A project of the Galen Institute

Issue: "Mandates"

Experts question MNsure average rate increase of 4.5 percent

Ricardo Lopez, Minneapolis Star-Tribune
Fri, 2014-10-24
"Almost immediately after the state’s insurance regulator earlier this month announced that rates for plans sold through MNsure would rise 4.5 percent on average, Republicans, health policy experts and other critics decried the figure as bogus and misleading. The state Commerce Department has steadfastly defended the figure — a straight average of rate changes reported by the four returning carriers to MNsure — acknowledging that some consumers will see higher or lower rate changes. State agency officials said consumers can shop around once open enrollment begins Nov. 15 “to find the best option that fits their individual health and financial needs.” But other states, like California, Colorado and Washington, report their increases in premiums for their respective exchange plans as weighted averages. Calculated that way, Minnesota’s figure for next year is not 4.5 percent, but 11.8 percent."

Now There Can Be No Doubt: Obamacare Has Increased Non-Group Premiums In Nearly All States

Chris Conover
Forbes
Thu, 2014-10-23
"Remember this categorical assurance from President Obama? “We’ll lower premiums by up to $2,500 for a typical family per year. .  .  . We’ll do it by the end of my first term as president of the United States” OK, it’s probably a little unfair to take some June 2008 campaign “puffery” literally–even though it was reiterated by candidate Obama’s economic policy advisor, Jason Furman in a sit-down with a New York Times reporter: “‘We think we could get to $2,500 in savings by the end of the first term, or be very close to it.” Moreover, President Obama subsequently doubled-down on his promise in July 2012, assuring small business owners “your premiums will go down.” Fortunately, the Washington Post fact-checker, Glenn Kessler, honestly awarded the 2012 claim Three Pinocchios (“Significant factual error and/or obvious contradictions”)."

Sorry, Obamacare Is Still Unfixable

Ramesh Ponnuru
Bloomberg View
Thu, 2014-10-23
"For the most part, the political debate over President Barack Obama's health-care overhaul has become a duel between vague slogans: Republicans say they want to "replace" the Affordable Care Act but generally don't say with what. Democrats say they want to "fix" it but usually don't say how. So Democratic Senators Mark Warner and Mark Begich deserve credit for advancing specific legislation to change the law. The main change they're advocating, though, is unlikely to make people any happier with the law -- and could cause new problems."

The Real Story on How Much Obamacare Increased Coverage

Ed Haislmaier and Drew Gonshorowski
The Daily Signal
Thu, 2014-10-23
"We now have the Medicaid and private-market health insurance enrollment data for the second quarter of 2014 needed to complete the picture of how Obamacare’s rollout affected coverage. What we’ve learned is that the Obamacare gains in coverage were largely a result of the Medicaid expansion and that most of the gain in private coverage through the government exchanges was offset by a decline in employer-based coverage. In other words, it is likely that most of the people who got coverage through the exchanges were already insured."

Reestimating Obamacare: The evidence mounts that it will increase future deficits, despite what CBO says.

James Capretta
American Action Forum
Thu, 2014-10-23
"During the long congressional debate over the Affordable Care Act (ACA) — i.e., Obamacare — one thing was certain: The Congressional Budget Office (CBO) would ultimately certify that the final legislation would lower future budget deficits. It had to be that way. President Obama had made an unequivocal promise in a nationally televised address to Congress: He would not sign a bill that added “one dime” to projected federal deficits. The only way to make good on that promise was to have in hand a CBO cost estimate showing modest deficit reduction from the law’s provisions. CBO delivered what the president was looking for with its final cost estimate of the legislation in March 2010."

New for 2015: Obamacare insurers' opt-out clause

Dan Mangan, CNBC
Thu, 2014-10-23
"These insurers will sell you some Obamacare—at least as long as the government is footing the bill for most of their customers. Insurers doing business on HealthCare.gov will be allowed to terminate their health plans if there's a halt on federal tax credits that help most Obamacare customers buy the coverage, according to new language for 2015 contracts. The language giving insurers the new opt-out does make clear, however, that individual state laws still may force insurers to continue the coverage."

GOP 2016 contenders: Repeal Obamacare, reform Medicaid

Jennifer Rubin
Washington Post
Thu, 2014-10-23
"Gov. John Kasich of Ohio was the first potential 2016 candidate to get snared in the Obamacare/Medicaid media snafu. As one of several GOP governors who expanded Medicaid, he naturally defends that move, which in an Associated Press interview came out as a defense of Obamacare, to which the Medicaid extension was attached. Kasich clarified his view, but the liberal media, Democrats and potential 2016 opponents may think they have their gotcha quote. Kasich, however, is correct that one can be for repealing Obamacare and still support states’ expansion of Medicaid. But other governors should be forewarned: You better be crystal clear about what you want to do."

State-by-State Estimates of Individual Mandate Payments

Conor Ryan, American Action Forum
Thu, 2014-10-23
"Using data on household income and health insurance coverage maintained by the Census Bureau and McKinsey estimates on previously uninsured households enrolled through the Health Insurance Marketplace, the American Action Forum was able to construct state-level estimates of individual mandate payments. After accounting for exemptions, AAF estimates that 5.2 million people will be subject to the individual mandate penalty for being uninsured in 2014 and will pay a total of $5.8 billion in additional taxes. The AAF estimates include the exemptions for unauthorized immigrants, households that do not file income taxes, households that earn less than 138 percent of the federal poverty level, and households that cannot purchase a Bronze plan with 8 percent of household income, but do not attempt to project how many households may apply for one of the many hardship exemptions."

'•The ACA will push more women than men into part-time work.'

Casey Mulligan
Mercatus Center
Wed, 2014-10-22
"Much of the ACA’s tax effect resembles unemployment insurance: both encourage layoffs and discourage people from returning to work. The ACA’s overall impact on employment, however, will arguably be larger than that of any single piece of legislation since World War II. •The ACA’s employment taxes create strong incentives to work less. The health subsidies’ structure will put millions in a position in which working part time (29 hours or fewer, as defined by the ACA) will yield more disposable income than working their normal full-time schedule. •The reduction in weekly employment due to these ACA disincentives is estimated to be about 3 percent, or about 4 million fewer full-time-equivalent workers.

Obamacare’s small-business exchanges to see major changes in the coming months

J.D. Harrison, Washington Post
Wed, 2014-10-22
"One year in, the new small-business insurance marketplaces born out of the new federal health-care law have fallen short of their promise in nearly every state, both in terms of functionality and enrollment. However, many are scheduled to see some important updates heading into year two — ones that health officials say should make them much more useful and appealing to small employers and their workers. In the nation’s capital, for example, officials are preparing to roll out the third major update to the District of Columbia’s health-care marketplace, which already houses one of the country’s most robust small-business exchanges, often called SHOP (Small Business Health Options Program) exchanges. District small businesses have already been able to shop for and select plans online — an option that was delayed by at least a year in most states."

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