Tag: "Health Care Costs"

Hits and Misses

Surgeon Operating on a PatientVA hospital administrators close operating rooms at 3 p.m.

ObamaCare causes hospitals to cut back on charity care.

Reference pricing for elective surgeries saved one large public employer $5.5 million in two years.

77 percent of doctors sanctioned by New York State Department of Health continue to practice.

Hospitals are lobbying to obliterate Medicare oversight that has recovered $8 billion in improper payments.

For Opponents, ObamaCare’s “Bailout” of Insurers is a Richer Target than Ever

UntitledghgThe Administration continues to move the goalposts on its so-called “bailout” of insurers which lose money in ObamaCare’s exchanges. Formally, this is labelled “risk corridors”, and describes a process by which the Administration will take money from insurers which profit more than expected in the exchanges, and transfer it to those insurers which lose more money than expected.

Unfortunately, taxpayers are at risk because the revenue coming into the risk corridors is determined by premiums, whereas the payouts are determined by medical claims. If, overall, the insurers charged premium that are too low, the risk corridors will suffer deficits. This blog has covered the risk corridors thoroughly, and we expect that there will be a significant deficit. Our latest entry on the topic questioned the Administration’s assertion that the risk corridors would be budget neutral.

ObamaCare’s Medicaid Expansion is a Bad Deal for States

Medicaid is the single largest component of state expenditures, accounting for 23.5 percent of the $1.7 trillion spent by states in 2013.

Largely as a consequence of the ACA, state and local spending for Medicaid is projected to nearly double over the next decade.

(Joe Antos, American Enterprise Institute)

Hits and Misses

prescription-bottleMany ObamaCare exchange beneficiaries to pay twice as much for prescription meds as those with job-based plans.

Humana: ObamaCare “Bailout” will account for almost half insurance giant’s profit.

Junk health insurance in California: ObamaCare subscribers sue Blue Shield for lying about limited provider networks.

30 percent of Medicare beneficiaries are in private Medicare Advantage plans that ObamaCare cuts: Low-income, minorities overrepresented.

Some insurers who offered plans in 2013 did not enter ObamaCare exchanges. Result? Policies 11 percent more expensive.

Hits and Misses

Ambulance at Emergency EntranceEmergency department visits for traumatic brain injury increased 29.1 percent, 2006-2010.

“Buying health insurance across state lines”: The most popular Republican talking point is uncompetitive, unconstitutional, and unnecessary.

Early ObamaCare 2015 premium notices have double digit hikes.

Medicaid expansion creates poverty by punishing work.

Price transparency: Three major insurers to publish provider prices online in 2015.

Study: Surgeries take 25 percent less time in ambulatory surgery centers than hospitals.

Hospital Price Transparency: More Toothless Regulation

The Administration continues to promulgate ineffective regulations that are supposed to help patients understand how much money they owe their hospital. Here is this month’s proposed rule updating the hospital Inpatient Provider Payment Services (IPPS) schedule for 2015:

Hospitals are responsible for establishing their charges and are in the best position to determine the exact manner and method by which to make those charges available to the public. Therefore, we are providing hospitals with the flexibility to determine how they make a list of their standard charges public. Our guidelines…are that hospitals either make public a list of their standard charges (whether that be the charge master itself or in another form of their choice), or their policies for allowing the public to view a list of those charges in response to an inquiry.

It is hard to imagine how this is going induce hospitals to present good-faith charges to patients, whether they are insured or not. A better solution would rely on common law, not federal regulation.

By Shunning the Exchanges, Republican Governors Helped Taxpayers and Helped Make ObamaCare Work Better

A new report, by former Missouri Insurance Commissioner Jay Angoff, shows that states in which governors and/or legislators resisted ObamaCare, and whose Attorneys-General challenged its constitutionality, had the lowest cost-per-enrollee:


States which established their own ObamaCare exchanges cost much more to enroll people. The worst, Hawaii, cost $23,899 per enrollee. The “best” of the state-based exchanges is California’s, which cost $758 per enrollee. For all states with their own exchanges, the average cost was $1,503 per enrollee.

If heavily populated Republican states, like Texas and Florida, had established their own exchanges that cost the same as California’s, the bill to federal taxpayers would have been $15 million higher than it was. If they had set up exchanges that cost the same as the average state-based exchange, the tab would have been $30 million higher.

Headlines I Wish I Hadn’t Seen

risingObamaCare is driving up Medicaid costs — even in states that rejected Medicaid expansion.

Buyer’s remorse: ObamaCare patients learn their doctors are not in network — even though insurers told them they were.

ObamaCare contractors paid to do nothing: “Their goals are set to process two applications per month and some people are not even able to do that.”

Study: Being ignored on Facebook leads to low self-esteem.

Goldman Sachs: ObamaCare is good for economy.

Can Safety Net Hospitals Survive?

The Need:

health-care-costsHealth-care providers faced between $74.9 billion to $84.9 billion in care costs for the uninsured and people who struggled to pay their medical bills, according to new estimates published in the journal Health Affairs. Using the lower of the two estimates, Urban Institute researchers calculated that hospitals provided $44.6 billion of the uncompensated care, publicly supported community providers delivered $19.8 billion, and office-based physicians provided about $10.8 billion.

Dwindling resources:

Some of the most notable cuts outlined in in the [Affordable Care Act] are to what’s known as Disproportionate Share Hospital payments under the Medicare and Medicaid programs. These safety-net hospitals are expecting to see a total $22.1 billion cut to Medicare DSH payments between the 2014 and 2019 fiscal years, and the ACA originally called for $17.1 billion in cuts to the Medicaid DSH program through 2020.

Jason Millman.

Unnecessary Care

As many as 42% of Medicare beneficiaries in 2009 underwent unnecessary medical treatments, costing the federal government as much as $8.5 billion, according to a study published yesterday in JAMA Internal Medicine. The analysis is the first large-scale examination into what Medicare spends on procedures that are widely considered to be unnecessary, such as advanced imaging for lower back pain and placing stents in patients with controlled heart disease. (KHN)