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

Obamacare reached age 5 on Monday [1]. As I’ve pointed out earlier, this anemic child is not exactly a picture of health, falling behind the lofty expectations set for it on many dimensions. But the one bright spot for its proud parents relates to how much the law has reduced the number of uninsured. The president’s Council of Economic Advisors ecstatically announced last December: “the drop in the nation’s uninsured rate so far this year is the largest over any period since the early 1970s.” A little perspective is in order.

First, taking the CEA’s figures at face value (which my chart below does), this decline amounts to a 2.8 percentage point net reduction in the rate of being uninsured, that is, above and beyond the decline that would have occurred anyway according to CBO [2]. It may well be the biggest one-year decline since the 1970′s, but CBO’s expectation at the time the law was passed was that uninsured risk would drop by 6 percentage points in 2014 alone. Even as late as May 2013, CBO was expecting the net decline to be 3.5%. In short, in its first year, Obamacare scored 46% if we use CBO’s original projection as the scoring standard and 79% if we used the May 2013 projection. Clearly we would like this child to perform better than that in future years. But that would require the number of newly covered Americans to increase an additional 79% this year compared to last year.

Reality check: that is certainly not going to happen. Charles Gaba at ACASignups estimates that estimated paid sign-ups on the Exchanges are only 10.5 million so far, compared to 7.06 million last April [the original post stated 10 million, see Update #1 for explanation]. That’s only a 49% increase, suggesting Obamacare will fall even further behind CBO expectations for 2015 [the original post stated 42%, see Update #1 for explanation]. Medicaid won’t fill the gap, since Medicaid evidently is growing by about 300,000 persons per month. Even if we assume all of these are uninsured, that would reduce the uninsured rate by only 0.1% monthly, or 1.2% over 2015 as a whole. That provides only about half of what’s needed to keep pace with CBO projections, leaving the Exchanges to fill the gap. But as we’ve seen, the Exchanges are lagging behind.

Can government get people to buy a product that millions think isn’t worth the price?

That’s the question that health care analysts are asking as they pore over the results of the Obamacare open season that concluded on February 15.

On the surface, the data released earlier this month by the Department of Health and Human Services are encouraging. Nearly 11.7 million people selected a plan this year, compared with just more than 8 million during the 2014 open season.

There are some cautionary signs. Despite the influx of new subscribers, the age profile continues to skew older. Nearly half are 45 or older and 26 percent are over 55. Interest among the young remains largely unchanged over last year.

So is interest among middle income people who lack coverage. Enrollment has been dominated by those with the lowest incomes. HHS reports that 83 percent of people who have selected plans have incomes between 100 percent ($11,770) and 250 percent ($29,425) of the federal poverty level (FPL). Medicaid, meanwhile, has grown by nearly 20 percent since Obamacare was launched, swelling its ranks to 70 million. Roughly 22 percent of the U.S. population is now on Medicaid, despite the refusal of 22 states to expand their programs.

More than a year after egregious security failures in the government’s healthcare website were exposed in congressional hearings, data remains compromised and the ill-fated site is still subject to cyberattacks and vulnerable to massive identity theft.

In fact, just this week Judicial Watch obtained documents from the government that show a possible mass breach of the privacy of innocent Americans involving the disastrous Obamacare website (Healthcare.gov). The records, from the U.S. Department of Health and Human Services (HHS), also reveal that top officials with the Centers for Medicare and Medicaid Services (CMS) knew of massive security risks with the healthcare website but chose to roll it out without resolving the problems.

When the Obamacare internet drama blew up in the administration’s face the Department of Homeland Security (DHS) was called to help clean up, according to the records recently made public by JW. Electronic mail exchanges between various DHS and CMS officials indicate that White House pressure to promote a “robust” digital Obamacare ad campaign allowed private information of Healthcare.gov users to be shared with advertisers. The email chain pushing this controversial use of citizen information includes a security expert’s assessment that security was an “afterthought” on the Obamacare website, that 70,000 Healthcare.gov records were easily viewed using Google and that the official in charge was fired for not signing off on the website’s security.

