“Having access to health insurance is slowing the rate of young adults who head to the emergency department for care, a new study suggests. Relative use of the ED decreased among 19- to-25-year-olds after the healthcare reform law allowed them to stay on their parents’ policies. The authors say the results show insurance can reduce ED overuse by removing the economic barriers to preventive care.
“It’s possible that when people have healthcare insurance they are less worried about the financial costs of care,” said Tina Hernandez-Boussard, assistant professor of surgery and biomedical informatics at Stanford University and lead author of a study published Monday in the journal Health Affairs. “They might seek appropriate care elsewhere and take care of conditions earlier. This could lead to a reduction in utilization of the emergency department.””
“New Health and Human Services Secretary Sylvia Mathews Burwell tried to hit the reset button on perceptions of the health-care rollout in her first public speech since taking the job at the embattled department overseeing it.
“What I’ve told my team at HHS is that we’re not here to fight last year’s battles, we’re here to fight for affordability, access and quality,” said Ms. Burwell to an audience of George Washington University students and faculty on Monday. “Let’s move beyond the back and forth, let’s move forward together.”
Ms. Burwell is stepping into the spotlight after around 100 days on the job and as the agency tries to reorient itself in time for the new enrollment season when millions more Americans are supposed to come to HealthCare.gov to buy coverage in just a few weeks.
She has brought on board several new faces since taking over as secretary from Kathleen Sebelius. They include the head of Connecticut’s health insurance exchange Kevin Counihan to serve as CEO for the site, former clean-up contractor Andy Slavitt as an operations administrator at the Centers for Medicare and Medicaid Services, and her former Walmart colleague Leslie Dach as her senior counselor.”
“The Affordable Care Act attempts to help low- and middle-income families avoid some of the tough sacrifices that would be necessary to purchase health insurance without assistance. But no program can change the fundamental reality that society itself has to make sacrifices in order to deliver health care to more people. Workers and therefore production have to be taken away from other industries to beef up health care, or the workforce itself has to get bigger, or somehow people have to work more productively. Although the ACA helps specific populations by giving them a bigger slice of the economic pie, the law diminishes the pie itself. It reduces the amount that Americans work, and it makes their work less productive. This slows growth in both personal income and gross domestic product.”
“When Congress returns this week, action in both chambers will mostly be a show for the voters back home ahead of the midterm election. In the House, that will include a vote on a bill to allow insurance companies to continue offering any plan that was sold in the group market in 2013.
Noticeably absent from congressional politicking in the next few weeks is the Affordable Care Act’s risk corridor program, which was, as recently as a few months ago, a major Republican criticism of the law. But that doesn’t mean the “insurer bailout” fight is dead. Republicans in both chambers are quietly working to challenge the legality and projected cost of the program. And that could tee up the issue to become a bargaining chip in the budget fights to come at the end of this year, regardless of who wins the Senate.
The Affordable Care Act’s risk corridor program runs from 2014 through 2016, and was established to encourage insurers to take a chance on covering an unknown population — the Americans who would be purchasing insurance on state and federal exchanges. The program collects funds from qualified health plans that bring in more money than they paid for medical claims, and then pays that money to plans with claims that cost more than they brought it from consumers.
But what happens if there isn’t enough money from well-performing insurers to pay all of the insurers that missed the mark? The federal government is on the hook, but where they find the money to pay those insurers is a question being debated throughout Washington. That’s because the law did not give the federal government a clear appropriation to spend money to make up for losses. And Republicans are, of course, very unlikely to give them one.”
“Obamacare created a new entitlement through its exchange subsidies and vastly expanded another one, Medicaid. The Congressional Budget Office expects these two pieces of the law to cost over $1.8 trillion over the next decade.
To offset some of this new spending, the law includes 18 new or increased taxes and fees that are estimated to bring in nearly $800 billion in new revenue from 2013-2022. Many of Obamacare’s taxes fall directly on the middle class, breaking the president’s promise to the contrary, while others will affect taxpayers indirectly through increased costs for goods, higher insurance premiums or lost wages.”
“Dive Brief:
•In an effort to reduce the backlog of contested Medicare claims, the Centers for Medicare and Medicaid Services has offered to pay hospitals 68% of what they say they are owed for short-term inpatient stays.
•The system of hearings on challenged claims has been on hold since December, when the HHS Office of Medicare Hearings and Appeals temporarily suspended most new requests for administrative law judge hearings on payment denials by recovery audit contractors.
•Hospitals will have 60 days to decide whether to accept CMS’ offer, which does not apply to any short-term hospital admission that occurred after October 1, 2013.”
“Medicaid expansion is expanding profits for a bunch of hospitals.
A new analysis of major for-profit health systems found that hospitals in states that expanded Medicaid eligibility under Obamacare are seeing far fewer uninsured patients, a large rise in paying patients and more revenue as a consequence—which stands in stark contrast to hospitals in nonexpansion states.
For example, there was about a 47 percent decrease in the rate of admissions of uninsured or self-paying patients at the hospitals in expansion states in the first half of 2014. Yet, hospitals in nonexpansion states either saw a slight reduction in such admissions or no decreases at all, according to the PricewaterhouseCoopers Health Research Institute. ”
“Reduced costs for medical services and labor have trimmed the 10-year projected cost of Medicare and Medicaid by $89 billion, the Congressional Budget Office said Wednesday.
Medicare spending is projected to drop by $49 billion — or less than 1 percent — from 2015 and 2024, while Medicaid spending is expected to drop by $40 billion — or about 1 percent — over the next decade, CBO said in an update to its April forecast.
Despite the long-term projected drop, federal spending for major health care programs will jump this year by $67 billion — or about 9 percent — the agency estimated. The largest increase will be for Medicaid, which is projected to grow by $40 billion, or 15 percent. Most of this short-term increase is attributable to the Affordable Care Act, including its Medicaid expansion and the financial assistance to help people purchase health insurance.”
“Thursday’s announcement that Pennsylvania will expand its Medicaid program brings the country one state closer to the original expansion outlined under Obamacare. But because of the Supreme Court’s 2012 decision making the expansion a voluntary program, there are still 23 states that haven’t expanded public health insurance to all of their low-income residents.
The expansion in Pennsylvania will add about 500,000 low-income to adults to the Medicaid rolls. According to numbers from the Kaiser Family Foundation, about 281,000 of those people were falling into what’s known as the “coverage gap”— people who don’t qualify for Medicaid but also don’t get subsidies for purchasing insurance on their own, either. About 4.5 million people across the country fall into this coverage gap, according to Kaiser.”
“Signed into law by President Obama on March 23, 2010, the Affordable Care Act has proven to be its own kind of jobs act, especially when it comes to the Washington-area IT community.
When, in several places, the bill called for the creation of an “Internet website” to allow Americans to find and sign up for new health insurance coverage, it opened the tap on hundreds of millions of dollars that would eventually go to creating HealthCare.gov’s front end and back end, as well as a small universe of accompanying digital sites. On Wednesday, the office of Daniel Levinson, the inspector general of the Department of Health and Human Services, put out a report detailing the dozens of contracts that went into building out the Federal Marketplace project. And a look at each in the disaggregate paints a picture of an effort far more sweeping than even that suggested by the half-billion dollars the federal government has already paid out to implement the digital side of the health insurance law.
So, how do you spend that much money building HealthCare.gov and its companion sites? A few million here, a few hundred thousand there, and eventually it adds up.”