ObamaCare’s impact on health costs.

The Affordable Care Act (ACA) changed the American health care system in myriad ways. The primary objectives of the ACA were to expand insurance coverage while reducing the cost of insurance, and to rein in the increasing cost of health care. Whether these goals are being achieved and at what cost to the budget and to the healthcare stakeholders are important considerations. Five years after passage of the ACA, this report attempts to synthesize many of the studies and cost estimates which have been produced in order to answer these questions.

Key Take-Aways

The number of uninsured individuals has decreased, but not by as much as the Congressional Budget Office (CBO) originally predicted.[1]

· 15 million: fewer uninsured individuals since 2010

· 35 million: individuals still without insurance

· 12 million: more people enrolled in Medicaid since 2010

· 11 million: individuals have insurance through a state or federal exchange

· 7.7 million: individuals receiving subsidies for coverage through an exchange

The cost of expanded insurance coverage is being felt at the individual, state, and federal level.

· $300: average increase in annual deductibles for ESI from 2010-2014

· $5,730: average annual cap on out-of-pocket expenses for plans purchased through the exchange in 2014; $2,719 more than the average for ESI plans

· $43 billion: projected individual mandate penalties over the next 10 years

· $167 billion: mandate penalties paid by employers over the next 10 years

· $42.6 billion: cost of ACA regulations implemented thus far

· $1.2 trillion: federal cost for ACA coverage provisions over the next 10 years

The growth in total health expenditures has also returned to pre-recession rates, demonstrating no bend in the cost curve.[2]

· $3.15 trillion: national health care expenditures in 2014

· 17.9: percent of GDP spent on health care in 2014

Two Republican committee chairmen are pressing the Obama administration to improve its oversight of how state-run ObamaCare marketplaces use federal dollars, citing an inspector general report on potential violations of law.

Sens. Orrin Hatch (R-Utah) and Chuck Grassley (R-Iowa) wrote to the head of the Centers for Medicare and Medicaid Services (CMS) on Monday asking for the agency to issue clarifying guidance on how the federal dollars can be spent.

State-run ObamaCare marketplaces received federal funds to help set themselves up, but after Jan. 1 of this year, they marketplaces are supposed to be self-sustaining. They are now prohibited by law from using federal funds for “operating expenses.” They can only use the money for “design, development, and implementation.”

The problem is that the definition of these two categories can be unclear, as noted by an HHS Inspector General report late last month. The senators want clearer definitions from CMS.
State-based marketplaces (SBMs) “cannot be allowed to use hard-earned taxpayer dollars for expenses that are statutorily prohibited,” the senators write.

Three-quarters of emergency physicians say they’ve seen ER patient visits surge since Obamacare took effect — just the opposite of what many Americans expected would happen.

A poll released today by the American College of Emergency Physicians shows that 28% of 2,099 doctors surveyed nationally saw large increases in volume, while 47% saw slight increases. By contrast, fewer than half of doctors reported any increases last year in the early days of the Affordable Care Act.

Such hikes run counter to one of the goals of the health care overhaul, which is to reduce pressure on emergency rooms by getting more people insured through Medicaid or subsidized private coverage and providing better access to primary care.

A major reason that hasn’t happened is there simply aren’t enough primary care physicians to handle all the newly insured patients, says ACEP President Mike Gerardi, an emergency physician in New Jersey.

This tax season, millions of Americans are feeling the impact of the ACA on their tax return for the first time. Those who failed to obtain minimum essential health insurance coverage last year will have had to send the Internal Revenue Service (IRS) a check for $1,130, on average.1 Setting aside the impact on these millions of people’s wallets, this figure is also worth noting because it highlights the ineffectiveness of the individual mandate. Yes, the estimated 6.3 million people paying the penalty didn’t buy health insurance, but neither did the more than 30 million who qualified for an exemption from the mandate.2 If the mandate were 100 percent effective, everyone would have health insurance. However, there were still tens of millions of people uninsured in the U.S in 2014.

