By Chris Jacobs
We’ve seen few administrative controversies with Obamacare’s second open-enrollment season, but as a Wall Street Journal article noted last week, the start of the 2014 tax-filing season could bring a new wave of public discontent.
This tax-filing season brings the first enforcement of the Affordable Care Act’s individual mandate–the complexity of which could become a boon for tax-preparation firms. The instructions for completing the mandate exemption form run 12 pages, list 19 types of exemptions (with multiple codes), and include worksheets that may require individuals to go to their state exchange’s Web site to find the monthly premiums that will determine whether they had access to “affordable” coverage.
The outrage was swift and loud. Millions of people were feared to be in danger of losing their health insurance last year because their plans did not comply with the Affordable Care Act..
To keep people covered and quell consumer anger, President Barack Obama and many states allowed people to renew their old plans temporarily — including 73,000 in Maryland.
But that offer has expired and now people like Raymond Liu have been thrust onto health exchanges where they must purchase new plans. Many are finding higher premiums or less coverage, as they worried would happen.
By Megan McArdle: While I was away last week, Vermont decided to scuttle its single-payer health-care plans. I predicted as much six months ago, for one simple reason: A single-payer system would cost too much. When faced with the choice of imposing double-digit payroll taxes or dropping his cherished single-payer plan, the governor of Vermont blinked.
“But Megan!” I hear you cry. “Single-payer systems are cheaper, not more expensive! Look at Europe!”
Sarah Dutton, Jennifer De Pinto, Anthony Salvanto and Fred Backus: Fifty-two percent of Americans say they find basic medical care affordable, but that’s down from 61 percent last December. Today, for 46 percent of Americans, paying for medical care is a hardship, up 10 points.
Similarly, just over half of Americans are at least somewhat satisfied with their health care costs, while 43 percent are dissatisfied.
In November, voters across the country elected new Republican governors and legislators, many of whom campaigned heavily against Obamacare’s Medicaid expansion. Although some of these new leaders (including Governor-elect Asa Hutchinson in Arkansas) will be taking control of states that have opted into Obamacare expansion, there is new hope that these governors and state legislators will work to reduce government dependency and restore the working class.
One idea rapidly gaining currency among legislators and new governors’ transition teams is the possibility of renewing Medicaid expansion on a temporary basis for those who have already signed up, but immediately freezing enrollment going forward. This approach would stop the bleeding, but allow for a more gradual wind down of the program and allow enrollees to keep their plans until they increased their incomes, transitioning out of eligibility.
“The prices of some generic drugs have soared more than 1,000 percent in the last year, and federal officials are demanding that generic drug makers explain the reasons for the increases or potentially face new regulation.
The increased use of generic drugs has been one of the rare success stories in national efforts to curb the nation’s $2.8 trillion medical bill, since generics have historically been far cheaper than name-brand versions. More than eight in 10 prescriptions are filled with generic drugs, according to the Food and Drug Administration. In the 10-year period from the beginning of 2003 through 2012, generic drug use has generated more than $1.2 trillion in savings, according to the Generic Pharmaceutical Association.”
OBAMACARE DOESN’T AND CAN’T WORK. It is a rolling disaster that is wreaking havoc on the American economy and health care sector. Americans are experiencing first-hand the damage the law is doing. It is making their health
insurance more expensive, driving doctors out of practice, and undermining the goal of improved health care.
And the law doesn’t even come close to universal coverage—leaving at least 31 million uninsured, according to
estimates by the Congressional Budget Office.
So what should we do to fix the mess? Some conservatives want Republicans to rally around one bill to replace ObamaCare and then take that plan to the voters for the November elections. That approach, however, entails both
political and policy risks that can be mitigated with a different strategy.
Conservatives should focus first on laying out a vision of true competition and patient choice, gaining a mandate from voters to begin to pass ‘repeal and replace’ bills in the next session of Congress based upon the vision of providing people with access to quality, affordable, innovative health care.”
“Media coverage of the two Supreme Court cases challenging Obamacare’s HHS mandate for employers to provide workers with “free” coverage of abortion-inducing drugs largely focused on Hobby Lobby, the arts and crafts chain founded by the Greens, an evangelical Christian family.
The case of another family-owned business also was heard by the high court, though — that of Conestoga Wood Specialties and the Hahns, Mennonite Christians from East Earl, Pa. The Hahns established their business — the manufacture of custom wood kitchen cabinets and parts — on Christian values and say they’re committed to applying those values in the workplace.
Why did they go to court, represented by the Alliance Defending Freedom? Regulations drawn up by the Department of Health and Human Services to implement the Affordable Care Act, or Obamacare, included the HHS rule mandating that employee insurance plans cover 20 forms of contraception, four of which are considered seen by many to be potentially life-ending.”
““Direct primary care” is a rapidly growing alternative to the traditional “fee-for-service” model of paying for medical care. Instead of the patient or his insurance plan paying the doctor separately for each visit or service, the patient pays the physician a set monthly fee. In exchange, the physician is available to consult with and treat the patient as necessary.
For patients, the benefits of direct primary care are greater access to their doctors and more convenient and personalized care. Under direct primary care, patients can generally expect “all primary care services covered, including care management and care coordination…seven-day-a-week, around the clock access to doctors, same-day appointments, office visits of at least 30 minutes, basic tests at no additional charge, and phone and email access to the physician.” Some practices may offer additional services under the arrangement, such as EKGs or medications at wholesale cost.
Physicians benefit from eliminating costly and time-consuming overhead required to get paid on a fee-for-service basis. It also enables them to reduce their practice costs and spend more time actually treating their patients–-which is why they became doctors in the first place.
Direct primary care often comes with a reasonable price tag. Twelve percent of direct primary care practices charge less than $50 per person per month. One-third of practices charge $50 to $100 per month, and nearly two-thirds charge $135 or less per month. Those rates compare quite favorably to other common monthly consumer expenses. For instance, the average monthly cable bill is $123 a month, and, according to the U.S. Census Bureau, the average household spends $221 a month on gasoline and $320 a month on groceries.”
“The annual report from the Social Security and Medicare trustees predicted that Medicare will be solvent until 2030, four years later than the trustees predicted last year. That’s thanks to the recent slowdown in Medicare spending and a stronger economy that yields higher revenue through payroll tax contributions to the Medicare trust fund.
The administration and congressional Democrats are taking credit for elements of the Affordable Care Act that have helped to slow the growth in Medicare spending, and they warn against changes to Medicare that they fear would shift costs to seniors and undermine the program.
Republicans, however, see little good in the trustees’ report. “Don’t be fooled by the news that Medicare has a few more years of solvency,” Rep. Kevin Brady, chairman of the House Ways and Means subcommittee on health, said in a statement. More fundamental changes to Medicare are needed, many Republicans argue, such as transforming the program to a premium-support or voucher model.
Here are three points that might have been lost in the back and forth over the report by those on the left and the right:”