ObamaCare’s impact on health costs.
“Despite the success of the Affordable Care Act in Kentucky, state Democrats are having a hard time winning over even those Republicans who admit they are benefiting from the law.
The Affordable Care Act allowed Robin Evans, an eBay warehouse packer earning $9 an hour, to sign up for Medicaid this year. She is being treated for high blood pressure and Graves’ disease, an autoimmune disorder, after years of going uninsured and rarely seeing doctors.
“I’m tickled to death with it,” Ms. Evans, 49, said of her new coverage as she walked around the Kentucky State Fair recently with her daughter, who also qualified for Medicaid under the law. “It’s helped me out a bunch.”
But Ms. Evans scowled at the mention of President Obama — “Nobody don’t care for nobody no more, and I think he’s got a lot to do with that,” she explained — and said she would vote this fall for Senator Mitch McConnell, the Kentucky Republican and minority leader, who is fond of saying the health care law should be “pulled out root and branch.””
“This week exchangers could get data on enrollment in the small business exchanges operated by the federal government as Mayra Alvarez, director of CCIIO’s State Exchange Group, will testify at a House Small Business Committee hearing Thursday on SHOP exchange implementation. CMS Administrator Marilyn Tavenner will also return to the House to face the Oversight Committee on Thursday on healthcare.gov security concerns, one day after the Government Accountability Office’s planned Sept. 17 release of a report on that controversial subject.
Academics and researchers are also diving into new data out Tuesday (Sept. 16) from the Centers for Disease Control and Prevention and the U.S. Census Bureau on the number of uninsured. The CDC’s early release of data from the National Health Interview Survey found that the uninsured rate for adults ages 18 to 64 had dipped from 20.4 percent in 2013 to 18.4 percent in the first three months of 2014. The survey does not account for the late surge of enrollments toward the end of the first exchanges open enrollment period, however it is the first official government report to document the reduction in uninsured following the ACA’s coverage expansions.”
“House Ways & Means health subcommittee chair Kevin Brady (R-TX) questions HHS’ authority to settle hospitals’ appeals of denied inpatient claims and is urging HHS Secretary Sylvia Burwell to retract what he views as an “ill thought” settlement process. Brady wants Burwell to work with lawmakers to come up with a different “fair, transparent and conclusive settlement process.”
Brady wrote to Burwell Tuesday (Sept. 16) that he is dismayed by HHS’ reluctance to work with the committee on an equitable settlement process that is fully legal, adding that the “lack of engagement makes it challenging for the Congress to solve the current appeals problems and prevent similar problems in the future.”
CMS announced late last month (Aug. 29) that it will pay hospitals 68 percent of denied inpatient status claims in the appeals queue if hospitals take them out of the backlogged appeals process. The agency has been encouraging hospitals to take advantage of the settlement to “alleviate the burden of Medicare appeals on both the hospital and Medicare systems,” according to the CMS website.
Hospitals should decide whether to participate by the end of October, and CMS in a Frequently Asked Questions document released Sept. 9 says that four hospitals have already stepped forward to take the settlement offer. The document also states that this is a one-time offer from CMS.”
“Last year I wrote that Obamacare could leave doctors holding the bag for claims for patients who don’t pay their insurance premiums. That’s because the law includes a three-month grace period during which health insurers must continue to cover patients who sign up, but don’t pay the price of their insurance. If the patients eventually make good, there’s no problem. But if patients don’t pay the owed premiums, the insurance company has to cover the cost of claims filed during the first month. Providers are stuck with the tab for any claims filed during months two and three.
The piece I wrote last July was theoretical. The notification letter I’m holding in my hand, addressed to my wife’s pediatric practice, is reality. And reality costs, in this case, over $600. That’s the outstanding balance owed the practice by a patient insured by BlueCross BlueShield of Arizona. It’s a balance that my wife might have to eat, or else try to collect herself.”
