Tag: "Health Reform"

Why ObamaCare is Never Likely to be Popular

Jonathan Bernstein at Bloomberg View:

Caduceus with First-aid KitFor most of us, ObamaCare isn’t that visible, and the benefits often are the least visible part. The biggest winners are probably those on expanded Medicaid, and I’m confident many of them don’t know they were helped by ObamaCare. Don’t expect it to get better; it’s going to be less and less likely that people will identify the benefits they are receiving with “ObamaCare.” In five years, plenty of those in the exchanges won’t realize that under the old system they would have had a pre-existing condition that would have barred them from being insured. Even if they realize that such a restriction once existed, they almost certainly won’t realize that their minor medical condition would have qualified.

Given all that, once Republican opposition guaranteed that the ACA would be controversial it was likely that it would poll badly, even if it worked well — and even if it worked so well it couldn’t be repealed.

Employers Switch from Commercial Insurance to Self-Insured Plans

According to Citibank’s top ranked analyst Carl McDonald:

By our analysis, since 2002, risk enrollment at the publicly traded plans has fallen by over 14 million lives…The emergence of private exchanges that rely on a risk model (like the exchange product offered by Aon Hewitt) could help slow the loss of risk enrollment but the benefits of self-funding are so significant for many employers that we believe risk enrollment will continue to shrink.

Cooking the ObamaCare Stats?

caduceus_blogOut of the blue, the Census Bureau has changed how it counts health insurance — at the precise moment when ObamaCare is roiling the insurance markets.

Since 1987, the Current Population Survey, or CPS, has collected information on the health-insurance coverage status of Americans. The annual reports are widely cited because their large sample sizes improve accuracy, the data are gathered constantly, and they tease out state-by-state details. But this year the Census revamped the CPS household insurance questions, muddying comparisons between the pre- and post-ObamaCare numbers. The results of the new method will be disclosed this fall. (WSJ)

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.

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Deductibles in ObamaCare Exchanges

dfgFrom the Heritage Foundation, ObamaCare in Pictures.

Bobby Jindal’s Health Reform

The plan begins by repealing ObamaCare. It would also “guarantee access” to people with pre-existing conditions, through a “high-risk pool, reinsurance, or some other method ensuring those with chronic conditions can obtain needed care.”

Like the Republican Study Committee’s plan, Jindal’s proposal replaces the current exclusion of employer-based tax benefits with a standard tax deduction. The problems:

  • It is regressive, giving more tax relief, the higher your income tax bracket.
  • It is not helpful to the half of the population that does not pay income tax.

Now that ObamaCare has handed out tax credits to millions of people in the health-insurance exchanges, the total effect of the plan would likely be to take insurance away from a large proportion of the people insured through the exchanges, as well as all the people covered by ObamaCare’s Medicaid expansion. By election day, it would probably un-insure ten million people.

Large Employer Cost of ObamaCare

Umoney-crossroadsntil now, the mainstream media focus on ObamaCare’s blows has been on individuals and small businesses. But large employers will not avoid the costs of the Affordable Care Act (ACA). According to a new study published by the American Health Policy Institute:

  • The cost of the ACA to large U.S. employers (10,000 or more employees) is estimated at $480 to $590 per employee per year, over the next ten years.
  • These large employers will see overall ACA-related cost hikes of between $163 million and $200 million per employer, or an increase of 4.3 percent in 2016 and 8.4 percent in 2023 over and above what they would otherwise be spending.
  • The total cost of the ACA to all large U.S. employers over the next ten years is estimated at between $151 billion to $186 billion.

Did Republicans Just Make ObamaCare Better?

And if they did, who knew about it?

At the prodding of business organizations, House Republicans quietly secured a recent change in President Barack Obama’s health law to expand coverage choices, a striking, one-of-a-kind departure from dozens of high-decibel attempts to repeal or dismember it…

The provision itself was relatively minor. It eliminated a cap on deductibles for small group policies offered inside the law’s health care exchanges as well as outside; the cap was set at $2,000 for individuals and $4,000 for families…

No member of the House GOP leadership has publicly hailed the fix, which was tucked, at Republicans’ request, into legislation preventing a cut in payments to doctors who treat Medicare patients.

It is unclear how many members of the House rank and file knew of it because the legislation was passed by a highly unusual voice vote without debate. (AP)

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.

CBO’s Increasing Pessimism

cbouiprojections

Source: Chris Conover at Forbes.