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

Bernie Sanders formalized the Democratic Party’s left turn on Tuesday, finally endorsing Hillary Clinton and praising her for embracing so many of his ideas. “We have begun a political revolution to transform America, and that revolution continues,” the Vermont socialist said—and the latest evidence for his boast is the revival of ObamaCare’s “public option.”

This liberal ambition—a new health-care entitlement akin to Medicare for all middle-class Americans under age 65—couldn’t pass a Democratic Congress in 2010. Mrs. Clinton revived the public option over the weekend, and now President Obama is also lending his support, in an op-ed that appears under his byline in this week’s Journal of the American Medical Association.

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The Republican assertion that the administration is spending on health insurance subsidies without required congressional authority hasn’t gotten much news coverage. Many people dismiss it as yet another time-wasting attempt by Republicans to undermine the president’s signature domestic policy achievement.

But the central issue goes beyond health care to the fundamental division of federal power, particularly in a time of deep fissures between the legislative and executive branches.

Congress is supposed to approve every penny of federal spending. But the institution is in such partisan disarray that the appropriations process barely functions, giving rise to the temptation for presidents to assert greater power over the purse, marginalizing Congress.

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Hillary Clinton reaffirmed her support on Saturday for creating a “public option” within Obamacare and allowing people to enroll in Medicare at age 55.

The presumptive Democratic presidential nominee also called for a substantial increase in funding in medical clinics that serve low-income Americans, fully embracing a proposal from Sen. Bernie Sanders (I-Vt.).

While Clinton has long supported the creation of new government-run insurance options and reiterated that support several times this year, Saturday’s statement comes three days before she is scheduled to make her first joint campaign appearance with Sanders ― who has championed government-run insurance and federally financed clinics throughout his career and during his own bid for the presidency.

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In 2013, one Affordable Care Act component taking effect — a medical device excise tax — imposed a new financial burden on American Laboratory Products Co.

The 2.3 percent tax on revenue took a bite out of the company’s bottom line, “no question about it,” said Sean Conley, president of the family-owned-and-operated Alpco. “This obviously has an impact on where our funds go and makes it a bit more challenging to continue to create new jobs.”

The controversial medical device tax was a focus of conversation Friday when U.S. Sen. Kelly Ayotte visited the company for a discussion and tour.

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As Hillary Clinton prepares to take another big step toward supporting liberal calls for universal health care coverage, a new study concludes that Donald Trump’s proposals for replacing Obamacare would strip nearly 18 million mostly low-income Americans of their current coverage.

The study by the non-partisan Center for Health and Economy provides the first detailed analysis of the presumptive GOP nominee’s scattershot proposals on health care. They include removing barriers to the sale of health insurance across state lines, expanding the use of health savings accounts to mitigate the cost of high-deductible insurance policies and allowing households to deduct premiums from their taxable income.

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The release of the House GOP health-care plan last month was a milestone event in the long-running debate over the future of health care in the United States. Republican leaders had been promising to repeal and replace the Affordable Care Act — a.k.a. Obamacare — since it was enacted in 2010. But this is the first time that GOP leaders in Congress have presented a plan that could accurately be described as “the Republican alternative.” If the GOP is in a position in Congress to take up health-care legislation in 2017 (or later), this plan will almost certainly be the starting point.

House Speaker Paul Ryan deserves the credit for making this happen. He announced last fall after taking over the speakership that he wanted the GOP to offer a proactive agenda in order to give voters a clear idea of what Republicans would do if given the opportunity to govern. He followed through on that promise by getting his House colleagues to support plans for top-to-bottom reform of most key responsibilities of the federal government.

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Obamacare enrollment has a smoking problem.

A new study from the Yale School of Public Health finds that an anti-smoking provision in the health law is discouraging people from signing up for insurance while simultaneously failing to get them to kick the habit.

Under the Affordable Care Act, individual health insurance plans sold on statewide marketplaces can only set how high their premiums are based on three factors: a customer’s geographic region, age, and smoking status. This is meant to let health insurers adjust their prices for how much medical care an enrollee may wind up using.

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It’s policymaking 101: When a policy delivers benefits to people, support for the policy grows. Political scientists call situations like these “policy feedback loops,” and they are a big part of the story of how Social Security and Medicare became so entrenched in American life. But what happens if hyper-partisanship stops the loop? Consider the Affordable Care Act (ACA). Over the past four years, some 20 million people have gained health coverage and the already-insured have received new protections. But public opinion of the ACA has remained mixed.

The numbers are stark. Monthly tracking polls show that 49 percent hold unfavorable views of the ACA versus just 38 percent holding favorable views.

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Employees contribute far below the maximum amount allowed to an individual-coverage or family-coverage health savings account (HSA), a sign consumers aren’t taking full advantage of the account’s tax benefits, according to a new analysis of consumer records.

Managing health costs, particularly for consumers in or approaching retirement, is considered a growth area for insurance agents and advisors doing comprehensive financial planning. HSAs are primed to play a key role.

More than 20 million Americans have access to health plans with HSAs, according to the trade association America’s Health Insurance Plans (AHIP). Congress recently passed bipartisan legislation expanding the use and contribution limits for HSAs.

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During the first year of Obamacare’s implementation, the individual insurance market became less healthy while the uninsured and Medicaid populations became healthier, according to a new analysis.

A Health Affairs data analysis released Wednesday underscores the often stated observation that the Affordable Care Act has brought sicker, more expensive enrollees into the individual marketplace while healthier people have tended to resist enrollment.

The analysis uses information in the National Health Interview Survey, conducted by the National Center for Health Statistics. It was conducted by officials from the Agency for Healthcare Research and Quality, the Congressional Budget Office, and Social and Scientific Systems.

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