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

“Missouri health insurance consumers can get a first look at rates for 2015 coverage on HealthCare.gov, but they may be in for a bit of sticker shock.
St. Louis-area customers will have almost twice as many options to consider once open enrollment begins Saturday. Four insurers are selling a total of 42 different plans, a substantial increase from last year when only two carriers combined to sell 25 plans.”

“With the Affordable Care Act to start enrollment for its second year on Nov. 15, some unpleasant surprises may be in store for some.
That’s because a number of low-priced Obamacare plans will raise their rates in 2015, making those options less affordable. On top of that, penalties for failing to secure a health-insurance plan will rise steeply next year, which could take a big bite out of some families’ pocketbooks.
“The penalty is meant to incentivize people to get coverage,” said senior analyst Laura Adams of InsuranceQuotes.com. “This year, I think a lot of people are going to be in for a shock.””

“The Supreme Court on Friday agreed to hear a case on a subject that’s important to millions of people who receive subsidies to help purchase coverage under the health-care law. Friday’s decision follows earlier action in July when two U.S. appeals courts issued conflicting rulings on the issue. KHN’s Mary Agnes Carey answers some frequently asked questions about those court decisions and how they impact consumers.”

“With the second open enrollment period of the health insurance marketplaces approaching, this analysis provides an initial look at premium changes for marketplace plans for individuals in 15 states and the District of Columbia that have publicly released comprehensive data on rates or rate filings for all insurers.
The analysis examines premium changes for the lowest-cost bronze plan and the two lowest-cost silver plans in 16 major cities. The second-lowest cost silver plan in each state is of particular interest as it acts as a benchmark that helps determine how much assistance eligible individuals can receive in the form of federal tax credits. The findings show that in general, individuals will pay slightly less to enroll in the second-lowest cost plan in 2015 than they did in 2014, prior to the application of tax credits.”

“Since the outcome of Tuesday’s elections became clear, a lot has been said, and threatened, about repeal of the Affordable Care Act.
Republican control of the next Congress is likely to bring ACA challenges in two flavors. There will be early “statement legislation” to repeal the law and possibly to repeal the ACA’s individual mandate, a linchpin of the law that spreads risk and makes its insurance market changes work. These bills, intended to honor election promises to the Republican base, would be vetoed by President Barack Obama if they pass.”

“MIT economist Jonathan Gruber is one of the foremost architects of Obamacare, having bragged that he “knows more about this law” than anyone else in his field. He’s also emerged as an unintentional one-man wrecking ball against Obamacare, making public statements that have undermined the Obama administration’s legal and political defenses of the president’s signature domestic legacy. Over the summer, a three-judge panel on the DC Circuit Court of Appeals dealt a substantial blow to the law, ruling that the legislative text means what is says on a critical subject. As written and signed into law, Obamacare specifies that only consumers who live in states (a term that is explicitly defined) that set up their own “exchange” marketplace are eligible to receive taxpayer-funded subsidies to offset high costs.”

“Lillian Saldana turned down Obamacare coverage once, and she might do it again..
With sign-ups set to resume Saturday, the 23-year-old Covina resident and her younger sister are hesitant to enroll because their parents are immigrants who are not citizens and therefore ineligible for benefits under the Affordable Care Act.
Saldana, an after-school tutor, admits she could put the insurance to good use for a checkup, but she worries about putting her parents at risk or creating a rift at home.
“We’ve always done things together as a family,” she said.”

“Big Republican election gains in Congress will position the GOP to aggressively challenge Obamacare in 2015. Now the questions are how sweeping Republican efforts will be to roll back the law, and whether the party will pursue its longstanding goal of restructuring Medicare and Medicaid. Everyone will be watching where President Barack Obama draws the line with his veto pen.
Repealing the Patient Protection and Affordable Care Act was a key campaign issue propelling Republicans to gain control of the Senate and their largest majority in the House since the Great Depression. Sen. Mitch McConnell (R-Ky.), who is expected to be the new Senate majority leader, has vowed to dismantle Obamacare “root and branch.””

“Within days of the Republican Party regaining control of the Senate, a host of policy issues has quickly risen to the top of Washington’s priorities list: trade, corporate tax reform, the Keystone pipeline. And then there’s the medical device tax.
The tax, passed as part of the Affordable Care Act, plays a marginal role in the health-care overhaul, but the push to repeal it has attracted millions of dollars of lobbying, as well as high-profile supporters on the Hill, from Sen. Elizabeth Warren (D-Mass.) to Sen. Orrin Hatch (R-Utah).”

“Beginning on November 15, a new period of open enrollment for the Affordable Care Act will begin, putting the notorious federal insurance exchange portal, Healthcare.gov, to a new test. Outwardly, officials insist that the many issues that the website experienced in late 2013 and early 2014 are only a memory. The Washington Post’s reporting indicates, however, that administration officials may be less confident in the Obamacare website than they appear.
“[F]ederal health officials and government contractors are scrambling, according to confidential documents and federal and outside experts familiar with this work,” The Post reported on Monday. “They have been making contingency plans in case the information technology or other aspects prove less sturdy than the administration predicts. And some preparations are coming down to the wire.”