ObamaCare’s impact on health costs.

“One of the oft-repeated arguments in favor of the Affordable Care Act is that it will reduce people’s need for more intensive care by increasing their access to preventive care. For example, people will use the emergency room less often because they will be able to see primary care physicians. Or, they will not develop as many chronic illnesses because they will be properly screened and treated early on. And they will not require significant and invasive care down the line because they will be better managed ahead of time.
Moreover, it is often asserted that these developments will lead to reductions in health care spending. Unfortunately, a growing body of evidence makes the case that this may not be true.
One of the most important facts about health care overhaul, and one that is often overlooked, is that all changes to the health care system involve trade-offs among access, quality and cost. You can improve one of these – maybe two – but it will almost always result in some other aspect getting worse.”

“After being without health insurance for two years, Miranda Childe of Hallandale Beach found a plan she could afford with financial aid from the government using the Affordable Care Act’s exchange.
Childe, 60, bought an HMO plan from Humana, one of the nation’s largest health insurance companies, and received a membership card in time for her coverage to kick in on May 1st.
But instead of being able to pick a primary care physician to coordinate her healthcare, Childe says she repeatedly ran into closed doors from South Florida doctors who are listed in her plan’s provider network but refused to see patients who bought their coverage on the ACA exchange.
“I just felt that I wasn’t being treated like a first-class citizen,’’ said Childe, who eventually found a doctor with the help of a Humana counselor. “Nobody, I don’t care what kind of degrees they have, should ever be treated that way.’’
Nearly one million Floridians enrolled in a private health plan through the ACA exchange but some, like Childe, are finding that some physicians refuse to honor their coverage — even when the doctors are included in the plan’s provider network.”

“The evidence is piling up now: Obamacare really does seem to be helping the uninsured.
Survey after survey is showing that the number of uninsured people has been going down since the start of enrollment last fall. The numbers don’t all match, and health care experts say they’re not precise enough to give more than a general idea of the trend.
But by now, the trend is unmistakable: Millions of people who didn’t have health insurance before the Affordable Care Act have gained it since last fall. The law is not just covering people who already had health coverage, but adding new people to the ranks of the insured — which was the point of the law all along.
There’s still a lot of variation in the numbers, too much for health care experts to pin down an exact number with any confidence. But even health care analysts who think the law is a bad idea acknowledge that the evidence suggests the uninsured are being helped. Given the predictions of doom that accompanied the law’s passage and launch, that’s a sweet bit of vindication for the president and ACA supporters.”

“A primary aim of the Patient Protection and Affordable Care Act (ACA) is to expand insurance coverage, especially among households with lower incomes. The Congressional Budget Office (CBO) projects that about one-third of the additional insurance coverage expected to occur because of the law will come from expansion of the existing, unreformed Medicaid program. The rest of the coverage expansion will come from enrolling millions of people into subsidized insurance offerings on the ACA exchanges — offerings that have strong similarities to Medicaid insurance.
Unfortunately, ample evidence demonstrates that this kind of insurance model leaves the poor and lower-income households with inadequate access to health care. The networks of physicians and hospitals willing to serve large numbers of Medicaid patients have been very constrained for many years, meaning access problems will only worsen when more people enroll and begin using the same overburdened networks of clinics and physician practices.
It does not have to be this way. It is possible to expand insurance coverage for the poor and lower-income households without reliance on the flawed Medicaid insurance model. Opponents of the ACA should embrace plans to replace the current law with reforms that would give the poor real choices among a variety of competing insurance offerings, including the same insurance plans that middle-class families enroll in today. Specifically, we propose a three-part plan that includes a flexible, uniform tax credit for all those who lack employer-based coverage; deregulation of Medicaid; and improved safety-net primary and preventive care.”

“Alabama, buckle up. You’ll soon learn how much your health insurance premiums will go up for next year. The percentage increase will probably be in the double digits.
But that’s nothing compared to what you’ll face in 2017. In May, I released a comprehensive study showing how the Affordable Care Act — otherwise known as Obamacare — will likely play out. The diagnosis isn’t good.
In two years, the ACA will cause substantial premium increases. This will likely cause Alabamians to leave the insurance market in droves — they won’t be able to afford health insurance, even with federal subsidies. Within a decade, this could swell the ranks of the uninsured by nearly 11 percent.
I reached this conclusion by using a peer-reviewed economic model published in several health journals. It was funded by both private and government sources, including the Department of Health and Human Services.

“Before dawn on a Wednesday in January, Cesar Flores, a 40-year-old employed by a large retail chain, woke up at his home in Chula Vista, California. He got in his car and crossed the border into Tijuana. From there, he headed for a local hospital, where he got lab tests—part of routine follow-up to a kidney stone procedure. He had his blood drawn and left the hospital at 7:30. He arrived home before 10.
Uninsured Americans have long known that seeking medical care abroad is often more cost-effective than seeking it at home. Even after you factor in travel expense and time off work, you still often come out ahead. A hip replacement that would cost $75,000 for an uninsured patient in the U.S. is $9,000 in India. A heart bypass in the U.S. runs about $210,000; in Thailand it’s $12,000. According to Patients Beyond Borders, a company that facilitates medical tourism, those savings drove about 900,000 Americans to leave the country for medical procedures last year—a number they estimate is growing by 15 percent per year.
But Flores’s situation isn’t medical tourism as we know it. Flores has insurance through his wife’s employer. But his insurer, a small, three-year-old startup H.M.O. called MediExcel, requires Flores to obtain certain medical treatment at a hospital across the border. In part due to cost-pressures generated by the Affordable Care Act, other sorts of plans that require travel have the potential to expand.”

“ObamaCare hurts businesses. That’s the result of an exhaustive study polling small to medium-sized businesses.
The controversial government health-care reform increases company and employee costs and sometimes stops companies from hiring as well, participants told the International Foundation of Employee Benefit Plans in its new study.
“More than half of single employers believe the Affordable Care Act has had a negative effect on their company,” according to the report.
The survey, which polled some employers and their health-care pros, found that the majority of respondents, 54 percent, thought the effect of the ACA on their firms had been “negative” or “very negative.”
The same respondents also expected that the negative effects from ACA would increase to 66 percent in the near future as the program unfolds.”

“Chattanooga’s success in achieving bargain-priced policies offers valuable lessons for other parts of the country as they seek to satisfy consumers with insurance networks that limit their choices of doctors and hospitals. Nationwide, about 70 percent of the lowest-priced plans included narrow networks, according to the consultants McKinsey & Company.
But few places have put them into place as successfully as here in Eastern Tennessee, where BlueCross BlueShield of Tennessee, the area’s dominant insurer, cut a low price deal with one of the three big hospital systems to be the sole provider in their cheapest network. If all areas of the country had such low premiums, the federal government’s tab for subsidizing part of the cost of policies—totaling an estimated $29 billion for the fiscal year beginning Oct. 1—would be dramatically lower.”

“Supporters of ObamaCare are nervously awaiting a decision by the D.C. Court of Appeals that could have even more dramatic consequences for the law’s ability to function than the Supreme Court’s religious liberty decisions issued last week.
Judge Thomas B. Griffith presided in March over arguments in one of the four cases – Halbig v. Burwell – challenging the Obama administration’s decision that subsidies for health insurance can flow through federal as well as state exchanges.
The Affordable Care Act says that health insurance subsidies are available only “through an exchange Established by the State.” The IRS, however, interpreted the statute to mean that the subsidies also could be distributed in the now 36 states where the federal government is operating exchanges.
During oral arguments, Judge A. Raymond Randolph indicated he felt the statute was quite clear in repeating “seven times” in that section that the subsidies are available only if the state sets up its own exchange.”

“Several indicators suggest that the political waters may be calming for the Affordable Care Act (ACA). This doesn’t guarantee that the law will achieve its goals and be judged a success. It means that the law stands a better chance of being implemented free of constant political turmoil–and will have a better shot at success.
Consider:
*Public support for the ACA fell after the Web site debacle last fall, but while overall opinion toward the law continues to tilt negative, the falloff in the polls has stopped, according to the June Kaiser Family Foundation Health Tracking poll.
*After the administration rapidly repaired the Web site, the ACA exceeded the widely cited 7 million target for the first open-enrollment season, which had become a political litmus test for the law. And with no similarly big controversy, the ACA has become a far less juicy, and less prominent, media story.
*Some Republicans seem to be shifting their midterm strategy to focus less on the ACA and more on other issues they have with the president and the direction of the country.
*More people say that they are getting their information on the law from personal experience and from the experiences of family and friends, and fewer say that they are getting it from the news media, which they also say focuses mostly on politics and not what the law means for them. Increasingly, public perception of the law is about people’s experiences–whether good or bad–rather than ideology and partisan politics.”