The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers

Asking whether the Obamacare Cadillac tax will increase worker wages might seem nonsensical on its face. But wait until you hear the answer: yes AND no. Don’t worry: Schrodinger’s cat hasn’t wandered into the thicket of health policy (nor am I channeling my inner two-handed economist). It’s a trick question: the answer depends on whether employers respond to the Cadillac tax by trimming health benefits to avoid the tax, or instead simply keep their health benefits as is and pass the tax onto their employees. For employers who trim health benefits I have a high degree of confidence that on average, worker wages will rise. For employers who absorb the Cadillac tax increase, average worker wages will fall.

The Supreme Court agreed Friday to settle a widespread dispute between the Obama administration and religious non-profits over insurance coverage for birth control, which is sure to elevate issues of religious freedom and reproductive rights in next year’s presidential campaign.

As Congress considers year-end legislative options, one small change in the Affordable Care Act could make a big difference in access to quality health care for millions of Americans: Lifting the ban on creation and expansion of physician-owned hospitals.

Health plans that offer coverage of doctors and hospitals outside the plan’s network are getting harder to find on the insurance marketplaces, according to two analyses published this week. Two-thirds of the 131 carriers that offered silver-level preferred provider organization plans in 2015 will either drop them entirely or offer fewer of them in January, an analysis by the Robert Wood Johnson Foundation found. Those cutbacks will affect customers in 37 states, according to the foundation.

Advocates in Washington of the Affordable Care Act have been fighting tooth and nail to preserve the president’s signature health-care law—and they’re fighting even harder to expand it in the states. Conservative lawmakers in our home states of Utah and Florida recently defeated a combined three proposals to expand Medicaid under ObamaCare. They were absolutely right to do so, as the fiscal messes in states that did expand Medicaid demonstrate.

When open enrollment began on the nation’s healthcare exchanges on November 1, many people who bought insurance for 2015 found that the 2016 plans they had to choose from have narrower networks of hospitals. In addition, premiums might be significantly higher. Insurers have asked the federal government for permission to increase premiums by as much as 40 percent or more. All of this is happening because health insurers say that people who have signed up for coverage under the Affordable Care Act have been sicker than expected.

After nearly two years in operation and millions of dollars spent in development, the small business health insurance exchange created by the Affordable Care Act is struggling to catch on. Nationally, about 85,000 people, from 11,000 small businesses, have coverage through the online marketplace known as the Small Business Health Options Program, or SHOP, according to the latest federal data released in May. Those totals do not include employers that began coverage in 2014 and have not yet renewed their coverage through HealthCare.gov for 2015.

“Everyday people with good health insurance and ready access to medical care die of preventable diseases,” my friend John, a retired surgeon, wrote me recently. My friend was lamenting a recent article appearing in many Idaho newspapers about the tragic death of a woman with asthma. Her death was blamed on lawmakers who have refused to expand government-run programs like Medicaid to include able-bodied, childless adults.

“Everyday people with good health insurance and ready access to medical care die of preventable diseases,” my friend John, a retired surgeon, wrote me recently. My friend was lamenting a recent article appearing in many Idaho newspapers about the tragic death of a woman with asthma. Her death was blamed on lawmakers who have refused to expand government-run programs like Medicaid to include able-bodied, childless adults.

Government health officials worked diligently this year to improve consumer experience on Healthcare.gov and make sure people know what they are getting for their money when they pick health insurance. But one thing is out of the government’s control: whether doctors and hospitals will agree to accept patients who buy these plans. Surveys and data are limited, so it’s difficult to gauge the extent of the issue, but anecdotal evidence from patients and providers show it is a struggle. Some newly insured patients wonder whether it’s worth paying for coverage they can’t actually use. Even when they do find a provider, reports show they face crippling out-of-pocket costs they didn’t expect.