Health care premiums are continuing to rise in 2015. While the pace of change has slowed since the dramatic increases of 2014, the savings promised under the Affordable Care Act (ACA) have still not materialized.

Measuring changes in premiums is an important element in understanding the impact of the ACA. In previous analysis, The Heritage Foundation determined that the new regulations and benefit mandates put in place through the ACA caused premiums to increase drastically in 2014, with average premiums increasing more than 50 percent in some states.[1] This Issue Brief examines premium changes in 2015 and finds continued but slower premium growth, indicative of a market going through a sorting process.

ObamaCare is celebrating its fifth anniversary, but few Americas are cheering.

The Real Clear Politics average of the latest major opinion polls about the health law shows that 52.5% oppose it and only 42% approve. The 10.5% spread is identical to the average of polls taken when the law was signed five years ago. Approval numbers never have topped disapproval numbers since the law was enacted. It is not getting more popular and it is not settled law, as President Obama claims.

President Obama is touting the increased number of people who have health insurance as a result of the law. According to Gallup, the uninsured rate among U.S. adults averaged 12.9% in the fourth quarter of last year. The uninsured rate was 14.4% the year before the health law passed, also according to Gallup.

So our health sector has been thrown into turmoil, millions of people have lost their private health plans, $1 trillion in new and higher taxes have been imposed on individuals and businesses – and the uninsured rate has dropped a net of 1.5%.

If you like your health insurance plan, you actually might have been able to keep it this year.

Fewer than 1 million Americans had their health insurance plans canceled for 2015 for noncompliance with Obamacare rules, according to a report by the Urban Institute and Robert Wood Johnson Foundation.

The report, which called that number “quite small,” suggests that in the latest enrollment season there was relatively little disruption of either the individual or job-based insurance market due to plans not meeting Affordable Care Act-related regulations.

Those rules set certain minimum standards for coverage, including prescriptions, maternity care and mental health treatment, which were not required in plans prior to the ACA’s enactment.

In King v. Burwell, four Virginia residents are a challenging an IRS Obamacare rule in the Supreme Court. While the case involves only a handful of plaintiffs, it is really about the millions of Americans who are victims of Obamacare’s mandates and penalties.

Like the King plaintiffs, millions are harmed by Obamacare’s individual mandate, which forces them to either buy insurance that they don’t want or to pay a tax penalty. But the IRS rule also has devastating consequences for countless other Americans and their families.

OUR VIEW: If Obamacare plaintiffs win, millions lose

Dec. 26, 2014, was strike three for Pamela Weldin.

The day after Christmas, Weldin, of Minatare, Neb., had logged on to Facebook to find a message from a friend of hers. Included in the note was a link to an article from the Omaha World-Herald announcing that CoOportunity Health, a nonprofit health insurance company offering plans in Nebraska and Iowa, had been taken over by state regulators.

The insurer, one of 23 Consumer Operated and Oriented Plans, or co-ops, started with the backing of the federal government and received $145 million in loans from the Centers for Medicare and Medicaid Services. But, CoOportunity’s expenses and medical claims would far exceed its revenue for 2014.

WASHINGTON (AP) — The official sign-up season for President Barack Obama’s health care law may be over, but leading congressional Democrats say millions of Americans facing new tax penalties deserve a second chance.
Three senior House members told The Associated Press that they plan to strongly urge the administration to grant a special sign-up opportunity for uninsured taxpayers who will be facing fines under the law for the first time this year.
The three are Michigan’s Sander Levin, the ranking Democrat on the Ways and Means Committee, and Democratic Reps. Jim McDermott of Washington, and Lloyd Doggett of Texas. All worked to help steer Obama’s law through rancorous congressional debates from 2009-2010.