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

ObamaCare needs to be replaced with a plan that provides Americans with affordable coverage and reliable access to doctors. Fortunately, many Republicans — including the bulk of the GOP field running for president — agree on the core ideas behind a replacement plan.

Sally C. Pipes of the Pacific Research Institute lists some of those ideas, including replacing income-based subsidies on the individual market for refundable tax credits and reforming the Medicaid program.

Are New Yorkers looking at a health insurance tax to pay for the more than $200 million in unpaid doctor and hospital bills remaining after the collapse of the state’s consumer-run nonprofit insurance co-op? Or could that money come from the billions in bank settlements that have flowed to state coffers in recent years?

Those are among the questions that lawmakers and Gov. Andrew Cuomo will likely be debating in the upcoming legislative session. Also unclear is the future status of the approximately 215,000 New Yorkers who had low-cost health insurance policies through the short-lived Health Republic co-op.

According to the Department of Health and Human Services, half the uninsured who are eligible for subsidized coverage through the exchanges have refused to purchase it. As a result, those remaining in the insurance pool have tended to be sicker and older — and they’ve used more health services than insurers expected.

How much more? According to the consulting firm McKinsey & Co., insurers collectively swallowed $2.5 billion in unexpected medical expenses from exchange enrollees in 2014.

The health insurance industry will be watching and waiting to see if antitrust regulators approve several big insurance mergers, whether the Affordable Care Act’s exchange market grows more sustainable, and whether states adopt new regulations governing provider network adequacy.

Looming above all those issues is the possibility of the election of a Republican president who would seek to jettison the ACA framework and replace it with an entirely different healthcare financing framework.

Released on December 22, 2015, the third estimate of Gross Domestic Product (GDP) for the third quarter indicates growth in health services spending is maintaining a disproportionate share of still slow GDP growth.

Spending on health services grew faster (4.8%, annualized, in current dollars) than spending on non-health services (3.9%) The growth in health services spending ($24.8 billion, annualized) accounted for 17% of all GDP growth ($146.5 billion), just under one fifth of personal consumption expenditure ($130.6 billion) ), and 29% of all services spending ($84.7 billion).

The evidence continues to indicate Obamacare is not bending the cost curve.

 

 

A growing number of people are turning to health-care ministries to cover their medical expenses instead of buying traditional insurance, a trend that could challenge the stability of the Affordable Care Act (ACA).

The ministries, which operate outside the insurance system and aren’t regulated by states, provide a health-care cost-sharing arrangement among people with similarly held beliefs. Their membership growth has been spurred by an ACA provision allowing participants in eligible ministries to avoid fines for not buying insurance.

Ministry officials estimate they have about 500,000 members nationwide, more than double the roughly 200,000 members before the law was enacted in 2010.

On Wednesday, Kentucky Governor Matt Bevin announced that he was planning to keep ObamaCare’s Medicaid expansion, but would seek federal waivers to “transform” the program. But Bevin’s plan is already hitting an a snag: he wants to use a Section 1332 waiver to “transform Medicaid.” The snag: Section 1332 doesn’t provide any authority for Medicaid reform.

A group of state insurance commissioners is developing a proposal to limit the amount that health insurers might have to pay out under the Affordable Care Act’s risk adjustment program, New Mexico Insurance Superintendent John Franchini told SNL.

The plan would install a so-called circuit breaker to prevent companies from paying more than 2% of their premium revenue into the program each year. That boundary would make insurers’ financial obligations more predictable and avoid the kinds of surprise payouts that contributed to the destabilization of several health plans in 2015.

Only 7% of the uninsured correctly identify this as the deadline to enroll in coverage and 20% say they have been contacted by someone about signing up for coverage. When asked why they have not purchased health insurance this year, nearly half of the uninsured (46%) say they have tried to get coverage but that it was too expensive.

According to the Organization for Economic Cooperation and Development (OECD), the United States spends $8,713 per person on health care — more than double the OECD average.  But under ObamaCare, that high level of spending isn’t buying the best care. The law’s numerous regulations and intrusions have simply inflated the nation’s healthcare tab — without actually improving the quality of care available to patients. The US has long spent more than other nations on care. ObamaCare has just accelerated that trend, despite the law’s goal of reducing health spending. Last year, health expenditures jumped 5.3%, up from an average of 3.9% over the previous six years, according to data from the Centers for Medicare and Medicaid Services.