A project of the Galen Institute

Issue: "Quality/Access"

Tara O’Neill: Obamacare Failed to Address ER Overcrowding

American Action Forum
Mon, 2015-05-18
One primary goal of the Affordable Care Act (ACA) was to expand access to affordable health care. However, in the five years since the ACA’s passage, we have found that while more people have health insurance, they do not necessarily have access to affordable health care. In order to pay for the subsidies that have facilitated the expansion of health insurance coverage, many recipients of federal funds were forced to accept payment reductions. Hospitals were faced with cuts of $260 billion over ten years.[1] These reductions came in the form of delayed payment updates for Medicare hospital services and reduced Disproportionate Share Hospital (DSH) payments meant to compensate hospitals for treating a high percentage of patients for whom the hospital is often inadequately reimbursed.

Felice J. Freyer: Report alleges cover-up of impending Health Connector failure

The Boston Globe
Mon, 2015-05-11
A report scheduled for release Monday by a conservative-leaning think tank accuses state officials of misleading the federal government and the public about the Massachusetts Health Connector’s readiness to launch its new website in October 2013. The report from the Pioneer Institute draws on public audit reports and interviews with anonymous people described as “whistle-blowers” to detail what they characterize as a bungled effort by the University of Massachusetts Medical School, software developer CGI, and the Connector to upgrade the Connector’s software in 2012 and 2013. The Connector — designed to link people with health insurance when they don’t have another source — eventually ended its relationships with UMass and CGI.

Chris Jacobs: An Obamacare Lesson for Small Health Insurers?

The Wall Street Journal
Fri, 2015-05-08
In 2011, analysts were speculating that Assurant Health might exit the insurance business, the Milwaukee Journal Sentinel reported last week. So the recent news that Assurant’s parent company was looking to “sell or shut down” the insurance carrier by year’s end was not a total surprise. The issue now is whether its demise holds larger lessons about Obamacare’s impact on insurance markets. One analyst called Assurant, which reported operating losses of nearly $64 million in fiscal 2014 and $84 million in the first quarter of fiscal 2015, a “casualty” of the law. The Affordable Care Act “required health plans to cover a package of basic benefits and required health insurers to spend at least 80 cents of every premium dollar on medical care or quality initiatives,” the Journal-Sentinel reported.

Contrary to goals, ER visits rise under Obamacare

USA Today
Mon, 2015-05-04
Three-quarters of emergency physicians say they've seen ER patient visits surge since Obamacare took effect — just the opposite of what many Americans expected would happen. A poll released today by the American College of Emergency Physicians shows that 28% of 2,099 doctors surveyed nationally saw large increases in volume, while 47% saw slight increases. By contrast, fewer than half of doctors reported any increases last year in the early days of the Affordable Care Act. Such hikes run counter to one of the goals of the health care overhaul, which is to reduce pressure on emergency rooms by getting more people insured through Medicaid or subsidized private coverage and providing better access to primary care. A major reason that hasn't happened is there simply aren't enough primary care physicians to handle all the newly insured patients, says ACEP President Mike Gerardi, an emergency physician in New Jersey.

Grace-Marie Turner: Cleaning Up The ObamaCare Mess

Forbes
Tue, 2015-04-28
Republicans are being ridiculed by the right and the left for weighing ideas that would rescue ObamaCare health insurance policies for people in 37 states if the petitioners prevail in King v Burwell. “Republicans Are Now Trying To Pass Obamacare Extension To Save Their Own Asses,” writes Allen Clifton in Forward Progressives. “GOP Gets Ready to Save the Day If the Court Strikes Down Obamacare Subsidies,” says Rush Limbaugh. If the Supreme Court decides against the Obama administration in the case, leaders in Congress are indeed determined to pass legislation to protect coverage for an estimated six million people. ObamaCare has so distorted the market for individually-purchased and small group health insurance that Congress has little choice but to throw them a safety net.

