A project of the Galen Institute

Issue: "States"

Reforming Obamacare: Start With the Young

Real Clear Politics
Wed, 2015-01-21
After the lofty promises that led to passage of the Patient Protection and Affordable Care Act, young people are waking up to how much the law targets them with higher costs. Yes, those lucky enough to be covered on their parents' health plans can postpone the consequences until they are 26. But for the rest, the situation is grim: Young people face disproportionately high costs to pay for coverage and a crushing burden of taxes that could impede their future prosperity. Young people 20-35 constitute about 20 percent of America's population, but they represent 46 percent of the uninsured -- and, according to an analysis by Manhattan Institute scholar Avik Roy and colleagues, a 25-year-old male living in California and earning just $29,000 a year pays more than $1,140 more per year for health insurance due to the ACA.

Transcending King v. Burwell: With The Supreme Court's Blessing, The GOP Can Replace Obamacare's Exchanges

Forbes
Thu, 2015-01-15
By Avik Roy On March 4, the Supreme Court will hear oral arguments in King v. Burwell, the case that many pundits claim will “blow up Obamacare.” That’s an exaggeration; whatever the High Court decides, Obamacare will remain entrenched in federal law. But if the Supremes do end up ruling against the Obama administration—a distinct possibility—they will be giving Congress a uniquely important opportunity to reshape the Affordable Care Act in far-reaching ways. Here’s how that could work. Background on the Supreme Court case First, some background on the issue, one we’ve been writing about since 2011, before it reached the courts. Obamacare expands coverage to the uninsured using two mechanisms. The law was designed to achieve about half of its coverage expansion by expanding Medicaid, the 1965-vintage single-payer health care system for the poor.

Obamacare Problems? Now in Hands of IRS

Town Hall
Wed, 2015-01-14
Bruce Bialosky Deluged with catastrophes, court challenges and criticism, Obamacare (ACA) has had a controversial life to date. Yet it is ready to enter a completely new phase where the implementation gets shifted to the Internal Revenue Service – America’s favorite three words. If you liked the health care plan up to now, you ain’t seen nothing yet. 2010 was actually the first year that the IRS was involved in Obamacare enforcement. The Small Business Health Care Tax Credit went into effect with this filing year. You may remember I wrote that there was mass resistance to this credit by the tax-preparer community. We could not figure out how to get the credit for our clients while at the same time keeping the cost of preparing the paperwork lower than the actual credit being received by our clients.

Millions of Obamacare enrollees have to fill out tax forms

The Mercury
Wed, 2015-01-14
By RICARDO ALONSO-ZALDIVAR, Associated Press WASHINGTON — If you’re among the millions of consumers who got financial help for health insurance last year under President Barack Obama’s law, better keep an eye on your mailbox. The administration said Monday it has started sending out tax reporting forms that you’ll need to fill out your 2014 return. Like W-2s for health care, they’re for people who got health insurance tax credits provided under the law. Because this is the first time Americans will experience the complex connections between the health care law and taxes, there’s concern that some people may not realize the new forms are important, and that they do need to open that envelope. Some consumers may not know what to do with the paperwork. Called 1095-A, the forms come filled out with information from HealthCare.gov or your state’s insurance exchange.

Dissecting ObamaCare

CBS 60 Minutes
Mon, 2015-01-12
The following is a script of "Obamacare" which aired on Jan. 11, 2015. Lesley Stahl is the correspondent. Rich Bonin, producer. This month marks one year since health insurance coverage under the Affordable Care Act began, and from the president's point of view: so far, so good. More than 10 million Americans who didn't have health insurance before have signed up. But congressional Republicans are gunning for Obamacare. Even if they can't outright repeal it, they want an overhaul. And with the debate just getting underway, author Steven Brill, who has spent the past two years immersing himself in the subject, has come out with a new book, "America's Bitter Pill," that takes a comprehensive look at what the new law does and doesn't do.

Is Obamacare Squeezing The Middle Class?

