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

It’s no secret that health care and insurance are complex. But just how complicated are they to navigate?

Take scheduling a doctor visit to have a rash checked out. Finding out what it will cost requires answering a series of questions: Is the doctor in your insurer’s network? Is the facility? What’s your copay for the visit? If you have a yearly deductible, how much of it have you already fulfilled? If the rash requires a procedure to treat it, will that require seeing a different doctor? If so, is that doctor in your insurer’s network?

It’s now clear that the actual impact of ObamaCare’s individual mandate tax penalty will be far worse than the benign intent that the Obama administration claimed.
“What we’re talking about is a penalty for the few people who will refuse to buy health insurance — even though they can afford it — and who expect the rest of us to pick up the tab for their care,” a September 2009 White House defense of the individual mandate states.

The reality, though, is a bit more complicated. Obamacare hasn’t led to a shift from full-time employment to part-time. But the evidence suggests it has led some employers to limit the hours of workers who were already part-time, effectively giving a pay cut to some of the most vulnerable Americans.

Have employers cut work hours to avoid ObamaCare penalties? There’s no clearer test than the one put forth by the White House Council of Economic Advisers.
The Affordable Care Act employer mandate applies to workers who clock at least 30 hours per week. So if companies were seeking to minimize liability, we’d likely see a drop in the number of workers with hours just above that threshold relative to the number with hours just below it.

Decades later, my dad and I can laugh about this story, but only because he was able to step up and pay for the repair, and I did indeed make good on payday.

But they’re not laughing about this on Capitol Hill. At least five states took federal money to build Obamacare state exchanges, then had to close or abandon the exchanges when they failed to work. And now, as some of the contractors responsible for those failures are being forced to make good, the states want some of that money.

Oregon is right now paying $650 per hour to a law firm with connections to former Gov. John Kitzhaber, who resigned in disgrace partially over the state’s health exchange debacle, to pursue a lawsuit against Oracle its own attorneys say it has little chance of winning. Why? Because Oregon thinks it can get some of those dollars should they start to flow.

Maryland failed so badly at its attempt to establish an exchange that Democrat Anthony Brown, who presided over the project as lieutenant governor under now-presidential candidate Martin O’Malley, lost his bid to become governor in a state that is 2:1 Democrat. But now, Maryland has reached an out-of-court settlement with its contractor that will net $125 million, of which the state is set to receive some proceeds.

About 1.8 million households that got financial help for health insurance under President Barack Obama’s law now have issues with their tax returns that could jeopardize their subsidies next year. Administration officials say those taxpayers will have to act quickly.

“There’s still time, but people need to take action soon,” said Lori Lodes, communications director for the Centers for Medicare and Medicaid Services, which runs HealthCare.gov.

Much has been said about the formularies, cost-sharing, and patient burden required of enrollees on the ACA health insurance exchanges. Deductibles averaged nearly $3,000 for silver plans on the exchanges, and cost-sharing for specialty drugs can often reach 40 percent or higher. None of this is new, and this is a trend going on outside of the exchanges, in the employer-sponsored market as well. According to the Kaiser Family Foundation, employer plans now have deductibles averaging over $1,000 and a small, but growing share of plans use coinsurance rather than copays even for physician visits. Fundamentally, this means that patients are more involved in their health care decision-making.

WASHINGTON — Hoping to avoid another political uproar over the Affordable Care Act, the Obama administration is trying to persuade states to cut back big rate increases requested by many health insurance companies for 2016.

ObamaCare enrollees are less satisfied with their plans than people with other types of health insurance, according to a new poll.

The poll from the Deloitte Center for Health Solutions, the research arm of the consulting firm, finds that 30 percent of people with insurance through ObamaCare’s marketplaces are satisfied with their plans.

When the ACA networks began covering patients in 2014, one of the first complaints was that many plans were trying to cut costs by including many fewer providers in their networks than pre-ACA health plans. In some cases, patients even had to cancel previously scheduled surgeries and lost access to prescription drugs, since the surgeons and/or the hospitals were not in their new networks. Now, a study by the health consulting firm Avalere confirms that these were not isolated cases – on average, exchange plans include a 34 percent fewer in-network providers than non-exchange plans (such as employer-sponsored plans), with even larger shortcomings in specialties like oncology and cardiology.