The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers

Anthem fought back against an Obama administration antitrust lawsuit on Wednesday by conditioning its expansion in the struggling Obamacare market to approval of its acquisition of Cigna. The company plans to add nine states to its Obamacare participation if the deal goes through, company officials said on a call with investors. Last week, the Department of Justice sued to block Anthem’s proposed $54 billion acquisition of Cigna and also filed suit against Aetna’s planned $37 billion takeover of Humana.

. . .

Anthem Inc., the No. 2 U.S. health insurer by membership, said medical spending rose in the second quarter, driven by higher costs from the insurer’s Affordable Care Act plans and Medicaid business.

The shares dropped as much as 4.1 percent, the biggest intraday decline since April 27, and were down 0.5 percent to $136.95 at 9:55 a.m. Anthem said it spent 84.2 cents of every premium dollar on medical care, up from 82.1 cents a year earlier.

. . .

Anthem Inc. said it is now projecting losses on its Affordable Care Act plans this year, a turnaround for a major insurer that had maintained a relatively optimistic tone about that business.

Anthem said it now believed it would see a “mid-single-digit” operating margin loss on its ACA plans in 2016, due to higher-than-expected medical costs. It expects better results next year, because it is seeking substantial premium increases.

Anthem’s financial performance on ACA plans had previously been a relative bright spot among major insurers, many of which continue to struggle.

. . .

Health insurer Anthem Inc on Wednesday vowed to fight U.S. government efforts to block its planned acquisition of Cigna Corp and said it expects to lose money this year on its business selling individual health coverage under President Barack Obama’s healthcare law.

Anthem has argued that its planned $45-billion purchase of Cigna will give it greater leverage to negotiate better prices from healthcare providers and pass on those savings to consumers, including those signing up for “Obamacare” plans on public insurance exchanges.

“To be clear, our board and executive leadership team at Anthem is fully committed to challenging the (U.S. Department of Justice’s) decision in court,” Chief Executive Joseph Swedish told analysts on a conference call.

. . .

Bernie Sanders said Monday night that the Democratic party’s platform — and this election — is about universal healthcare and giving the citizenry a public option.

Other Democrats including Massachusetts Sen. Elizabeth Warren, New York Sen. Kirsten Gillibrand and First Lady Michelle Obama also touted the importance of healthcare in the election.

“I am happy to tell you that at the Democratic Platform Committee there was a significant coming together between the two campaigns and we produced, by far, the most progressive platform in the history of the Democratic Party,” Sanders said.

. . .

Bernie Sanders celebrated the health care concessions he won from Hillary Clinton Monday night as he gave a rousing endorsement to his former presidential rival.

In a Democratic convention speech that revisited the agenda of his surprisingly competitive campaign for the nomination, Sanders reminded the audience that while he may have lost the race, he did succeed in convincing Clinton to support three important proposals: a “public option” for Obamacare, letting people join Medicare early, and a big funding increase for community health centers.

. . .

In a presidential campaign that has been much more about personality than policy, here’s some news: A lot of Americans really do care about health care.

Terrorism and the personal attributes of Donald Trump and Hillary Clinton top a list of 10 issues that registered voters consider “extremely important” in a recent poll, but not far behind are gun policy, the economy and, at No. 5, health care. The Kaiser Tracking Poll found 37 percent of voters checked off this issue.

And the Trump vs. Clinton race offers voters a stark choice, starting with their views on the Affordable Care Act, also known as Obamacare. Clinton wants to improve it and make it more affordable. Trump has vowed to kill it, starting on the day he takes office.

. . .

Pence has always been a vocal opponent of the Affordable Care Act, even after the federal law passed in 2010 and was upheld by the Supreme Court.

But when faced with the choice of whether to expand Medicaid to cover Indiana residents who earn incomes that are 138 percent or below the federal poverty level — a key part of the ACA — Pence made a compromise. He debuted a conservative-friendly version of the expansion, one that requires Medicaid recipients to pay a monthly contribution, based on income, into a health savings account.

. . .

The Obama administration went to court Thursday to block two major health insurance mergers, siding with consumer advocates and medical groups worried that the consolidation of large national health plans could lead to higher premiums.

The long-anticipated move by the Justice Department and attorneys general in California and 10 other states,  will at least temporarily prevent Anthem Inc.’s $48-billion purchase of Cigna Corp., a combination that would create the nation’s largest health insurer.

And it will stop Aetna Inc.’s $34-billion bid to acquire Humana Inc., a merger that would have combined the nation’s third- and fifth-biggest health plans.

. . .

The Journal of the American Medical Assn. recently published a very unusual article: a scientific study authored by a sitting president of the United States. That’s never happened before.

In a sense, it’s cool that President Obama cares enough about science to want to publish a paper in one of the world’s leading medical journals. But JAMA has set a bad precedent. The article, on healthcare reform in the United States, is problematic not only in its content but in the threat it poses to the integrity of scientific publishing.

It would be difficult, if not impossible, to find another paper in any scientific journal in which a politician was allowed to subjectively analyze his own policy and declare it a success. This is a textbook definition of conflict of interest.

. . .