“This week’s double-barreled release of government statistics on health insurance coverage leaves us with only one question: How many Americans are insured because of Obamacare? Remarkably, the two highly regarded government surveys released this week do not even agree whether the number of uninsured increased or decreased. The survey that received a great deal of attention said there were 3.8 million fewer uninsured. The other, which was hardly noticed, found that there were 1.3 million more uninsured.
The Centers for Disease Control (CDC) reported preliminary results on the expansion of health insurance coverage. Its National Health Interview Survey (NHIS) interviewed 27,000 people in the first three months of this year. The survey estimates that the number of uninsured dropped by 3.8 million since 2013. That represents a 1.3 percentage point decline in the uninsured rate, from 14.4 percent last year to 13.1 percent early this year.”
“A major innovation in health insurance plan design over the past several years has been the rapid growth of “narrow network” plans. Such plans either limit enrollee choices of providers, or place providers in differential cost tiers whereby individuals face higher cost in selecting some providers relative to others. This movement harkens back to the restrictions put in place during the U.S. initial infatuation with managed care in the mid-1990s. That episode ended badly for the limited choice model, as the “HMO backlash” induced regulatory restrictions on plans which handicapped choice limitations within the HMO model.
The latest growth of narrow network plans has been hastened by the introduction of health insurance exchanges under the Affordable Care Act (ACA). State exchanges have fostered strong insurer competition through both organizing the marketplace and through tying low income health insurance tax credits to the second-lowest cost plan in the silver tier. Insurers have responded to these competitive incentives in many ways, but perhaps the most notable is the expansion of narrow network insurance products. Such products are widespread on exchanges and appear to be growing rapidly.”
“We did not see big changes in employer-based coverage in the Kaiser-HRET annual Employer Health Benefit Survey released last week. Mostly this is good news, particularly on the cost side where premiums increased just 3%.
But one long-term trend that is not so good is how this market works for firms with relatively large shares of lower-wage workers (which we define as firms where at least 35% of employees earn less than $23,000). These low-wage firms often do not offer health benefits at all. And, as the chart below shows, when they do offer coverage, it has lower premiums on average (likely meaning skimpier coverage) and requires workers to pay more for it. Workers in low-wage firms pay an average of $6,472 for family coverage, compared with $4,693 for workers in higher wage firms.”
“Lawmakers told officials with the Department of Health and Hospitals on Wednesday they needed to provide more complete information going forward about Bayou Health, Gov. Bobby Jindal’s Medicaid privatization program.
The Legislative Audit Advisory Council heard testimony from DHH and the Legislative Auditor’s Office about an audit that raised a number of questions about the program. Auditors testified 74 percent of the transparency report was based on self-reported data with no corroborating documentation.”
“The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of this provision in 2012, some nonprofit and for profit employers with religious objections to contraceptives have brought legal challenges to this rule. For many women today, their contraceptive coverage depends on their employer or when they purchased their individual insurance plan.”
“The uninsured rate for kids under age 18 hasn’t budged under the health law, according to a new study, even though they’re subject to the law’s requirement to have insurance just as their parents and older siblings are. Many of those children are likely eligible for coverage under Medicaid or the Children’s Health Insurance Program.
The Urban Institute’s health reform monitoring survey analyzed data on approximately 2,500 children, comparing the uninsured rate in June 2014 with the previous year, before the health insurance marketplaces opened and the individual mandate took effect. It found that rates remained statistically unchanged at just over 7 percent for both time periods.”
“As the image above shows, reporters and pundits–including some of the most respected ones I know–have different takes on the importance of Obamacare as an election issue now that implementation of the law is moving forward and some of the controversy around it has cooled. Observers are split: Some emphasize the law’s decline as a hot political issue, others its staying power as a rallying cry for the right, and a few suggest that the ACA may emerge as an issue Democrats want to run on.
Each of these positions may be at least partly right. Obamacare has cooled as an issue now that there isn’t an obvious controversy, such as last fall’s website debacle, to occupy the front pages. But the law, now a more conventional Republican talking point than an outsize rallying cry, is still useful to some Republican candidates as a tool to motivate their anti-Obama base. Less clear is whether many Democrats will choose to run on some of the ACA’s most popular provisions, such as its protections for people with pre-existing medical conditions. This was the consensus of an event Tuesday the Kaiser Family Foundation and the Cook Political Report held in Washington about the ACA and the midterm elections; it featured people from both organizations and journalists covering tight Senate races for the Des Moines Register and the Charlotte Observer.”
“The federal government will wait until January to roll out its five-star rating system meant to help consumers compare quality at dialysis centers across the country.
Use of the system on the CMS’ dialysis centers compare website had been scheduled for October, but was met with angst by dialysis providers who questioned the methodology and said the program was likely to be more confusing than helpful.
In response, the federal agency announced Wednesday that it has moved the date by about three months.
The CMS began using the rating program on nursing homes in December 2008 and earlier this year applied a similar rubric to physician groups. In July, the agency announced plans to extend the program to dialysis facilities starting Oct. 9.”
“Obamacare’s defenders are busy declaring victory again. Ezra Klein is touting a new survey of Obamacare benchmark premiums in some regions of the country as evidence that the law is defying the predictions of critics and working to cut costs rather than increase them.
But, as Bob Laszewski notes, the truth about Obamacare implementation is far less rosy than the latest round of cheerleading would indicate.
For starters, the federal and state websites remain largely a dysfunctional mess, although the media isn’t really covering the story anymore. The supposed “fix” that allowed millions of consumers to sign up with plans on the exchanges from December through April really wasn’t much of a fix after all. It was a workaround, allowing consumers to access large federal subsidies with minimal verification.”
“DETROIT– A lawsuit has been filed on behalf of potentially thousands of immigrants who have been rejected for full Medicaid coverage in Michigan because of computer problems.
The lawsuit in Detroit federal court says the state has known about the problem for weeks but is moving too slowly to fix it. Attorneys are asking a judge to issue an injunction to get things moving.
The Center for Civil Justice in Flint says many immigrants are approved only for emergency services. The group says federal law typically grants full health coverage under Medicaid to low-income refugees and poor lawful permanent residents.”