Tag: "health policy"

Hits and Misses

woman-with-childA commonly used drug can protect fertility in women undergoing chemotherapy.

Shocker! Bernie Sanders, the only socialist in the U.S. Senate, wants to fix the VA by privatizing the provider network.

Are health insurers lobbying to extend the risk-corridor “bailout” beyond three years?

Thousands of Georgia doctors lack medical-malpractice liability insurance.

Californians complaining to state regulators about ObamaCare plans: Can’t get ID cards, few providers in networks.

Study: Half a Million More Uninsured by 2019, Four Million More by 2025

A new study by Professor Steve Parente and Professor Michael Ramlet estimates that the number of uninsured will increase under ObamaCare, from 36.5 million in 2015 to 40.5 million in 2025. It further estimates that the average cost of an ObamaCare Silver plan will increase by over $4,000 in five years.

Nationally, we estimate an initial decrease in the uninsured with greater use of the private health insurance subsidies, but over time health plan prices are likely to increase faster than the value of the insurance subsidy. As a result of the declining purchasing power of the insurance subsidy, the implementation of the qualified health plan requirements and the end of the reinsurance and risk corridor programs we estimate a significant reduction in the private insurance market in 2017 with steady declines continuing for the rest of the decade. The Medicaid population is estimated to grow substantially in 2015 as more individuals are enrolled in states who have chosen to expand the program. Medicaid enrollment is estimated to slow down to between 2% to 3% each year from 2016 to 2024.

I guess they had not heard the President’s declaration that the debate over ObamaCare is over.

Primary-Care Physicians Earn Only 20 Percent of What They Charge

If $180,000.00 is 20% of the total reimbursement, then a PCP brings in $900,000.00 a year. Therein lays the misconception that doctors are overpaid, but remember: the doctor does not pocket that total. At a patient load of 7,200 patients that is $125.00 for a 15 minute appointment. This is great pay. But remember also that 80% of that total goes to pay the staff salaries and benefits, rent, utilities, as well as such government mandated programs like Electronic Medical Records and all other costs needed to keep a business running. (The InsureBlog)

Over Half of Workers Would Have to Borrow Money to Pay for Unexpected Medical Costs

AFLAC has just published its fourth annual survey of employees and business leaders about health benefits. Overall, the responses show how poorly our system of prepaid healthcare (inaccurately labelled “health insurance”) protects workers from the costs of catastrophic illness. Highlights include:

  • 53 percent of workers would have to borrow from their 401(k)s and/or use a credit card to cover costs associated with an unexpected serious illness or accident;
  • 49 percent have less than $1,000 to pay for out of pocket expenses associated with a serious illness or accident, and 27 percent have less than $500;
  • 42 percent say they are not at all or not very prepared to pay out-of-pocket expenses associated with a serious illness or injury.

Health Insurers Continue To Grow Under ObamaCare

Although health insurers’ profit margins shrank a little in 2013, enrollment amongst the largest for-profit insurers jumped by eight million over 2012, according to a new analysis by Mark Farrah Associates. The report concludes that “leaders in the health insurance sector have good reason to remain optimistic”.

Although all major insurers succeeded in enrolling members in the new ObamaCare health insurance exchanges, this is still a small fraction of their business.


Latest IRS Rule Outlaws Decades-Old Benefits, But Will Not Stop Employers Dumping Workers into ObamaCare’s Broken Exchanges

The New York Times‘ Robert Pear has covered an IRS rule that he interprets as barring employers from dumping workers into ObamaCare health insurance exchanges. Although this is the goal of the IRS rule, it is unlikely to have a significant effect on employers’ executing such changes.

Pear’s article covers a Q&A just released by the IRS that summarizes a decision it made back in September (Notice 2013-54). That notice laid down rules for Health Reimbursement Accounts (HRAs), Flexible Spending Accounts (FSAs), and Employer Payment Plans (EPPs). Employers have made pre-tax contributions to these plans for many years.

The notice clarifies that HRAs and FSAs must be “integrated” with employers’ group health plans to count towards ObamaCare’s minimum essential coverage. EPPs are a little known method for employers to contribute non-taxable dollars to workers’ premiums for individual insurance, and were defined by the IRS way back in 1961. Unfortunately, I can find no estimate of how many workers have such arrangements, although one expert source suggests they are “not as common” as HRAs and FSAs. My contacts confirm that benefits advisors have also proposed to employers that they fund HRAs and FSAs for workers, as long as those workers have individual policies. The contributions don’t necessarily fund premiums directly, but the money is considered fungible by workers who pay premiums out of their wages.

How Many Signed Up for ObamaCare? Time to Bury That Story

health-insuranceThe most transparent administration in history has decided to discontinue the monthly Affordable Care Act enrollment reports now that open enrollment is closed.

But while the official open enrollment period is closed, that doesn’t mean that activity on the health insurance exchanges has shut down. People who have experienced a “qualifying life event” — getting a job, having a baby or moving to another state, among others — are still eligible to enroll in an exchange policy.

Meanwhile, other people will be exiting the system — they will get a job that has benefits, marry someone with benefits, or just stop making their payments and go without insurance.

And, of course, voters need to know these numbers in order to evaluate the signature legislative achievement of this administration and the many members of Congress who will be standing for re-election come November.

(Megan McArdle, Bloomberg View)

Tax Credits Cure Food Sales Tax Complexity. Why Not Use Them in ObamaCare Reform?

California’s tax treatment of food and ObamaCare’s tax treatment of health insurance have something in common. Both sets of regulation are so bad that people buying the same product can be taxed or subsidized differently in ways that are almost impossible to decipher.

As Joe Eskenazi of SF Weekly explains, California taxes the same bunch of carrots differently depending on whether the “buyer is a homeless shelter (no), a racetrack (yes), an ostrich farm (no), or a zoo (maybe).”

Sold in combination, a cup of coffee and a cup of gazpacho are a taxable meal. Sold separately, they are not. Cream-filled donuts are not taxable, but a croissant sandwich is. A cold sandwich with hot gravy poured on it is taxable even if it is cooled to room temperature. So is a previously hot, but currently cold, soup.

At first, the state held that movie popcorn was heated food. The movie theaters disagreed. They claimed that the lights over the popcorn were dehumidifier lamps, not heating lamps. They hired popcorn experts to measure the internal heat of the popcorn piles. Multiple hearings and many dollars later, the California Board of Equalization ruled that the heat in the popcorn was indeed a by-product of those dehumidifier lamps. Movie popcorn became a tax exempt food.

Health Costs for Family of Four Average $23,215, Slowest Rate of Growth Since 2002

Employers pay the largest portion of healthcare costs, contributing $13,520 per year, or 58% of the total. However, increasing proportions of costs have been shifted to employees. Since 2007, when the economic recession began, the average cost to employers has increased 52% — an average of 6% per year — while the expenses borne by the family, through payroll deductions and out-of-pocket costs, have grown at an even faster rate, 73% (average of 8% per year).

(Milliman Medical Index)

Some New Medicines are Approved More Quickly than Others

Joe DiMasi of the Tufts Center for the Study of Drug Development, and colleagues, have reviewed the time it takes for the FDA to review different types of new drugs.

seniors-and-prescriptionsFDA’s Neurology division, which approves drugs for Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, and stroke, takes three times as long to approve drugs as the Oncology division. These differences cannot be explained by differences workload, the type and complexity of the drugs reviewed, or the safety of the drugs approved.

If the FDA could cut the performance gap between the divisions in half, the authors estimate that the cost of developing a new drug would decrease by $46 million — a savings that adds up to approximately $874 million per year.

Full report available from the Manhattan Institute.