ObamaCare’s impact on health costs.

“Since enactment of the Affordable Care Act (ACA) in 2010, much of the attention in the policy community has been on modernizing Medicare’s traditional fee-for-service (FFS) program. Through Accountable Care Organizations (ACOs), larger “bundles” of payments to fee-for-service providers for episodes of care, and tests of pay-for-performance models, the hope is that the traditional Medicare model can be remade through sheer force of bureaucratic will. The stated intent is to find a way to pay for value, not volume.
These efforts may or may not bear much fruit, but, over the longer term, it’s not likely to matter much. That’s because a more important transformation of Medicare is already well underway and is occurring despite more resistance than assistance from the program’s bureaucracy. According to the 2014 Medicare Trustees’ report, enrollment in Medicare Advantage – the private plan option in Medicare — has been surging for a decade. In 2005 there were 5.8 million Medicare beneficiaries enrolled in MA plans — 13.6 percent of total enrollment in the program. Today, there are 16.2 million beneficiaries in MA plans, or 30 percent of program enrollment. (See Table IV.C1) In addition, the Medicare drug benefit, which constitutes about 12 percent of total program spending, is delivered entirely through private plans.”

“There is nothing more time consuming and expensive for a patient than undergoing extra tests or procedures during a trip to the emergency room, doctor’s office or urgent care center.
Often a physician will know exactly what a patient’s diagnosis is but will order an x-ray, CT scan, blood work or MRI to reaffirm his clinical judgment. The common rationale is to back up his opinion in case there is a lawsuit.”

“LOS ANGELES On the heels of an advertising blitz funded by health insurance companies, California voters on Tuesday tanked a proposal to give the state’s insurance commissioner veto authority over health insurance premiums.
About 60 percent of voters cast ballots against the plan to give the elected commissioner expanded authority over small group and individual health plans.”

“Tuesday’s re-election of Republican governors in closely contested races in Florida, Georgia, Wisconsin, Maine and Kansas dims the chances of Medicaid expansion in those states.
Advocates hoping for Democratic victories in those states were disappointed by the outcomes, but Alaska, which also has a Republican incumbent, remains in play as an independent challenger holds a narrow lead going into a count of absentee ballots.
“No one would say it was a good night for the prospects of Medicaid expansion,” said Joan Alker, executive director of the Center for Children and Families at Georgetown University.”

“The Obama administration plans to close a loophole in the Affordable Care Act that allows large companies to refuse to cover in-patient hospital stays in any of their health insurance plans, according to an official involved in the internal discussions.
The official requested anonymity until the announcement is made because “the guidance that will be issued is not finalized.””

“Monthly premiums for health insurance soared in 2014, the first year of Obamacare’s full implementation, according to a new study.
The report by HealthPocket.com — a site that allows consumers to compare health plans — compared rates from 2013 and 2014. “The analysis of pre- and post-Obamacare health insurance in the individually purchased health insurance market demonstrates a clear increase of average premiums across age groups and both sexes,” researchers found. “While the degree of increase varied by age and sex, the occurrence of an increase did not.””

“Right now, the U.S. Supreme Court is deciding whether to hear a case that could have devastating implications for Obamacare and hundreds of thousands of people currently receiving health insurance through its exchanges.
The case, King v. Burwell, is one of several challenges based on language in the Affordable Care Act that authorizes the government to offer subsidies to people who enroll in policies sold on the health exchanges. The subsidies were introduced to make health care coverage more affordable, but the lawsuits charge that the wording of the Affordable Care Act doesn’t allow for federal subsidies.”

“Heading into the highly consequential midterm elections, voters continue to give the U.S. health care system less than stellar reviews and believe it will get worse under the national health care law.
A new Rasmussen Reports national telephone survey finds that just 36% of Likely U.S. Voters rate the nation’s health care system as good or excellent, though that’s up from 32% in September and is the highest positive rating since April. Thirty-two percent (32%) still give it poor marks, showing no change from the previous survey.”

“The Washington Examiner’s Susan Ferrechio has a possible scoop buried in her post today on Republican efforts to peal back Obamacare after the election. Speaking of Sen. John Barrasso (R-WY), Ferrechio writes:
“Barrasso said the GOP would also take up legislation to block the Obama administration from reimbursing insurers who lose money in the healthcare exchanges.””

“Call it drugs for the departed: A quirky bureaucratic rule led Medicare’s prescription drug program to pay for costly medications even after the patients were dead.
That head-scratching policy is now getting a second look.
A report released Friday by the Health and Human Services Department’s inspector general said the Medicare rule allows payment for prescriptions filled up to 32 days after a patient’s death — at odds with the program’s basic principles, not to mention common sense.”