“Under Obamacare, the industry is transfigured from an inefficient, barely competitive mess that tries, against the laws of health care gravity, to control medical costs, to a non-competitive, profit-regulated utility rewarded with 15 to 20 extra cents for every dollar it allows its medical costs to rise.”
“Essentially, the Court struck down the mandate while retaining the penalty. So those champions of Obamacare who relied on behavioral economics to argue that the law’s individual mandate could be sufficient to avert an insurance death spiral must now contend with the fact that the Court has closed off that argument.”
“Regulations are slowly strangling HSAs. Under Obamacare, “fully insured” policies must spend at least 80 percent (small group and individual market) or 85 percent (large group market) of every premium dollar on health care related expenses (called the medical loss ratio or MLR). The remainder can be spent on administrative costs (improving health care delivery or combating fraud) and profits.”
“The Supreme Court has spoken, but problems built into the Affordable Care Act (ACA) have not been resolved by the decision and may have worsened. Even accepting the law’s assumptions about how the health system should be reformed, actually putting all the pieces in place is exceptionally expensive and difficult. If President Obama wins a second term, fiscal pressures and practical challenges will force him to scale back the unaffordable spending and slow down the unrealistic implementation timeline.”
“Logistically a company with only 30 full-time employees managing thousands of part-time employees sounds far-fetched. However, with this sort of perverse financial incentive, companies in many industries–-particularly those with low-skilled, low wage employees – will ‘do the math’ and hire part-time workers over full-time workers. While this may keep human resource departments busy, it will cause many businesses to miss out on some economies of scale, as they devote more time and effort to hiring and training part-time workers.”
“A new insider survey of 58 legal experts conducted after the oral arguments concluded found that most predict that the court will strike down the so-called individual mandate, a central provision within the law requiring that every American purchase a government-approved form of health insurance. The same expert survey was conducted before the hearings began, which found the opposite: Most thought the law would be upheld.”
“The Health and Human Services Department has missed nearly half of its legal deadlines while implementing President Obama’s healthcare law, according to an analysis by the American Action Forum. HHS has faced 42 statutory deadlines in the roughly two years since the Affordable Care Act became law — and it missed 20 of them, according to the AAF’s count.”
“In 1993, Augusta passed coverage laws that resemble those that ObamaCare is about to impose nationwide: Insurers could only vary premiums within narrow bands regardless of age or health status, a regulation known as community rating. Four of Maine’s five insurers in the individual market stopped offering coverage and fled, and the state entered an insurance ‘death spiral’ in which premiums don’t cover underlying medical costs. That leads to higher premiums, consumers dropping coverage as a result, and still higher premiums in turn.”
“HSAs prove that having more control over health care decisions goes a long way toward creating savings. Instead of building on this successful cost-saving model, Obamacare all but obliterates it. Many provisions of the law affect HSAs. For example, the medical loss ratio (MLR), which requires insurers to spend at least 80 percent (85 percent for group plans) of premiums on medical claims or quality improvement, weakens HSAs. Obamacare’s MLR does not take contributions to HSAs into account when determining if a plan meets the 80 percent threshold.”
“Here’s the reason the Affordable Care Act’s future is predictable: Its basic requirements have been tried, and failed, in many states in the past two decades. A new study, prepared by Milliman, Inc. for AHIP, the group representing America’s healthcare insurers, examines the experience of eight states, including Kentucky, Maine and Washington, that adopted the two basic pillars of the Obama plan in the 1990s.”