Audits and investigations into the effects of ObamaCare from congressional committees, government auditors, advocacy groups, and others.

“Before dawn on a Wednesday in January, Cesar Flores, a 40-year-old employed by a large retail chain, woke up at his home in Chula Vista, California. He got in his car and crossed the border into Tijuana. From there, he headed for a local hospital, where he got lab tests—part of routine follow-up to a kidney stone procedure. He had his blood drawn and left the hospital at 7:30. He arrived home before 10.
Uninsured Americans have long known that seeking medical care abroad is often more cost-effective than seeking it at home. Even after you factor in travel expense and time off work, you still often come out ahead. A hip replacement that would cost $75,000 for an uninsured patient in the U.S. is $9,000 in India. A heart bypass in the U.S. runs about $210,000; in Thailand it’s $12,000. According to Patients Beyond Borders, a company that facilitates medical tourism, those savings drove about 900,000 Americans to leave the country for medical procedures last year—a number they estimate is growing by 15 percent per year.
But Flores’s situation isn’t medical tourism as we know it. Flores has insurance through his wife’s employer. But his insurer, a small, three-year-old startup H.M.O. called MediExcel, requires Flores to obtain certain medical treatment at a hospital across the border. In part due to cost-pressures generated by the Affordable Care Act, other sorts of plans that require travel have the potential to expand.”

“WASHINGTON — More than half of privately insured women are getting free birth control under President Barack Obama’s health law, a major coverage shift that’s likely to advance.
This week the Supreme Court allowed some employers with religious scruples to opt out, but most companies appear to be going in the opposite direction.
Recent data from the IMS Institute document a sharp change during 2013. The share of privately insured women who got their birth control pills without a copayment jumped to 56 percent, from 14 percent in 2012. The law’s requirement that most health plans cover birth control as prevention, at no additional cost to women, took full effect in 2013.”

“Obamacare’s technological nightmare might not be over yet.
Due to problems with the backend of the website, the Department of Health and Human Services reported last month that there were nearly 3 million inconsistencies on applications for health insurance. At the time, officials assured the public they were aggressively working to solve the problem.
But now, a new inspector general report reveals that nearly nine out of 10 erroneous applications have yet to be resolved, and the government isn’t really sure how to fix the problem.
The IG said the primary issues with the applications revolve around verifying citizenship status and income. Under the law, legally residing immigrants can receive subsidies, while undocumented residents cannot. Problems verifying income have also affected subsidy eligibility and the amount those who qualified have received. If enrollees received too much in subsidies, they will be required to pay them back through tax returns next year.”

“The Supreme Court’s opinion Monday holding that some for-profit firms do not have to provide women the contraceptive coverage required under the Affordable Care Act if they have religious objections addressed only half of the ongoing legal battle over the birth control mandate.
But those on both sides of the issue think the court’s majority may have telegraphed which way it could rule when one of those other cases reaches the justices.
Depending on whose count you use, there are more than 50 other lawsuits still working their way toward the high court. They were filed by nonprofit groups, mostly religious educational and health organizations like universities and hospitals.”

“SEATTLE — Washington State’s health insurance exchange is looking to be an attractive marketplace for new health insurance carriers, according to an early analysis of insurer premium rate filings by McKinsey & Company.
Four new insurers have applied to sell individual policies in the state’s exchange next year, making Washington among the states with the highest number of new exchange entrants of the 12 states where preliminary 2015 rates have been filed, according to McKinsey. If insurance regulators approve the new carriers, Washington will have 12 insurers on the exchange in 2015, up from eight participating this year.
Washington’s not the only state attracting new health insurance business. Michigan also has four new exchange applicants, and five new carriers have applied in Indiana, the state so far with the highest number of new insurance carriers showing interest, according to the real-time tracking of state insurance department rate filings that McKinsey is doing.”

“The Supreme Court decision upholding Hobby Lobby’s ability to refuse to cover certain contraceptive services based on its owners’ religious beliefs has set off a wave of analysis of what the decision means. That will not be resolved anytime soon. But we do know what women think of the policy issue at the core of the case.
Overall, by a margin of 59% to 35%, women oppose the idea of letting companies deny coverage of contraceptives based on their owners’ religious beliefs. But women’s views on this issue–studied in the Kaiser Family Foundation Health Tracking Poll last month–differ by party, ideology and their religion.
White evangelical protestants, conservatives and women who are Republican are more supportive of Hobby Lobby’s position. Women who are liberal, Democrats, and protestant and Catholic are much more likely to oppose the company’s position.”

“If you offer it, will they come? Insurers and some U.S. senators have proposed offering cheaper, skimpier “copper” plans on the health insurance marketplaces to encourage uninsured stragglers to buy. But consumer advocates and some policy experts say that focusing on reducing costs on the front end exposes consumers to unacceptably high out-of-pocket costs if they get sick. The trade-off, they say, may not be worth it.
“It’s a false promise of affordability,” says Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms. “If you ever have to use the plan, you won’t be able to afford it.””

“The Obama administration announced they hit their revised goal of 6 million enrollees on the Affordable Care Act exchanges this week, several days before enrollment closes tomorrow. Politically, hitting this benchmark is an important symbol for the administration, as it has struggled to recover from the disastrous rollout of the insurance exchange websites this fall. But policy-wise, it doesn’t mean nearly as much. And it may take until 2016 to really see if the law is successful at consistently getting lots of Americans affordable health insurance.”

“In recent weeks, I’ve talked to a handful of large healthcare firms and medical practices that offer specialty medical services. I asked them what kinds of prices they’re soliciting from the new health plans now taking shape under Obamacare. These providers said that they’re demanding, and in some cases securing, pretty rich reimbursement rates from the new, Obamacare health plans.”

“The main focus of our analysis is assessing access to primary-care physicians under the health-care law. The reason for this focus is twofold: first, we already know that we will be facing a primary-care shortage in the coming years, so understanding the role that Obamacare plays in affecting the shortage is important; second, much of the law was motivated by the argument that expanding access to inexpensive (or free) preventive care and primary care physicians would ultimately bend the curve of health-care spending.”