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

“The fact of the matter is that IPAB won’t make the notoriously inefficient Medicare program any more efficient. Through arbitrary reductions on payments to providers, it will simply reduce the supply of care. Even before the advent of a new, more powerful IPAB and a new, tougher limit on spending, Medicare’s chief actuary warned that ObamaCare will drive providers out of the program. If you love Medicaid, you’ll adore the new IPAB version of Medicare.”

“The Department of Health and Human Services has released draft rule that governs Accountable Care Organizations. ACOs are groupings of health care providers who join together under specific rules in order to create shared savings. The idea is to bundle a single payment for a patient so that providers do not have incentives to prescribe additional services that generate additional fees. This sounds like a relatively simple concept, and it is worth exploring different ideas for needed payment reform. But the truth is, changing payment systems is far from simple. The devil is in the details about the ‘specific rules’ that define an ACO’s structure.”

“Obamacare is already exacerbating some of the current trends in American medicine that work against the interests of patients. Paramount among them is an erosion in the quality of the nation’s doctors. If unaddressed, America’s heyday as the world leader in the practice of medicine could draw to a close.”

“In 2009, using a PPACA-adjusted MLR
definition, we estimated that 29% of insurer-state
observations in the individual market would have
MLRs below the 80% minimum, corresponding to
32% of total enrollment. Nine states would have
at least one-half of their health insurers below the
threshold. If insurers below the MLR threshold
exit the market, major coverage disruption could
occur for those in poor health; we estimated
the range to be between 104,624 and 158,736

“Every year, thousands of people make a deal with their doctor: I’ll pay you a fixed annual fee, whether or not I need your services, and in return you’ll see me the day I call, remember who I am and what ails me, and give me your undivided attention. But this arrangement potentially poses a big threat to Medicare and to the new world of medical care envisioned under President Barack Obama’s health overhaul.”

“The problem is common here and across the country, especially as states, scrambling to balance their budgets, look for cuts in Medicaid, which is one of their biggest expenditures. And it presents the Obama administration with a major challenge, since the new federal health care law relies heavily on Medicaid to cover many people who now lack health insurance.”

“In other words, the new rules constitute a detailed attempt by the federal government to tell primary care doctors, specialists, and other providers exactly how they should work together. Rather than encourage private, market-driven experimentation, ObamaCare’s ACOs create yet another model of care built around satisfying government rules and regulations.”

“Access, cost, and quality have long been known as the three-legged stool of health reform. It is hard to improve one without worsening the others. So trade-offs must be made.
But not this time. Congress decided it no longer had to make trade-offs. It could have its cake and eat it, too, by creating (drum roll)…tah daaaaah!…ACCOUNTABLE CARE ORGANIZATIONS (ACOs)!!!!”

“A new article in Health Affairs brings attention to the problem of ‘churning’ in the eligibility requirements for subsidized ObamaCare. The study by Benjamin Sommers and Sara Rosenbaum looks at how often people will fall in and out of eligibility for, on one hand, Medicaid for people up to 133% of the poverty level, and on the other hand, subsidized coverage for those up to 400% of poverty in the Exchange.”

“The absolute worst feature of Obama Care (and it truly is inexplicable) is that close to 310 million Americans are going to get more primary care coverage than they had before. Not just welfare mothers, but Bill Gates, Bill Gates’ father, Warren Buffett — everyone in the whole country is going to have access to a long list of preventive care services with no deductible or copayment. If they respond to their new incentives, they will all try to get more care than they were getting before.”