“The Commonwealth Fund has a new study out on Obamacare enrollment, estimating that about 9.5 million people gained coverage through Medicaid and the exchanges; this is roughly in line with some previous estimates but perhaps slightly more encouraging for the law’s supporters. Jonathan Cohn uses the estimate to declare that the law is meeting expectations in covering the uninsured:
… The Congressional Budget Office predicted that, one year into full implementation, Obamacare would reduce the the number of Americans without insurance by 12 million. That included the young adults who got insurance before 2014, by signing onto their parents’ plans. There’s been some controversy over exactly how many more young people are insured because of that new option, but the best estimates I’ve seen place the number somewhere between 1 and 2.5 million. Add that number to the 9.5 million from the Commonwealth survey, and you’re close or equal to the CBO projections.
Of course, the Commonwealth survey has a hefty margin of error and the CBO projections, revised to take account of the early technological problems on Obamacare websites, were never that scientific. But the figures seem to be in the same ballpark. That’s what matters.

In broad strokes, this is plausible: Obamacare has stabilized, it’s insuring substantial numbers of people, the disaster scenarios have been averted and most people getting coverage seem reasonably happy with it. I would only offer the caveat that when Cohn says “in the same ballpark,” he means “in the same ballpark, but probably lower than what was hoped for, which in turn was lower than what was originally projected.””

“Alabama, buckle up. You’ll soon learn how much your health insurance premiums will go up for next year. The percentage increase will probably be in the double digits.
But that’s nothing compared to what you’ll face in 2017. In May, I released a comprehensive study showing how the Affordable Care Act — otherwise known as Obamacare — will likely play out. The diagnosis isn’t good.
In two years, the ACA will cause substantial premium increases. This will likely cause Alabamians to leave the insurance market in droves — they won’t be able to afford health insurance, even with federal subsidies. Within a decade, this could swell the ranks of the uninsured by nearly 11 percent.
I reached this conclusion by using a peer-reviewed economic model published in several health journals. It was funded by both private and government sources, including the Department of Health and Human Services.

“The government hasn’t reported how many people have signed up for health plans since the last enrollment period ended and it won’t estimate how many may enroll because of changes in their insurance.
Americans who get married, seek citizenship or lose jobs may find themselves invited to sign up for Obamacare by supporters trying to sustain momentum for the program as political attacks mount in its off-season.
By mid-April, the end of the first year’s official enrollment period, more than 8 million Americans gained coverage under the health law, beating the government’s own estimates. While standard enrollment won’t start again until Nov. 15, as many as 3 million people whose jobs or lives change in ways that affect their insurance may sign up immediately.
Supporters are seeking to dip into that group before the next enrollment begins. The goal: Keep their positive message alive at the grassroots, while offsetting any potential losses to enrollment totals from those who find alternative coverage, or simply drop out.”

“Tired of waiting for states to reduce their backlogs of Medicaid applications, the Obama administration has given six states until Monday to submit plans to resolve issues that have prevented more than 1 million low-income or disabled people from getting health coverage.
The targeted states are Alaska, California, Kansas, Michigan, Missouri and Tennessee.
“CMS is asking several state Medicaid agencies to provide updated mitigation plans to address gaps that exist in their eligibility and enrollment systems to ensure timely processing of applications and access to coverage for eligible people,” said Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services. He said the agency will monitor states’ progress in solving the problems getting people enrolled in the state-federal insurance program for the poor.”

“Before dawn on a Wednesday in January, Cesar Flores, a 40-year-old employed by a large retail chain, woke up at his home in Chula Vista, California. He got in his car and crossed the border into Tijuana. From there, he headed for a local hospital, where he got lab tests—part of routine follow-up to a kidney stone procedure. He had his blood drawn and left the hospital at 7:30. He arrived home before 10.
Uninsured Americans have long known that seeking medical care abroad is often more cost-effective than seeking it at home. Even after you factor in travel expense and time off work, you still often come out ahead. A hip replacement that would cost $75,000 for an uninsured patient in the U.S. is $9,000 in India. A heart bypass in the U.S. runs about $210,000; in Thailand it’s $12,000. According to Patients Beyond Borders, a company that facilitates medical tourism, those savings drove about 900,000 Americans to leave the country for medical procedures last year—a number they estimate is growing by 15 percent per year.
But Flores’s situation isn’t medical tourism as we know it. Flores has insurance through his wife’s employer. But his insurer, a small, three-year-old startup H.M.O. called MediExcel, requires Flores to obtain certain medical treatment at a hospital across the border. In part due to cost-pressures generated by the Affordable Care Act, other sorts of plans that require travel have the potential to expand.”

