Tag: "ObamaCare"

One Quarter of Obamacare Enrollees Dropped Out in 2015

people-in-waiting-roomThe administration recently announced 12.7 million people selected or were automatically enrolled in an Obamacare exchange plan at the end of the third open season – February 1. Except for special cases, anyone who missed that deadline cannot enroll in an Obamacare plan for 2016.

That is a few more people than the 11.7 million than at the end of 2015’s open enrollment. However, the administration also announced that only 8.8 million people remained enrolled in Obamacare on December 31, 2015. That is a drop of almost one quarter from the end of 2015 open enrollment.

Whither Obamacare’s Death Panel?

elderly-man-worriedPresident Obama’s nomination of Merrick Garland to the U.S. Supreme Court has not shaken Senate Republicans from their commitment not to hold confirmation hearings for any candidate President Obama might nominate to the Supreme Court in the last eleven months of his second term.

Given the high drama and politics surrounding presidential appointments that require Senate confirmation, it might be a good time to ask why another 15-member “court,” which President Obama himself established in 2010, and which was supposed to deliver its first decision in January 2014, has not yet seen its first member nominated!

This “court” is the almost forgotten “death panel,” officially named the Independent Payment Advisory Board (IPAB). Based on a target rate of Medicare spending per capita, the IPAB was supposed to start cutting Medicare payments to providers in 2015.

Massive Fraud Likely in Obamacare Exchange Subsidies

HSAThe Government Accountability Office has just released a report detailing the massive opportunities for fraudulently getting tax credits in Obamacare’s health insurance exchanges. Obamacare sends billions of taxpayers’ dollars to health insurers which operate in these exchanges – $37 billion last year alone. These tax credits are used to discount premiums for plans offered in the exchanges.

During undercover testing, the federal Marketplace approved subsidized coverage under the act for 11 of 12 fictitious GAO phone or online applicants for 2014. The GAO applicants obtained a total of about $30,000 in annual advance premium tax credits, plus eligibility for lower costs at time of service. The fictitious enrollees maintained subsidized coverage throughout 2014, even though GAO sent fictitious documents, or no documents, to resolve application inconsistencies.

Health Care Savings in Obama’s Budget

(A version of this Health Alert was published by The Hill.)index1

In a remarkable move breaching a four-decade precedent and characterized by many as a snub, the Republican chairmen of the House and Senate Budget Committees declined to invite the director of the Office of Management and Budget to present President Obama’s 2017 budget to their committees.

Utterly ignoring the president’s proposed budget is short-sighted, especially since congressional Republicans are disunited on fiscal issues. In January the Congressional Budget Office (CBO) updated its estimate of the cumulative federal deficit for the next 10 years to $8.5 trillion, versus just $7 billion last August.

The reason for the increase is that Republicans, who control both chambers, have won some tax cuts but no spending cuts. Obama’s latest budget offers the opportunity to remedy this, if only to a small degree and only by being very selective.

Believe it or Not, The Republican Obamacare Replacement Plan Might Come Together

health-care-costs(A version of this Health Alert was published by Forbes.)

Earlier this month, Speaker Paul Ryan announced six task forces, each comprised of House Committee Chairmen, to develop a “bold, pro-growth agenda.” What was remarkable was that one of the task forces was on health care reform. Many had thought Congressional Republicans were investing too much time and energy grandstanding Obamacare repeal, and not enough developing a credible alternative.

That may have changed with the selection of four Committee Chairman to the Health Care Reform Task Force. They are: Budget Committee Chairman Tom Price (R-GA), Education & the Workforce Committee Chairman John Kline (R-MN), Energy & Commerce Committee Chairman Fred Upton (R-MI), and Ways & Means Committee Chairman Kevin Brady (R-TX).

With respect to private health insurance, the composition of the task force indicates the emerging House Republican plan will improve the post-Obamacare health system not only versus Obamacare, but versus the pre-Obamacare system. One of the reforms will almost certainly be refundable tax credits to finance health care for those of us who do not have employer-based benefits. Importantly, these tax credits will likely be much simpler to calculate than Obamacare’s tax credits, which impose high marginal income taxes at certain incomes, and reduce people’s incentives to work.

Obamacare’s Premium Hikes Are Much Bigger Than You’ve Been Told

Healthcaredotgov(A version of this Health Alert was published by Forbes.)

