“A primary aim of the Patient Protection and Affordable Care Act (ACA) is to expand insurance coverage, especially among households with lower incomes. The Congressional Budget Office (CBO) projects that about one-third of the additional insurance coverage expected to occur because of the law will come from expansion of the existing, unreformed Medicaid program. The rest of the coverage expansion will come from enrolling millions of people into subsidized insurance offerings on the ACA exchanges — offerings that have strong similarities to Medicaid insurance.
Unfortunately, ample evidence demonstrates that this kind of insurance model leaves the poor and lower-income households with inadequate access to health care. The networks of physicians and hospitals willing to serve large numbers of Medicaid patients have been very constrained for many years, meaning access problems will only worsen when more people enroll and begin using the same overburdened networks of clinics and physician practices.
It does not have to be this way. It is possible to expand insurance coverage for the poor and lower-income households without reliance on the flawed Medicaid insurance model. Opponents of the ACA should embrace plans to replace the current law with reforms that would give the poor real choices among a variety of competing insurance offerings, including the same insurance plans that middle-class families enroll in today. Specifically, we propose a three-part plan that includes a flexible, uniform tax credit for all those who lack employer-based coverage; deregulation of Medicaid; and improved safety-net primary and preventive care.”
“Two years ago Saturday, the Supreme Court changed the law that changed an industry.
The Court’s June 28, 2012, decision to uphold the Affordable Care Act—by the slender margin of a single vote—did more than allow the law’s ambitious agenda to proceed. It famously altered the law itself, by allowing states to choose whether or not to opt into Obamacare’s Medicaid expansion.”
“IPAB is supposed to be composed of 15 members who will each serve six-year terms. They must be nominated by the President and confirmed by the Senate. Since it is nearly May, that leaves only four months to meet the draft proposal deadline. In other words, four months for members to be nominated, for the Senate to hold hearings and confirmation votes, and then for IPAB to put together its proposal.”
“Senate Majority Leader Harry Reid (D-Nev.) says he shares colleagues’ concerns that the Affordable Care Act could become a ‘train wreck’ if it’s not implemented properly. Reid warned that people will not be able to choose health insurance plans on government health exchanges if federal authorities lack the resources to set them up and educate the public.”
“The office implementing most of President Obama’s healthcare law is not furloughing its workers as a result of sequestration, its director said Wednesday. Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, said Wednesday that his office has not cut its workers’ hours and pay as a result of the automatic budget cuts that went into effect in March.”
“Nevertheless, there is merit to continued evaluation of full-scale alternatives to the PPACA. One common defense of the law is that there has been no competing alternative, which is not true. But there is virtue to continuing to develop and refine as many alternatives as may be proposed. Toward that end, this short paper outlines one practical, conservative approach to replacing the law with a market-based reform plan.”
“Even when the law was passed three years ago, $1 billion for implementation was thought to be just the start. Getting the massive law up and running was expected to cost 10 times that. And that was before the federal exchange task ballooned as conservative states refused to do much to make the law a success.”
“Here’s another ominous sign for ObamaCare’s future: The Department of Health and Human Services admitted yesterday that setting up the law has cost twice as much as expected so far. And you can’t really blame Republican opposition for the overrun: That’s just accounting for the cost of building exchanges in states that said they want to run them.”
“Citing worries that ‘taxpayers will lose a significant amount of the money,’ House Committee on Oversight and Government Reform officials are significantly expanding their probe of the $2 billion Obamacare loan program to fund new health insurance co-operatives to compete with established private-sector firms in 24 states.”
“As the Affordable Care Act (ACA) celebrates its third anniversary, the law has already imposed $21 billion in private-sector burdens, $9.8 billion in unfunded state liabilities, and 111 million paperwork burden hours. When the American Action Forum (AAF) reviewed the law’s regulatory impact last year, the ACA had imposed a combined cost of $12.4 billion and 50 million hours, meaning in the last year the administration has more than doubled the cost of implementation and added 21 million compliance hours.”