A project of the Galen Institute

Issue: "Exchanges"

Gruber Model Errs in Colorado as Vermont Prepares to Rely on Data

Vermont Watchdog
Tue, 2014-12-16
By Bruce Parker | Vermont Watchdog Jonathan Gruber’s health care forecasting is failing in Colorado as Vermont’s Gov. Peter Shumlin prepares to use the economist’s math for single-payer health care. As Vermonters anxiously await a Gruber-modeled financing plan for Green Mountain Care, modeling done for Colorado’s health exchange by Jonathan Gruber Associates has proven wildly erroneous. In 2011, following Colorado’s decision to set up a state health exchange for Obamacare, the state hired Gruber to forecast enrollment trends from which the state and federal government could estimate costs. According to a presentation delivered to the Colorado Health Benefit Exchange Board on Sept.

Health Law Hurts Some Free Clinics

The Wall Street Journal
Mon, 2014-12-15
By Stephanie Armour: Some free health clinics serving the uninsured are shutting their doors because of funding shortfalls and low demand they attribute to the Affordable Care Act’s insurance expansion. Nearly a dozen clinics that have closed in the past two years cited the federal health law as a major reason. The closings have occurred largely in 28 states and Washington, D.C., which all expanded Medicaid, the federal-state insurance program for low-income people, and are being heralded by some clinic officials as a sign the health law is reducing the number of uninsured. Continued at... http://www.wsj.com/articles/health-law-hurts-some-free-clinics-1418429551

If the Supreme Court Breaks Obamacare, Will Republicans Fix It?

National Journal
Mon, 2014-12-15
By Sam Baker and Sophie Novack: Republicans want the Supreme Court to blow a major hole in Obamacare next year, but they are still debating whether they would help repair it—and what they should ask for in return. There's a very real chance the high court will invalidate Obamacare's insurance subsidies in most of the country, which would be devastating for the health care law. It would become almost entirely unworkable in most states, and the cost of coverage would skyrocket. That loss for the Affordable Care Act might seem like a clear-cut political win for the GOP, but the reality would be far messier. Such a ruling would weaken the law's individual mandate and make coverage unaffordable for millions of people.

A Post-ObamaCare Strategy

The Wall Street Journal
Mon, 2014-12-15
With the Supreme Court due to rule on a major ObamaCare legal challenge by next summer, thoughts in Washington are turning to the practical and political response. If the Court does strike down insurance subsidies, the question for Republicans running Congress is whether they will try to fix the problems Democrats created, or merely allow ObamaCare’s damage to grow. The time to define a strategy is soon, as King v. Burwell will be heard in March with a ruling likely in June. As a matter of ordinary statutory construction, the Court should find that when the law limited subsidies to insurance exchanges established by states, that does not include the 36 states where the feds run exchanges. But in that event one result would be an immediate refugee crisis. Of the 5.4 million consumers on federal exchanges, some 87% drew subsidies in 2014, according to a Rand Corporation analysis. Continued... http://www.wsj.com/articles/a-post-obamacare-strategy-1418601071

Medicaid is broken and expansion won't fix it

Washington Examiner
Mon, 2014-12-15
By Philip Klein | More than one in five Americans, or 68 million people, will receive their health coverage through Medicaid this year — more than any other government health program. But as it adds millions of beneficiaries as a result of President Obama’s healthcare law, there is mounting evidence that Medicaid is broken. Medicaid is administered jointly by the state and federal government, offering health coverage to Americans earning up to about $16,000 in the states participating in Obamacare’s expansion of the program and up to roughly $12,000 in the states that do not. Providing these benefits comes at a great cost to taxpayers. In fiscal 2013 (even before the program expanded) federal and state governments spent nearly $460 billion combined on Medicaid.