Yesterday was the last date for open enrollment in Obamacare’s third season. Since October, at least six independent and credible sources have confirmed rate increases will be in the double digits. However, these are gross premium hikes. Net premium hikes paid by enrollees are distorted by tax credits paid to insurers. These badly designed tax credits have a number of perverse consequences. It is widely understood that they impose disincentives to work.

What is less well understood is that the tax credits are so badly designed that they impose a ratchet effect causing net premium hikes greater than the gross premium hikes. According to new research published by the National Center for Policy Analysis, this effect is concentrated among Obamacare enrollees in the lowest income brackets.

Obamacare’s Cost per Beneficiary Explodes with Shrinking Enrollment

CBOThe Congressional Budget Office’s latest budget estimate shows Obamacare’s costs per beneficiary have exploded, as enrollment in Obamacare’s broken exchanges collapses. January’s update estimates 2016 exchange enrollment at 13 million people (p. 69).  Although the Administration had previously downgraded its estimate of Obamacare enrollment, this is the first significant change by the non-partisan CBO.

What is really shocking is the January update still estimates tax credits, which subsidize insurers participating in exchanges, will cost taxpayers $56 billion this year (p. 182). That amounts to about $4,308 per enrollee (although not all are subsidized). Back in March 2010, CBO estimated that 21 million people would be covered in exchanges in 2016, for a total cost of $59 billion in tax credits (pp. 20-23). That would amount to about $2,810 per enrollee.

Obamacare Joins Pile of Unfunded Liabilities

index1(A version of this Health Alert was published by the Orange County Register.)

The congressional vote last month to fund the government through next September, while extending some special-interest tax breaks and introducing some new ones, was the first time a majority of Republicans voted in favor of Obamacare. It looks like Congress’ alternative to Obamacare is deficit-financed Obamacare.

While failing to cut one penny of Obamacare spending, the so-called “taxibus” (tax extenders plus omnibus spending) cut almost $40 billion in Obamacare tax revenue by “temporarily” delaying three taxes for a year or two: the medical device excise tax, the health insurance fee and the excise tax on high-cost employer benefit plans.

Make no mistake: all three taxes are harmful and should be eliminated. However, just kicking them down the road without making any effort to cut Obamacare spending does nothing to repeal the Affordable Care Act.

Trouble Paying Medical Bills: Uninsured Do Better Than Obamacare Insured

iStock_000007047153XSmall(A version of this Health Alert was published by Forbes.)

The Centers for Disease Control and Prevention’s National Center for Health Statistics conducts thorough research on health insurance coverage. Recently published early results of the latest National Health Interview Survey have been misrepresented in the media to show that Obamacare is reducing the number of uninsured Americans, and that the number of people having trouble paying for health care has dropped as a result.

Actually, this is not the case. The data show some factor other than Obamacare has caused the survey’s respondents to state that they are having less trouble paying medical bills than in previous years. We know this because those who remained uninsured improved their ability to pay medical bills more than those who got coverage through Obamacare.

Only 45 million Americans under 65 years old reported they were in families with problems paying medical bills in 2015. In 2011, the number was 57 million. That drop of 12 million corresponds with a significant increase in health insurance coverage. The number without insurance dropped by 18 million, from 46 million to 28 million, while the population increased by about three million.

So, it looks like two thirds of the 18 million people insured after Obamacare took hold have no more worries about medical bills. Hooray for Obamacare, right? Not at all. In fact, it is those who remained uninsured who account for the biggest share of the decrease in the number of Americans with troubles paying medical bills.

Who Pays Obamacare’s “Slacker Mandate”? Workers with No Kids!

LGBT-ACA-ADThe “slacker mandate” is the provision in Obamacare requiring employer-based health plans to offer benefits to adult dependents of their workers, up to age 26. I previously discussed research showing the mandate reduced work among adults, aged 19 to 26, and increased the time they spend socializing, sleeping, and exercising.

What about the financial costs of the mandate? Speak to an insurance agent or benefits consultant and they will tell you the cost are fully borne by working parents. In the old days, employer-based health insurance was offered to workers in three sizes: Single, couple, or family. It did not matter how many kids you had. Today, each dependent adds to the premium. So, the “slacker mandate” is paid for by the working parents. That is not really a problem for society. However, there is more to the story.

A remarkable study published by the National Bureau of Economic Research concludes this happened. The slacker mandate reduced wages among workers without children by $211 a month, but did not reduce wages among workers with children (either minor or adult) by a statistically significant amount.