be $5.7 billion lower in 2014 than they otherwise would have been.” The difference between 10.3 million and 8 million is only 2.3 million, and that is quite a comedown from HHS’ May estimate that 8.1 million people “selected” private coverage in exchanges.

If we were asked to give a one-sentence justification for Obamacare’s increased federal spending on Medicaid or tax credits for private health insurance, it would go something like this: “People with health insurance will get timely primary care, and that will relieve the pressure on hospitals’ emergency departments.” This feel-good statement has been rolled out countless of times by advocates of so-called universal coverage. Empirically, it falls flat: Emergency departments are jammed with both Medicaid dependents and (somewhat less so) privately insured patients.

Obamacare Might Have Enrolled Only 6 Million (Not 8.1 Million)

I’ve been discussing evidence that Obamacare enrollment has been shrinking, and that the number of uninsured might have increased in 2014. Now, there’s more.

According to new research published by SNL Financial LC, which reviewed insurers’ filings at the National Association of Insurance Commissioners (NAIC) and California Department of Managed Care, the aggregate change in individual enrollment from the third quarter of 2013 to the second quarter of 2014 was just over 6 million. That period roughly corresponds to Obamacare’s open enrollment, after which the Administration announced 8.1 million enrollees.

Obamacare Will Devour Your Pay Raise

Mercer’s latest National Survey of Employer Sponsored Health Plans reports that the cost of employer-based benefits will jump significantly in 2015

Employers in the U.S. are predicting that health benefit cost per employee will rise by 3.9 percent on average in 2015, preliminary results from a new survey by Mercer reveal. Cost growth slowed to 2.1 percent in 2013, a 15-year low, but appears to be edging back up. Moreover, a higher percentage of employees signing up for coverage through the worksite could be a wildcard driving costs higher.

The projected increase for 2015 reflects actions employers plan to take to manage cost. If they make no changes to their plans for 2015, they predict that costs will rise by 5.9 percent on average. However, only 32 percent of respondents are simply renewing their existing plans without making changes.

Commonwealth Fund: Most Who Visited Obamacare Exchanges Rated Them Fair or Poor

The media have cheered the latest Commonwealth Fund survey of Americans who have tried to enroll in Obamacare plans on health-insurance exchanges. For those who actually read the report, the results are significantly worse for Obamacare than championed by the press release.

To put it bluntly: Visiting an Obamacare health insurance exchange to choose coverage is an experience you would not wish on your worst enemy. Things have gotten a little better during the year: Last October, 61 percent of respondents reported that it was “very difficult or impossible” to “find plans they needed and could afford by end of open enrollment,” and this had dropped in the April-June quarter to 54 percent (Exhibit 2). That is a significant improvement — but it is also a tricky question.

Obamacare Has Eliminated 350,000 Jobs, Cut Small-Biz Payrolls $22.6 Billion

New research published by the American Action Forum further corroborates our conclusion that Obamacare is harming U.S. employment. In a new scholarly paper, Ben Gitis and colleagues estimate that:

…Affordable Care Act (ACA) regulations are reducing small business (20 to 99 workers) pay by at least $22.6 billion annually. In addition, ACA regulations and rising premiums have reduced employment by more than 350,000 jobs nationwide, with five states losing more than 20,000 jobs.

We found that, on average, employees who work a full year for a business with 50-99 employees lose $935 annually due to ACA regulations, while employees of businesses with 20-49 employees, on average lose $827.50 annually.

Laszewski, Back From Summer Vacation, Still Predicts Obamacare Train Wreck

health-insuranceIf I have one complaint about the summer of 2014, it was the absence of health insurance expert Bob Laszewski from his blog since July 31. Well, he came back last Sunday, and the summer break did not temper his criticism of Obamacare.

Obamacare supporters have applauded announcements of relatively moderate rate increases for 2015. Laszewski points out that the name of the game for insurers is market share. The risk-mitigation mechanisms that Obamacare erected (about which I recently testified at a Congressional committee hearing) largely immunize insurers from losses for three years, so premiums do not really indicate how much Obamacare is costing. Here’s Laszewski:

Obamacare Tax Merry-Go-Round

Get a load of how Obamacare health insurance premium taxes work. According to Medicaid Health Plans of America: “This situation results in the federal government taxing itself and taxing state governments to fund the higher Medicaid managed care payments required to fund the ACA health insurer fee”.

It look me a few times to get my head around that. What it means is that Obamacare levies a premium tax on private health plans — including those to contract to provide Medicaid coverage. So, the federal and state governments, which are Medicaid’s payers, pay those taxes. USA Today has summarized what the taxes will cost in some large states:

Obamacare Exchanges are as Broken as Ever

Let’s go into the Labor Day weekend with a reminder of something that the Administration would like us to forget: Obamacare’s exchanges are as broken as they ever were.

From October through March, the media enjoyed reporting on the countless glitches people were suffering as they tried to apply for Obamacare coverage at either healthcare.gov or a state exchange. Since the Administration announced that it had slightly exceeded its target enrollment, with 8.1 million people signed up, it decided to stop reporting subsequent enrollment in the exchanges.

Since April, these stories have receded from the headlines; but you don’t have to look very far to see that nothing has really been fixed in the exchanges. Here are a few stories from the last day or two:

Where’s the Obamacare Health Spending Boom?

A version of this post appeared at Forbes.

The Bureau of Economic Analysis has released the second estimate of second quarter Gross Domestic Product (GDP). There is good news — especially for those of us concerned with health policy.

First, the BEA seems to have figured out how to measure health spending under Obamacare, no longer giving huge updates to initial estimates, like it did in the first quarter. The second estimate is little revised from the advanced estimate: Real GDP increased by 4.2 percent (annualized) versus an advanced estimate of 4.0 percent; and health spending accounted for just 0.05 percent of the increase, versus an advanced estimate of 0.08 percent.

Can Taxpayers Recover Hundreds Of Millions of Dollars from Obamacare Exchanges?

The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services has just released a report on the contracts issued to private vendors to set up the federal pieces of Obamacare’s disastrous health insurance exchanges. This is only the first of a series of reports, and limits itself to describing the extent of the problem, not recommending solutions.

The OIG identified 60 contracts that started between January 2009 and January 2014. (That start date is a little mysterious, because Obamacare was not signed into law until March 2010.) The total estimated value of the contracts, when they were signed, was $1.7 billion.