The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers
“After the worst transition to Obamacare in the country, Massachusetts is still without a functional exchange website and just 769 people have enrolled in Obamacare-subsidized plans.
To avoid accountability and political repercussions, Massachusetts Gov. Deval Patrick is about to cut two special deals with the federal government: the “Commonwealth Kickback” which grants Massachusetts the most generous taxpayer-funded premium subsidies in the entire country, while the “Bay State Bailout” gives 300,000+ MA residents “temporary” Medicaid coverage in 2014, without any verification of their eligibility.
These deals are reminiscent of the controversial ACA-related “Cornhusker Kickback” and “Louisiana Purchase,” but they also can be added to the growing list of special deals cut for Massachusetts as the state struggles to transition to the ACA.”
“As President Barack Obama’s administration gears up for its second open enrollment period next month, the president’s health care overhaul is now facing two new threats. Either piece of news, on its own, should warrant concern from the law’s most ardent supporters for the program’s long-term prospects.
The first threat is a group of legal challenges to the law that are making their way through the courts. At issue is what the plain text of Section 1401 of the Affordable Care Act means. Even though the text of the law states that the subsidies are available “through an Exchange established by the State under 1311 of the Patient Protection and Affordable Care Act,” the Internal Revenue Service (IRS), without congressional authorization, allowed federal subsidies to flow into states participating in the federal exchange when it implemented the law.”
“Americans are angry about the manifest failure of Obamacare. Many have felt the impact directly, from the millions who lost their health plans after being promised they could keep them, to those facing sky-high deductibles and premiums, to those — including some in the midst of cancer treatments — who are losing access to their family doctors.
But at the same time, Americans want insurance that is secure and covers treatments they need. They want the uninsured and those with preexisting conditions to have access to coverage, and they know costs are rising dramatically. They know a safety net is needed for those who lose coverage, particularly those undergoing treatments for serious diseases.”
“ObamaCare rate increases are coming to some key battleground states, fueling Republican attacks ahead of next month’s midterm elections.
“It looks like we’re going to have double-digit premium increases in places like Alaska, and Iowa and Louisiana,” said health economist John Goodman. “Where we’ve got very close races for Senate, and Republican candidates are making a big deal over this.””
“Almost immediately after the state’s insurance regulator earlier this month announced that rates for plans sold through MNsure would rise 4.5 percent on average, Republicans, health policy experts and other critics decried the figure as bogus and misleading.
The state Commerce Department has steadfastly defended the figure — a straight average of rate changes reported by the four returning carriers to MNsure — acknowledging that some consumers will see higher or lower rate changes. State agency officials said consumers can shop around once open enrollment begins Nov. 15 “to find the best option that fits their individual health and financial needs.”
But other states, like California, Colorado and Washington, report their increases in premiums for their respective exchange plans as weighted averages.
Calculated that way, Minnesota’s figure for next year is not 4.5 percent, but 11.8 percent.”
“It’s been a tough week for North Carolina Senator Kay Hagan, who’s clinging to a razor-thin lead in her re-election fight. She chose not to attend a ‘debate’ this week, ceding an hour of statewide airtime to her surging Republican opponent, Thom Tillis. Her chair sat empty throughout the forum. What didn’t she want to discuss? Perhaps it was her decision to skip a key classified briefing on ISIS in favor of a New York City fundraiser. Or maybe it was the explosion of reports that her immediate family benefited directly from the “stimulus” law she voted for. It could have been President Obama’s endorsement of candidates like Hagan as strong supporters of his agenda in Washington; the extent of Hagan’s fealty was underscored again in yesterday’s CQ analysis of 2014 voting records:”
“Remember this categorical assurance from President Obama?
“We’ll lower premiums by up to $2,500 for a typical family per year. . . . We’ll do it by the end of my first term as president of the United States”
OK, it’s probably a little unfair to take some June 2008 campaign “puffery” literally–even though it was reiterated by candidate Obama’s economic policy advisor, Jason Furman in a sit-down with a New York Times reporter: “‘We think we could get to $2,500 in savings by the end of the first term, or be very close to it.” Moreover, President Obama subsequently doubled-down on his promise in July 2012, assuring small business owners “your premiums will go down.” Fortunately, the Washington Post fact-checker, Glenn Kessler, honestly awarded the 2012 claim Three Pinocchios (“Significant factual error and/or obvious contradictions”).”
“For the most part, the political debate over President Barack Obama’s health-care overhaul has become a duel between vague slogans: Republicans say they want to “replace” the Affordable Care Act but generally don’t say with what. Democrats say they want to “fix” it but usually don’t say how.
So Democratic Senators Mark Warner and Mark Begich deserve credit for advancing specific legislation to change the law. The main change they’re advocating, though, is unlikely to make people any happier with the law — and could cause new problems.”
“We now have the Medicaid and private-market health insurance enrollment data for the second quarter of 2014 needed to complete the picture of how Obamacare’s rollout affected coverage.
What we’ve learned is that the Obamacare gains in coverage were largely a result of the Medicaid expansion and that most of the gain in private coverage through the government exchanges was offset by a decline in employer-based coverage. In other words, it is likely that most of the people who got coverage through the exchanges were already insured.”
“During the long congressional debate over the Affordable Care Act (ACA) — i.e., Obamacare — one thing was certain: The Congressional Budget Office (CBO) would ultimately certify that the final legislation would lower future budget deficits.
It had to be that way. President Obama had made an unequivocal promise in a nationally televised address to Congress: He would not sign a bill that added “one dime” to projected federal deficits. The only way to make good on that promise was to have in hand a CBO cost estimate showing modest deficit reduction from the law’s provisions. CBO delivered what the president was looking for with its final cost estimate of the legislation in March 2010.”