Forbes
Tue, 2015-01-06
Here is something few pundits predicted. Poor, long-uninsured patients are getting Medicaid through Obamacare and finally going to the doctor’s office for care. But middle-class patients are increasingly staying away. Take Praveen Arla, who helps his father run a family practice in Hillview, Kentucky. The Arlas’ patient load used to be 45% commercially insured and 25% Medicaid. Those percentages are now reversed, report Laura Ungar and Jayne O’Donnell in USA Today. What’s the difference? Medicaid patients generally face no deductible or copayment when they seek care. But people who get health insurance at work or buy it in the (Obamacare) exchanges can face high out-of-pocket costs. Nationwide, the size of the average deductible more than doubled in eight years, from $584 to $1,217 for individual coverage according to the Kaiser Foundation. Deductibles of $1,000 and up are now the workplace norm.

2015: The ObamaCare Crucible

Commentary Magizine
Mon, 2015-01-05
By Tevi Troy The Affordable Care Act, otherwise known as ObamaCare, has had a tough run of it since being signed into law nearly five years ago. It has faced constitutional challenges, voters ousting congressional Democrats who supported it, and the disastrous rollout of its federal website in October 2013. This past fall, supporters launched a public-relations campaign dedicated to the proposition that things were finally going well for ObamaCare’s 7 million sign-ups, but their campaign was derailed when the Obama administration admitted that it had added 400,000 dental patients to the roster of health-insurance enrollees to falsely claim it had reached the 7 million number. It is likely that ObamaCare’s low point hasn’t been reached. The year 2015 is shaping up to be the ACA’s worst yet.

ObamaCare slaps states with $15 billion in new costs

Galen Institute
Mon, 2015-01-05
By Grace-Marie Turner Thirty-six states that rely on private managed care programs to provide medical services to all or some of their Medicaid recipients are facing an added ObamaCare tax. According to a report by Milliman consulting actuaries, states that contract with Medicaid managed care plans face up to $15 billion in added costs over 10 years for their share of the law’s tax on private health insurance. States will pay even if they strongly oppose ObamaCare and are refusing to establish health insurance exchanges or expand Medicaid. The health law imposes an annual tax on private health insurance plans – a tax designed to recoup what some call their “windfall” from the millions of new customers they could gain because of the law. The tax on health insurers was expected to raise a total of $8 billion in 2014 and as much as $150 billion over the next 10 years.

John Fund: As Vermont Goes...

National Review
Mon, 2014-12-22
The one state that not only embraced Obamacare but insisted on going beyond it to a full single-payer system was Vermont, the haven of hippies and expatriate New Yorkers, which has become one of the most liberal states in the nation. In 2011, it adopted a form of neighboring Canada’s government-financed health care and promised to implement it by 2017. (And Jonathan Gruber was a key architect of this plan as well as of Obamacare.) This week, however, Governor Peter Shumlin, a Democrat, admitted the state couldn’t afford the plan’s $2 billion price tag and consequent sky-high taxes, and pulled the plug. The lessons for Obamacare are obvious and profound. Scott Milne, the little-known Republican who opposed Shumlin in last month’s election and came within 1 percentage point of winning the most votes, isn’t surprised.

6 Reasons Why Vermont's Single-Payer Health Plan Was Doomed From The Start

Forbes
Mon, 2014-12-22
Avik Roy: Last week, Vermont Governor Peter Shumlin (D.) announced that he was pulling the plug on his four-year quest to impose single-payer, government-run health care on the residents of his state. “In my judgment,” said Shumlin at a press conference, “the potential economic disruption and risks would be too great to small businesses, working families, and the state’s economy.” The key reasons for Shumlin’s reversal are important to understand. They explain why the dream of single-payer health care in the U.S. is dead for the foreseeable future—but also why Obamacare will be difficult to repeal. Leading left-wing economists worked on Vermont plan Shumlin’s predecessor in Montpelier was a Republican, Jim Douglas. In 2009, Douglas announced that he would not be seeking a fifth two-year term; five Democrats joined the contest to replace him. Progressive activists demanded that each candidate promise to enact single-payer health care if nominated; all five complied.

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