Category: New Health Care Law

Congress Set To Deficit Fund Obamacare Almost $40 Billion

iStock_000007047153XSmallI had always feared that Congress’ alternative to Obamacare was deficit funded Obamacare, and it looks like that is coming to pass. This is being done through the so-called “taxibus”, a legislative package that combines popular “tax extenders” (items like research and development tax credits that are legally temporary but practically permanent) with funding the federal government through September 2016.

The bill proposes a couple of years delay in three Obamacare taxes: The medical-device excise tax, he health insurance fee, and the excise tax on high-cost employer benefit plans. All three taxes are bad. However, the bill just delays them without cutting any Obamacare spending.

How Obamacare Crushes Working Class Job Opportunities

Family and Their HouseThe Congressional Budget Office recently confirmed its estimate that Obamacare will shrink the workforce by 2 million full-time equivalent (FTE) jobs in 2025. When the CBO first published its (initially somewhat larger) estimate, in February 2014, it felt compelled to wriggle around the headline, claiming that it did not really mean what it said.

It is strictly true that some of this job loss will be “voluntary,” in that Obamacare’s subsidies will cause them to seek less work than otherwise. Those individuals will probably feel better off than if they had been laid off or fired. However, cutting back working hours because government subsidies encourage it is not quite the same as cutting back because you have changed your priorities – either economically or morally.

The new analysis allows us to see where the burden on employment lies – mostly on those eligible for tax credits in Obamacare’s exchanges. These are people who earn between 100 percent (or 138 percent, depending on the state) and 400 percent of the Federal Poverty Leve. For a family of four this ranges from $24,250 to $97,000 in 2016.

That Free Wellness Visit Can Cost You a Fortune!

Preventive care is supposedly free under Obamacare. However, a recent article in U.S. News & World Report discussed the confusion that often occurs when people see their doctor for their annual “free” wellness visit. The problem: it is easy to inadvertently cross the line into non-free medical services that cause the wellness visit to be coded as something rather costly.

Patricia Jones thought she was getting the much-talked-about free physical under Obamacare when she went to see a doctor in May. But, she says, a few small things that happened during her checkup ended up making the visit cost more than $450.

Indeed, asking the wrong question during a wellness visit can sometimes result in the physician using a different billing code other than the “free” codes for preventive medical services.

In the process of answering questions from her doctor, Ms. Jones and her doctor turned a wellness visit into a diagnostic visit. Diagnostic visits are not covered under preventive care. Moreover, many people have high-deductible plans. A question or two, or agreeing to tests that are not medically necessary, can easily make that free wellness visit into a diagnostic visit that must be entirely paid for out of pocket.

Stop for a minute and think about the implications. A wellness visit that does little more than take your blood pressure and ask how you’re feeling is essentially worthless if your doctor is not allowed to act on anything he or she finds.

Broad Coalition Calls For Congress Not To Hand Health Insurers’ Losses To Taxpayers

JRGrahamUnitedHealth Group’s proposal (threat? promise?) to withdraw from Obamacare’s health insurance exchanges, and the failure of Obamacare’s COOPs are both events which NCPA has been predicting for a long time (see here and here).

Two years ago, we identified Obamacare’s “risk corridors” as a vehicle through which the Administration would expose taxpayers to unlimited liability for insurers’ losses in Obamacare. Due to our research and testimony, Congress prevented this exposure last December.

What with the exchanges unravelling so quickly, we are not surprised to learn that lobbyists are pressuring Congress to restore unlimited liability. We joined a broad-based coalition to write a letter to Congress urging the current policy be maintained.

Obamacare must be completely renegotiated from root to branch. Just handing taxpayers’ money to insurers for losses they incur will not solve the problem.

Read the entire letter here.

Work & Employment Down, Sleep & Socializing Up: Obamacare’s “Slacker Mandate”

sleeping-womanWhat with Obamacare’s health insurance exchanges unraveling pretty quickly, Americans might be excused for having forgotten one of Obamacare’s first intrusions: The “slacker mandate.” This was the provision that requires employer-based health plans to cover “children” on their parents’ plans until they are 26.

It took effect in 2010. The results are in, according to a new study published by the National Bureau of Economic Research:

If, as suggested by prior work, the provision reduced the amount of time young adults work, the question arises, what have these adults done with the extra time?

