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

“Developments in the last ten days make it more likely that the entire U.S. Court of Appeals for the D.C. Circuit will agree to hear the leading challenge of the Pacific Legal Foundation (PLF) to the Obamacare individual-mandate penalty — and whoever does not prevail at this level will have a compelling case to take to the Supreme Court. An order from the D.C. Circuit last week, instructing the Obama administration to respond to PLF’s petition for rehearing, and an impressive set of amicus briefs supporting PLF’s petition filed yesterday confirm that this is no ordinary litigation.
Readers will recall that Chief Justice John Roberts joined four justices in 2012 to hold that the individual mandate was not authorized by the Commerce Clause or other congressional power, but he sided with four other justices in holding that the penalty for not buying insurance could be read as a tax, pursuant to Congress’s taxing power. No judge below had accepted the tax theory, so the debate over the tax issue in the Supreme Court briefs was truly brief. The Court was careful to write that Congress still had to comply with all constitutional requirements for the exercise of its taxing power, so the initial Obamacare ruling did not purport to end litigation that raised that and other issues.”

“I will be covering Medicaid Health Plans of America’s annual conference in Washington, DC from October 26 to 28. So, I thought I’d prepare for it by reviewing the research on health outcomes for patients on Medicaid. What a tangled web!
According to evidence cited by Forbes opinion editor and Manhattan Institute Senior Fellow Avik Roy, “patients on Medicaid have the worst health outcomes of any insurance program in America – far worse that those with private insurance and, strikingly, no better than those with no insurance at all. “ On March 10, 2011, the Wall Street Journal published a column by Forbes contributor and American Enterprise Institute Resident Fellow Scott Gottlieb, MD, which concluded that “Medicaid coverage is worse than no coverage at all.””

“Since the Affordable Care Act was passed in 2010, 28,476 pages of notices, proposed rules, and finalized rules containing the phrase, “Affordable Care Act” have been written in the Federal Register. This includes 843 notices, 222 proposed rules, and 234 final rules.
Then-Speaker of the House Nancy Pelosi had it right when she famously said, “we have to pass the bill so that you can find out what is in it.”
And unfortunately, there is still more to come.”

“With just one month to go until the start of Obamacare’s second open enrollment period, state and federal officials are being cautiously optimistic about their health exchange websites—assuring the public that there won’t be a repeat of last year’s technological nightmare.Speaking to health reporters last week, Health and Human Services Secretary Sylvia Burwell touted the newly revamped Healthcare.gov as a vast improvement over last year’s website—which was plagued with technical glitches.Related: Millions Wasted on Broken Obamacare State WebsitesBut when asked about how some of state exchanges that had trouble last year are shaping up, Burwell hesitated and said HHS is monitoring them on a state-by-state basis.”

“Insurance consultants were shocked recently to learn that Obama administration rules allow large companies to offer 2015 worker health plans that don’t include hospital benefits. Now the administration is concerned too.
Treasury Department officials are preparing to reverse course on an official calculator that permits plans without hospital coverage to pass the health law’s strictest standard for large employers, said industry lawyers who have spoken to them. These sources expect the administration to disallow such coverage by the end of the year.”

“The producer of a new movie that criticizes Obamacare has reportedly become the latest prominent conservative slapped with an IRS audit.
Logan Clements, producer of “Sick and Sicker: ObamaCare Canadian Style,” announced via press release Tuesday that he is being audited for the first time ever.”

“There are dozens of ways to escape Obamacare’s individual mandate tax — but good luck figuring that out come tax season.
Tens of millions of Americans can avoid the fee if they qualify for exemptions like hardship or living in poverty, but the convoluted process has some experts worried individuals will be tripped up by lost paperwork, the need to verify information with multiple sources and long delays that extend beyond tax season.
“It’s not going to be pretty,” said George Brandes, vice president of health care programs at Jackson Hewitt, a tax prep firm. “Just because you theoretically qualify for hardship, or another exemption, doesn’t mean you’re going to get it.””

“It’s been more than four, long painful years since the Affordable Care Act became law.
When it passed, many believed small-business owners and their employees would suffer under its weight. That’s why my organization, the National Federation of Independent Business, tried to stop it by suing the federal government.
Since the Supreme Court’s disappointing decision in 2012 to uphold Obamacare, the results for small business continue to be alarmingly bad or disastrous.”

“WASHINGTON, D.C. — Although more provisions of the Affordable Care Act have taken effect over the past year, more Americans still say the law has hurt rather than helped them. Compared with early 2014, fewer Americans say it has had no effect, although this group is still in the majority, at 54%.
Americans overall are both more positive and more negative about the law’s effect on themselves and their families. Since the start of this year, the percentage saying the law has helped them has increased from 10% to 16%, while the percentage saying it has hurt them has also gone up, and by a similar amount, from 19% to 27%.”

“President Obama said healthcare costs are rising for Indiana steel workers because employers are not “shopping” correctly for insurance plans during an event at Millennium Steel Service in Princeton, Ind., on Friday.
“We are seeing almost a double-digit increase in health-care costs every year,” General Manager Mihir Paranjape said. “Do you think that trend is going to go down, and what can we do to control that trend?”
“That’s really interesting, you’re gonna have to talk to Henry,” Obama said, referring to the company’s CEO, Henry Jackson. “The question is whether you guys are shopping effectively enough.”
Obama said healthcare premiums were rising at the slowest rate in 50 years and that the higher-ups at Millennium Steel were simply not aware of the options they have in the healthcare market to ensure they are getting the best deal.”