“Last Thursday, the Institute of Medicine finally released its long-awaited set of recommendations for how the Secretary of Health and Human Services should accomplish the impossible–determining the ‘essential health benefits’ for tens of millions of Americans under the to-be-implemented Affordable Care Act. Early reviews indicate that, not surprisingly, there is no way to please everyone, or perhaps even anyone, in this highly political exercise. The countervailing pressures ‘essentially’ are that one side wants to ensure that benefits are more comprehensive and generous to ensure that everyone either gets what they want, or what other interests and experts think they must get anyway. “
“In other words, Sebelius’ dilemma is whether or not to take away a perfectly good option—catastrophic coverage—that the market currently offers patients. And the expert advice is that she should not. I’m not sure whether to applaud this dawn of wisdom or weep that the Obama administration needed a panel to tell it the obvious. What’s next? An expert panel advising the administration that GM should, after all, keep its wheels round?”
“In the end, avoiding grants with significant policy strings attached, while important, is only part of the task for state lawmakers opposed to Obamacare. They should also be pursuing their own agenda of patient-centered, market-based reforms that will constitute the “replace” part of “repeal and replace.” Given that the political, judicial, and logistical impediments to implementing Obamacare are actually increasing over time, those alternatives might be needed sooner than anyone expected.”
“Republican state politicians are clearly hardening their stance against exchanges. It appears that they are no longer fooled by the argument that if they do not collaborate to establish state-based exchanges, the federal government will enter their state and do it for them. Recent close reading of the law has debunked this notion. As written, the Patient Protection and Affordable Care Act (PPACA) has (at least) two clauses that will prevent this from happening.”
“Because of a quirk in ObamaCare, people who buy health insurance through a federally run exchange may not be eligible for premium subsidies… Section 1311 of ObamaCare instructs state governments to set up an exchange. If a state refuses, Section 1321 lets the federal government establish an exchange in the state. Yet ObamaCare states that the tax credit is available to people who are enrolled in an ‘an exchange established by the state under (Section) 1311.’ It makes no mention of people enrolled in federal exchanges being eligible for the tax credit.”
“Is employer-sponsored health insurance on life support? A new survey shows that one out of every 10 midsized and large companies say they’ll stop offering health insurance once federal insurance exchanges kick off in 2014, according to the survey, which was conducted by consulting firm Tower Watson.”
“Glenn Morton, the author of the new book Passing Obamacare, has worked for nearly two decades in the health-insurance business, most recently as a broker who helps employers find better deals among providers. In a discussion with Reason’s Nick Gillespie, Morton adds another problem with recently released Obamacare rules: The mandate to reduce the percentage of insurance costs that go to administrative costs effectively means that insurance brokers’ commissions will be either drastically cut or reduced altogether. If brokers’ role in hunting for better coverage plans is eviscerated, argues Morton, companies will lose their main ally in the search for affordable and dependable coverage plans.”
“Now, there’s a new study that suggests that employer dumping under Obamacare could be significant, leading to an explosion of the law’s costs and thereby the federal debt. A working paper by economists Richard Burkhauser and Sean Lyons of Cornell and Kosali Simon of Indiana, published by the National Bureau for Economic Research, examined various reasonable assumptions regarding the behavior of employers under the law.”
“Investors believe that the government guarantee of millions of customers to health plans will lead to profits. Unfortunately, this optimism is likely unfounded.
ObamaCare distributes federal grants to states that encourage their insurance departments to increase power of prior approval of premium increases.
And the coming wave of political interference will threaten health plans’ very solvency. We already know that such laws do not keep a lid on health costs.”
“Federal payments required by President Barack Obama’s health care law are being understated by as much as $50 billion per year because official budget forecasts ignore the cost of insuring many employees’ spouses and children, according to a new analysis. The result could cost the U.S. Treasury hundreds of billions of dollars during the first ten years of the new health care law’s implementation.”