Sen. David Vitter (R-La.) has a simple question: How and why did Congress qualify as a “small business” eligible for special taxpayer subsidies under the Affordable Care Act (ACA)? For anyone in a real small business — private employers who get no such subsidies — the very idea is absurd. But getting a straight answer is as difficult as getting Lois Lerner’s IRS emails.

In search of answers, Vitter proposed subpoenaing documents from the District of Columbia Health Benefits Exchange Authority. But his colleagues on the Small Business and Entrepreneurship Committee recently voted (14 to five) to block the effort. They’ve tried to justify their lack of curiosity by calling the proposed subpoena an unnecessary “distraction” or an invitation to a “protracted” legal fight. But these are rather obviously lame excuses.

With Milwaukee-based Assurant Health continuing to bleed red ink, its parent company announced in a Tuesday news release it will either sell the health insurer or exit the health insurance business.

Assurant Health’s product lines include Time Insurance and John Alden. The company has more than 1,000 employees at its downtown Milwaukee offices, 501 W. Michigan St.

The impact on those employees will depend on whether the company is sold and the business strategy of a buyer.

“It’s premature for us to comment on possible outcomes,” said Assurant Inc. spokeswoman Vera Carley of impact on employees.

Republicans are being ridiculed by the right and the left for weighing ideas that would rescue ObamaCare health insurance policies for people in 37 states if the petitioners prevail in King v Burwell.

“Republicans Are Now Trying To Pass Obamacare Extension To Save Their Own Asses,” writes Allen Clifton in Forward Progressives. “GOP Gets Ready to Save the Day If the Court Strikes Down Obamacare Subsidies,” says Rush Limbaugh.

If the Supreme Court decides against the Obama administration in the case, leaders in Congress are indeed determined to pass legislation to protect coverage for an estimated six million people. ObamaCare has so distorted the market for individually-purchased and small group health insurance that Congress has little choice but to throw them a safety net.

As the state struggled under the national spotlight to fix its deeply flawed online health insurance marketplace last year, officials awarded more than $84 million in contracts without competition, about a third of the money spent on the troubled website. About 15 companies benefited from the “sole-source” and “emergency” contracts that did not use competitive bidding, according to documents obtained by The Baltimore Sun through public information requests. The Maryland Health Benefit Exchange’s lack of transparency has been criticized by government watchdogs and state officials, including Gov. Larry Hogan during his successful campaign, but the amount of the noncompetitive awards is now raising eyebrows among government procurement experts and prompting pledges from the administration to curtail the practice.
– See more at: http://www.capitalgazette.com/bs-hs-exchange-contracting-20150417,0,807245,full.story#sthash.q5qkVCoy.dpuf

Despite being designed to help the poor, certain aspects of Obamacare are holding millions of individuals back who fall into what is being called the “coverage gap.”

Reverend Vann R. Ellison, the president of the Florida based St. Matthew’s House, is trying to bring attention to the issue which he says affects people that fall between the $10,000 and $12,000 a year income range. St. Matthew’s House, which takes care of roughly 1,500 people, provides food and shelter to those individuals trying to work their way out of poverty.

“We generally deal with lower income people trying to get their lives together,” Ellison told The Daily Caller News Foundation. “These are people that can’t afford their own apartments.”

Those in that income range make too much to qualify for assistance under Obamacare but often times make too little to actually afford coverage or the fee that comes with not being covered. It’s an issue that impacts many of the lower income people Ellison is trying to help.

Although the Affordable Care Act (ACA) was enacted 5 years ago, 2014 was the first year of implementation for most of the health law’s major provisions. In fact, it turned out to be a glitch machine. Defying the expectations of even the law’s most ardent critics, Obamacare’s rollout of the federal online health exchange was a disaster, combined with the cancellation of millions of private health insurance policies (if you “liked” your plan, too bad), a delay in reporting requirements of the employer mandate, and new administrative exemptions from the individual mandate penalty.

Nonetheless, the Obama administration’s allies insist that the law is “working” and that it will even become popular with the majority of Americans with the passage of time. The law’s congressional supporters, they hope, will reap political benefits rather than political retribution.