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

“Two Planned Parenthood chapters, two United Way organizations, a food bank association and a Catholic hospital system are among 90 nonprofit groups that will receive a total of $60 million to help people sign up for health insurance, the Department of Health and Human Services announced today.
The money will help people in 34 states that rely on the federal government fully or in part for their Affordable Care Act insurance exchanges, where individuals can buy Obamacare policies. States with their own exchanges have separate funding to help consumers get assistance.”

“Heading into the 2014 mid-term congressional elections, health care is not shaping up as a make-or-break issue, according to a new poll.
Health care trails jobs and the economy as a top issue on voters’ minds this fall, 21 percent to 13 percent. Only 3 percent of voters in the monthly tracking poll by the Kaiser Family Foundation mentioned the health law by any name (Affordable Care Act/Obamacare) when asked about issues most likely to determine their vote. (Kaiser Health News is an editorially independent program of the foundation).
Health care is even less important to independent voters, those who frequently decide close races. While Democrats and Republicans both chose health care as their second ranked issues with 15 and 16 percent respectively, independents rank of health care tied for fifth with 9 percent.
The issue is, however, nonetheless playing a role in the current campaigns, particularly in key swing states where control of the U.S. Senate is at stake. Republicans need to capture a net gain of six seats to gain a majority in that chamber.”

“The Affordable Care Act attempts to help low- and middle-income families avoid some of the tough sacrifices that would be necessary to purchase health insurance without assistance. But no program can change the fundamental reality that society itself has to make sacrifices in order to deliver health care to more people. Workers and therefore production have to be taken away from other industries to beef up health care, or the workforce itself has to get bigger, or somehow people have to work more productively. Although the ACA helps specific populations by giving them a bigger slice of the economic pie, the law diminishes the pie itself. It reduces the amount that Americans work, and it makes their work less productive. This slows growth in both personal income and gross domestic product.”

“Allowing young adults to stay on their parents’ health plans is one of the most popular elements of the president’s health-care law, but a pair of new studies out today raises questions about the overall impact of the coverage expansion to an estimated 3 million people.
The provision, which allows young adults to stay on their parents’ health insurance plans until their 26th birthday, was one of the earliest parts of the law to take effect, in 2010, and researchers are now starting to report on the effects of that expansion. As expected, it increased the rate of health insurance among young adults, who historically had the highest uninsured rates of any age group. But the provision didn’t change whether the age group perceived themselves as healthier or whether they thought health care was any more affordable, according to a new study in JAMA Pediatrics.”

“Republican operatives believe they have found a smoking gun against Democratic U.S. Sen. Mark Udall, who said during a 2008 debate he was against a “government-sponsored” solution for health care.
The then-congressman, who was running for an open seat in the U.S. Senate, echoed arguments made by conservatives.
“I’m not for a government-sponsored solution,” Udall said. “I’m for enhancing and improving the employer-based system that we have.”
In a debate overshadowed by other issues — rising energy prices and the war on terror — Udall’s answer that July barely created a ripple. But in the context of Sen. Udall’s vote for the Affordable Care Act in 2010 and his tough re-election bid against Republican Congressman Cory Gardner in November, the statement takes on new meaning.”

“Americans living in rural areas will be a key target as states and nonprofit groups strategize how to enroll more people in health law insurance plans this fall.
Though millions of people signed up for private insurance or Medicaid in the first year of the Affordable Care Act, millions of others did not. Many live in rural areas where people “face more barriers,” said Laurie Martin, a RAND Corp. senior policy researcher. Brock Slabach, a senior vice president at the National Rural Health Association, said “the feds are particularly concerned about this.”
Distance is one problem: Residents have to travel farther to get face-to-face assistance from the so-called navigators and assisters hired to help consumers figure out the process. And Internet access is sometimes spotty, discouraging online enrollment.
But the most significant barriers may stem directly from state decisions about whether to expand Medicaid eligibility — more than 20 states chose not to — and whether to operate their own health exchanges. States that embraced those parts of the law generally had more federal resources as well as funds generated by their online marketplaces for outreach efforts to boost enrollment, including those aimed at consumers in less accessible areas, and more coverage options, through Medicaid, for which these consumers might be eligible.”

