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

Eight of the states that will determine the Senate majority in November are likely to see significant reductions in the number of insurers participating in ObamaCare marketplaces.

The likely departures of insurers in Illinois, Wisconsin, Florida, Pennsylvania, Ohio, North Carolina, Arizona and Missouri are pushing the healthcare law toward the center of some of the most competitive Senate races in the country.

GOP strategists say Obama-Care’s troubles this year are morphing into a perfect storm for their candidates, providing a boost in a year when the party is defending 24 Senate seats.

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Just over 50 percent of Americans disapprove of the Affordable Care Act, according to a Gallup poll released Thursday.

Among people surveyed in the poll, 51 percent said they disapproved of the law, while 44 percent said they approved of it. It’s a slight increase in disapproval of the law since the spring, when a Gallup poll found 49 percent of people disapproved of the law and 47 percent of people approved of it. Overall, Gallup polls have found people have been more pessimistic than optimistic about the law for the past three years.

 

Significant spikes in premiums, insurer dropouts and persistently low enrollment numbers are combining to make this fall’s sign-up period a crossroads for the Obama administration’s signature health law. Federal officials characterize the turbulence as temporary. At the same time, the administration is making a push in its final months to shore up the law by trying to sign up healthy people who are critical to the law’s sustainability but have so far rejected insurance. That push will take place against a backdrop of elections that will shape the law’s future.

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President Obama and his Democratic allies are seizing on the exodus of private insurers from ObamaCare markets to renew their push for a so-called “public option” — but Republicans say more “government intervention” is not the answer to the latest Affordable Care Act woes.

A public option — or insurance plan offered by the government — had been written into early versions of the bill but failed to make the final cut in the law signed by Obama in March 2010.

But with many states seeing private insurers exit ObamaCare markets amid concerns over cost and other factors, Democrats see a silver lining to what critics are calling another ObamaCare crisis — a reason to bring the option back.

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In its quest to remake the nation’s health care system, the Obama administration has urged doctors and hospitals to band together to improve care and cut costs, using a model devised by researchers at Dartmouth College.

But Dartmouth itself, facing mounting financial losses in the federal program, has dropped out, raising questions about the future of the new entities known as accountable care organizations, created under the Affordable Care Act.

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The best measurement of people who lack health insurance, the National Health Interview Survey published by the Centers for Disease Control and Prevention (CDC), has released early estimates of health insurance for all fifty states and the District of Columbia in the first quarter of 2016. There are three things to note.

First: 70.2 percent of residents, age 18 to through 64, had “private health insurance” (at the time of the interview) in the first quarter of this year, which is which is the same rate as persisted until 2006. Obamacare has not achieved a breakthrough in coverage. It has just restored us to where we were a decade ago. Further, the contribution of Obamacare’s exchanges to this is almost trivial, covering only four million people.

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Steve Banke employs 40 people at 3-Points, a small IT outsourcing company he founded almost 15 years ago. And he wants those workers and their families to have strong health insurance options.

Employees at the firm, based in Oak Brook, Ill., can choose between two types of Blue Cross and Blue Shield of Illinois plans: a PPO with a broader network of hospitals and doctors or a cheaper HMO network. Banke’s company covers a percentage of the premiums, and those costs have risen rapidly over the past several years, often more than 12% annually, he said.

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Average premium increases above 25%, roughly one-third of U.S. counties projected to lack any competition in the Affordable Care Act (ACA) exchanges next year, and enrollment less than half of initial expectations provide strong evidence that the law’s exchange program is failing. Moreover, the failure is occurring despite massive government subsidies, including nearly $15 billion of unlawful payments, for participating insurers. As bad news pours in and with a potentially very rough 2017 open enrollment period ahead, the Obama administration signaled on Friday that it may defy Congress and bail out insurers through the risk corridor program. Congress should take all steps at its disposal to prevent the administration from doing so.

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Senate Republicans have returned from a seven-week recess with a unified message they plan to repeat until November: Obamacare is imploding.

News of double-digit premium increases in 2017, insurers pulling out of the marketplace, failing co-ops, and low enrollment numbers have handed an opportunity to Senate Republicans who worried about losing the majority in the fall. They get to say, “I told you so,” after a six years of Obamacare messaging, and they get to tell voters that a GOP majority will fix these issues.

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Conservatives should acknowledge that the coverage expansion is real, it is large (though not as large as we were led to expect), and that while it is not necessarily going to make people much healthier, it is probably going to reduce financial hardship among at least some of the people who have gained coverage. That’s significant, though we can still argue about whether the benefit was worth the cost. (If Obamacare were being voted on today, I would still oppose it).

Liberals, however, should also acknowledge uncomfortable facts. The first is that most of the decrease in the uninsured population came in 2014 and 2015, and is now leveling off. Unless younger and healthier people start buying insurance in much larger numbers, we’re probably not going to see huge improvement. The fact that so few young, healthy people are buying insurance may not only mean that the number of uninsured people stops going down. It could mean that that figure starts going up again.

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