Audits and investigations into the effects of ObamaCare from congressional committees, government auditors, advocacy groups, and others.
“President Reagan gauged the success of a welfare program by how quickly people were able to move off government assistance and into remunerative work. Yet President Obama, the White House, and their allies are measuring the success of Obamacare by how many people can be enrolled in their new government entitlement programs.
The president celebrated the law’s “success” in getting seven million people enrolled in Medicaid and eight million (or so) people enrolled in exchange coverage, 87 percent of whom are receiving government subsidies for their insurance. And he hopes to lure another five million people onto Obamacare programs starting with the November 15 enrollment period. There is no expectation that participation in these government programs will be a temporary boost but rather that they will become a permanent fixture in people’s lives.”
“Since enactment of the Affordable Care Act (ACA) in 2010, much of the attention in the policy community has been on modernizing Medicare’s traditional fee-for-service (FFS) program. Through Accountable Care Organizations (ACOs), larger “bundles” of payments to fee-for-service providers for episodes of care, and tests of pay-for-performance models, the hope is that the traditional Medicare model can be remade through sheer force of bureaucratic will. The stated intent is to find a way to pay for value, not volume.
These efforts may or may not bear much fruit, but, over the longer term, it’s not likely to matter much. That’s because a more important transformation of Medicare is already well underway and is occurring despite more resistance than assistance from the program’s bureaucracy. According to the 2014 Medicare Trustees’ report, enrollment in Medicare Advantage – the private plan option in Medicare — has been surging for a decade. In 2005 there were 5.8 million Medicare beneficiaries enrolled in MA plans — 13.6 percent of total enrollment in the program. Today, there are 16.2 million beneficiaries in MA plans, or 30 percent of program enrollment. (See Table IV.C1) In addition, the Medicare drug benefit, which constitutes about 12 percent of total program spending, is delivered entirely through private plans.”
“When the Affordable Care Act marketplace opens on Nov. 15, consumers can expect healthcare.gov to have robust technology, amped-up functions, and a shorter application form for individual plans.
What they won’t see – and likely won’t know about – are the ongoing communication problems that many on the insurance industry say continue to plague the “back-end” transfer of consumer files between the website and insurance companies.”
“Tuesday’s re-election of Republican governors in closely contested races in Florida, Georgia, Wisconsin, Maine and Kansas dims the chances of Medicaid expansion in those states.
Advocates hoping for Democratic victories in those states were disappointed by the outcomes, but Alaska, which also has a Republican incumbent, remains in play as an independent challenger holds a narrow lead going into a count of absentee ballots.
“No one would say it was a good night for the prospects of Medicaid expansion,” said Joan Alker, executive director of the Center for Children and Families at Georgetown University.”
“The Obama administration plans to close a loophole in the Affordable Care Act that allows large companies to refuse to cover in-patient hospital stays in any of their health insurance plans, according to an official involved in the internal discussions.
The official requested anonymity until the announcement is made because “the guidance that will be issued is not finalized.””
“When Tony Smith lost his job as a corporate paralegal two years ago, a state program stepped in to help him keep his health insurance — and the expensive drugs his life had depended on since his 2008 HIV diagnosis.
Now Smith, 42, of Coral Springs, has been told he must sign up for coverage on Florida’s federally run insurance exchange or the state will stop helping him pay his premiums.
“The landscape of healthcare has changed, and with the passage of the Affordable Care Act we have the opportunity to access and enroll in cost-effective health plans,” an official at the AIDS Insurance Continuation Program wrote in a letter to Smith and other AICP beneficiaries.
But it is not clear that ACA insurance plans will be cheaper — or even affordable — for those with HIV and AIDS, according to patient advocates.”
“Most of us have long realized that the New York Times’ standards are low. Just look at who the Gray Lady endorses for president and other high political offices. But even we were a little surprised at what little it takes for the editors to call Obamacare a success.
The Times poses the question “Is the Affordable Care Act Working?” Given all the ACA’s problems, one could be forgiven for thinking it was a rhetorical question. It wasn’t. The paper asserts, “After a year fully in place, the Affordable Care Act has largely succeeded in delivering on President Obama’s main promises, an analysis by a team of reporters and data researchers shows.””
“A federal judge in Florida on Tuesday jumped into the latest round in the legal wrangling over a Patient Protection and Affordable Care Act provision involving birth-control coverage and how it applies to religious institutions.
U.S. District Judge James Moody Jr. temporarily blocked the federal government from enforcing on a Roman Catholic college a new workaround HHS had developed on the thorny issue.”
“Do you suppose any of the 2014 candidates will find time in the closing week to talk about Obamacare again, in the midst of all the other slow rolling disasters? (Aside from the occasional Root and Branch repeal call, that is.) If they do, they might want to mention a new study from the Medical Group Management Association which has some rather depressing figures in terms of medical services availability next year for participants. Barbara Boland has the story.
Over 214,000 doctors won’t participate in the new plans under the Affordable Care Act (ACA,) analysis of a new survey by Medical Group Management Association shows. That number of 214,524, estimated by American Action Forum, is through May 2014, but appears to be growing due to plans that force doctors to take on burdensome costs. It’s also about a quarter of the total number of 893,851 active professional physicians reported by the Kaiser Family Foundation.
In January, an estimated 70% of California’s physicians were not participating in Covered California plans.”
“For health policy wonks, the end of the year isn’t just the holiday season. With the falling temperatures will come a renewed “doc fix” debate, as Congress deliberates on ways to avoid a scheduled double-digit (24 percent last year) cut in Medicare’s physician payments. And avoid it they will. As health economist Austin Frakt put bluntly: “Good luck getting physicians to keep Medicare patients if the payments are suddenly cut 24 percent.””