A project of the Galen Institute
Los Angeles Times
09/25/14
"The 2010 federal healthcare law experimented with a number of ways to limit healthcare costs, but the real impetus to hold down spending has come from those who pay for coverage — most notably large employers and governments — and from doctors, hospitals and insurers seeking more sustainable business models. A good illustration is the HMO established recently by Anthem Blue Cross and several top Southern California hospitals, which will reward healthcare providers if they cut waste while improving patients' results. It's a welcome development, although the industry will have to go even further to rid itself of the perverse incentives that drive up costs."
John R. Graham, Forbes
09/25/14
"Are death panels on the rebound? Obamacare envisioned Medicare paying physicians to discuss end-of-live-care with their patients. When this sparked fierce blowback from citizens who feared that “death panels” would ration care to elderly patients, the Administration backed off. However, the American Medical Association (AMA) has been lobbying for the execution (pun intended) of this provision. The AMA is a business which profits from its monopoly over the billing codes that physicians use when they submit claims to Medicare. The more billing codes there are, the better it is for the AMA. For patients, however, it is risky to allow the government to pay physicians to counsel us on end-of-life issues. There is another approach, but it is so emotionally challenging that it may be impossible to implement."
Melissa Quinn, Daily Signal
09/25/14
"In 2009, President Obama repeatedly told the American people, “If you like the plan your health care plan, you’ll be able to keep your health care plan, period.” However, implementation of the Affordable Care Act, popularly known as Obamacare, quickly led to the debunking of the president’s claim. But why exactly did millions of Americans receive cancellation notices from their health insurance companies? Robert Graboyes, senior research fellow at George Mason University’s Mercatus Center, dug through the Affordable Care Act’s 1,000 pages and came up with a simple way to explain the specific provisions that prompt insurers to cancel plans."
Joseph Antos, AEI
09/25/14
"This week’s double-barreled release of government statistics on health insurance coverage leaves us with only one question: How many Americans are insured because of Obamacare? Remarkably, the two highly-regarded government surveys released this week do not even agree whether the number of uninsured increased or decreased. The survey that received a great deal of attention said there were 3.8 million fewer uninsured. The other, which was hardly noticed, found that there were 1.3 million more uninsured. The Centers for Disease Control (CDC) reported preliminary results on the expansion of health insurance coverage. Its National Health Interview Survey (NHIS) interviewed 27,000 people in the first three months of this year. The survey estimates that the number of uninsured dropped by 3.8 million since 2013. That represents a 1.3 percentage point decline in the uninsured rate, from 14.4 percent last year to 13.1 percent early this year."
Peter Gosselin, Bloomberg
09/25/14
"Nearly five years after passage, the Affordable Care Act (ACA) and a companion electronic health records (EHR) program have run a startup tab of more than $73 billion, the Bloomberg Government analysis finds. Part of that total is the cost of healthcare.gov, the flawed website and related enrollment system intended to expand U.S. health insurance coverage. BGOV’s analysis shows that costs for both healthcare.gov and the broader reform effort are far greater than anything publicly discussed. They’re also substantially greater than what the Congressional Budget Office (CBO) initially estimated health reform would cost by this point, although not what the agency’s more recent piecemeal estimates suggest."
John Wilkerson, Inside Health Policy
09/25/14
"Governors suggest in a new report that states consider easing restrictions on physician assistants to help deal with swelling Medicaid rolls. The National Governors Association says states should consider including PAs in the definition of "provider," loosening so-called scope-of-practice laws to let physicians delegate more tasks to PAs, opening clinical training sites and encouraging PAs to work in primary care. "To increase the use of the physician assistant workforce, states should review the laws and regulations affecting the profession and consider actions to increase the future supply of PAs," an NGA release states."
Julie Appleby, Kaiser Health News
09/25/14
"Insurers Cigna and Blue Shield of California misled consumers about the size of their networks of doctors and hospitals, leaving enrollees frustrated and owing large bills, according to two lawsuits filed this week in Los Angeles. “As a result, many patients were left without coverage in the course of treatment,” said Laura Antonini, staff attorney for Consumer Watchdog, a Santa Monica-based advocacy group that filed the case. Both cases allege that the insurers offered inadequate networks of doctors and hospitals and that the companies advertised lists of participating providers that were incorrect. Consumers learned their doctors were not, in fact, participating in the plans too late to switch to other insurers, the suits allege, and patients had to spend hours on customer service lines trying to get answers. Both cases seek class action status."
Nick Budnick, Oregonian
09/25/14
"Officials at Cover Oregon have realized the number of people affected by tax credit errors is much larger than previously thought -- meaning they may owe money at tax time. Early this month, The Oregonian revealed the existence of the erroneous formula, which had to do with the tax credits used by qualified individuals to reduce their premiums. Cover Oregon first noted the formula was wrong in January, but correcting it took a back seat to fixing the exchange's technological problems, officials said."
Noam Levey, LA Times
09/25/14
"The Obama administration, which is scrambling to prepare a new push to enroll Americans in health coverage under the federal health law, is reassessing how many more people will sign up, Health and Human Services Secretary Sylvia Mathews Burwell said Wednesday.. About 7.3 million people are enrolled in health plans being sold through marketplaces created this year by the Affordable Care Act, according to federal figures."
Inside Health Policy
09/24/14
"Several unions want the Labor Department to broadly authorize employer-sponsored "wraparound" coverage for workers to supplement their exchange plan benefits and subsidies, according to comments on a rule that is currently being reviewed by the White House. Under a little-noticed proposed rule the Labor Department issued on Dec. 24, the Obama administration proposed to treat as "excepted benefits" certain limited coverage provided by employers that would wrap around an individual market policy. If the wraparound coverage meets a number of requirements, it's considered an excepted benefit and would not disqualify the employee from getting subsidized coverage on the exchanges. While unions generally supported the concept, many complained that the parameters the administration proposed would prevent lower wage employees from having access to the coverage and they are the ones that would benefit most."

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