A project of the Galen Institute

Issue: "Federal Budget/Deficit"

The ACA: Some Unpleasant Welfare Arithmetic

Casey B. Mulligan, Cato Institute
Thu, 2014-08-21
"The Affordable Care Act (ACA) presents employers and potential employees with a variety of new rewards and penalties. These are, in part, exactly what the law intended: by penalizing potential employees for not purchasing health insurance, and employers for not providing it, the law aims to increase the fraction of the population with health insurance.

New York Federal Reserve: Higher Health Costs, More Part-Time Workers from Obamacare

Sean Hackbarth, U.S. Chamber of Commerce
Thu, 2014-08-21
"Obamacare puts employers in a bind, two New York Federal Reserve surveys show. Employers’ health care costs continue to rise, and the health care law is driving them to hire more part-time labor, CNBC reports: The median respondent to the N.Y. Fed surveys expects health coverage costs to jump by 10 percent next year, after seeing a similar percentage increase last year. Not all firms surveyed said the Affordable Care Act (ACA) is to blame for those cost increases to date. But a majority did, and the percentage of businesses that predicted the ACA will hike such costs next year is even higher than those that said it did this year. Obamacare's higher costs will cascade down to consumers.

Kill the tax exclusion for health insurance

Thomas P. Miller
National Review
Thu, 2014-08-21
"Last Saturday, August 16, marked the 60th anniversary of the enactment of the Internal Revenue Code of 1954, which permanently established in federal law generous tax advantages for employer-paid health-insurance premiums. Those group health benefits are excluded from employees’ taxable wages and thereby are not subject to income and payroll taxes. This tax break has been praised as a pillar of our employer-based private health-insurance system, but its age is showing. A growing list of critics agrees that the tax exclusion needs to be changed. The key questions are when and how. We should expect a significant overhaul, but not a full retirement party, within the next five to ten years. The simplified history of the tax exclusion for health care usually begins with a 1942 ruling by the War Labor Board that allowed employers to bypass wartime wage controls by providing fringe benefits to workers.

The Secret Committee Behind Our Soaring Health Care Costs

Katie Jennings
Politico
Thu, 2014-08-21
"It was late in the afternoon on a warm Friday in early fall and Doug Sumrell was mowing the lawn outside his suburban home in Evans, Georgia. As he pushed the mower across the yard, Sumrell began to feel faint — his chest tightened and the back of his neck started throbbing — so he went inside to take a break and drink a glass of water. But each time he went outside to finish the job, the feeling came back. He drove himself to the hospital as the sun was setting. On the way there, he left a message for his primary care doctor, Dr. Paul Fischer. At the hospital, a cardiac enzyme test showed Sumrell’s levels were extremely high, a strong indication that Sumrell had experienced a heart attack. The emergency room doctors said that they wanted to admit him, but it was already after midnight and Sumrell’s symptoms had subsided. His wife was out of town and their dog Buddy needed to be let out. Sumrell checked himself out of the hospital. He was jolted awake at 7:30 a.m. by the telephone.

Obamacare Or Not, Republicans Should Focus On Reducing The Cost Of Health Care

Avik Roy
Forbes Magazine
Thu, 2014-08-21
"For all the endless talk about reforming the health care system these past five years, it’s remarkable how little we’ve done to solve its actual problems. Spending hundreds of billions of taxpayer dollars to subsidize insurance coverage for several million people? That’s the easy part. The hard part is addressing the fact that American health care is so expensive. The high price of U.S. health care is the fundamental reason tens of millions of Americans are uninsured. It’s the principal suppressor of middle-class wage growth. It’s a constant threat to businesses’ operating margins, and it’s the primary driver of the federal debt. In May the American Health Policy Institute surveyed the chief human resource officers of 360 large employers, representing 10 million workers.

