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

“Arkansas’ “Private Option” ObamaCare Medicaid expansion has been rough. Costs have run over budget every single month. 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. And the Private Option is already prioritizing coverage for able-bodied adults over care for truly needy patients like Chloe Jones. News is so bad that Governor Beebe’s office is secretly trying to silence negative press about this failed ObamaCare experiment.
Understandably, the Governor is pretty desperate for some good news. Unable to find any, it seems he decided instead to make it up. Beebe’s office sent out a self-congratulatory press release about next year’s Private Option premiums, hoping to salvage the program’s deteriorating image. But a careful review of the facts makes one thing clear: any promise of Arkansas’ ObamaCare expansion costing taxpayers less money next year is just as empty as the empty promises Beebe and other ObamaCare cheerleaders made to get the program passed in the first place.”

“The key findings from the survey, conducted from January through May 2014, include a modest increase in the average premiums for family coverage (3%). Single coverage premiums are 2% higher than in 2013, but the difference is not statistically significant. Covered workers generally face similar premium contributions and cost-sharing requirements in 2014 as they did in 2013. The percentage of firms (55%) which offer health benefits to at least some of their employees and the percentage of workers covered at those firms (62%) are statistically unchanged from 2013. The percentage of covered workers enrolled in grandfathered health plans – those plans exempt from many provisions of the Affordable Care Act (ACA) – declined to 26% of covered workers from 36% in 2013. Perhaps in response to new provisions of the ACA, the average length of the waiting period decreased for those with a waiting period and the percentage with an out-of-pocket limit increased. Although employers continue to offer coverage to spouses, dependents and domestic partners, some employers are instituting incentives to influence workers’ enrollment decisions, including nine percent of employers who attach restrictions for spouses’ eligibility if they are offered coverage at another source, or nine percent of firms who provide additional compensation if employees do not enroll in health benefits.”

“Consumers may soon find a surprise in their mailbox: a notice that their health plan is being canceled.
Last year, many consumers who thought their health plans would be canceled because they didn’t meet the standards of the health law got a reprieve. Following stinging criticism for appearing to renege on a promise that people who liked their existing plans could keep them, President Barack Obama backed off plans to require all individual and small group plans that had not been in place before the health law to meet new standards starting in 2014. The administration initially announced a transitional policy that, with state approval, would allow insurers to renew plans that didn’t comply with coverage or cost standards starting in December 2013 and continue doing so until October 2014. Then in March, the administration said it would extend the transitional policy for two more years, meaning that some people will be able to hang onto their non-compliant plans through 2017.”

“The latest Kaiser Health Tracking Poll finds that public opinion on the Affordable Care Act (ACA) remains more negative than positive, with 47 percent viewing the law unfavorably (closer to levels measured earlier this year after rising to 53 percent in July) and 35 percent having a favorable view. Partisan divisions on the law are as deep as ever, not only when it comes to overall opinion but also in the public’s perception of how the law has impacted their own families and the next steps they want Congress to take.
This poll takes a special look at registered voters’ views of the ACA and what role, if any, the law might be playing in the upcoming midterm election. The survey finds that health care is named as an important voting issue by about one in eight voters, ranking behind the economy and jobs, and clustered with several other issues such as foreign policy and national defense, dissatisfaction with government, immigration, and education. At the same time, the ACA is prominent among the issues voters report hearing about from candidates in their campaigns and advertising. And the messages they are hearing in political advertising are decidedly more anti-ACA than pro-ACA, particularly in states with competitive Senate races. This messaging in advertising may be a reflection of Republican candidates playing to their base, as the survey finds that most Republican voters want candidates to continue talking about the ACA, while most Democrats want them to focus on other issues. Two months out from Election Day, Republicans have a modest edge among the most enthusiastic voters. However, it does not appear that opposition to the ACA is a big driver of that enthusiasm, as these voters are no more likely than others to mention health care as an important factor in their vote.”

“As the image above shows, reporters and pundits–including some of the most respected ones I know–have different takes on the importance of Obamacare as an election issue now that implementation of the law is moving forward and some of the controversy around it has cooled. Observers are split: Some emphasize the law’s decline as a hot political issue, others its staying power as a rallying cry for the right, and a few suggest that the ACA may emerge as an issue Democrats want to run on.
Each of these positions may be at least partly right. Obamacare has cooled as an issue now that there isn’t an obvious controversy, such as last fall’s website debacle, to occupy the front pages. But the law, now a more conventional Republican talking point than an outsize rallying cry, is still useful to some Republican candidates as a tool to motivate their anti-Obama base. Less clear is whether many Democrats will choose to run on some of the ACA’s most popular provisions, such as its protections for people with pre-existing medical conditions. This was the consensus of an event Tuesday the Kaiser Family Foundation and the Cook Political Report held in Washington about the ACA and the midterm elections; it featured people from both organizations and journalists covering tight Senate races for the Des Moines Register and the Charlotte Observer.”

