ObamaCare’s impact on health costs.

“That brings up a question I’ve been pondering: Why did the Barack Obama administration put exchanges, and particularly state-based exchanges, at the heart of the operation? Billions have now been spent setting them up, and they will cost more money to run — more than some of these states can really afford”

“According to a new Avalere Health analysis, 17 of the 26 states that did not expand Medicaid in the first three months of 2014 still reported growth in Medicaid enrollment, ranging from 0.1 percent in Texas to 10.1 percent in Montana. Since these states had decided not to expand Medicaid eligibility levels under the Affordable Care Act (ACA), these numbers show the impact of the “woodwork effect,” which is when individuals who were previously eligible, but not enrolled in Medicaid, newly sign up as a result of increased outreach and awareness. These enrollees may place a strain on state budgets, since states are required to contribute to the cost of their coverage based on traditional Medicaid matching rates.”

“Even states that refused Obamacare’s Medicaid expansion are seeing enrollment growth in the health-care program, according to a new analysis.
Medicaid enrollment in 17 of the 26 states that hadn’t expanded Medicaid as of the end of March saw their rolls increase by a combined 550,300 new beneficiaries, reports the Avalere Health consulting firm.”

“Enrollment in California’s healthcare program for the poor has soared as the state implements President Obama’s federal overhaul, pleasing advocates who have sought expanded coverage but also presenting new costs for the state.

Nearly one-third of California’s total population — roughly 11.5 million people — will be enrolled in Medi-Cal next year, according to Gov. Jerry Brown’s administration.

Enrollment is expected to exceed previous estimates by 1.4 million, and administration officials said it would cost the state $1.2 billion more than originally thought.”

“The first Obamacare enrollment period barely just ended, and it’s already time for insurers in some states to file information on premiums for 2015. The 2014 rate filings last year became major political stories in a non-election year, so it’s safe to assume the same will happen this year. And the 2015 rates will give us a glimpse into the future of the health-care industry.”

“Conservatives have long argued that “first dollar” insurance coverage helps raise the cost of health care, as people tend to overconsume services they perceive as free. Implementation of state insurance exchanges appears to confirm that hypothesis: Several states that used “free” federal dollars to build complicated exchanges may end up scrapping them.”

“The first thing Michelle Pool did before picking a plan under President Barack Obama’s health insurance law was check whether her longtime primary care doctor was covered. Pool, a 60-year-old diabetic who has had back surgery and a hip replacement, purchased the plan only to find that the insurer was mistaken.”

‘Paul Siperke is the co-owner of Fat Head’s, a popular brew pub in Cleveland. He has fewer than 50 full-time employees, so he’s classified under the Affordable Care Act as a small business. He doesn’t have to provide health insurance to his employees, but that’s what he’s been doing since the bar opened in 2009, despite some pretty dramatic volatility in rates.

“They just seemed to keep going up every year,” he says. “One year we got a 38 percent increase, another year we got 11. One year we got three.”‘

“Gene Sperling, former director of President Obama’s National Economic Council and former Assistant to the President for Economic Policy, argues that Obamacare should appeal to those who desire competition and choice in health care. But the very nature of Obamacare fosters neither.”

“The day that many health policy wonks have been waiting for has come: Obamacare’s first open–enrollment period has officially ended on April 15, 2014. Wasting little time, the Department of Health and Human Services (HHS) has released the last of its first–year enrollment reports. The update from HHS contains some good news, and some not–so–good news. Overall, it appears highly unlikely that the healthcare law will collapse.”