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

“SEATTLE — As Washington’s health care exchange prepares for its second open enrollment period, officials were still trying to resolve billing and computer problems involving about 1,300 accounts from the previous round of sign-ups.
Exchange officials began with about 24,000 problem accounts that were detected as people started to use their insurance earlier this year.”

“A majority of the state’s voters support extending current health insurance programs to all low-income Californians, including undocumented immigrants, according to a new statewide poll released today.
The poll was commissioned by The California Endowment, a foundation that has been actively working to expand health insurance access to all people, regardless of immigration status. The Affordable Care Act expressly bars undocumented immigrants from receiving any of its benefits, including subsidies to purchase health insurance. (Note: The California Endowment funds some of KHN’s coverage.)”

“Meal, drink, tip … insurance?
Some Los Angeles restaurants are adding a 3 percent surcharge to diners’ tabs in order to cover employees’ health insurance.
The owners of the restaurants deny that the additional charge is a “political statement” about the Affordable Care Act, saying it’s merely a way to provide for their employees.
“We want our staff to have health care,” Josh Loeb, a co-owner of the restaurant Milo & Olive told the Los Angeles Times. “It’s not because we support Obama or don’t support Obama, or are Democrats or are not Democrats.””

“This time last year there seemed to be a new catastrophe or scandal every day related to the roll-out of the Affordable Care Act, a.k.a. ObamaCare: many predicted the federal website would never be up and running by the looming deadline, the cost kept escalating, private contractors publically blamed bumbling bureaucrats and vice versa. Meanwhile, individuals who attempted to sign up ran into technical problems, and there were horror stories about people being told they would be dropped by their current insurance provider despite the fact the president had assured them this would not happen. Confusion was everywhere. Ultimately, key players got fired or resigned in disgrace.
So, where do we stand today, one year later?
That’s what the non-profit Transamerica Center for Health Studies (TCHS) wanted to know.”

“At the heart of Halbig v. Burwell[1] and the series of cases that are following it through the federal court system is an attempt to understand what state and federal legislators were thinking last year, two years ago, even four years ago when the Affordable Care Act (ACA) passed. While many experts and lawyers in this case have hypothesized about Congress’ intent, contrary to the claims of the Government, at least one establishing and one non-establishing state understood the language of the statute to condition subsidies on state establishment of Exchanges when they made their determination on whether to establish an Exchange. Furthermore, this understanding was timely in the chronology of ACA implementation.”

“Last week, Americans for the first time could look up their doctor to see what payments, if any, they received from pharmaceutical and medical device companies. And Morning Consult polling shows patients will make decisions based off that information: The majority of registered voters say they would be less likely to choose a certain physician if they took money from a drug or medical device company. It’s this mindset that has physicians, pharmaceutical and medical device companies worried.
The database, which was established in the Affordable Care Act, went public Tuesday afternoon. It allows users to see how much money doctors were paid by drug and medical device companies between August and December 2013. There were 4.4 million payments made totaling $3.5 billion, according to the Centers for Medicare and Medicaid Services (CMS). Payments were made to 546,000 physicians and nearly 1,360 teaching hospitals. CMS directly acknowledges the database does not differentiate between payments that could be interpreted as a positive, like a physician doing clinical research, or negative, like money for a trip to promote a certain drug or device.”

“Medicare is fining a record number of hospitals because they readmitted too many patients within 30 days for more treatment, according to federal records released this week.
During the next year, 2,610 hospitals will see their reimbursement levels reduced and 39 hospitals will be hit with the largest penalty allowed, according to Kaiser Health News.
The federal government’s penalties are designed to make hospitals pay more attention to their patients after they are discharged.”

“Proposition 45 offers a simple choice for voters: Do they want the state insurance commissioner to regulate health care rates for small businesses and individual health plans?
The campaign fight over whether that would be beneficial for consumers is much more complicated.
Initiative proponents, led by Democratic Insurance Commissioner Dave Jones and Consumer Watchdog, a Santa Monica-based consumer group with backing from attorneys, say the initiative would add transparency to the rate-setting process.”

“As soon as Air Force One touched down in Indiana on Friday, Gov. Mike Pence met President Barack Obama on the tarmac with a plea: Expand the state’s access to government-sponsored health insurance.
The catch: Pence wants to do it with a conservative twist.
At least, that’s how he’s selling his proposal. And his political future could hinge on whether the first-term Republican can convince conservatives that he’s not just rebranding Obamacare.
Pence has spent much of his first two years in office trying to strike a bargain on one of the health care law’s core components. Indiana will expand Medicaid coverage, Pence says, but only if it’s allowed to do it through a tweaked version called the “Healthy Indiana Plan,” which also requires users to make small payments into health savings accounts.”

“The Supreme Court on Monday returns to work to face a rich and varied docket, including cases on First Amendment rights in the digital age, religious freedom behind bars and the status of Jerusalem.
Those cases are colorful and consequential, but there are much bigger ones on the horizon.
“I’m more excited about the next 12 months at the Supreme Court than about any Supreme Court term in its modern history,” said Thomas C. Goldstein, who argues frequently before the court and is the publisher of Scotusblog.
In the coming weeks, the justices will most likely agree to decide whether there is a constitutional right to same-sex marriage, a question they ducked in 2013. They will also soon consider whether to hear a fresh and potent challenge to the Affordable Care Act, which barely survived its last encounter with the court in 2012.”