A Misleading Debate on Health-Care Costs

National Review
Fri, 2014-12-12
David Leonhardt of the New York Times has offered up a misleading defense of the Affordable Care Act (ACA) — i.e., Obamacare. Like several others, he celebrates the slowdown in health-care-cost escalation and suggests that the ACA is one reason for the deceleration. Specifically, he suggests that key ACA provisions — which he describes as nudging “the health care system away from paying for the quantity of medical care rather than the quality” — have already played a role in making the health system better and more efficient. It would be an effective argument for the ACA if it were true. Unfortunately, it isn’t. Leonhardt is responding to the recent government announcement that national health spending rose 3.6 percent in 2013. That’s certainly a low growth rate — well below the long-term trend over the past several decades. But it isn’t a trend that began with passage of the ACA. In 2001, national health spending rose 8.5 percent. The following year it rose 9.6 percent.

Economics professor brilliantly explains how Obamacare is a tax on full-time work

College Fix Staff
Mon, 2014-12-08
Casey Mulligan, a professor of economics at the University of Chicago and author of “Side Effects: The Economic Consequences of the Health Reform,” recently gave a speech in which he essentially explains in easily understood terms how the Affordable Care Act is a tax on full-time work, and a huge downer on our economy. It’s a must-read for anyone who wants to understand how Obamacare is dragging down our American workforce. Portions of his speech are reprinted below with permission from Imprimis, a publication of Hillsdale College: So what are the tax distortions that emanate from the ACA? Here let me simply focus on two aspects of the law: the employer mandate or employer penalty—the requirement that employers of a certain size either provide health insurance for full-time employees or pay a penalty for not doing so; and the exchanges—sometimes they’re called marketplaces—where people can purchase health insurance separate from their employer.

Newly insured struggle to find primary physicians

Associated Press
Mon, 2014-12-08
By KELLI KENNEDY Associated Press MIAMI -- When Olivia Papa signed up for a new health plan last year, her insurance company assigned her to a primary care doctor. The relatively healthy 61-year-old didn't try to see the doctor until last month, when she and her husband both needed authorization to see separate specialists. She called the doctor's office several times without luck. "They told me that they were not on the plan, they were never on the plan and they'd been trying to get their name off the plan all year," said Papa, who recently bought a plan from a different insurance company. It was no better with the next doctor she was assigned.

ObamaCare’s Threat to Private Practice

The Wall Street Journal
Mon, 2014-12-08
By Scott Gottlieb Dec. 7, 2014 5:12 p.m. ET Here’s a dirty little secret about recent attempts to fix ObamaCare. The “reforms,” approved by Senate and House leaders this summer and set to advance in the next Congress, adopt many of the Medicare payment reforms already in the Affordable Care Act. Both favor the consolidation of previously independent doctors into salaried roles inside larger institutions, usually tied to a central hospital, in effect ending independent medical practices. Republicans must embrace a different vision to this forced reorganization of how medicine is practiced in America if they want to offer an alternative to ObamaCare. The law’s defenders view this consolidation as a necessary step to enable payment provisions that shift the financial risk of delivering medical care onto providers and away from government programs like Medicare.

Exploring the shortcomings and fault lines of the Affordable Care Act

Physicians for a National Health Program
Mon, 2014-12-08
The case for single payer – Medicare for All By Jeoffry B. Gordon, M.D., M.P.H. December 3, 2014 The Patient Protection and Affordable Care Act (ACA) has as its main and overriding purpose the expansion and subsidization of health insurance coverage for many (usually poor and uninsured) Americans who were previously unable to reliably access medical services. Under its auspices, the federal law has provided for health insurance enrollment for 1 million to 3 million additional 19- to 26-year-olds; 6 million new, expanded Medicaid enrollees; and 7.2 million commercial Qualified Health Plan enrollees. Of the latter, about 80 percent qualify for financial subsidy. Taking into account additional factors, e.g. the fact that some of the new enrollees were previously insured, there has been a net gain of about 10 million people who have coverage. Yet even at full expansion, it is estimated that the ACA will not insure another 30 million U.S.

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