The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers
Our health care system is a complex system. As I explained in Priceless, there is no known, reliable model of how it works. Whatever policy changes we make, there are certain to be unintended consequences and they may make matters worse than when we started. So how should we approach health policy? In an article in the Journal of Legal Medicine, I argued that before we try to solve social problems in health care we should first make sure that government is not the cause of the very problems we are trying to solve. How do we do that? By identifying the major ways in which government policies create harmful, perverse incentives and then replacing them with neutral (do no harm) policies. Once we have removed the perverse incentives government has created, we will be in a position to see if there are any remaining problems that need to be solved.
HealthCare.gov is going to see some shrinkage in 2016. The number of health insurance plans available on that huge federal Obamacare marketplace for 2016 is decreasing by up to 12 percent compared with this year, industry sources told CNBC. And there will be an even sharper reduction — of more than 40 percent — in the number of health plans on HealthCare.gov known as PPO plans, which offer customers the most flexibility in where they can get medical services covered by their insurer, sources said.
After months of internal debate, the House passed a budget-reconciliation bill last Friday taking aim at Obamacare, but it is far from assured that the bill, or even an amended version of it, will ever emerge from the Senate. Budget-reconciliation bills are powerful legislative vehicles because they cannot be filibustered in the Senate (it takes 60 votes to invoke cloture and close off debate on most bills). That means, in theory at least, that the Republican majority in the Senate should be able to pass a reconciliation bill and send it to the president for signature or veto without needing any Democratic support.
The Pacific Legal Foundation filed an appeal Monday asking the Supreme Court to hear a new challenge to the Affordable Care Act which argues that the ACA’s taxes are unconstitutional because they originated in a bill written by the Senate. Under the Constitution’s Origination Clause, all bills that levy and raise taxes must begin in the House of Representatives. Contrary to this provision, the text of the ACA was written by the Senate and later adopted by the House. Senate Majority Leader Harry Reid gutted an unrelated House bill, leaving only the bill number, and in its place, he inserted the 2,076 pages of the ACA.
Yesterday, the White House and Congressional leaders announced a last-minute budget agreement that avoids a so-called government shut-down for now. The deal has four health-related items, and is expected to reduce net federal health spending by about $4.5 billion over five years, and $15.5 billion over ten years. Overall, it is not a bad deal with respect to health care. However, some of its budget savings are fragile and it largely avoids reforms that will actually reduce the growth of health spending.
Voters in the battleground state of Colorado will likely have a big issue to vote on in 2016 — and it’s not the presidential election. The Centennial State is looking to implement a universal health care proposal that goes above and beyond what Obamacare offers. “Part of the reason Obamacare is so unpopular is that it’s a one-size-fits-all approach for 50 different states,” Colorado Democratic state Sen. Irene Aguilar, a doctor, told The Blaze. “What we are hoping to do with this is create a plan that works for Colorado.”
The Obama administration was able to push the Affordable Care Act — Obamacare — through Congress in part because the Congressional Budget Office said it would modestly reduce future federal budget deficits. The claim of deficit reduction rests on a shaky foundation. It depends entirely on the uninterrupted implementation of four carefully constructed “indexing” provisions. These provisions, which make annual adjustments to key spending and tax parameters of the law (or specify that such adjustments will not be made), were written with the clear intention of making the ACA look better financially as time passed. Our new study, published by the Mercatus Center at George Mason University, shows that these budgetary manipulations are no more likely to survive mounting political pressure than did income-tax “bracket creep” in the 1970s or across-the-board cuts in Medicare physician fees over the past 15 years.
Some health insurance plans sold on the Affordable Care Act’s federal marketplace may not provide reasonable access to medical specialists, new research suggests. Under the act, also known as Obamacare, the federal marketplace offers subsidized private health insurance to consumers in states that didn’t establish their own health insurance exchanges.
Monday night’s spending agreement between the White House and Congress would repeal part of the Affordable Care Act. But the provision is a narrow one that few people knew existed and even fewer supported enthusiastically. The Obama administration had stalled writing the rules that would have put it into effect and, with no signs of imminent action, most Washington insiders figured it was only a matter of time before Congress took it off the books anyway. For better or worse, or maybe a bit of both, the provision was the regulatory equivalent of a dead man walking.
Proponents of the Affordable Care Act (ACA) have frequently pointed to official cost estimates projecting that the law will reduce federal budget deficits. Much less attention has been paid to the primary reason for this favorable outlook: the law’s heavy reliance on indexing important provisions to restrain spending and increase revenue. These components of the ACA will automatically impose perpetual, across-the-board cuts on payments to certain institutional medical providers; increase premiums for lower-income households; and raise taxes on an ever-expanding segment of taxpayers.