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

“States in the South and Mountain West, which traditionally have the lowest rates of primary care physicians, could struggle to provide medical services to the surge of new patients expected to enroll in Medicaid under the health overhaul and federal incentives may not provide much help, according to a report issued today by a Washington health research group.”

“My critics say that I’m ‘cynical’ because I say that Medicaid’s reimbursement rates are too low, and yet oppose spending more money that we don’t have. This is a false dichotomy. There are a lot of things we can do to make Medicaid more cost-efficient: starting with converting the program into block grants for the states, and letting states focus on fully funding care for the truly needy.”

“Under the Patient Protection and Affordable Care Act (PPACA), Medicaid enrollment is expected to grow by 16 million people by 2019, an increase of more than 25 percent. Given the unwillingness of many primary care physicians (PCPs) to treat new Medicaid patients, policy makers and others are concerned about adequate primary care capacity to meet the increased demand. States with the smallest number of PCPs per capita overall—generally in the South and Mountain West—potentially will see the largest percentage increases in Medicaid enrollment, according to a new national study by the Center for Studying Health System Change (HSC). In contrast, states with the largest number of PCPs per capita—primarily in the Northeast—will see more modest increases in Medicaid enrollment. Moreover, geographic differences in PCP acceptance of new Medicaid patients reflect differences in overall PCP supply, not geographic differences in PCPs’ willingness to treat Medicaid patients.”

“Sandy Chung is grappling with a new kind of request at her pediatrics office in Fairfax, Va.: prescriptions for aspirin and diaper-rash cream.

Patients are demanding doctors’ orders for over-the-counter products because of a provision in the health-care overhaul that slipped past nearly everyone’s radar. It says people who want a tax break to buy such items with what’s known as flexible-spending accounts need to get a prescription first.”

“At the same time, it’s not clear how hospitals will save money through integration. Many proposed cost-reduction measures–such as new electronic medical-records systems–involve expensive up-front capital investments that may not yield savings.
Further, ObamaCare calls on providers to deliver more care–not less–through the ACOs. The president and his allies hope that elevated levels of primary and preventive care for Medicare patients will head off the need for surgeries or other expensive procedures down the road.”

“In light of all this evidence about the benefits of hospital competition, it might be surprising to learn that the new health reform law will decrease rather than increase competition between hospitals due to the encouragement of Accountable Care Organizations (ACOs). ACOs will not be implemented until 2012, but already hospitals are buying out physician practices to create what amount to, in many locations, geographic monopolies that will restrict patient choice and stifle innovation.”

“2011 has commenced and even though New Year’s cards may still remain prominently displayed on the kitchen table, a newly implemented provision of the health care overhaul law likely has some physicians and patients across the country yearning for the good old days of 2010. As of January 1, 2011, the Patient Protection and Affordable Care Act (PPACA) states patients with flexible savings accounts (FSAs) and health savings accounts (HSAs) can no longer use these tax-sheltered vehicles to purchase over-the-counter (OTC) medicines without a doctor’s prescription. This legislation will adversely impact physicians, patients, health care costs, and flies in the face of the enabling law that established these programs.”

“The negative consequences of the Patient
Protection and Affordable Care Act already
are cascading through the health sector, with
millions of Americans in states across the
country learning that their health insurers
have withdrawn from the market, making it
increasingly difficult for them to find
affordable coverage.”

“Despite all the uncertainty, private insurers aren’t taking any chances. They’re in the midst of adjusting to the law’s requirement that they spend a certain percentage of their revenues on medical claims. ObamaCare’s advocates hope the provision will ensure consumers get good value for their premium dollars. And if the rule makes life harder for insurers, so much the better.
Unfortunately this ‘minimum medical loss ratio’ regulation will harm not just insurers but workers and employers too, as they’ll face higher prices and fewer choices for insurance.”

“The most significant change is a wave of frantic consolidation in the health industry. Because the law mandates that insurers accept all patients regardless of pre-existing conditions, insurers will not make money with their current premium and provider-payment structures. As a result, they have already started to raise premiums and cut payments to doctors and hospitals. Smaller and weaker insurers are being forced to sell themselves to larger entities.”