The extra time has gone into socializing, and to a lesser extent, into education and job search. Availability of insurance and change in work time appear to have increased young adults’ subjective well-being, enabling them to spend time on activities they view as more meaningful than those they did before insurance became available.

(Gregory Dolman & Dhaval Dave, “It’s About Time: Effects of the Affordable Care Act Coverage Mandate on Time Use,” NBER Working Paper No. 21725, November 2015.)

Large Insurer May Exit Exchange: The Exchange System is Collapsing Under its Own Weight

I reported earlier this week that the Obamacare Marketplace is slowly failing. Three days later the largest health insurer in America, UnitedHealth Group, announced it expects to lose $500 million on exchange plans next year and may exit the market in 2017.

Why Does Obamacare Over Invest in Spanish Customer Service?

The Center for Medicare & Medicaid Services (CMS) has started to publish its weekly reports on Obamacare enrollment via the federally facilitated exchanges.

A little over half a million people have selected a plan for the third open season. What is interesting is the exchanges’ overinvestment in Spanish capabilities. We first noted this last January.

The Snapshot reports that the average wait on the phone for a Spanish-speaking customer-service representative is 11 seconds, versus four minutes and 38 seconds for an English speaker. That’s 25 times longer. 52,023 of the 741,112 calls (seven percent) were in Spanish.

Snapshot

Peak Obamacare? We’re Almost There

money-burdenThe administration has released a report estimating that enrolment in Obamacare will reach only 9.4 million to 11.4 million at the end of 2016. Back in 2010, when the law was passed, the Congressional Budget Office estimated exchange coverage would be 21 million next year (Table 4).

Why the come down? Obamacare has a miserable take-up rate: Few who do not get significant subsidies sign up. Even worse, many of those who sign up at open enrolment cannot afford the premiums and drop out. Indeed, 15 percent of Obamacare beneficiaries who signed in 2015’s open season (which ended in February) were gone by the end of June. (The New York Times has just published interviews with some struggling to pay their premiums and maintain coverage.)

One year ago, I coined the term “Peak Obamacare” to describe this phenomenon. Although the administration’s cheerleaders have twice celebrated very high Obamacare enrolment during open season, the administration has finally decided to accept reality: We are on the verge of Peak Obamacare.

Congress Uses “Reconciliation” to Push Deficit-Funded Obamacare

Congressional Republicans are using a procedural tool called “reconciliation” to repeal a miniscule number of Obamacare provisions, according to Chris Jacobs of the Conservative Review:

Lost in the noise amidst Speaker Boehner’s resignation last week was the House of Representatives’ decision to begin moving its budget reconciliation bill. Earlier this spring, conservatives voted for the budget blueprint in both the hope and expectation that the reconciliation bill coming from that budget would be used to put full repeal of Obamacare on President Obama’s desk. But based on the newly released legislative proposals, those expectations have been disappointed.

Just as important, however, the Obamacare legislative proposals are limited to the following provisions:

  1. Repeal of the law’s auto-enrollment mandate for employers;
  2. Repeal of the Prevention and Public Health “slush fund;”
  3. Repeal of the individual mandate;
  4. Repeal of the employer mandate;
  5. Repeal of the tax on medical devices;
  6. Repeal of the “Cadillac tax” on high-cost employer health plans; and
  7. Repeal of the Independent Payment Advisory Board (IPAB).

That’s it. Under the proposed reconciliation instructions, a grand total of seven out of Obamacare’s 419 legislative sections—just over one percent of the law—would actually be repealed.

15 Percent of Obamacare’s Second Season Enrollees Were Gone by June 30

Obamacare’s second enrollment season closed around the end of February, with 11.7 million signed up. By March 31, that had dropped to 10.2 million who actually paid their first month’s premium. New data from the administration report that number dropped further to 9.9 million by June 30.

What is also notable is that the entire drop of paid enrollees occurred in states using the federal exchange, not state-based exchanges (for which enrolment stayed at 2.7 million). There is no word on whether the drop-outs got employer-based coverage, descended into Medicaid, or stayed uninsured. 423,000 were dropped by the administration because of lack of documentation of citizenship or immigration status.

A stable market? Not quite, I guess.