The one state that not only embraced Obamacare but insisted on going beyond it to a full single-payer system was Vermont, the haven of hippies and expatriate New Yorkers, which has become one of the most liberal states in the nation. In 2011, it adopted a form of neighboring Canada’s government-financed health care and promised to implement it by 2017. (And Jonathan Gruber was a key architect of this plan as well as of Obamacare.) This week, however, Governor Peter Shumlin, a Democrat, admitted the state couldn’t afford the plan’s $2 billion price tag and consequent sky-high taxes, and pulled the plug. The lessons for Obamacare are obvious and profound.
By Tom Coburn And Phil Roe
In the four years since the Affordable Care Act was passed, health care in our country has become more complicated and expensive. The law has many troubling aspects, but the Independent Payment Advisory Board is among the worst and most dangerous. This is why, on Thursday, several members of the House will file an amicus brief asking the U.S. Supreme Court to take up Coons v. Lew. This lawsuit, filed by the Goldwater Institute on behalf of Dr. Eric Novack, an orthopedic surgeon, and Nick Coons, an Arizona businessman, challenges the constitutionality of IPAB.
In the 2014 midterm elections, opposition to the Affordable Care Act — i.e., Obamacare — was a clear political winner. That’s obvious from the election results themselves but also from polling that consistently finds that far more of the electorate disapproves of the law than approves of it.
“Illegal immigrants protected from deportation under President Obama’s executive action will be eligible for Medicare and other benefits once they enter the federal system.
The sweeping White House announcement last week means that up to 5 million people will be considered lawfully present in the United States despite having entered the country illegally.
This status makes them eligible for programs such as Medicare and Social Security if they work and submit payroll taxes that flow to those programs. This fact was noted Tuesday in a report by The Washington Post.”
“Dr. Oliver Korshin, a 71-year-old ophthalmologist in Anchorage, is not happy about the federal government’s plan to have all physicians use electronic medical records or face a Medicare penalty. A few months ago when he applied for an exemption to the latest requirement, he had to pick an exemption category that fit.
“The only one that possibly applied to me was disaster,” Korshin says. “So I picked disaster and I described my disaster as old age and I submitted as my supporting document a copy of my passport.””
“President Reagan gauged the success of a welfare program by how quickly people were able to move off government assistance and into remunerative work. Yet President Obama, the White House, and their allies are measuring the success of Obamacare by how many people can be enrolled in their new government entitlement programs.
The president celebrated the law’s “success” in getting seven million people enrolled in Medicaid and eight million (or so) people enrolled in exchange coverage, 87 percent of whom are receiving government subsidies for their insurance. And he hopes to lure another five million people onto Obamacare programs starting with the November 15 enrollment period. There is no expectation that participation in these government programs will be a temporary boost but rather that they will become a permanent fixture in people’s lives.”
“Since enactment of the Affordable Care Act (ACA) in 2010, much of the attention in the policy community has been on modernizing Medicare’s traditional fee-for-service (FFS) program. Through Accountable Care Organizations (ACOs), larger “bundles” of payments to fee-for-service providers for episodes of care, and tests of pay-for-performance models, the hope is that the traditional Medicare model can be remade through sheer force of bureaucratic will. The stated intent is to find a way to pay for value, not volume.
These efforts may or may not bear much fruit, but, over the longer term, it’s not likely to matter much. That’s because a more important transformation of Medicare is already well underway and is occurring despite more resistance than assistance from the program’s bureaucracy. According to the 2014 Medicare Trustees’ report, enrollment in Medicare Advantage – the private plan option in Medicare — has been surging for a decade. In 2005 there were 5.8 million Medicare beneficiaries enrolled in MA plans — 13.6 percent of total enrollment in the program. Today, there are 16.2 million beneficiaries in MA plans, or 30 percent of program enrollment. (See Table IV.C1) In addition, the Medicare drug benefit, which constitutes about 12 percent of total program spending, is delivered entirely through private plans.”
“Call it drugs for the departed: A quirky bureaucratic rule led Medicare’s prescription drug program to pay for costly medications even after the patients were dead.
That head-scratching policy is now getting a second look.
A report released Friday by the Health and Human Services Department’s inspector general said the Medicare rule allows payment for prescriptions filled up to 32 days after a patient’s death — at odds with the program’s basic principles, not to mention common sense.”
“For health policy wonks, the end of the year isn’t just the holiday season. With the falling temperatures will come a renewed “doc fix” debate, as Congress deliberates on ways to avoid a scheduled double-digit (24 percent last year) cut in Medicare’s physician payments. And avoid it they will. As health economist Austin Frakt put bluntly: “Good luck getting physicians to keep Medicare patients if the payments are suddenly cut 24 percent.””
“After the worst transition to Obamacare in the country, Massachusetts is still without a functional exchange website and just 769 people have enrolled in Obamacare-subsidized plans.
To avoid accountability and political repercussions, Massachusetts Gov. Deval Patrick is about to cut two special deals with the federal government: the “Commonwealth Kickback” which grants Massachusetts the most generous taxpayer-funded premium subsidies in the entire country, while the “Bay State Bailout” gives 300,000+ MA residents “temporary” Medicaid coverage in 2014, without any verification of their eligibility.
These deals are reminiscent of the controversial ACA-related “Cornhusker Kickback” and “Louisiana Purchase,” but they also can be added to the growing list of special deals cut for Massachusetts as the state struggles to transition to the ACA.”