“Congress is returning to Washington with just two months left before ObamaCare’s second enrollment period.
For most of the lawmakers’ August recess, news on the Affordable Care Act and other healthcare debates was fairly quiet.
But that ended for Republicans with the Sept. 4 announcement that a hacker had breached part of HealthCare.gov in July.
Though the exchange was not specifically targeted and no personal data was stolen, the GOP sees an opening to hammer the administration over the site’s security.
House Oversight Committee Chairman Darrell Issa (R-Calif.) has already called Marilyn Tavenner, Centers for Medicare and Medicaid Services administrator, to testify on the matter later this month.
The topic is also likely to dominate Republican remarks at a hearing Wednesday on the Affordable Care Act’s implementation, hosted by the Ways and Means Subcommittee on Health.
The House Republican Conference also plans to zing the healthcare law in at least one set of votes this week.
Majority Leader Kevin McCarthy (R-Calif.) said the chamber will consider a measure to allow insurers to continue offering certain small-group health plans that might not comply with ObamaCare’s rules.
The legislation is a Republican response to President Obama’s much-criticized remark that people could keep their plans under the reform.”

Rep. Bill Cassidy (R-La.), the measure’s sponsor, is challenging Sen. Mary Landrieu (D-La.) in November; the issue will undoubtedly play a role in that campaign.”

“Large businesses expect to pay between 4 and 5 percent more for health-care benefits for their employees in 2015 after making adjustments to their plans, according to employer surveys conducted this summer.
Few employers plan to stop providing benefits with the advent of federal health insurance mandates, as some once feared, but a third say they are considering cutting or reducing subsidies for employee family members, and the data suggest that employees are paying more each year in out-of-pocket health care expenses.
The figures come from separate electronic surveys given to thousands of mid- to large-size firms across the country by Towers Watson, the National Business Group on Health and PriceWaterhouseCoopers, consulting groups that engage with businesses on health insurance issues.
Bracing themselves for an excise tax on high-cost plans coming in 2018 under the Affordable Care Act, 81 percent of employers surveyed by Towers Watson said they plan to moderately or significantly alter health-care benefits to reduce their costs.”

“RICHMOND, Va. — Virginia Gov. Terry McAuliffe is set to unveil his plan to increase health care coverage for the state’s poor.
The Democratic governor will speak publicly Monday on his plans for health care expansion.
The governor unsuccessfully tried to persuade Republican lawmakers to expand Medicaid during this year’s legislative session. The impasse led to a protracted stalemate over the state budget that ended with a GOP victory.”

“When Congress returns this week, action in both chambers will mostly be a show for the voters back home ahead of the midterm election. In the House, that will include a vote on a bill to allow insurance companies to continue offering any plan that was sold in the group market in 2013.
Noticeably absent from congressional politicking in the next few weeks is the Affordable Care Act’s risk corridor program, which was, as recently as a few months ago, a major Republican criticism of the law. But that doesn’t mean the “insurer bailout” fight is dead. Republicans in both chambers are quietly working to challenge the legality and projected cost of the program. And that could tee up the issue to become a bargaining chip in the budget fights to come at the end of this year, regardless of who wins the Senate.
The Affordable Care Act’s risk corridor program runs from 2014 through 2016, and was established to encourage insurers to take a chance on covering an unknown population — the Americans who would be purchasing insurance on state and federal exchanges. The program collects funds from qualified health plans that bring in more money than they paid for medical claims, and then pays that money to plans with claims that cost more than they brought it from consumers.
But what happens if there isn’t enough money from well-performing insurers to pay all of the insurers that missed the mark? The federal government is on the hook, but where they find the money to pay those insurers is a question being debated throughout Washington. That’s because the law did not give the federal government a clear appropriation to spend money to make up for losses. And Republicans are, of course, very unlikely to give them one.”