“Thirty-four House Democrats bucked their party to vote against Obamacare when it passed in 2010. Today, only four of those lawmakers are still in office and running for reelection this fall.
The dramatic downsize underscores not only how consequential the health care law vote was but how quickly moderate Democrats have been eliminated on Capitol Hill. Even those who opposed the law had trouble surviving the highly partisan atmosphere it helped to create.
With the divide only more pronounced in 2014, the final four are trying to avoid a similar fate. Obamacare remains a volatile issue, and all still tout their “no” vote. Yet their vulnerability also reflects a more daunting and long-lasting problem for lawmakers who would occupy the middle ground.
“I don’t think you can just look at the Affordable Care Act — you have to look at the broader picture,” said Democratic Rep. Collin Peterson of Minnesota. “You just don’t have many people like myself left.
“How much leeway do employers and insurers have in deciding whether they’ll cover contraceptives without charge and in determining which methods make the cut?
Not much, as it turns out, but that hasn’t stopped some from trying.
Kaiser Health News readers still write in regularly about this.
In one of those messages recently, a woman said her insurer denied free coverage for the NuvaRing. This small plastic device, which is inserted into the vagina, works for three weeks at a time by releasing hormones similar to those used by birth control pills. She said her insurer told her she would be responsible for her contraceptive expenses unless she chooses an oral generic birth control pill.
“When the Obama administration in November 2013 decided to allow states to decide if individuals could keep noncompliant insurance plans, speculation began about what effect that decision would have on premiums and enrollment for plans that did comply with provisions of the Patient Protection and Affordable Care Act. Subsequently, the administration this March gave states the option of a maximum two-year extension into 2016.
Early indications of how many individuals opted to keep those plans have begun to emerge as have signs of the effect on premiums. As with so much else related to the ACA, the results depend on what state is being discussed.
Twenty-five states are allowing noncompliant plans to continue through 2015, which creates a continuing impact for insurers attempting to formulate premium levels in 2014, according to data compiled by America’s Health Insurance Plans, an insurer trade group.
“Research published last week in the British Medical Journal Open provides interesting insight into the cause of rising health care costs. Analysis of the study raises concerns that Obamacare could ultimately bend the cost curve up. The University of California at San Francisco research studied variations in the average charges of 10 commonly ordered outpatient blood tests in California hospitals in 2011, using data from the reports of nonfederal, general acute-care California hospitals to the California Office of Statewide Health and Planning Development.
The researchers uncovered significant and substantial variation in hospital charges across the Golden State. For example, the median charge for a basic metabolic panel (a routine laboratory test that includes such tests as sodium, potassium and glucose) was $214. Yet, for the 189 California hospitals that reported this test, the charges ranged between $35 and $7,303.”
NOTE: This story is behind a pay wall.
“Most of the political class seems to have decided that ObamaCare is working well enough, the opposition is fading, and the subsidies and regulation are settling in as the latest wing of the entitlement state. This flight from reality can’t last forever, especially as the evidence continues to pile up that the law is harming the labor market.
On Thursday the Federal Reserve Bank of Philadelphia reported the results of a special business survey on the Affordable Care Act and its influence on employment, compensation and benefits. Liberals claim ObamaCare is of little consequence to jobs, but the Philly Fed went to the source and asked employers qualitative questions about how they are responding in practice.
The bank reports that 78.8% of businesses in the district have made no change to the number of workers they employ as the specific result of ObamaCare and 3% are hiring more. More troubling, 18.2% are cutting jobs and employees.
“The Obama administration is moving forward with regulations meant to enable certain businesses and charities to steer clear of the Affordable Care Act’s so-called birth control mandate, while ensuring free contraception coverage for women under the law.
The action amounts to an administrative workaround in response to a slew of legal challenges from groups citing religious objections to portions of the mandate. In June, the Supreme Court ruled that closely held religious companies cannot be compelled to offer their employees certain forms of birth control.
Under the proposal, the government would step in and cover the law’s contraception requirements in instances where employers announce their religious objections in writing. The organizations would not have to play any direct role in providing for contraceptive coverage to which they object, according to a final interim rule from the Centers for Medicare and Medicaid.”
“The Affordable Care Act gives the president’s cabinet officers sweeping powers to implement the law, but the administration managed to overreach these powers by allowing people in 36 states to illegally access health insurance subsidies.
That was the conclusion of the D.C. Circuit Court of Appeals in July.
At issue is the ability of people who sign up for coverage through exchanges established by the federal government to receive credits to reduce the cost of their health insurance.
D.C. Appeals Court Judge Raymond Randolph said the statute was quite clear in repeating seven times that subsidies are available only “through an Exchange established by the State.”
When the health law was passed, its authors apparently believed they had sufficiently cajoled the states.
“Democrats generally are not campaigning on the Affordable Care Act, but in a new campaign ad Arkansas Sen. Mark Pryor does just that.
Some have commented on the fact that Mr. Pryor does not mention the ACA by name in the ad, referring to it as “a law he helped pass.” Just as interesting is the part of the law the ad features: its protections for people with pre-existing medical conditions. With all of the focus on the ACA’s rollout problems last fall and the ACA’s coverage expansion, we have not heard much about “pre-x” in some time, but in many respects it’s the mega benefit in the law.”
“The Affordable Care Act (ACA) presents employers and potential employees with a variety of new rewards and penalties. These are, in part, exactly what the law intended: by penalizing potential employees for not purchasing health insurance, and employers for not providing it, the law aims to increase the fraction of the population with health insurance.
Details“Insurance expansion under healthcare reform is starting to yield patient volume for hospitals, but the costs of staffing up for more patients are eclipsing the additional revenue.
Earnings reports for not-for-profit systems in the first half of the year show that many providers are seeing rising salary and benefit expenses cut into revenue gains, leading to smaller operating surpluses.
“As the pieces of the Affordable Care Act are coming together, it’s changing the demand for care,” said Jeff Jones, managing director at Huron Consulting Group. “It’s shifting the way that providers are thinking about their labor pools.”
A report from Standard & Poor’s similarly found that in 2013, expenses increased 7%, outpacing revenue growth of 5%. The rating agency attributed the rising costs to preparations that systems were making to prepare for healthcare reform, including staffing needs.”