The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers
“Before dawn on a Wednesday in January, Cesar Flores, a 40-year-old employed by a large retail chain, woke up at his home in Chula Vista, California. He got in his car and crossed the border into Tijuana. From there, he headed for a local hospital, where he got lab tests—part of routine follow-up to a kidney stone procedure. He had his blood drawn and left the hospital at 7:30. He arrived home before 10.
Uninsured Americans have long known that seeking medical care abroad is often more cost-effective than seeking it at home. Even after you factor in travel expense and time off work, you still often come out ahead. A hip replacement that would cost $75,000 for an uninsured patient in the U.S. is $9,000 in India. A heart bypass in the U.S. runs about $210,000; in Thailand it’s $12,000. According to Patients Beyond Borders, a company that facilitates medical tourism, those savings drove about 900,000 Americans to leave the country for medical procedures last year—a number they estimate is growing by 15 percent per year.
But Flores’s situation isn’t medical tourism as we know it. Flores has insurance through his wife’s employer. But his insurer, a small, three-year-old startup H.M.O. called MediExcel, requires Flores to obtain certain medical treatment at a hospital across the border. In part due to cost-pressures generated by the Affordable Care Act, other sorts of plans that require travel have the potential to expand.”
“When the District launched its federally mandated health insurance exchange last fall, officials went to great lengths to woo professional insurance brokers — launching a special broker web portal, establishing a “concierge” hotline just for brokers and holding broker-only training classes.
Despite those efforts, many brokers have yet to be paid for the policies they’ve sold through the exchange, known as D.C. Health Link — generating frustration among professionals who say their patience in navigating the changes wrought by the Affordable Care Act has not been rewarded.
“I’ve been very supportive, I put a lot of work into it, and I’ve gotten nothing,” said Steve Nearman, a Virginia-based broker who says he has helped nearly 100 city residents find and buy insurance through the exchange and is owed thousands of dollars in commissions.”
“ObamaCare hurts businesses. That’s the result of an exhaustive study polling small to medium-sized businesses.
The controversial government health-care reform increases company and employee costs and sometimes stops companies from hiring as well, participants told the International Foundation of Employee Benefit Plans in its new study.
“More than half of single employers believe the Affordable Care Act has had a negative effect on their company,” according to the report.
The survey, which polled some employers and their health-care pros, found that the majority of respondents, 54 percent, thought the effect of the ACA on their firms had been “negative” or “very negative.”
The same respondents also expected that the negative effects from ACA would increase to 66 percent in the near future as the program unfolds.”
“Supporters of ObamaCare are nervously awaiting a decision by the D.C. Court of Appeals that could have even more dramatic consequences for the law’s ability to function than the Supreme Court’s religious liberty decisions issued last week.
Judge Thomas B. Griffith presided in March over arguments in one of the four cases – Halbig v. Burwell – challenging the Obama administration’s decision that subsidies for health insurance can flow through federal as well as state exchanges.
The Affordable Care Act says that health insurance subsidies are available only “through an exchange Established by the State.” The IRS, however, interpreted the statute to mean that the subsidies also could be distributed in the now 36 states where the federal government is operating exchanges.
During oral arguments, Judge A. Raymond Randolph indicated he felt the statute was quite clear in repeating “seven times” in that section that the subsidies are available only if the state sets up its own exchange.”
“President Obama’s healthcare law could be dealt a severe blow this week if a U.S. appeals court rules that some low- and middle-income residents no longer qualify to receive promised government subsidies to pay for their health insurance.
The case revolves around a legal glitch in the wording of the Affordable Care Act, which as written says that such subsidies may be paid only if the insurance is purchased through an “exchange established by the state.”
That would seem to leave out the 36 states in which the exchanges are operated by the federal government.
A ruling could come as early as Tuesday.
The administration has argued that Congress intended to offer the subsidies nationwide to low-and middle-income people who bought insurance through an exchange, without making a distinction.”
“Planned Parenthood unveiled a text helpline Monday for women who have lost or will lose contraception coverage in their healthcare plans after last week’s Supreme Court Hobby Lobby ruling.
The pro-abortion rights group says women who have lost birth control coverage or have questions about their healthcare can text the helpline to learn about their options.
The Supreme Court ruled last week some employers could deny workers access to free contraception coverage under their health insurance plans if it would infringe on the employer’s religious beliefs.
The group says women can text “birth control” to 69866 to report an employer’s refusal to pay for coverage. Those who use the text service get an email or phone follow-up from Planned Parenthood explaining what options the worker has and help on how to get free birth control.”
“Senate Majority Leader Harry Reid said Monday that Democrats will take up legislation in the “coming weeks” to address last month’s Supreme Court decision that allowed some employers with religious objections to opt out of Obamacare’s contraception mandate.
Democrats on Capitol Hill have overwhelmingly criticized the high court’s ruling in the Hobby Lobby case and are working to craft a response that would restore the coverage, though no specifics have yet been outlined.”
“Several indicators suggest that the political waters may be calming for the Affordable Care Act (ACA). This doesn’t guarantee that the law will achieve its goals and be judged a success. It means that the law stands a better chance of being implemented free of constant political turmoil–and will have a better shot at success.
*Public support for the ACA fell after the Web site debacle last fall, but while overall opinion toward the law continues to tilt negative, the falloff in the polls has stopped, according to the June Kaiser Family Foundation Health Tracking poll.
*After the administration rapidly repaired the Web site, the ACA exceeded the widely cited 7 million target for the first open-enrollment season, which had become a political litmus test for the law. And with no similarly big controversy, the ACA has become a far less juicy, and less prominent, media story.
*Some Republicans seem to be shifting their midterm strategy to focus less on the ACA and more on other issues they have with the president and the direction of the country.
*More people say that they are getting their information on the law from personal experience and from the experiences of family and friends, and fewer say that they are getting it from the news media, which they also say focuses mostly on politics and not what the law means for them. Increasingly, public perception of the law is about people’s experiences–whether good or bad–rather than ideology and partisan politics.”
“The Supreme Court’s ruling this week that “closely-held” companies like Hobby Lobby aren’t obligated to comply with the health law’s contraception mandate because it conflicts with their religious beliefs has put a renewed focus on the employer-sponsored healthcare.
Consumers getting their healthcare through their employers is a deeply ingrained practice in the United States (although that trend has been diminishing in recent years), and the court ruling has sparked all kinds of arguments pertaining to that the arrangement. Some have concluded that it will lead workers to seek alternatives outside the workplace, which they can find on the federal health exchanges created under Obamacare.
However, a new poll from Morning Consult found that the public isn’t there yet.
In fact, a strong majority of workers are worried that their employers will stop offering health insurance altogether and move them into the Obamacare exchanges. Workers with employer-sponsored health plans largely have a negative view of what such a move would mean for their coverage, and would even consider looking for a new job under that scenario, the poll found.”
“WASHINGTON — More than half of privately insured women are getting free birth control under President Barack Obama’s health law, a major coverage shift that’s likely to advance.
This week the Supreme Court allowed some employers with religious scruples to opt out, but most companies appear to be going in the opposite direction.
Recent data from the IMS Institute document a sharp change during 2013. The share of privately insured women who got their birth control pills without a copayment jumped to 56 percent, from 14 percent in 2012. The law’s requirement that most health plans cover birth control as prevention, at no additional cost to women, took full effect in 2013.”