“If you are looking for information on how Americans are engaging with the Affordable Care Act, the Census Bureau’s recently released latest annual estimates of health insurance coverage is probably not the place to look—at least for now.
The Census Bureau, which derives its information on healthcare from the Annual Social and Economic Supplement—the same survey where it asks how many toilets, computers, microwaves, etc., people have in their homes—does provide some useful insights.
It catalogues the demographic characteristics of the population based on participation in different types of health insurance coverage—government health care programs, private employer and individual plans, and the uninsured. It tells us young adults make up a disproportionate share of the uninsured and provides useful information on the relative availability of employer-sponsored coverage by industry and firm size.
But its hard numbers on enrollment and enrollment trends are not reliable for drawing “big picture” conclusions, especially regarding the ACA. Indeed, that unreliability is why this year the Census Bureau started using a new set of health coverage questions in the ASEC.”
“Since the Affordable Care Act’s (ACA) passage, a number of lawsuits have been filed challenging various provisions of the law. The Supreme Court has decided cases about the constitutionality of the ACA’s individual mandate and Medicaid expansion as well as the applicability of the contraceptive coverage requirement to closely held for-profit corporations with religious objections. In addition, several cases challenging the availability of premium subsidies in the Federally-Facilitated Marketplace (FFM) are currently progressing through the federal courts. All of this litigation has altered, or has the potential to alter, the way in which the ACA is implemented and consequently could affect the achievement of the law’s policy goals. This issue brief examines the federal courts’ role to date in interpreting and affecting implementation of the ACA, with a focus on the provisions that seek to expand access to affordable coverage.
Court decisions about how to interpret the ACA will continue to affect the number of people who ultimately obtain affordable coverage. At present, access to Medicaid up to 138% FPL is dependent upon where people live because the Supreme Court held that implementation of the ACA’s Medicaid expansion is effectively a state option. This has resulted in a coverage gap for just over 4.5 million people with incomes too high to qualify for Medicaid but too low to qualify for Marketplace subsidies in the states that have not implemented the ACA’s Medicaid expansion to date.”
“At a hearing to discuss the rising costs of healthcare benefits for Miami-Dade County, Fla., employees this year, a labor union consultant raised his hand to ask what seemed like a basic question.
Could the committee charged with reducing Miami-Dade labor’s healthcare expenses look at the spreadsheet showing the rates that the county pays local hospitals and doctors for medical services to employees?
“We really need to understand where the money is being spent in order to be insightful about benefit design changes,’’ said Duane Fitch, a healthcare consultant for SEIU Local 1991, which represents physicians and nurses at the county-owned Jackson Health System.”
“This week exchangers could get data on enrollment in the small business exchanges operated by the federal government as Mayra Alvarez, director of CCIIO’s State Exchange Group, will testify at a House Small Business Committee hearing Thursday on SHOP exchange implementation. CMS Administrator Marilyn Tavenner will also return to the House to face the Oversight Committee on Thursday on healthcare.gov security concerns, one day after the Government Accountability Office’s planned Sept. 17 release of a report on that controversial subject.
Academics and researchers are also diving into new data out Tuesday (Sept. 16) from the Centers for Disease Control and Prevention and the U.S. Census Bureau on the number of uninsured. The CDC’s early release of data from the National Health Interview Survey found that the uninsured rate for adults ages 18 to 64 had dipped from 20.4 percent in 2013 to 18.4 percent in the first three months of 2014. The survey does not account for the late surge of enrollments toward the end of the first exchanges open enrollment period, however it is the first official government report to document the reduction in uninsured following the ACA’s coverage expansions.”
“Three little words is all it takes to change voters’ minds about Medicaid expansion.
Morning Consult polling shows using the term “Affordable Care Act” can make a difference in how a voter feels about expanding Medicaid. When asked if Medicaid should be expanded for low income adults below the federal poverty line, 71 percent of registered voters said yes. When asked if Medicaid should be expanded “as encouraged under the Affordable Care Act”, support dropped nine percentage points.”
“A Republican-controlled Senate cannot repeal Obamacare, no matter how fervently GOP candidates pledge to do so on the campaign trail this fall. But if they do win the majority, Senate Republicans could inflict deep and lasting damage to the president’s signature law.
Republicans are quick to say they are not yet measuring the proverbial drapes. But they are taking the political measurements of repealing large parts of the health law, considering which pieces could be repealed with Democratic support, and how to leverage the annual appropriations and budget process to eliminate funding or large pieces of the law.
Initial targets are likely to include the medical device tax, the individual and employer mandates, the 30-hour workweek to qualify for coverage, and spending on a preventive health fund that Republicans call a slush fund.”
“There’s been a fierce debate over whether Obamacare has increased health insurance premiums. Progressives have argued Obamacare is working due to modest projected premium increases on the Exchanges for 2015. Conservatives have retorted that “there can be no doubt that health care today is more costly than it would have been without Obamacare.”
But this argument has focused on the health Exchanges, where only 7-8 million people bought their coverage in 2014. Readers would do well to remember that more than 20 times that number of people rely on employer-provided health benefits (Table C-1).
In the employer-based market, the adverse effects of Obamacare on premiums and affordability are strikingly obvious. The growing burden of employer-provided health care has accelerated under Obamacare. And yet the New York Times would have you believe everything is hunky-dory since “the growth in health insurance premiums was only 3 percent between 2013 and 2014. That’s tied for the lowest rate of increase since Kaiser started measuring (this is the 16th year of the survey).” This view is dead wrong: here’s why.”
“Some of Obamacare’s big supporters say the new law has already contributed to decreases in the rate of growth of health spending.
But a new report from the Center for Medicare and Medicaid Services Office of the Actuary says the rate slowed because of a slow economic recovery, increased cost-sharing for those enrolled in private plans and sequestration.
Indeed, the report does not even mention Obamacare when assessing the situation. “The recent period is marked by a four-year historically low rate of health spending growth, which is primarily attributable to the sluggish economic recovery and constrained state and local government budgets following the 2007-09 recession,” the report states.”
“The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of this provision in 2012, some nonprofit and for profit employers with religious objections to contraceptives have brought legal challenges to this rule. For many women today, their contraceptive coverage depends on their employer or when they purchased their individual insurance plan.”
“Doctors and hospitals treated more patients and collected more payments in the spring as millions gained insurance coverage under the health law, new figures from the government show.
But analysts called the second-quarter increases modest and said there is little evidence to suggest that wider coverage and a recovering economy are pushing health spending growth to the painful levels of a decade ago.”