“Most health plans provide some prescription drug benefits. Drug coverage will become more prevalent as more uninsured families gain health insurance as a result of the 2010 Patient Protection and Affordable Care Act (ACA)… As drug coverage has become widespread, so have calls to impose additional regulations on drug plans and the firms that manage them. In the guise of protecting consumers, there are frequent calls for state and federal lawmakers to enact laws that hamper efficient management of prescription drug benefits. These efforts are short-sighted.”
“The architects of Obamacare designed the scheme without much thought to how its overlapping incentives would discourage competition on the price of the new coverage. Health plans will try to drive down costs by offering very narrow networks of providers that they can more easily control. It will be a race to the bottom to see which plan can offer the cheapest benefit, while still meeting minimum standards. But it won’t be a race to the bottom on price.”
“But the quality measures built into ObamaCare’s ACOs aren’t working so well yet either. Indeed, last week, virtually all of the health providers that Medicare has dubbed ‘Pioneer ACOs’—the program’s leaders and examples—sent a letter to Medicare officials overseeing the program in which they threatened to drop out. The reason is that the Pioneers feel that the performance and quality metrics aren’t up to snuff—and the data doesn’t yet exist to determine what the metrics should look like.”
“On Friday, HHS all but admitted that at least one element of the exchanges won’t be entirely ready on time: the Small business Health Options Program (SHOP) — the health insurance exchanges ObamaCare set up to serve small employers. The SHOP exchanges were supposed to be fully in place by January 1, 2014. But newly released regulations propose delaying a key part of the small business exchanges for a year: the employee choice provisions that were arguably the most significant feature of the program.”
“When Obamacare was being debated 2009, proponents banked heavily on its transformative potential. When skeptics caviled about the costs, the reformers pointed out that there were all sorts of pilots, and delivery system reforms like these ACO demonstration projects, that hadn’t gotten scored as cost-saving by the Congressional Budget Office… So far, pretty much every one of those promised improvements has underwhelmed, and the skeptics have been vindicated.”
“In some cases we’ve heard about, a local McDonalds has hired employees to operate the cash register or flip burgers for 20 hours a week and then the workers head to the nearby Burger King BKW -2.82% or Wendy’s to log another 20 hours. Other employees take the opposite shifts. Welcome to the strange new world of small-business hiring under ObamaCare.”
“The GAO has been issuing warnings about ObamaCare’s shaky budget assumptions for a while now, but this is the first time it’s put a concrete number against it. Still, bad as this $6.2 trillion deficit boost is, the real figure is likely to be much higher, since the GAO is still being far too optimistic about the rest of ObamaCare. Here are five big assumptions the GAO makes that aren’t likely to hold true.”
“House Republican doctors released a ‘healthcare state of the union’ video Wednesday that criticizes President Obama’s signature healthcare law but does not mention repealing it. The video shows floor speeches from frequent critics of the healthcare law, including Reps. Phil Roe (R-Tenn.) and Phil Gingrey (R-Ga.). It shows lawmakers arguing that the Affordable Care Act will raise costs and criticizing its taxes on medical devices.”
“A GOP subcommittee chairman railed against the medical-loss ratio (MLR) in President Obama’s healthcare law Wednesday for increasing fraud in the private sector. In committee, Rep. Joe Pitts (Pa.) said that most anti-fraud efforts are categorized as ‘administrative’ expenses and thus limited to 20 percent of a plan’s spending under the MLR.”
“Under a different set of assumptions, the law has the opposite effect over time, the GAO said — the deficit will increase by 0.7 percent of gross domestic product (GDP) if the law’s cost-containment measures are phased out. The report attributed this potential increase in part to the law’s most expensive features — the Medicaid expansion and the provision of insurance subsidies.”