Connor Wolf: Obamacare Leaves Behind Millions Of Lower Income Workers

The Daily Caller
Tue, 2015-04-28
Despite being designed to help the poor, certain aspects of Obamacare are holding millions of individuals back who fall into what is being called the “coverage gap.” Reverend Vann R. Ellison, the president of the Florida based St. Matthew’s House, is trying to bring attention to the issue which he says affects people that fall between the $10,000 and $12,000 a year income range. St. Matthew’s House, which takes care of roughly 1,500 people, provides food and shelter to those individuals trying to work their way out of poverty. “We generally deal with lower income people trying to get their lives together,” Ellison told The Daily Caller News Foundation. “These are people that can’t afford their own apartments.” Those in that income range make too much to qualify for assistance under Obamacare but often times make too little to actually afford coverage or the fee that comes with not being covered.

Robert Moffit PhD: Five Years Later: Obamacare’s Dim Prospects

MedPage Today
Thu, 2015-04-23
Although the Affordable Care Act (ACA) was enacted 5 years ago, 2014 was the first year of implementation for most of the health law's major provisions. In fact, it turned out to be a glitch machine. Defying the expectations of even the law's most ardent critics, Obamacare's rollout of the federal online health exchange was a disaster, combined with the cancellation of millions of private health insurance policies (if you "liked" your plan, too bad), a delay in reporting requirements of the employer mandate, and new administrative exemptions from the individual mandate penalty. Nonetheless, the Obama administration's allies insist that the law is "working" and that it will even become popular with the majority of Americans with the passage of time. The law's congressional supporters, they hope, will reap political benefits rather than political retribution.

Ben Boychuk: Playing the specialty drug lottery

The Sacramento Bee
Fri, 2015-04-17
My son Benjamin has a serious growth hormone deficiency. He’ll be 13 years old in May but could easily pass for a boy of 8 or 9. In fact, many 8- and 9-year-olds are taller than him. He’s a full head shorter than all of his pals in seventh grade. Although his mother and I don’t have medical degrees, we medical degrees, we had Benjamin’s diagnosis pegged when he was 3 years old and still wearing clothing for an 18-month-old. Several trips to his pediatrician along with a couple simple tests to assess Benjamin’s bone age confirmed with data what we could see with our own eyes. Our boy wasn’t just in the bottom percentile in average height for kids his age – he was in the sub-basement

Chris Jacobs: Has Obamacare Enrollment Peaked?

The Wall Street Journal
Fri, 2015-04-10
Has the effort peaked to sign up uninsured Americans for coverage? The announcement that the nonprofit organization Enroll America is laying off staff and redirecting its focus in the face of funding cuts comes amid inconsistent sign-ups during the second Affordable Care Act open-enrollment period and concerns about affordability. A recent New York Times analysis compared Kaiser Family Foundation estimates of potential enrollees with sign-up data from the Department of Health and Human Services. While some states that signed up few people in 2014 recovered during the 2015 open enrollment, other states lagged: “California, the state with the most enrollments in 2014, increased them by only one percentage point this year, despite a big investment in outreach. New York improved by only two percentage points. Washington’s rates are unchanged.” Most states could not post consistent gains in both open-enrollment periods.

Chris Jacobs: Obamacare Enrollment Split: Subsidies vs. No Subsidies

The Wall Street Journal
Tue, 2015-03-31
Two reports released in the past week demonstrate a potential bifurcation in state insurance exchanges: The insurance marketplaces appear to be attracting a disproportionate share of low-income individuals who qualify for generous federal subsidies, while middle- and higher-income filers have generally eschewed the exchanges. On Wednesday, the consulting firm Avalere Health released an analysis of exchange enrollment. As of the end of the 2015 open-enrollment season, Avalere found the exchanges had enrolled 76% of eligible individuals with incomes between 100% and 150% of the federal poverty level—between $24,250 and $36,375 for a family of four. But for all income categories above 150% of poverty, exchanges have enrolled fewer than half of eligible individuals—and those percentages decline further as income rises.

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