A project of the Galen Institute

Issue: "Jobs/Economic Impact"

The Stakes Beyond the Halbig Lawsuit

Drew Altman for Wall Street Journal
Fri, 2014-07-25
"A lot of attention is being paid to the dueling decisions in two U.S. appeals courts about whether the U.S. government can provide tax credits to people in federal- as well as state-run insurance exchanges. In human terms, the stakes are high: Millions of moderate-income people will not be able to afford health coverage without a subsidy, and a court ruling could gut coverage expansion in the 36 states with federally run insurance exchanges, unless states decide to set up their own exchanges. One of the cases, Halbig v. Burwell, also adds uncertainty to the enrollment process set to begin this fall, when millions more people are expecting to get tax credits–and wondering if they may be taken away. Amid the reaction, little attention has been paid to whether Americans will perceive Halbig as a legitimate legal question or as more inside-Washington politics. The plaintiffs paint this as a case about statutory language and intent.

After Health Law Rulings, Here Are Possible Next Steps

"Margot Sanger-Katz, NY Times
Tue, 2014-07-22
"We now have two federal appeals courts that have issued conflicting rulings on a major provision of the Affordable Care Act. Those decisions are not the final word on whether residents of some states will be able to continue receiving financial assistance to buy health insurance. Here are some possible next steps:"

What We Learned About Obamacare July 8-14, 2014

Natalie Scholl, American Enterprise Institute
Tue, 2014-07-15
"1.) AEI’s Joseph Antos and James Capretta present “A health reform framework: Breaking out of the Medicaid model.” Here’s a peek: The Congressional Budget Office (CBO) projects that about one-third of the additional insurance coverage expected to occur because of the law will come from expansion of the existing, unreformed Medicaid program. The rest of the coverage expansion will come from enrolling millions of people into subsidized insurance offerings on the ACA exchanges — offerings that have strong similarities to Medicaid insurance. Unfortunately, ample evidence demonstrates that this kind of insurance model leaves the poor and lower-income households with inadequate access to health care…. 2.) “Some still lack coverage under health law,” notes The Wall Street Journal: Months after the sign-up deadline, thousands of Americans who purchased health insurance through the Affordable Care Act still don’t have coverage due to problems in enrollment systems.

What’s Trending in Health Care? Conservative Ideas.

Drew Altman in Wall Street Journal
Tue, 2014-07-15
"Conservative criticism of the Affordable Care Act has created the impression that liberal, “big government” ideas are driving the health-care system. But plenty of ideas that conservatives like are taking hold in health care as well. To wit: *The number of Medicare beneficiaries in private Medicare Advantage plans reached nearly 16 million this year, a record, and the Congressional Budget Office projects that it will hit 22 million by 2020. This partial privatization of Medicare is happening despite concerns that reductions in payments to private plans (what some call over-payments) would curtail enrollment. *More than half of people on Medicaid are enrolled in managed-care plans, which are typically run by private insurers that contract with states on a capitated, or risk, basis. More than 30 million low-income Medicaid beneficiaries are in private plans.

Why Improving Access to Health Care Does Not Save Money

Aaron E. Carroll, NY Times
Mon, 2014-07-14
"One of the oft-repeated arguments in favor of the Affordable Care Act is that it will reduce people’s need for more intensive care by increasing their access to preventive care. For example, people will use the emergency room less often because they will be able to see primary care physicians. Or, they will not develop as many chronic illnesses because they will be properly screened and treated early on. And they will not require significant and invasive care down the line because they will be better managed ahead of time. Moreover, it is often asserted that these developments will lead to reductions in health care spending. Unfortunately, a growing body of evidence makes the case that this may not be true. One of the most important facts about health care overhaul, and one that is often overlooked, is that all changes to the health care system involve trade-offs among access, quality and cost.

