“1.) AEI’s Joseph Antos and James Capretta present “A health reform framework: Breaking out of the Medicaid model.” Here’s a peek:
The Congressional Budget Office (CBO) projects that about one-third of the additional insurance coverage expected to occur because of the law will come from expansion of the existing, unreformed Medicaid program. The rest of the coverage expansion will come from enrolling millions of people into subsidized insurance offerings on the ACA exchanges — offerings that have strong similarities to Medicaid insurance. Unfortunately, ample evidence demonstrates that this kind of insurance model leaves the poor and lower-income households with inadequate access to health care….
2.) “Some still lack coverage under health law,” notes The Wall Street Journal:
Months after the sign-up deadline, thousands of Americans who purchased health insurance through the Affordable Care Act still don’t have coverage due to problems in enrollment systems.
“Conservative criticism of the Affordable Care Act has created the impression that liberal, “big government” ideas are driving the health-care system. But plenty of ideas that conservatives like are taking hold in health care as well. To wit:
*The number of Medicare beneficiaries in private Medicare Advantage plans reached nearly 16 million this year, a record, and the Congressional Budget Office projects that it will hit 22 million by 2020. This partial privatization of Medicare is happening despite concerns that reductions in payments to private plans (what some call over-payments) would curtail enrollment.
*More than half of people on Medicaid are enrolled in managed-care plans, which are typically run by private insurers that contract with states on a capitated, or risk, basis. More than 30 million low-income Medicaid beneficiaries are in private plans.
“While enrollment in private health insurance through online marketplaces may be closed until Nov. 15, Medicaid and the Children’s Health Insurance Program added almost a million new patients in May, according to the Centers for Medicare and Medicaid Services.
Between April and May 928,628 people signed up for Medicaid or CHIP across the 48 states that reported data, up from 805,038 who joined in April but down from the 1.4 million who joined in March. The May figures, released Friday, bring total enrollment to nearly 66 million.
Medicaid is jointly funded by states and the federal government to serve low-income children, parents, the elderly and disabled people. The program was expanded through the Affordable Care Act to childless adults earning up to about $15,856 for a single household, though states can choose whether to expand. Twenty-six states and the District of Columbia have done so.
“WASHINGTON — A two-page federal form has provoked a titanic clash between the government and many religious organizations.
The form allows some religious organizations to opt out of providing contraceptive coverage, which many insurers and group health plans are required to provide under the Affordable Care Act and related rules.
The opt-out sounds like a way to accommodate religious beliefs. But many religious employers like Wheaton College and the Little Sisters of the Poor are unwilling to sign the form. By signing it, they say, they would authorize their insurers or plan administrators to pay for contraceptives, including some that they believe may cause abortion.”
“One of the oft-repeated arguments in favor of the Affordable Care Act is that it will reduce people’s need for more intensive care by increasing their access to preventive care. For example, people will use the emergency room less often because they will be able to see primary care physicians. Or, they will not develop as many chronic illnesses because they will be properly screened and treated early on. And they will not require significant and invasive care down the line because they will be better managed ahead of time.
Moreover, it is often asserted that these developments will lead to reductions in health care spending. Unfortunately, a growing body of evidence makes the case that this may not be true.
One of the most important facts about health care overhaul, and one that is often overlooked, is that all changes to the health care system involve trade-offs among access, quality and cost.
“The last round of oral argument in the most serious legal challenge to Obamacare’s insurance coverage subsidies ended over three months ago. Now the courthouse watch for a final ruling in the U.S. Circuit Court of Appeals for the D.C. Circuit has neared a fever pitch.
Diehard defenders of the Affordable Care Act (ACA) are worried that a three-judge panel is about to overturn an Internal Revenue Service rule issued in May 2012 that authorized distribution of insurance premium assistance tax credits in health exchanges administered by the federal government. By the end of a March 25 hearing on motions for summary judgment in Halbig v. Burwell, it appeared that two of the judges (a majority) were leaning toward agreeing with a group of private individuals and employers (who were appealing a federal district court ruling against them) that only an exchange “established by a state” is eligible for federal tax credits under the ACA.”
“There’s been quite a bit of bad news about Obamacare in recent weeks:
•a SCOTUS smackdown on the contraception mandate overreach,
•the possibility of an even more momentous court decision being handed down next week,
•worrying signs of more rate shock to face Exchange plan buyers next fall, with many states seeing double-digit premium increases, and
•a bleak picture of Obamacare’s unfolding fiscal disaster.
In that context, it should be no surprise that progressives are cheering the purported good news that the number of uninsured appears to be declining since last summer:
•A Commonwealth Fund survey released in June shows 9.5 million fewer uninsured adults age 18 and older;
•A RAND survey released in April found a decline of 9.3 million uninsured non-elderly adults;
•An Urban Institute survey released in June shows a decline of 8 million uninsured non-elderly adults, and
•Gallup shows a decline in the percentage of adults (18 and older) who are uninsured of 3.7 percen
“After being without health insurance for two years, Miranda Childe of Hallandale Beach found a plan she could afford with financial aid from the government using the Affordable Care Act’s exchange.
Childe, 60, bought an HMO plan from Humana, one of the nation’s largest health insurance companies, and received a membership card in time for her coverage to kick in on May 1st.
But instead of being able to pick a primary care physician to coordinate her healthcare, Childe says she repeatedly ran into closed doors from South Florida doctors who are listed in her plan’s provider network but refused to see patients who bought their coverage on the ACA exchange.
“I just felt that I wasn’t being treated like a first-class citizen,’’ said Childe, who eventually found a doctor with the help of a Humana counselor.
“The evidence is piling up now: Obamacare really does seem to be helping the uninsured.
Survey after survey is showing that the number of uninsured people has been going down since the start of enrollment last fall. The numbers don’t all match, and health care experts say they’re not precise enough to give more than a general idea of the trend.
But by now, the trend is unmistakable: Millions of people who didn’t have health insurance before the Affordable Care Act have gained it since last fall. The law is not just covering people who already had health coverage, but adding new people to the ranks of the insured — which was the point of the law all along.
There’s still a lot of variation in the numbers, too much for health care experts to pin down an exact number with any confidence. But even health care analysts who think the law is a bad idea acknowledge that the evidence suggests the uninsured are being helped.
“A new software system for the state’s health insurance website passed its first key test this week, and a final decision on whether Massachusetts will run its own site or join the federal exchange will be made in early August, a top state official said.
Maydad Cohen, special adviser to the governor, told the Massachusetts Health Connector board Thursday morning that the new software from hCentive performed every task required by federal officials, and then some, in a Washington, D.C., demonstration Monday.
This success, he said in an interview afterward, leaves him increasingly but cautiously optimistic that the state will be able to employ the hCentive software when open enrollment starts Nov. 15.
In the spring, the Health Connector abandoned its original, dysfunctional software, made by CGI, and adopted a “dual track” approach: working on a new system while simultaneously preparing to join the federal exchange, healthcare.gov.”