“Dan wrote up yesterday’s Washington Post/ABC News poll, which was jammed with crooked numbers for President Obama. Most striking was the (30/55) majority deeming Obama’s presidency “a failure,” along with the prevailing opinion that he’s divided the country, and his unsightly leadership score. The survey also included a dreadful (38/56) presidential approval rating on the implementation of Obamacare; support for the law itself was also underwater, with an outright majority opposed, despite this polling series’ silly question wording that omits any mention of ‘Obamacare’ or the ‘Affordable Care Act.’ A new Kaiser Family Foundation poll produces similar findings, with support for the president’s signature domestic accomplishment swamped by opposition. It’s been this way for years, across hundreds of national surveys.
One major reason for the enduring opposition is that the law has violated virtually every major promise erected in dishonest ideologues’ sales pitch. Another is that an ongoing parade of unpleasant developments continues to make headlines, including the recent revelation that Healthcare.gov was hacked last month. Apologists can cherry-pick useful data points to try to convince the public that Obamacare is reducing premium costs and driving down costs, but that’s simply not the case. Individual market premiums exploded in 2014, and are expected to grow by roughly eight percent in 2015 (with many consumers confronting double-digit spikes) — to say nothing of high out-of-pocket costs and narrow coverage networks. Overall health spending continues an upward climb. The law was billed as a dramatic premium reducer that would also bend down the so-called “cost curve.””

Dan wrote up yesterday’s Washington Post/ABC News poll, which was jammed with crooked numbers for President Obama. Most striking was the (30/55) majority deeming Obama’s presidency “a failure,” along with the prevailing opinion that he’s divided the country, and his unsightly leadership score. The survey also included a dreadful (38/56) presidential approval rating on the implementation of Obamacare; support for the law itself was also underwater, with an outright majority opposed, despite this polling series’ silly question wording that omits any mention of ‘Obamacare’ or the ‘Affordable Care Act.’ A new Kaiser Family Foundation poll produces similar findings, with support for the president’s signature domestic accomplishment swamped by opposition. It’s been this way for years, across hundreds of national surveys.
One major reason for the enduring opposition is that the law has violated virtually every major promise erected in dishonest ideologues’ sales pitch. Another is that an ongoing parade of unpleasant developments continues to make headlines, including the recent revelation that Healthcare.gov was hacked last month. Apologists can cherry-pick useful data points to try to convince the public that Obamacare is reducing premium costs and driving down costs, but that’s simply not the case. Individual market premiums exploded in 2014, and are expected to grow by roughly eight percent in 2015 (with many consumers confronting double-digit spikes) — to say nothing of high out-of-pocket costs and narrow coverage networks. Overall health spending continues an upward climb. The law was billed as a dramatic premium reducer that would also bend down the so-called “cost curve.”

“The ACA imposes several burdensome regulations that could potentially harm job and wage growth, including the employer mandate and requirements on the generosity of coverage. Under the ACA, employers with 50 or more full-time employees are required to provide health insurance for their workers or pay a fine. In addition, the ACA enforces rules that govern the type of insurance plans they can provide and restricts their options in choosing low-cost coverage. When employers are required to provide health insurance and their low-cost options are limited, costs will naturally rise and companies will be more responsive to changes in insurance premiums. As a result, employees are less insulated from insurance premium growth, and if premiums rise considerably under the ACA, then employers could be more likely to offset those costs by cutting jobs or wages.
Today, the central difficulty in analyzing the labor market implications of ACA regulations is that most significant rules have only been recently implemented. For instance, the employer mandate was scheduled for January 1, 2014, but the White House delayed the mandate to January 1, 2015, and then delayed it again to January 1, 2016 for businesses with 50 to 99 employees.”

“Obamacare is taking a toll on small businesses, according to a new analysis of the effects of the health-care reform law, which found billions of dollars in reduced pay and hundreds of thousands fewer jobs.
Take-home pay at small businesses was trimmed by some $22.6 billion annually because of the Affordable Care Act and related insurance premium hikes, researchers at the American Action Forum, a center-right think tank headed by former Congressional Budget Office director Douglas Holtz-Eakin, found in a report released Tuesday.
Individual year-round employees at businesses with 50 to 99 workers lost $935 annually, while those at firms with 20 to 49 workers are out an average of $827.50 per person in take-home pay, the report found.”

“The federal government will wait until January to roll out its five-star rating system meant to help consumers compare quality at dialysis centers across the country.
Use of the system on the CMS’ dialysis centers compare website had been scheduled for October, but was met with angst by dialysis providers who questioned the methodology and said the program was likely to be more confusing than helpful.
In response, the federal agency announced Wednesday that it has moved the date by about three months.
The CMS began using the rating program on nursing homes in December 2008 and earlier this year applied a similar rubric to physician groups. In July, the agency announced plans to extend the program to dialysis facilities starting Oct. 9.”