The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers
“Rob Weiner is at it again over at Balkinization. This time alleging he’s found some smoking gun to prove that the Halbig litigation is “anti-democratic” and rests on a flawed legal theory. As with his posts on the D.C. Circuit’s en banc procedures, Weiner’s diatribe is long on bluster, but short on meaningful claims. And, as before, he says some things that are false, irrelevant, or both.
Weiner starts with the supposed discovery of a video that shows the theory underlying Halbig was illegitimate from the start. The video is of a December 2010 conference at the American Enterprise Institute at which Vanderbilt law professor James Blumstein and health law attorney Tom Christina discussed pending and potential legal challenges to the PPACA. It was this presentation – though the slides posted on the AEI website, not the video as Weiner claims – that first alerted me to the fact Section 1401 of the PPACA only authorizes tax credits in health insurance exchanges “established by the State,” and not in federal exchanges. It was also where Michael Greve urged listeners to find a way to upend the PPACA. This, in Weiner’s telling, shows the unholy origins of the Halbig litigation.”
“Last Monday, Jed Graham of Investor’s Business Daily reported that insurers say Affordable Care Act enrollment is shrinking, and it is expected to shrink further. Some of those who signed up for insurance on the exchanges never paid; others paid, then stopped paying. Insurers are undoubtedly picking up some new customers who lost jobs or had another “qualifying life event” since open enrollment closed. But on net, they expect enrollment to shrink from their March numbers by a substantial amount — as much as 30 percent at Aetna Inc., for example.
How much does this matter? As Charles Gaba notes, this was not unexpected: Back in January, industry expert Bob Laszewski predicted an attrition rate of 10 to 20 percent, which seems roughly in line with what IBD is reporting. However, Gaba seems to imply that this makes the IBD report old news, barely worth talking about, and I think that’s wrong, for multiple reasons.”
“The American Hospital Association’s expenditures increased by 7% in 2013, to $117 million, spurred in part by efforts to convince states to expand Medicaid, according to the organization’s most recent tax return.
The group spent $3.3 million on grants to state hospital associations last year to assist with efforts to convince states that they should expand Medicaid to households with incomes up to 138% of the federal poverty level.
Under the Patient Protection and Affordable Care Act, the federal government will pick up 100% of the tab for the first three years of Medicaid expansion and 90% of the cost thereafter.”
“Republicans seeking to unseat the U.S. Senate incumbent in North Carolina have cut in half the portion of their top issue ads citing Obamacare, a sign that the party’s favorite attack against Democrats is losing its punch.
The shift — also taking place in competitive states such as Arkansas and Louisiana — shows Republicans are easing off their strategy of criticizing Democrats over the Affordable Care Act now that many Americans are benefiting from the law and the measure is unlikely to be repealed.
“The Republican Party is realizing you can’t really hang your hat on it,” said Andrew Taylor, a political science professor at North Carolina State University. “It just isn’t the kind of issue it was.”
The party had been counting on anti-Obamacare sentiment to spur Republican turnout in its quest for a U.S. Senate majority, just as the issue did when the party took the House in 2010. This election is the first since the law was fully implemented.
“Patient advocacy groups say health insurers are violating ObamaCare by discriminating against those with chronic diseases, and the groups are forcing the administration to respond.
A Health and Human Services spokesperson cited by The Associated Press says a response is nearly prepped for advocacy organizations fighting AIDS, leukemia, epilepsy and other diseases.
Groups such as the National Health Law Program and the AIDS Institute have filed complaints with the administration claiming insurers are in violation of the Affordable Care Act’s provisions that prevent them from discriminating against people with pre-existing conditions and chronic diseases.
They argue certain drugs are put on higher tiers, requiring patients with chronic diseases to pay bigger out-of-pocket costs. In some cases, they say, the co-pay for such drugs can be 30 percent or higher.
America’s Health Insurance Plans (AHIP), the largest health insurance lobby group, countered the claim by arguing that patients have the option to select a range of health plans that may suit their budgets better.”
“The White House has rejected a request to publicly disclose documents relating to the kinds of security software and computer systems behind the federal health care exchange website on the grounds that the information could “potentially” be used by hackers.
The Centers for Medicare and Medicaid Services denied a Freedom of Information Act request made late last year by the Associated Press amid concerns that Republicans raised about the security of the website, which had technical glitches that prevented millions of people from signing up for insurance under ObamaCare.
In denying access to the documents, including what’s known as a site security plan, Medicare told the AP that disclosing them could violate health-privacy laws because it might give hackers enough information to break into the service.
“We concluded that releasing this information would potentially cause an unwarranted risk to consumers’ private information,” CMS spokesman Aaron Albright said in a statement.
The AP is asking the government to reconsider. Obama instructed federal agencies in 2009 to not keep information confidential “merely because public officials might be embarrassed by disclosure, because errors and failures might be revealed, or because of speculative or abstract fears.” Yet the government, in its denial of the AP request, speculates that disclosing the records could possibly, but not assuredly or even probably, give hackers the keys they need to intrude.”
“The number of Connecticut residents covered by health insurance purchased through the state’s individual market rose by nearly 60,000 since last year, a 55 percent increase since the implementation of major provisions of Obamacare, according to figures released by the Connecticut Insurance Department.
The data also show that more than half the people who bought their own health insurance last year have maintained their old policies or other plans purchased late in 2013. But more than 50,000 of them won’t be able to keep their health plans beyond this year, potentially setting up a repeat of last fall’s turmoil and frustration among people whose policies were discontinued.”
“Obamacare challengers in the Halbig case have asked the D.C. Circuit Court of Appeals not to review a three-judge panel’s ruling against federal exchange subsidies, instead calling for “final resolution by the Supreme Court.”
The backstory: one month ago a divided three-judge panel prohibited Obamacare subsidies for residents buying from the federal exchange. The Obama administration asked the full D.C. Circuit bench to rehear the case, which is reserved for matters of exceptional importance.
The challengers don’t want that, because if they lose at the D.C. Circuit it would make the Supreme Court less likely to take the case.
“There is no doubt that this case is of great national importance. Not due to the legal principles at stake—this is a straightforward statutory construction case under well-established principles—but rather due to its policy implications for ongoing implementation of the Affordable Care Act (‘ACA’). Those implications, however, are precisely why rehearing would not be appropriate here, as Judges of this Court have recognized in many analogous cases,” the plaintiffs wrote in the brief filed Monday.
The Obama administration has an advantage in an en banc — or full bench — ruling: it would feature eight Democratic-appointed judges and five Republican-appointed judges. Now that the 4th Circuit Court of Appeals has ruled in favor of the federal subsidies, the only way the challengers can win is at the Supreme Court. The plaintiffs at the 4th Circuit have already asked the justices to take the case, which the Halbig plaintiffs pointed out.”
“The deadly Ebola outbreak spreading through Africa is so extreme, it is driving health officials to do something that they would instinctively resist in normal circumstances: Subject patients to unproven experimental drugs.
The drugs are risky. Some have not even been tested on humans. Even so, a World Health Organization ethics committee just declared such use ethical, and its reasoning is hard to dispute, at least for patients who would otherwise die. Some chance is better than none, even with unknown side effects.
Too bad American patients suffering from terminal illnesses have so much trouble getting the same chance.
The process for getting experimental drugs is so daunting that fewer than 1,000 people sought and got federal approval to take such drugs last year.
Food and Drug Administration rules require patients to clear a series of hurdles. First, they and their doctors must find a company to provide its drug. Many drug makers — worried that a patient’s death will spur a lawsuit or harm their chances for final FDA approval — refuse.”