Conservative 'Alternative' to Obamacare Misses the Market

Ira Stoll
Reason
Wed, 2014-08-20
"Instead of shutting down Obamacare's insurance exchanges, the government should expand them so that they also include patients who now are covered by Medicaid, Medicare, and veterans health programs. That's the gist of a big new health care policy proposal that's getting a lot of attention. It's newsworthy in part because it's so counter-intuitive. It comes from a think tank, the Manhattan Institute, that's generally known for conservative, free-market, center-right policy ideas. You'd expect them to be in favor of repealing Obamacare entirely, not expanding it. The proposal is attracting respectful praise from other conservative voices.

How the IRS Is Botching Obamacare Tax Collection

Brianna Ehley, Fiscal Times
Wed, 2014-08-20
"he Internal Revenue Service is struggling to collect a new tax that’s critical to financing the president’s health care law – and auditors say the IRS’s flawed collecting process is allowing it to raise only three-quarters or so of the revenue that was originally expected.A new report from the Treasury Inspector General for Tax Administration (TIGTA) flags the enforcement of the medical device excise tax, one of a handful of new taxes imposed under the Affordable Care Act.Related: Obamacare’s Next Challenge: IRS VerificationThe Affordable Care Act’s excise tax – equal to 2.3 percent of the sales price of medical devices – took effect in January and is estimated to bring in about $20 billion through 2019, the Joint Committee on Taxation has said.Auditors say the IRS had originally estimated that the tax would bring in about $1.2 billion in the second and third quarters of 2013 – but it’s only received $913.4 million."

Government Will Withhold One-Third of the Records from Database of Physician Payments

Charles Ornstein, Pro Publica
Mon, 2014-08-18
"Next month, when the federal government releases data about payments to physicians from pharmaceutical and medical device makers, one-third of the records will be withheld because of data inconsistencies, an official told ProPublica. The issue is the latest hurdle for the federal government as it seeks to launch the already-delayed Open Payments database mandated under the Physician Payment Sunshine Act, a provision of the 2010 Affordable Care Act. Making this information public is a crucial step in promoting greater transparency about conflicts of interest in medicine. The Centers for Medicare and Medicaid Services first turned up flaws in the data in the past two weeks, while investigating a physician's complaint that payments were being attributed to him even though they were made to another physician with the same name.

TRANSCENDING OBAMACARE: A Patient-Centered Plan for Near-Universal Coverage and

Avik Roy
Manhattan Institute
Sat, 2014-08-16
"In 2010, President Obama signed into law the Patient Protection and Affordable Care Act, also known as the “Affordable Care Act,” the “ACA,” or “Obamacare.” The ACA will reduce the number of Americans without health insurance— an important goal—but it will do so by increasing the cost of U.S. health coverage. Increasing the cost of health coverage, in turn, will worsen two of the nation’s most important policy problems. The first of those problems is the increasing unaffordability of private health insurance, a problem that is straining the budgets of middle-income Americans, and hampering social mobility. The second problem is the nation’s grave long-term fiscal instability, a problem primarily driven by government spending on health insurance and health care. Indeed, the ACA will especially drive up the cost of private health insurance that individuals purchase directly.

The Obama Administration Has Little to Tout About Obamacare

Ed Haislmaier
The Daily Signal
Thu, 2014-08-14
"There has not exactly been an overabundance of good news on Obamacare. So it did come as some surprise two weeks ago when the Department of Health and Human Services issued a press release with the headline: “Consumers have saved a total of $9 billion on premiums,” and the subheading; “Health care law will return to families an average refund of $80 each this year.” There is nothing unusual or even untoward about the Obama administration doing what it can to put a positive spin on the law. But what makes this item interesting is it reveals how little the administration actually has to tout about Obamacare and how far it must reach to manufacture a success story. The purpose of the press release was to announce data on the effects of Obamacare’s “medical loss ratio” regulation, which “requires insurers to spend at least 80 percent of premium dollars on patient care and quality improvement activities.

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