“The Affordable Care Act will drive health care spending up slightly, to nearly a fifth of the country’s gross domestic product by 2020, while extending insurance coverage to 30 million more Americans, a new report from CMS projects.”
“In our most dynamic case, when all covered employees are compensated in higher wages to offset their payment
of the full ESI premium in order that some will be able to take full advantage of an affordable coverage rule that
is broadly interpreted to mean affordable family coverage, we estimate that the movement of workers out of ESI
and into exchange-based coverage will: 1) overwhelm the number of workers moving into ESI by currently
uninsured workers in large firms due to the mandates; 2) cause the provision of health care insurance to working
Americans to become more sharply segregated based on family income; and 3) cost taxpayers up to $5 billion
dollars in gross subsidies for every one million workers who switch from being an ESI main policy holder to
receiving subsidized exchange coverage, all else equal. As a result, we estimate that increased exchange use in
the most dynamic case will require about $47.5 billion more in gross yearly subsidy payments than in the least
dynamic case.”
“A major provision of the healthcare reform law designed to prevent businesses from dropping coverage for their workers could inadvertently leave families without access to subsidized health insurance. The problem is a huge headache for the Obama administration and congressional Democrats, because it could leave families unable to buy affordable health insurance when the healthcare law requires that everyone be insured starting in 2014.”
“The Independent Payment Advisory Board (IPAB) was created based on the premise that decisions about the pricing of health benefits offered by Medicare are simply too contentious to be adequately handled by our present political system. But these decisions are precisely the kinds of consequential choices that should be subject to close public scrutiny and an open, rigorous, and transparent decision-making process that engages with Medicare’s stakeholders. Changes to the way Medicare pays for and covers medical services affect too many people in significant ways to be made behind the closed doors of an insulated committee.”
“Democrats don’t use such hyperbole, but more than half a dozen have signed on as cosponsors of a bill that would repeal the board. And many more, particularly Democrats in the House, never supported creating the board in the first place… [I]t could end up driving Medicare payments so low that providers will simply leave the program, or else go bankrupt if they can’t.”
“IPAB is fatally flawed, structured to punish innovative health care providers and threaten seniors’ access to care — while leaving the largest sources of Medicare spending untouched. It continues Washington’s obsession with price-fixing in Medicare’s separate ‘silos’ rather than changing the incentives that have led to rampant overspending, fraud and uneven care quality.”
“[D]ue to a glitch in Obamacare, married couples of early retirees making around $64,000 a year will become eligible for Medicaid. That’s more than four times the federal poverty level of $14,710… If we do a back-of-the-envelope calculation, in which the average annual Medicaid expenditure per early retiree is $15,000 per year, the ten-year cost of this glitch could be as high as $450 billion. Even if only half of those eligible opt to take advantage of the loophole, we’re talking at least $250-300 billion, as the sickest patients are the ones most likely to enroll.”
“If this issue is any indiction, we have a clue as to how Obamacare got so screwed up. Those who drafted and now tout it have a shaky understanding of how markets operate and a built-in preference for top-down management. But it turns out that millions of people making individual health-care decisions are a lot smarter than the bureaucrats who constructed such a massive structure that no one can be expected to understand it and its consequences. Who knew?”
“McKinsey met the criticism with the facts. It released the survey questions, methodology, and data, putting to rest questions about the objectivity. The survey was paid for by McKinsey and not any of its clients; it was administered by an internationally-recognized survey firm; the survey’s descriptions were largely fact-based and generic in nature; and it surveyed a large, representative sample of the nation’s employers.”
“Obamacare poses two great dangers to our nation: lower quality of care and runaway costs. It will stifle innovation and lead to rationing. But the overwhelming cost and the damage it will do to our nation’s finances at a pivotal moment in our history deserve greater scrutiny.”