Tag: "health insurance"

The Cost of ObamaCare Is Down 8%, but That May Not Be Good News

But so is access to doctors and hospitals in the plans offered on the health insurance exchanges.

A Congressional Budget Office report estimates lower federal spending (see the figure). The reason: Health plans in the exchanges look more like Medicaid than like employer-based coverage. Jason Millman reports:

The CBO report points out that it previously thought ObamaCare’s exchange plans would look more like employer-based coverage, but that hasn’t turned out to be the case so far — hence, the cheaper premiums. “The plans being offered through the exchanges this year appear to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than employment-based plans,” CBO wrote.

The CBO projects 42 million people will remain uninsured this year. In fact, the ACA will never cover more than 45% of the uninsured.

GH

Being Uninsured is Better than Being on Medicaid to Get a Doctor’s Appointment

doc-with-patientPosing as patients, researchers made almost 13,000 calls to doctors’ offices in ten states, seeking appointments for a variety of ailments. For those posing as privately insured patients, they got appointments 85 percent of the time. For those posing as patients on Medicaid, they only got appointments 58 percent of the time. Researchers also posed as uninsured patients who were willing to pay in full at the time of the appointment.

The result? 78 percent were successful (for appointments costing more than $75) — 36 percent better than those posing as Medicaid patients and quite close to those posing as privately insured.

Headlines I Wish I Hadn’t Seen

Administration does not know if it has legal authority to delay ObamaCare mandates.

New Jersey woman’s ObamaCare insurance turned down by 96 doctors — still no appointment.

What’s more difficult than signing up for an ObamaCare insurance plan? Cancelling one.

Headlines I Wish I Hadn’t Seen

black-man-worriedWhy liberal cities are bad for blacks: Some of the most segregated cities in the U.S. are above the Mason-Dixon line, including Chicago, Milwaukee, Philadelphia and Detroit.

Flight 370: If nothing else can be learned from this bizarre hunt, one thing has become clear: There’s a ton of trash in the Indian Ocean.

Day care costs more than college in 31 states.

Processing backlog: Hundreds of thousands of consumers who may qualify for new Medicaid coverage aren’t getting it.

Where Are The Medicare Dollars Going?

A recent analysis of Medicare data provided to The New York Times shows that two percent of doctors earn twenty-four percent of Medicare payments.

nm

Headlines I Wish I Hadn’t Seen

Blue Cross: 15% to 20% of enrollees aren’t paying premiums.

EPA tested deadly pollutants on humans.

Long-term antibiotics apparently work for lyme disease patients; but many doctors are afraid to prescribe them.

Hooray! The Medicare Doc Fix is Fixed Until Next April!

Confident DoctorsCongress has given up on repealing the Sustainable Growth Rate (SGR) as a way to pay physicians under Medicare. This blog has previously written about the futility of politicians’ efforts to “fix” the way they pay physicians (especially here, here and here).

The one they just passed last week runs for a year. And, just as always, these politicians who are elected for two-year to six-year terms voted to massively increase spending today, in exchange for draconian cuts a decade hence.

According to the Congressional Budget Office’s score of the bill, it increases Medicare’s physician payments by $15.8 billion over ten years. However, $11.2 billion (71 percent) is spent by 2015, and $13.3 billion (84 percent) is spent by 2016.

The savings to pay for this? Those come later, much later: Savings don’t become greater than spending until 2020, and not significant until 2024 — the last year of the mandated scoring “window“, when the law is supposed to claw back $9.3 billion from hospitals and re-impose the sequester on Medicare.

Good luck with that. Congress continues to make a mockery of Medicare-physician payment reform.

Medicaid Expansion Caused Most of the Economic “Growth” in January and February

We’ve already noted that health spending last quarter climbed at the highest rate in ten years, according to the Bureau of Economic Analysis’ latest quarterly GDP report.

Ben Casselman of FiveThirtyEight puts that spending spurt in another context. Examining the BEA’s February income report, he concludes that Medicaid expansion explains most of the growth:

The government’s definition of income includes not just salaries and other cash payments but also non-cash benefits such as employer-paid health insurance premiums and government programs such as Medicare and Medicaid. The health law has a particularly big impact on that last category because it made millions more people eligible for Medicaid. As a result, Medicaid payments increased $11.4 billion in February, representing 24 percent of the total increase in income. In January, Medicaid benefits represented an even bigger 47 percent of the increase in income.

In other words, the Bureau of Economic Analysis does not take into account whether people earned their income, or whether it was a welfare payment.

Is ObamaCare More Federalist Than We Thought?

According to the New York Times‘ Sharon Gay Stoltenberg and Robert Pear:

j0189571For consumers at least, the state of health care under the national law depends almost entirely on where a person lives.

The online insurance marketplace in Oregon is such a technological mess that residents have been signing up for health coverage by hand. In Texas, political opposition to President Obama’s health law is so strong that some residents believe, erroneously, that the program is banned in their state.

But in Connecticut, a smoothly functioning website, run by competent managers, has successfully enrolled so many patients that officials are offering to sell their expertise to states like Maryland, which is struggling to sign people up for coverage.

In some states that have expanded Medicaid, like Kentucky…the biggest chunk of the newly insured are Medicaid patients. More than 300,000 Kentuckians are enrolled in new health coverage, the state says, 80 percent of them through Medicaid.

Colorado Health Exchange Premiums Roughly Equal to Those of High Risk Pool

iStock_000004795595LargeIn 2013, Rebecca Ryan of Fort Collins, Colorado, paid $375 a month to be insured by CoverColorado, the state’s plan for people who are uninsurable. When the state ended that plan on December 31, 2013, 14,000 people became uninsured and had to find ObamaCare plans.

Ms. Ryan went to the state exchange. The least expensive available option was a Kaiser-Permanente HMO that cost about $360 a month. Ms. Ryan says that it had a roughly similar deductible of $5,000 per person and total out-of-pocket costs of $6,350. Unlike Kaiser, however, CoverColorado allowed members to see any provider in the state.

The Kaiser plan did not include Ms. Ryan’s longtime physician. The only exchange plan that did that was a new, untested, Co-op plan that cost $526 a month. When asked, the exchange representative agreed that “they are going to penalize me because I want to keep my doctor.”

Keep in mind that CoverColorado charged individual premiums that were 137 percent of the “industry average,” calculated as weighted average of Colorado’s five largest individual health insurance carriers’ premiums, adjusted for benefit differences.

Ms. Ryan’s experience in the exchange suggests that ObamaCare may have raised Colorado’s average individual premiums by 37 percent.