“Obamacare—or at least the version of it that the president and his advisers currently think they can get away with putting into place—has been upending arrangements and reshuffling the deck in the health system since the beginning of the year. That’s when the new insurance rules, subsidies, and optional state Medicaid expansions went into effect. The law’s defenders say the changes that have been set in motion are irreversible, in large part because several million people are now covered by insurance plans sold through the exchanges, and a few million more are enrolled in Medicaid as a result of Obamacare. President Obama has stated repeatedly that these developments should effectively shut the door on further debate over the matter.
Of course, the president does not get to decide when public debates begin or end, and the public seems to be in no mood to declare the Obamacare case closed. Polling has consistently shown that more Americans oppose the law than support it, and that the opposition is far more intense than the support. The law is built on a foundation of dramatically expanded government power over the nation’s health system, which strikes many voters as a dangerous step toward more bureaucracy, less choice, higher costs, and lower quality care. The beginning of the law’s implementation does not appear to have eased these fears, and in some cases has exacerbated them.”
“Employers have complained for years about their rising health-care costs. But over the past decade, as the chart above shows, premium increases for employer health insurance have moderated sharply and stabilized. Premiums for family policies in the group market grew 72% between 1999 and 2004; 34% between 2004 and 2009; and 26% between 2009 and 2014. Even as premium growth moderated, health insurance costs still outpaced inflation and wage growth. But this year premiums grew 3%, about the same rate as wages and inflation. Despite fears that premiums would rise in the group market because of the Affordable Care Act, they have remained stable.
Policy experts do not fully understand why health-care costs have moderated or when and how rapidly they might begin to again rise more quickly. And coverage is still very expensive: The average family policy costs $16,834 a year, with employers paying, on average, 71% of the expense and employees 29%.
Corporate benefits managers will continue to do what they can to tamp down annual premium increases, and companies will continue to raise deductibles and other forms of cost sharing to help constrain premium increases. But as long as these more modest increases in their health insurance premiums continue, corporate CEOs will see their health costs more like a chronic illness to be managed than an acute problem or crisis, and they will no doubt focus their energies on other problems.”
“A report out today puts numbers behind what hit many workers when they signed up for health insurance during open enrollment last year: deductible shock.
Premiums for employer-paid insurance are up 3% this year, but deductibles are up nearly 50% since 2009, the report by the Kaiser Family Foundation shows.
The average deductible this year is $1,217, up from $826 five years ago. Nearly 20% of workers overall have to pay at least $2,000 before their insurance kicks in, while workers at firms with 199 or fewer employees are feeling the pain of out-of-pocket costs even more: A third of these employees at small companies pay at least $2,000 deductibles.”
“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 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 key findings from the survey, conducted from January through May 2014, include a modest increase in the average premiums for family coverage (3%). Single coverage premiums are 2% higher than in 2013, but the difference is not statistically significant. Covered workers generally face similar premium contributions and cost-sharing requirements in 2014 as they did in 2013. The percentage of firms (55%) which offer health benefits to at least some of their employees and the percentage of workers covered at those firms (62%) are statistically unchanged from 2013. The percentage of covered workers enrolled in grandfathered health plans – those plans exempt from many provisions of the Affordable Care Act (ACA) – declined to 26% of covered workers from 36% in 2013. Perhaps in response to new provisions of the ACA, the average length of the waiting period decreased for those with a waiting period and the percentage with an out-of-pocket limit increased. Although employers continue to offer coverage to spouses, dependents and domestic partners, some employers are instituting incentives to influence workers’ enrollment decisions, including nine percent of employers who attach restrictions for spouses’ eligibility if they are offered coverage at another source, or nine percent of firms who provide additional compensation if employees do not enroll in health benefits.”
