“Research published last week in the British Medical Journal Open provides interesting insight into the cause of rising health care costs. Analysis of the study raises concerns that Obamacare could ultimately bend the cost curve up. The University of California at San Francisco research studied variations in the average charges of 10 commonly ordered outpatient blood tests in California hospitals in 2011, using data from the reports of nonfederal, general acute-care California hospitals to the California Office of Statewide Health and Planning Development.
The researchers uncovered significant and substantial variation in hospital charges across the Golden State. For example, the median charge for a basic metabolic panel (a routine laboratory test that includes such tests as sodium, potassium and glucose) was $214. Yet, for the 189 California hospitals that reported this test, the charges ranged between $35 and $7,303.”
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“Most of the political class seems to have decided that ObamaCare is working well enough, the opposition is fading, and the subsidies and regulation are settling in as the latest wing of the entitlement state. This flight from reality can’t last forever, especially as the evidence continues to pile up that the law is harming the labor market.
On Thursday the Federal Reserve Bank of Philadelphia reported the results of a special business survey on the Affordable Care Act and its influence on employment, compensation and benefits. Liberals claim ObamaCare is of little consequence to jobs, but the Philly Fed went to the source and asked employers qualitative questions about how they are responding in practice.
The bank reports that 78.8% of businesses in the district have made no change to the number of workers they employ as the specific result of ObamaCare and 3% are hiring more. More troubling, 18.2% are cutting jobs and employees. Some 18% shifted the composition of their workforce to a higher proportion of part-time labor. And 88.2% of the roughly half of businesses that modified their health plans as a result of ObamaCare passed along the costs through increasing the employee contribution to premiums, an effective cut in wages.
Those results are consistent with a New York Fed survey, also out this week, that asked “How, if at all, are you changing (or have you changed) any of the following because of the effects that the ACA is having on your business?” For “number of workers you employ,” 21% of Empire State manufacturers and 16.9% of service firms answered “reducing.””
“The Obama administration is moving forward with regulations meant to enable certain businesses and charities to steer clear of the Affordable Care Act’s so-called birth control mandate, while ensuring free contraception coverage for women under the law.
The action amounts to an administrative workaround in response to a slew of legal challenges from groups citing religious objections to portions of the mandate. In June, the Supreme Court ruled that closely held religious companies cannot be compelled to offer their employees certain forms of birth control.
Under the proposal, the government would step in and cover the law’s contraception requirements in instances where employers announce their religious objections in writing. The organizations would not have to play any direct role in providing for contraceptive coverage to which they object, according to a final interim rule from the Centers for Medicare and Medicaid.”
“The Affordable Care Act gives the president’s cabinet officers sweeping powers to implement the law, but the administration managed to overreach these powers by allowing people in 36 states to illegally access health insurance subsidies.
That was the conclusion of the D.C. Circuit Court of Appeals in July.
At issue is the ability of people who sign up for coverage through exchanges established by the federal government to receive credits to reduce the cost of their health insurance.
D.C. Appeals Court Judge Raymond Randolph said the statute was quite clear in repeating seven times that subsidies are available only “through an Exchange established by the State.”
When the health law was passed, its authors apparently believed they had sufficiently cajoled the states. Jonathan Gruber, a chief architect of the law, said in early 2012, “if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits.”
But when it became clear that most states would not be coerced, the White House called on the Internal Revenue Service to write a regulation that would allow the subsidies to flow through the default federal exchanges as well.
In Halbig v. Burwell, the D.C. court held that subsidies — as well as the coverage mandates that travel with them — apply only in states that have established their own exchanges.”
“Democrats generally are not campaigning on the Affordable Care Act, but in a new campaign ad Arkansas Sen. Mark Pryor does just that.
Some have commented on the fact that Mr. Pryor does not mention the ACA by name in the ad, referring to it as “a law he helped pass.” Just as interesting is the part of the law the ad features: its protections for people with pre-existing medical conditions. With all of the focus on the ACA’s rollout problems last fall and the ACA’s coverage expansion, we have not heard much about “pre-x” in some time, but in many respects it’s the mega benefit in the law.”
“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.
Yet these same rewards and penalties have additional effects, including on the incentive to work; Mulligan
(2014), for example, suggests that the ACA may reduce employment by 3 percent on average and have a range of
positive and negative effects on average hours worked.
In the work summarized here, I quantify the number of people who will have essentially no short-term financial reward from working more than 29 hours, since this would either render them ineligible for the ACA’s assistance or increase
the penalties that may be owed by their employer.
This is the first paper to show that the ACA will put millions of workers in the economically extreme situation of having
zero short-term financial reward (or less) to working full-time rather than part-time.”
“Insurance expansion under healthcare reform is starting to yield patient volume for hospitals, but the costs of staffing up for more patients are eclipsing the additional revenue.
Earnings reports for not-for-profit systems in the first half of the year show that many providers are seeing rising salary and benefit expenses cut into revenue gains, leading to smaller operating surpluses.
“As the pieces of the Affordable Care Act are coming together, it’s changing the demand for care,” said Jeff Jones, managing director at Huron Consulting Group. “It’s shifting the way that providers are thinking about their labor pools.”
A report from Standard & Poor’s similarly found that in 2013, expenses increased 7%, outpacing revenue growth of 5%. The rating agency attributed the rising costs to preparations that systems were making to prepare for healthcare reform, including staffing needs.”
“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. The surveys found that “36 percent of manufacturers and 25 percent of service firms said they were hiking prices in response” to Obamacare’s effects.
The Empire State Manufacturing Survey polls New York State manufacturers, and the Business Leaders Survey polls service firms in the New York Federal Reserve District.
A June Gallup poll found that four in ten Americans are spending more on health care in 2014 than in 2013.”
“A new poll shows 69% of California voters back Proposition 45, a November ballot measure giving the insurance commissioner the power to stop excessive health-insurance rate increases..
The Field Poll released Wednesday indicates broad support statewide for Proposition 45 ahead of what’s expected to be a costly and contentious battle between consumer groups and health insurers.
Overall, 69% of registered voters said they favored the health-rate regulation measure while 16% opposed it and 15% were undecided heading into the Nov. 4 election.
The poll found that a majority of registered Democrats and Republicans in the state supported Proposition 45.
Among Democrats, 75% of those surveyed offered support while 58% of Republicans also favored it.”
“Despite the president’s assurance that “if you like your health plan, you can keep your health plan,” Obamacare caused significant disruption to people’s coverage as the health insurance exchanges prepared for their first open enrollment. Beginning October 1, 2013, insurers knew they would struggle to price policies in the exchanges accurately.
The Affordable Care Act (ACA) included three mechanisms to backstop insurers’ risks: risk adjustment, reinsurance and risk corridors. The first, risk adjustment, consists of perpetual transfers of money from unexpectedly profitable insurers to unexpectedly loss-making insurers and is — at least conceptually — necessary to mitigate risk in a market where insurers are forbidden to charge beneficiaries actuarially accurate premiums.
The other two mechanisms, reinsurance and risk corridors, were designed to protect insurers from unforeseen losses in Obamacare’s first three years, when insurers would not have enough experience to know how much risk they faced. These financial protections are critical to insurers’ ability to survive in the exchanges through the end of 2016. Both schemes persist only through the first three years of Obamacare, by the end of which its architects believed actuarial risks in the exchanges will have stabilized.”