The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers
“Obamacare—or at least the version of it that the president and his advisers currently think they can get away with putting into place—has been upending arrangements and reshuffling the deck in the health system since the beginning of the year. That’s when the new insurance rules, subsidies, and optional state Medicaid expansions went into effect. The law’s defenders say the changes that have been set in motion are irreversible, in large part because several million people are now covered by insurance plans sold through the exchanges, and a few million more are enrolled in Medicaid as a result of Obamacare. President Obama has stated repeatedly that these developments should effectively shut the door on further debate over the matter.
Of course, the president does not get to decide when public debates begin or end, and the public seems to be in no mood to declare the Obamacare case closed. Polling has consistently shown that more Americans oppose the law than support it, and that the opposition is far more intense than the support. The law is built on a foundation of dramatically expanded government power over the nation’s health system, which strikes many voters as a dangerous step toward more bureaucracy, less choice, higher costs, and lower quality care. The beginning of the law’s implementation does not appear to have eased these fears, and in some cases has exacerbated them.”
“The uninsured rate for kids under age 18 hasn’t budged under the health law, according to a new study, even though they’re subject to the law’s requirement to have insurance just as their parents and older siblings are. Many of those children are likely eligible for coverage under Medicaid or the Children’s Health Insurance Program.
The Urban Institute’s health reform monitoring survey analyzed data on approximately 2,500 children, comparing the uninsured rate in June 2014 with the previous year, before the health insurance marketplaces opened and the individual mandate took effect. It found that rates remained statistically unchanged at just over 7 percent for both time periods.”
“Since the Affordable Care Act’s (ACA) passage, a number of lawsuits have been filed challenging various provisions of the law. The Supreme Court has decided cases about the constitutionality of the ACA’s individual mandate and Medicaid expansion as well as the applicability of the contraceptive coverage requirement to closely held for-profit corporations with religious objections. In addition, several cases challenging the availability of premium subsidies in the Federally-Facilitated Marketplace (FFM) are currently progressing through the federal courts. All of this litigation has altered, or has the potential to alter, the way in which the ACA is implemented and consequently could affect the achievement of the law’s policy goals. This issue brief examines the federal courts’ role to date in interpreting and affecting implementation of the ACA, with a focus on the provisions that seek to expand access to affordable coverage.
Court decisions about how to interpret the ACA will continue to affect the number of people who ultimately obtain affordable coverage. At present, access to Medicaid up to 138% FPL is dependent upon where people live because the Supreme Court held that implementation of the ACA’s Medicaid expansion is effectively a state option. This has resulted in a coverage gap for just over 4.5 million people with incomes too high to qualify for Medicaid but too low to qualify for Marketplace subsidies in the states that have not implemented the ACA’s Medicaid expansion to date.”
“Congress’ investigative arm said Tuesday (Sept. 16) that healthcare.gov continues to face security weaknesses, leaving the site subject to “increased and unnecessary” risk of unauthorized access, disclosure or modification of the information collected and maintained. CMS pledged to implement some of the fixes proposed by the Government Accountability Office, but GOP lawmakers used the opportunity to again blast the administration’s handling of Obamacare.
GAO recommended six ways CMS could put in place an effective information security program, and another 22 technical recommendations that could improve the effectiveness of information security controls.”
“Vermont Gov. Peter Shumlin (D) said Tuesday (Sept. 16) that the state has shut down its exchange website as it scrambles to finish operational and other improvements by Nov. 15, but the state expects the site to be “restored to full, improved operation before the start of open enrollment.”
The state made the decision to shut down the site after consulting with CMS, Shumlin said in a statement. The state also announced a number of management changes that will remove oversight of the exchange from the Department of Vermont Health Access and install Lawrence Miller, a senior advisor to the governor, as the person responsible for operational leadership of Vermont Health Connect. The Department of Vermont Health Access oversees the state’s Medicaid program.
“As all Vermonters know, we’ve had disappointment after disappointment with the Vermont Health Connect website,” Shumlin said. “I have been very frustrated that the website remains incomplete. Bringing down the site now to make improvements with our new partner Optum is the best choice to deliver a well-functioning, secure website for customers by the open enrollment period that begins Nov. 15.””
“Morning Consult’s healthcare poll finds that while a majority of voters (54%) are concerned about security breaches in the health exchange websites, 52% currently believe that the information on the exchange websites is secure. Further, a plurality of voters would choose to sign up for health insurance online over a paper application or over the phone.
This poll was conducted from September 12-13, 2014, among a national sample of 2,188 registered voters. The margin of error is plus or minus 2.1 percentage points. You can see the full results here (http://bit.ly/1BMkPRm).
A majority of voters (54%) are concerned about security breaches in the health exchange websites— Interestingly, a majority of both voters who approve of President Obama and those who disapprove of the President indicate they are concerned about security breaches in the exchange websites.”
“Federal health officials said Monday that more than 100,000 immigrants who bought health-care plans through the federal insurance exchange will have their coverage cut off at the end of the month, because they failed to provide proof by the Sept. 5 deadline that their citizenship or immigration status makes them eligible for insurance on the marketplace.
Those individuals can still send in the needed information to the federal exchange and if they are found eligible, they will be able to regain coverage, officials said. They will be considered under a special category reserved for people who have experienced a major life change, such as having a baby or getting divorced or losing a job with health insurance.”
“At a hearing to discuss the rising costs of healthcare benefits for Miami-Dade County, Fla., employees this year, a labor union consultant raised his hand to ask what seemed like a basic question.
Could the committee charged with reducing Miami-Dade labor’s healthcare expenses look at the spreadsheet showing the rates that the county pays local hospitals and doctors for medical services to employees?
“We really need to understand where the money is being spent in order to be insightful about benefit design changes,’’ said Duane Fitch, a healthcare consultant for SEIU Local 1991, which represents physicians and nurses at the county-owned Jackson Health System.”
“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.”
“Despite the success of the Affordable Care Act in Kentucky, state Democrats are having a hard time winning over even those Republicans who admit they are benefiting from the law.
The Affordable Care Act allowed Robin Evans, an eBay warehouse packer earning $9 an hour, to sign up for Medicaid this year. She is being treated for high blood pressure and Graves’ disease, an autoimmune disorder, after years of going uninsured and rarely seeing doctors.
“I’m tickled to death with it,” Ms. Evans, 49, said of her new coverage as she walked around the Kentucky State Fair recently with her daughter, who also qualified for Medicaid under the law. “It’s helped me out a bunch.”
But Ms. Evans scowled at the mention of President Obama — “Nobody don’t care for nobody no more, and I think he’s got a lot to do with that,” she explained — and said she would vote this fall for Senator Mitch McConnell, the Kentucky Republican and minority leader, who is fond of saying the health care law should be “pulled out root and branch.””