“During the 2014 open enrollment for Obamacare coverage, Mary Denson, 21, a student at Columbia (Mo.) College, qualified for a federal premium subsidy that reduced her premium contribution for buying health insurance to less than $20 a month.
But she fears that when she renews her coverage for 2015, she won’t have enough income from her nanny job to reach the subsidy income threshold of 100% of the federal poverty level and continue qualifying for premium tax credits. She isn’t eligible for Medicaid because Missouri hasn’t expanded that program for low-income adults. Denson says she’s considering looking for another job to reach the $11,670 income threshold but worries she may have to drop classes. Without the subsidy, her coverage would cost nearly $400 a month, far more than she can afford.
“I’m just going to have to re-apply and pretty much hope that I make the cut again,” Denson said.”
“States have developed various ways to avoid paying their fair share of Medicaid expenses over the years, in some cases costing the federal government hundreds of millions of dollars in extra funding for the program.
The Department of Health and Human Services, which runs Medicaid through its Centers for Medicare and Medicaid Services (CMS), has known about the issue for more than a decade, but states still find ways to game the system. The agency’s inspector general this year listed the issue among 25 key problems the agency needs to address.”
“When it comes to claims about Medicare, some political talking points just never die.
In Iowa and Virginia, Republicans have accused Democrats of cutting Medicare to pay for Obamacare. In Florida, a Republican was slammed for ending the Medicare “guarantee.” Other Medicare-related attacks have been deployed in Arkansas and Kentucky Senate races. The point of all the attacks is to convince midterm voters that one side or the other won’t protect the program.
Take this one, used in a recent ad aired by the National Republican Senatorial Committee in the hotly contested Iowa Senate race between Democratic Rep. Bruce Braley and Republican state Sen. Joni Ernst:
“Bruce Braley voted to cut $700 billion from Medicare to support Obamacare,” the ad says. “That’s just not fair. We paid in. We paid for it. That should be there for us.””
“Last week, we finally learned the prices for the new benchmark plans for Obamacare. The good news: Prices are falling slightly. The bad news: Contrary to optimistic early reports, that doesn’t mean that everyone’s costs are falling; consumers will have to be attentive to make sure that their costs don’t go up. The worse news: We won’t actually know what effect the Affordable Care Act is having on insurance prices until 2017, when a bunch of temporary subsidies for insurers expire.
The important thing to keep in mind is that when the “benchmark rate” goes down, that doesn’t mean that the cost of the old benchmark plan has fallen. It just means that whatever plan is now the second-cheapest “silver” plan on the exchanges is cheaper than whatever was the second-cheapest plan last year.”
“There’s been a fierce debate over whether Obamacare has increased health insurance premiums. Progressives have argued Obamacare is working due to modest projected premium increases on the Exchanges for 2015. Conservatives have retorted that “there can be no doubt that health care today is more costly than it would have been without Obamacare.”
But this argument has focused on the health Exchanges, where only 7-8 million people bought their coverage in 2014. Readers would do well to remember that more than 20 times that number of people rely on employer-provided health benefits (Table C-1).
In the employer-based market, the adverse effects of Obamacare on premiums and affordability are strikingly obvious. The growing burden of employer-provided health care has accelerated under Obamacare. And yet the New York Times would have you believe everything is hunky-dory since “the growth in health insurance premiums was only 3 percent between 2013 and 2014. That’s tied for the lowest rate of increase since Kaiser started measuring (this is the 16th year of the survey).” This view is dead wrong: here’s why.”
“Some of Obamacare’s big supporters say the new law has already contributed to decreases in the rate of growth of health spending.
But a new report from the Center for Medicare and Medicaid Services Office of the Actuary says the rate slowed because of a slow economic recovery, increased cost-sharing for those enrolled in private plans and sequestration.
Indeed, the report does not even mention Obamacare when assessing the situation. “The recent period is marked by a four-year historically low rate of health spending growth, which is primarily attributable to the sluggish economic recovery and constrained state and local government budgets following the 2007-09 recession,” the report states.”