“When the District launched its federally mandated health insurance exchange last fall, officials went to great lengths to woo professional insurance brokers — launching a special broker web portal, establishing a “concierge” hotline just for brokers and holding broker-only training classes.
Despite those efforts, many brokers have yet to be paid for the policies they’ve sold through the exchange, known as D.C. Health Link — generating frustration among professionals who say their patience in navigating the changes wrought by the Affordable Care Act has not been rewarded.
“I’ve been very supportive, I put a lot of work into it, and I’ve gotten nothing,” said Steve Nearman, a Virginia-based broker who says he has helped nearly 100 city residents find and buy insurance through the exchange and is owed thousands of dollars in commissions.”

“ObamaCare hurts businesses. That’s the result of an exhaustive study polling small to medium-sized businesses.
The controversial government health-care reform increases company and employee costs and sometimes stops companies from hiring as well, participants told the International Foundation of Employee Benefit Plans in its new study.
“More than half of single employers believe the Affordable Care Act has had a negative effect on their company,” according to the report.
The survey, which polled some employers and their health-care pros, found that the majority of respondents, 54 percent, thought the effect of the ACA on their firms had been “negative” or “very negative.”
The same respondents also expected that the negative effects from ACA would increase to 66 percent in the near future as the program unfolds.”

“Chattanooga’s success in achieving bargain-priced policies offers valuable lessons for other parts of the country as they seek to satisfy consumers with insurance networks that limit their choices of doctors and hospitals. Nationwide, about 70 percent of the lowest-priced plans included narrow networks, according to the consultants McKinsey & Company.
But few places have put them into place as successfully as here in Eastern Tennessee, where BlueCross BlueShield of Tennessee, the area’s dominant insurer, cut a low price deal with one of the three big hospital systems to be the sole provider in their cheapest network. If all areas of the country had such low premiums, the federal government’s tab for subsidizing part of the cost of policies—totaling an estimated $29 billion for the fiscal year beginning Oct. 1—would be dramatically lower.”

“It was an important step forward for Republicans. They could have continued to deploy their anti-spending fervor against the discretionary side of the budget rather than taking on the larger, faster-growing, and politically trickier entitlements. They could, that is, have adopted a posture rather than a policy. Medicare reform was a sign the party was interested in governing again. Control of entitlements is after all a fiscal precondition for reform conservatism, or any other serious agenda.
Yet no larger agenda followed the Medicare initiative. Republicans’ advocacy of Medicare reform did not sink them, as Democrats had hoped, but neither did it supply an answer to voters’ concerns about the status of the American dream. And even as Ryan’s boldness got him a spot on the Republican ticket, it seems to have exhausted the appetite for innovation on the part of his colleagues. The Republicans were still narrowly focused on cutting spending.
A few Republicans started to adopt reformist themes following the 2012 election. Just a few weeks after it, Ryan criticized Republicans (though not his running mate) for having too little to say to Americans who do not run a business. Governor Bobby Jindal of Louisiana took aim at the Republicans’ tendency to identify, and be identified, exclusively with the rich. Senator Marco Rubio of Florida touted a proposal to address Americans’ anxieties about the rising cost and uncertain payoff of college.”

“Supporters of ObamaCare are nervously awaiting a decision by the D.C. Court of Appeals that could have even more dramatic consequences for the law’s ability to function than the Supreme Court’s religious liberty decisions issued last week.
Judge Thomas B. Griffith presided in March over arguments in one of the four cases – Halbig v. Burwell – challenging the Obama administration’s decision that subsidies for health insurance can flow through federal as well as state exchanges.
The Affordable Care Act says that health insurance subsidies are available only “through an exchange Established by the State.” The IRS, however, interpreted the statute to mean that the subsidies also could be distributed in the now 36 states where the federal government is operating exchanges.
During oral arguments, Judge A. Raymond Randolph indicated he felt the statute was quite clear in repeating “seven times” in that section that the subsidies are available only if the state sets up its own exchange.”