“Since enactment of the Affordable Care Act (ACA) in 2010, much of the attention in the policy community has been on modernizing Medicare’s traditional fee-for-service (FFS) program. Through Accountable Care Organizations (ACOs), larger “bundles” of payments to fee-for-service providers for episodes of care, and tests of pay-for-performance models, the hope is that the traditional Medicare model can be remade through sheer force of bureaucratic will. The stated intent is to find a way to pay for value, not volume.
These efforts may or may not bear much fruit, but, over the longer term, it’s not likely to matter much. That’s because a more important transformation of Medicare is already well underway and is occurring despite more resistance than assistance from the program’s bureaucracy. According to the 2014 Medicare Trustees’ report, enrollment in Medicare Advantage – the private plan option in Medicare — has been surging for a decade.

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“During his post-midterm press conference yesterday, President Obama falsely claimed that Obamacare is working for Americans all over the country. Based on his rhetoric, he also seemed to fail at understanding the damage votes for his signature piece of legislation did to his former Democrat majority in the Senate.
According to Tuesday’s results and elections over the past few years, 28 Senators who voted for Obamacare will no longer be holding seats on Capitol Hill when January rolls around.”

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“On Dec. 24, 2009, the Democratic-controlled Senate passed President Obama’s healthcare law with a filibuster-proof 60-vote majority, triggering a massive backlash that propelled Republicans to control of the House the following year. On the Senate side, going into Tuesday’s elections, 24 senators who voted for Obamacare were already out or not going be part of the new Senate being sworn in on January.
To be sure, it isn’t fair to attribute all of the turnover in the chamber to Obamacare. Many senators voted for Obamacare and lost re-election battles in which they were hit hard for their support for the law, and other Democrats were forced to retire because they had no hope of getting re-elected given their support for the law. But in some cases — such as John Kerry leaving his seat to become secretary of state, or Robert Byrd passing away — Obamacare clearly had nothing to do with it.”

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“Republicans have retaken the Senate in the 2014 midterm elections. As of this writing, Republicans will gain somewhere between 7 and 9 seats—depending on what happens in Louisiana and Alaska—for a total of 52 to 54. The new Republican majority will doubtless hold a symbolic vote to repeal Obamacare. But more importantly, Republicans will now be able make smaller changes to the health law that President Obama might actually sign into law. Here are some of the possibilities that have been talked about in the press, but also many that have not.”

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“Republican candidates won a decisive victory at the voting booth on Tuesday, in all races: House, Senate, governorships, and state legislatures. The future of Obamacare has never looked more bleak.
The next battle is more daunting: the Republican Party needs to avoid shooting itself in the foot, govern in a way that achieves results rather than perpetuates partisan bickering, and continue to develop patient-centered health reform for the post-Obamacare future. Although Obamacare itself will not be repealed until January 2017, Republican success yesterday gives depth, resilience, and energy to the post-Obamacare health reform movement.”

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“There is nothing more time consuming and expensive for a patient than undergoing extra tests or procedures during a trip to the emergency room, doctor’s office or urgent care center.
Often a physician will know exactly what a patient’s diagnosis is but will order an x-ray, CT scan, blood work or MRI to reaffirm his clinical judgment. The common rationale is to back up his opinion in case there is a lawsuit.”

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“LOS ANGELES On the heels of an advertising blitz funded by health insurance companies, California voters on Tuesday tanked a proposal to give the state’s insurance commissioner veto authority over health insurance premiums.
About 60 percent of voters cast ballots against the plan to give the elected commissioner expanded authority over small group and individual health plans.”

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“While the GOP came out on top in today’s national vote, there was good news and bad news for both parties, relatively speaking, in today’s election according to CBS News exit polls. Overall, the Republicans’ advantages abounded. Concerns about terrorism, health care and the economy all provided them with a national vote edge. Among the nearly half of voters who said the health care law went too far, 83 percent supported Republican candidates. Those who were worried about terrorism–71 percent of voters–also gave GOP candidates a boost of 58 percent to 40 percent for Democrats.”

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“When the Affordable Care Act marketplace opens on Nov. 15, consumers can expect healthcare.gov to have robust technology, amped-up functions, and a shorter application form for individual plans.
What they won’t see – and likely won’t know about – are the ongoing communication problems that many on the insurance industry say continue to plague the “back-end” transfer of consumer files between the website and insurance companies.”

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“With two chambers of Congress under GOP control, the budget process could give the party its best chance to alter Obamacare, particularly if Senate Republicans try to use budget reconciliation, which requires just 51 votes. Congress will also try to fix the Sustainable Growth Rate, a pricey formula by which the government reimburses doctors who treat Medicare patients.”

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