“The ACA imposes several burdensome regulations that could potentially harm job and wage growth, including the employer mandate and requirements on the generosity of coverage. Under the ACA, employers with 50 or more full-time employees are required to provide health insurance for their workers or pay a fine. In addition, the ACA enforces rules that govern the type of insurance plans they can provide and restricts their options in choosing low-cost coverage. When employers are required to provide health insurance and their low-cost options are limited, costs will naturally rise and companies will be more responsive to changes in insurance premiums. As a result, employees are less insulated from insurance premium growth, and if premiums rise considerably under the ACA, then employers could be more likely to offset those costs by cutting jobs or wages.
Today, the central difficulty in analyzing the labor market implications of ACA regulations is that most significant rules have only been recently implemented. For instance, the employer mandate was scheduled for January 1, 2014, but the White House delayed the mandate to January 1, 2015, and then delayed it again to January 1, 2016 for businesses with 50 to 99 employees.”
“Obamacare is taking a toll on small businesses, according to a new analysis of the effects of the health-care reform law, which found billions of dollars in reduced pay and hundreds of thousands fewer jobs.
Take-home pay at small businesses was trimmed by some $22.6 billion annually because of the Affordable Care Act and related insurance premium hikes, researchers at the American Action Forum, a center-right think tank headed by former Congressional Budget Office director Douglas Holtz-Eakin, found in a report released Tuesday.
Individual year-round employees at businesses with 50 to 99 workers lost $935 annually, while those at firms with 20 to 49 workers are out an average of $827.50 per person in take-home pay, the report found.”
“Obamacare’s defenders are busy declaring victory again. Ezra Klein is touting a new survey of Obamacare benchmark premiums in some regions of the country as evidence that the law is defying the predictions of critics and working to cut costs rather than increase them.
But, as Bob Laszewski notes, the truth about Obamacare implementation is far less rosy than the latest round of cheerleading would indicate.
For starters, the federal and state websites remain largely a dysfunctional mess, although the media isn’t really covering the story anymore. The supposed “fix” that allowed millions of consumers to sign up with plans on the exchanges from December through April really wasn’t much of a fix after all. It was a workaround, allowing consumers to access large federal subsidies with minimal verification.”
“New Health and Human Services Secretary Sylvia Mathews Burwell tried to hit the reset button on perceptions of the health-care rollout in her first public speech since taking the job at the embattled department overseeing it.
“What I’ve told my team at HHS is that we’re not here to fight last year’s battles, we’re here to fight for affordability, access and quality,” said Ms. Burwell to an audience of George Washington University students and faculty on Monday. “Let’s move beyond the back and forth, let’s move forward together.”
Ms. Burwell is stepping into the spotlight after around 100 days on the job and as the agency tries to reorient itself in time for the new enrollment season when millions more Americans are supposed to come to HealthCare.gov to buy coverage in just a few weeks.
She has brought on board several new faces since taking over as secretary from Kathleen Sebelius. They include the head of Connecticut’s health insurance exchange Kevin Counihan to serve as CEO for the site, former clean-up contractor Andy Slavitt as an operations administrator at the Centers for Medicare and Medicaid Services, and her former Walmart colleague Leslie Dach as her senior counselor.”
“Heading into the 2014 mid-term congressional elections, health care is not shaping up as a make-or-break issue, according to a new poll.
Health care trails jobs and the economy as a top issue on voters’ minds this fall, 21 percent to 13 percent. Only 3 percent of voters in the monthly tracking poll by the Kaiser Family Foundation mentioned the health law by any name (Affordable Care Act/Obamacare) when asked about issues most likely to determine their vote. (Kaiser Health News is an editorially independent program of the foundation).
Health care is even less important to independent voters, those who frequently decide close races. While Democrats and Republicans both chose health care as their second ranked issues with 15 and 16 percent respectively, independents rank of health care tied for fifth with 9 percent.
The issue is, however, nonetheless playing a role in the current campaigns, particularly in key swing states where control of the U.S. Senate is at stake. Republicans need to capture a net gain of six seats to gain a majority in that chamber.”