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

“Deep down, Republicans who know health care know the truth: Obamacare isn’t about to be repealed.
But you won’t hear that in this election — and maybe not in 2016, either.
Republicans may be split on many issues, but they remain fiercely united in their loathing for the Affordable Care Act; they still see it as a terrible law, and they want it to go away. But GOP staffers and health care wonks also know that, even if they win the Senate, they’re not going to accomplish that in the next two years while President Barack Obama is still in office.
And after that? Well, think of the last time a major social program was repealed after three enrollment seasons, with millions of people getting benefits. That’s right — it hasn’t happened.”

“With the second Obamacare open-enrollment beginning on November 15th, the enrollment system’s testing begins with insurance companies this week.
Of course, last year the enrollment system testing was a real mess resulting in a humiliating Obamacare launch for the administration.
Up until now I wasn’t expecting any major problems with HealthCare.gov’s consumer enrollment system given all of the lessons learned and the new people running things.
But apparently, the administration is pretty worried about what could happen.”

“As we have written before, Arkansas’ “Private Option” ObamaCare Medicaid expansion has been a disaster for taxpayers, patients and politicians alike. Costs have run over budget every single month since the program’s launch. The Medicaid director who spearheaded the program abruptly resigned to “pursue other opportunities.” The program’s chief legislative architect, a three-term Republican state representative, lost his primary for an open Senate seat to a political newcomer, despite a significant fundraising advantage. And it’s a disaster for patients as well: the ObamaCare expansion plan is already prioritizing coverage for able-bodied adults over care for truly needy patients like Chloe Jones.”

“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.””

“The Obama administration has already debuted its new, improved version of HealthCare.gov, but still won’t release premium rates on the website until after the Nov. 4 elections.
The Department of Health and Human Services unveiled the updated federal Obamacare exchange on Wednesday. The website is, by all accounts, in much better condition than last year.
HHS secretary Sylvia Burwell has said that the administration has put the new version of HealthCare.gov through its paces. And the administration has allowed insurers to test the site out themselves — although they made clear that insurance companies are not allowed to share their results with the media.”

“Faced with the rising costs of generic prescription drugs, health insurers increasingly are turning to tiers and preferred lists on their formularies to keep costs down. Those strategies previously were used only for brand-name and specialty drugs. Experts say those approaches will increase out-of-pocket costs for patients and could make them less likely to adhere to drug regimens.
For years, insurers have encouraged patients to choose generic drugs because they were less expensive than their brand-name counterparts, and most prescription drugs currently used are generics.
But over the past year the cost of generic drugs has skyrocketed, including for products that have been on the market for many years. A study by Pembroke Consulting comparing CMS data for average generic drug acquisition costs between July 2013 and July 2014 found that half of the generic drugs listed rose in cost, with the median increase nearly 12%. Some drug prices saw extreme increases. For instance, the per-unit price for a 500 mg capsule of tetracycline, a common antibiotic, increased from $0.05 cents to $8.59, a more than 17,000 % increase.”

“Health Reform: Wal-Mart says it’s cutting health benefits to part-timers and boosting worker premiums. If a retail empire built on low prices can’t find a way around ObamaCare’s added costs, we are all doomed.
The world’s biggest retailer announced this week that its health costs will be about 48% higher for the current fiscal year than it had expected in February. As a result, it’s cutting 30,000 part-timers from its health benefit plan, raising worker-paid premiums by 19% and trimming its co-payment for health costs above the deductible.
“We had to make some tough decisions,” benefits director Sally Wellborn told the Associated Press. But to hear President Obama tell it, Wal-Mart just didn’t shop around.
That, at least, was what he said when the general manager of the Indiana-based Millennium Steel asked Obama last week about the company’s double-digit premium hikes.
Obama’s response: “The question is whether you guys are shopping effectively enough.””

“If the Congressional Budget Office is close to the mark, in the second open-enrollment season we will see about a doubling of the 7 million people enrolled in the Affordable Care Act insurance marketplaces. Open enrollment, which begins Nov. 15, is three months this year, or half as long as last year, and the remaining eligible uninsured are a more difficult-to-reach population. Here are the biggest challenges this time around:
First, the overwhelming reason the remaining uninsured cite as to why they have not already gotten coverage is that they believe they could not afford it. The message that most needs to reach the uninsured is that there are tax credits available to help make coverage more affordable. For a 30-year-old making $25,000 per year, the ACA tax credit would reduce the average cost of the most commonly selected “silver plan” from $2,877 per year to $1,729. Eighty-five percent of those who got coverage in the new insurance exchanges qualified for credits this year, but in our Kaiser Family Foundation survey of the uninsured in California, 73% of those eligible for assistance did not know they could get help.”

“There are obvious benefits to getting health insurance at work. For one, employer-sponsored insurance is not taxed, meaning that every dollar of compensation provided as medical coverage stretches further. Individual market plans, meanwhile, are purchased with post-tax dollars. The only way to get in on the tax exemption is to buy coverage at work.
But for low-wage workers, Obamacare  has introduced a new and big drawback to the employer insurance. Namely, anybody who gets access to affordable coverage at work is barred from getting subsidies through the new exchanges. This is even true for people who don’t buy insurance at work; just the act of getting offered employer coverage blocks individuals from using getting financial help.”

“Some health insurers are having trouble finding doctors and hospitals to accept low rates under Gov. Tom Corbett’s Medicaid expansion plan, leading one company to quit the program and another to reduce participation.
Highmark Inc., the state’s largest health insurer, said it won’t participate in Corbett’s Healthy PA program because it couldn’t sign enough doctors to its network. Healthy PA is an alternative to Medicaid expansion under the Affordable Care Act, proposed by Corbett and approved by the federal government in August, in which private insurers provide coverage to Medicaid recipients.”