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

“Having access to health insurance is slowing the rate of young adults who head to the emergency department for care, a new study suggests. Relative use of the ED decreased among 19- to-25-year-olds after the healthcare reform law allowed them to stay on their parents’ policies. The authors say the results show insurance can reduce ED overuse by removing the economic barriers to preventive care.
“It’s possible that when people have healthcare insurance they are less worried about the financial costs of care,” said Tina Hernandez-Boussard, assistant professor of surgery and biomedical informatics at Stanford University and lead author of a study published Monday in the journal Health Affairs. “They might seek appropriate care elsewhere and take care of conditions earlier. This could lead to a reduction in utilization of the emergency department.””

“RICHMOND — Gov. Terry McAuliffe (D), who vowed in June to defy the Republican-controlled legislature and expand healthcare to 400,000 uninsured Virginians, unveiled a much more modest plan Monday after being thwarted by federal rules and a last-minute change to state budget language.
McAuliffe outlined measures to provide health insurance to as many as 25,000 Virginians, just a fraction of those he had hoped to cover by expanding Medicaid under the Affordable Care Act.
The biggest change, covering 20,000 people with severe mental illness, will need funding approval from the General Assembly to continue past the current fiscal year. McAuliffe also offered proposals to improve care for people already in Medicaid and boost outreach efforts to those who qualify but are not enrolled.”

“New Health and Human Services Secretary Sylvia Mathews Burwell tried to hit the reset button on perceptions of the health-care rollout in her first public speech since taking the job at the embattled department overseeing it.
“What I’ve told my team at HHS is that we’re not here to fight last year’s battles, we’re here to fight for affordability, access and quality,” said Ms. Burwell to an audience of George Washington University students and faculty on Monday. “Let’s move beyond the back and forth, let’s move forward together.”
Ms. Burwell is stepping into the spotlight after around 100 days on the job and as the agency tries to reorient itself in time for the new enrollment season when millions more Americans are supposed to come to HealthCare.gov to buy coverage in just a few weeks.
She has brought on board several new faces since taking over as secretary from Kathleen Sebelius. They include the head of Connecticut’s health insurance exchange Kevin Counihan to serve as CEO for the site, former clean-up contractor Andy Slavitt as an operations administrator at the Centers for Medicare and Medicaid Services, and her former Walmart colleague Leslie Dach as her senior counselor.”

“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.”