A project of the Galen Institute

Issue: "Business Impact"

'•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."

HHS-Funded Study: Obamacare Will Suffer ‘Death Spiral’ If Subsidies Fail

Sarah Hurtubise, Daily Caller
Tue, 2014-10-21
"The Obama administration has funded a new study by top consulting firm RAND Health that startlingly finds that if taxpayer subsidies are eliminated, Obamacare exchanges will fall into a “death spiral.” The study comes in the wake of a number of lawsuits which are challenging the Obama administration’s implementation of Obamacare subsidies. Three lawsuits have made it to U.S. Circuit Courts, just one step from the Supreme Court, arguing that the text of the Affordable Care Act allows premium subsidies for state-run exchanges only. (RELATED: Second Court Strikes Down Obamacare Subsidies In Federal Exchanges)"

A recent poll shows that most doctors give Obamacare low grades – but should this influence voters’ evaluation of the program?

Ilya Somin
Washington Post
Tue, 2014-10-21
"A recent survey of doctors by the Physicians Foundation finds that most give low grades to Obamacare. Some 46% of the doctors polled gave Obamacare a grade of “D” or “F” and 29% gave it a “C.” Only 25 percent give it an “A” or a “B,” including just 4% who gave it the highest grade. It’s possible that some of the doctors who chose C really meant to say that it was at least reasonably good. But in modern America, thanks to grade inflation, a C is generally considered a very bad grade. Thus, it seems likely that a large majority of doctors have strongly negative view of the program."

More Plans Setting Spending Limits For Some Medical Services

Michelle Andrews, Kaiser Health News
Tue, 2014-10-21
"Aiming to contain health care costs, a growing number of employers and insurers are adopting a strategy that limits how much they’ll pay for certain medical services such as knee replacements, lab tests and complex imaging. A recent study found that savings from such moves may be modest, however, and some experts question whether “reference pricing,” as it’s called, is good for consumers. The California Public Employees’ Retirement System (CalPERS), which administers the health insurance benefits for 1.4 million state workers, retirees and their families, has one of the more established reference pricing systems. More than three years ago, the agency began using reference pricing for elective knee and hip replacements, two common procedures for which hospital prices varied widely without discernible differences in quality, says Ann Boynton, CalPERS’ deputy executive officer for Benefit Programs Policy and Planning."

Ask Your Doctor About Obama's Affordable Care Act

Jason Fodeman
Investors.com
Mon, 2014-10-20
"You shouldn't judge the Affordable Care Act based on headlines or by listening to politicians or talking heads. I tried for a while, but only heard wildly conflicting stories that seemed to have little basis in reality. Instead, you should ask someone who actually deals with the law on a daily basis — a doctor, for instance. The Physicians Foundation did exactly that in its "2014 Survey of American Physicians," which was released last month. The survey, which reached over 80% of doctors in the U.S. and elicited responses from some 20,000, is doctors' collective report card on the Affordable Care Act's first four years. The grades aren't good. Only 25% of doctors give it an "A" or a "B" grade. Nearly half ( 46%) give it a "D" or an "F""

Why doctors give Obamacare a failing grade

Jeffrey Singer
The Hill
Sun, 2014-10-19
"The Physicians Foundation made shockwaves last month when it released its 2014 Survey of America’s Physicians. The survey’s top-line finding: Of the 20,000 doctors surveyed, almost 50 percent stated that Obamacare deserves either a “D” or an “F.” Only a quarter of physicians graded it as either an “A” or a “B.” Count me among the discontented. Obamacare has harmed too many of my patients. It has done so by disrupting the doctor-patient relationship and thereby worsening the quality of patients’ care. This is the heart and soul of medicine, as I have learned in in my 33 years as a practicing physician. The doctor-patient relationship is critical for positive health outcomes because it allows both parties to work together to identify and ultimately treat medical problems. Simply put, a relationship of trust and continuity is essential to our professional mission."

Obamacare cancellations, again: Column

Tim Phillips
USA Today
Sun, 2014-10-19
"Last fall, millions of Americans breathed a sigh of relief when Obamacare didn't cancel their health care plans. Now they're holding their breath once again. Hundreds of thousands of Americans will soon receive cancellation letters affecting their 2015 health care plans — and that number may quickly rise into the millions. This wave of cancellations will fall into two categories. The first group hit will be in the individual market, the same group that suffered through at least 6.3 million cancellation letters last year. They will almost certainly be joined by millions of people in the small-employer market, which has 40 million plans and will be under Obamacare's control starting next year."

Will Obamacare's State Exchanges Be Ready for Year 2?

Briana Ehley
Fiscal Times
Thu, 2014-10-16
"With just one month to go until the start of Obamacare’s second open enrollment period, state and federal officials are being cautiously optimistic about their health exchange websites—assuring the public that there won’t be a repeat of last year’s technological nightmare.Speaking to health reporters last week, Health and Human Services Secretary Sylvia Burwell touted the newly revamped Healthcare.gov as a vast improvement over last year’s website—which was plagued with technical glitches.Related: Millions Wasted on Broken Obamacare State WebsitesBut when asked about how some of state exchanges that had trouble last year are shaping up, Burwell hesitated and said HHS is monitoring them on a state-by-state basis."

Administration Signals Doubts About Calculator Permitting Plans Without Hospital Benefits

Jay Hancock
Kaiser Health News
Thu, 2014-10-16
"Insurance consultants were shocked recently to learn that Obama administration rules allow large companies to offer 2015 worker health plans that don’t include hospital benefits. Now the administration is concerned too. Treasury Department officials are preparing to reverse course on an official calculator that permits plans without hospital coverage to pass the health law’s strictest standard for large employers, said industry lawyers who have spoken to them. These sources expect the administration to disallow such coverage by the end of the year."

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