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

“This week’s double-barreled release of government statistics on health insurance coverage leaves us with only one question: How many Americans are insured because of Obamacare? Remarkably, the two highly regarded government surveys released this week do not even agree whether the number of uninsured increased or decreased. The survey that received a great deal of attention said there were 3.8 million fewer uninsured. The other, which was hardly noticed, found that there were 1.3 million more uninsured.
The Centers for Disease Control (CDC) reported preliminary results on the expansion of health insurance coverage. Its National Health Interview Survey (NHIS) interviewed 27,000 people in the first three months of this year. The survey estimates that the number of uninsured dropped by 3.8 million since 2013. That represents a 1.3 percentage point decline in the uninsured rate, from 14.4 percent last year to 13.1 percent early this year.”

“Voters continue to give lackluster reviews to the U.S. health care system despite positive opinions of their own insurance coverage and care. Half still think the system will get worse under the new health care law.
A new Rasmussen Reports national telephone survey finds that only 32% of Likely U.S. Voters rate the nation’s health care system as good or excellent. Just as many (32%) give it poor marks, up from 29% in August but still below the 35% who felt that way in June.”

“States have developed various ways to avoid paying their fair share of Medicaid expenses over the years, in some cases costing the federal government hundreds of millions of dollars in extra funding for the program.
The Department of Health and Human Services, which runs Medicaid through its Centers for Medicare and Medicaid Services (CMS), has known about the issue for more than a decade, but states still find ways to game the system. The agency’s inspector general this year listed the issue among 25 key problems the agency needs to address.”

“Employer groups are ramping up their efforts to revise the ACA’s 30-hour full-time employee definition in hopes of getting it changed before the employer mandate kicks in for some large employers next year. The initiative, titled “More Time for Full-Time,” was announced Friday (Sept. 19) and is the latest tactic by employers to change the standard so that it defines a full-time employee as one who works 40 hours per week.
Groups involved in the initiative include the National Restaurant Association, the National Retail Federation, the U.S. Chamber of Commerce, the National Grocers Association and the International Franchise Association.
“As all Americans have known for decades, 40 hours represents the widely-accepted definition of a full-time work week. Unless there is a statutory change to the definition of a full-time employee in the ACA, there will be fewer full-time jobs, more part-time workers and fewer overall hours available for Americans to work,” International Franchise Association President and CEO Steve Caldeira said in a statement.”

“A major innovation in health insurance plan design over the past several years has been the rapid growth of “narrow network” plans. Such plans either limit enrollee choices of providers, or place providers in differential cost tiers whereby individuals face higher cost in selecting some providers relative to others. This movement harkens back to the restrictions put in place during the U.S. initial infatuation with managed care in the mid-1990s. That episode ended badly for the limited choice model, as the “HMO backlash” induced regulatory restrictions on plans which handicapped choice limitations within the HMO model.
The latest growth of narrow network plans has been hastened by the introduction of health insurance exchanges under the Affordable Care Act (ACA). State exchanges have fostered strong insurer competition through both organizing the marketplace and through tying low income health insurance tax credits to the second-lowest cost plan in the silver tier. Insurers have responded to these competitive incentives in many ways, but perhaps the most notable is the expansion of narrow network insurance products. Such products are widespread on exchanges and appear to be growing rapidly.”

“House Republicans on Friday replaced the firm handling their lawsuit against President Obama after the lawyer representing them pulled out over what was said to be political backlash among his colleagues at the firm, Baker Hostetler.
The lawyer, David B. Rivkin Jr., had taken the case on behalf of House Republicans in August, right after they voted to sue the president, accusing him of overstepping the powers of the presidency. Two people with knowledge of the situation said Mr. Rivkin withdrew from the case under pressure after facing criticism that he had taken on an overly partisan lawsuit. Some members of the firm feared the case against Mr. Obama could drive off potential clients and hurt Baker Hostetler’s credibility, according to one of the people with knowledge of the case. Both people said they were prohibited from publicly discussing such a delicate case.”

“Republicans have found a new opening against ObamaCare after struggling for months to craft a fresh strategy against a healthcare law that now covers millions of people.
Lifted by a pair of federal audits that found major flaws with the law’s implementation, Republicans see their first chance in months to launch a serious attack against the law.
“The news that we’ve seen over the last week and a half really emphasizes what conservatives and Republicans were trying to do last year, which was preventing a lot of this from happening,” said Dan Holler, a spokesman for the conservative political group Heritage Action for America.
“What I hope happens is that the Republican Party as a whole says, ‘Yes, there is a reason besides politics that we’re fighting ObamaCare: It’s hurting people,’” Holler said.”

“Republicans have found a new opening against ObamaCare after struggling for months to craft a fresh strategy against a healthcare law that now covers millions of people.
Lifted by a pair of federal audits that found major flaws with the law’s implementation, Republicans see their first chance in months to launch a serious attack against the law.
“The news that we’ve seen over the last week and a half really emphasizes what conservatives and Republicans were trying to do last year, which was preventing a lot of this from happening,” said Dan Holler, a spokesman for the conservative political group Heritage Action for America.
“What I hope happens is that the Republican Party as a whole says, ‘Yes, there is a reason besides politics that we’re fighting ObamaCare: It’s hurting people,’” Holler said.”

“Costs to buy coverage through Connecticut’s health insurance exchange won’t, on average, rise much next year. For some plans, the prices are dropping.
But some customers who get financial aid to buy their insurance could see price increases beyond the rise in sticker price if they stick with their current plans, according to an analysis by consultants for the exchange, Access Health CT.
As a result, some people might find lower prices by considering different plans, even if they bought the cheapest plan available this year, according to the analysis by Wakely Consulting Group.”

“The federal health insurance website is trying to resolve glitches and security questions raised by the Government Accountability Office, so people can safely and successfully sign up for insurance at open enrollment Nov. 15.
Much of the Obama administration’s success in enrolling 8.1 million people in health insurance over the past year was overshadowed by the momentous problems with HealthCare.gov and several state exchanges. As administration officials prepare to test the site with insurers Oct. 7, they’re trying to manage expectations while portraying some confidence.
Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner told a House panel Thursday that there will be “visible improvement, but not perfection” on HealthCare.gov.”: