“Mr. Obama’s new faith in federalism is trailed by his customary rhetorical asterisk. Any state that the Administration decided deserved a waiver would still need to cover the same number of uninsured, and its coverage would still need to include the same comprehensive benefits and be as “affordable” as the Administration says it should be. That is, it must be as heavily subsidized.”
“The Wyden–Brown legislation is thus much less than meets the eye. In practice, it will not grant the states, especially conservative ones, the degree of flexibility that Wyden claims, nor will it defuse state resistance to major parts of the ACA.”
“It’s significant that the president is finally acknowledging that ObamaCare is unworkable and will impose enormous burdens on the states. Or is he?
A closer look shows that the president is not lifting the burdensome requirements ObamaCare imposes on states. All he’s doing is proposing to move up, from 2017 to 2014, the date on which states can apply for federal permission to impose a different but equivalently or more coercive plan to expand health insurance coverage.”
“The White House has apparently decided that it won’t enforce the unpopular parts of its health-care plan until after the 2012 election. The latest evidence is its decision not to slash Medicare Advantage, the program that Democrats hate because it lets seniors choose private insurance options.”
“Despite all the uncertainty, private insurers aren’t taking any chances. They’re in the midst of adjusting to the law’s requirement that they spend a certain percentage of their revenues on medical claims. ObamaCare’s advocates hope the provision will ensure consumers get good value for their premium dollars. And if the rule makes life harder for insurers, so much the better.
Unfortunately this ‘minimum medical loss ratio’ regulation will harm not just insurers but workers and employers too, as they’ll face higher prices and fewer choices for insurance.”
“The Obama administration envisions accountable care organizations (ACOs) as the drivers of health care innovation, but such innovation has historically come from entrepreneurs in the private sector.
ACOs offer financial incentives to cut costs, but this means restricting patient choice and limiting the use of some expensive care.
The ACO concept is not new. Similar ideas have been tried before, but they failed because they were unable to control costs or manage medical risk.”
“Back in a November 2009, Utah governor Gary Herbert complained in remarks at the Heritage Foundation that the federal government was ‘freezing out the states’ on health-care reform. How have things gone since then? According to the governor’s remarks (as reported by Jane Norman of CQ HealthBeat) when he returned to the Heritage Foundation last week, ‘Utah officials waited for eight months to find out if the state would be allowed to us e-mail rather than paper to communicate with Medicaid recipients and save $6 million a year.’ Herbert concluded — with bemusement – that ‘they sent us a denial by e-mail.'”
“Obamacare was passed under the expansive notion that government can run Americans’ health care better than we can ourselves. Bureaucrats in Washington believes they have the power to get things done, but with unmet deadlines passing each month and promises to the American public broken, it seems to be the opposite.”
“If waivers are necessary to keep 733 insurance plans in place now, think of what will be necessary in 2013, when the amount policies must cover in a year will be nearly three times that cost, or in 2014, when full-blown PPACA kicks in and insurers are prohibited from offering a policy without unlimited coverage. The waiver option will be gone: nothing in PPACA gives HHS the authority to waive the statutory ban on annual limits. At the same time, other parts of PPACA will require Americans to have more comprehensive insurance than what they have now. Ineluctably, the result will be to require Americans to purchase insurance packages far more comprehensive and far more costly than what HHS has already determined in 733 cases is too expensive to buy.”
“Bending the cost curve is not a matter of simply paying less for a service. What’s needed is real and continuous productivity improvement in the health sector. Doctors, hospitals, nursing homes, labs, clinics and others finding better ways to deliver higher quality care at less cost. Because if productivity in the health sector does not rise, then payment-rate reductions will simply drive willing suppliers of services out of the marketplace.”