Alabama's Affordable Care Act Future is Bleak: Reader opinion

Stephen Parente, AL.com
Thu, 2014-07-10
"Alabama, buckle up. You'll soon learn how much your health insurance premiums will go up for next year. The percentage increase will probably be in the double digits. But that's nothing compared to what you'll face in 2017. In May, I released a comprehensive study showing how the Affordable Care Act — otherwise known as Obamacare — will likely play out. The diagnosis isn't good. In two years, the ACA will cause substantial premium increases. This will likely cause Alabamians to leave the insurance market in droves — they won't be able to afford health insurance, even with federal subsidies. Within a decade, this could swell the ranks of the uninsured by nearly 11 percent. I reached this conclusion by using a peer-reviewed economic model published in several health journals. It was funded by both private and government sources, including the Department of Health and Human Services.

Bosses bash Affordable Care Act: report

Gregory Bresiger, NY Post
Thu, 2014-07-10
"ObamaCare hurts businesses. That’s the result of an exhaustive study polling small to medium-sized businesses. The controversial government health-care reform increases company and employee costs and sometimes stops companies from hiring as well, participants told the International Foundation of Employee Benefit Plans in its new study. “More than half of single employers believe the Affordable Care Act has had a negative effect on their company,” according to the report. The survey, which polled some employers and their health-care pros, found that the majority of respondents, 54 percent, thought the effect of the ACA on their firms had been “negative” or “very negative.” The same respondents also expected that the negative effects from ACA would increase to 66 percent in the near future as the program unfolds."

Why the Political Heat on the ACA Is Cooling

Drew Altman, CEO of Kaiser Family Foundation
Tue, 2014-07-08
"Several indicators suggest that the political waters may be calming for the Affordable Care Act (ACA). This doesn’t guarantee that the law will achieve its goals and be judged a success. It means that the law stands a better chance of being implemented free of constant political turmoil–and will have a better shot at success. Consider: *Public support for the ACA fell after the Web site debacle last fall, but while overall opinion toward the law continues to tilt negative, the falloff in the polls has stopped, according to the June Kaiser Family Foundation Health Tracking poll. *After the administration rapidly repaired the Web site, the ACA exceeded the widely cited 7 million target for the first open-enrollment season, which had become a political litmus test for the law.

Workers Worried Employers Will Move Them To Obamacare Exchanges

Jonathan Easley
Mon, 2014-07-07
"The Supreme Court’s ruling this week that “closely-held” companies like Hobby Lobby aren’t obligated to comply with the health law’s contraception mandate because it conflicts with their religious beliefs has put a renewed focus on the employer-sponsored healthcare. Consumers getting their healthcare through their employers is a deeply ingrained practice in the United States (although that trend has been diminishing in recent years), and the court ruling has sparked all kinds of arguments pertaining to that the arrangement. Some have concluded that it will lead workers to seek alternatives outside the workplace, which they can find on the federal health exchanges created under Obamacare. However, a new poll from Morning Consult found that the public isn’t there yet. In fact, a strong majority of workers are worried that their employers will stop offering health insurance altogether and move them into the Obamacare exchanges.

Why Liberals are Abandoning the Obamacare Employer Mandate

Paige Winfield Cunningham and Kyle Cheney, Politico
Mon, 2014-07-07
"Robert Gibbs’ prediction that Obamacare’s employer mandate would — and perhaps should — be jettisoned shocked Democrats back in April. By July, the former aide and longtime confidant of President Barack Obama had a lot more company. More and more liberal activists and policy experts who help shape Democratic thinking on health care have concluded that penalizing businesses if they don’t offer health insurance is an unnecessary element of the Affordable Care Act that may do more harm than good. Among them are experts at the Urban Institute and the Commonwealth Fund and prominent academics like legal scholar Tim Jost. The employer mandate, Jost wrote in a Health Affairs post in June, “cries out for repair.” Repealing it “might not be such a bad idea,” if it’s replaced with something better for workers and busi

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