Posted in Access to healthcare, Affordable Care Act (ObamaCare), Direct-Pay Medicine, Direct-Pay Practice Models, Economic Issues, Health Insurance, Healthcare financing, Individual Market, Insurance subsidies, Medicaid, Medicaid Expansion, Medical Costs, News From Washington, Patient Safety, Policy Issues, Reforming Medicaid, Subsidies, Uncategorized

Options Will Increase, Sky Will Not Fall, If ACA Ends

For example, the AMA complains that hundreds of millions would be at risk of losing “coverage.” In fact, only a net 1.7 million people gained private coverageunder ACA, after subtracting the nearly 6 million who lost it, at a shocking cost of $341 billion or $200,000 per newly insured person. Most of the claimed increased coverage came from expanding Medicaid to childless, able-bodied adults. This reduced access to services by the sickest patients, and at least 21,904 patients died on Medicaid waiting lists according to a 2018 report.

Without ACA and its unaffordable requirements, Americans would have many more options to buy affordable insurance. Instead of paying as much as a mortgage payment for “coverage” they are unlikely to use, they might join a DPC (direct primary care) practice and get preventive care and routine medical treatment for at as little as $50/month. They might buy catastrophes-only major medical insurance that ACA outlaws for persons over 30 years of age. Congress might enact Health Freedom Accounts as proposed by Rep. Chip Roy (R-Tex.) and liberalize Health Reimbursement Accounts.

https://mailchi.mp/aapsonline/aca-standing-639035?e=f50410ece3

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Community Underwriting, Economic Issues, Employee Benefits, Essential Benefits under the ACA, Government Regulations, Health Insurance, Healthcare financing, Individual Market, Individual ObamaCare Market, Individual Underwriting Standards, Insurance subsidies, Large group insurance market, Medicaid, Medicaid Expansion, Medical Costs, Policy Issues, Uncategorized

Analysis of the ACA: A Public Policy “Devil in the Details”

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Individual Health Shrinkage Drives Up Uninsured Rate: CBO Data

~Enrollment in every other major type of coverage grew or held steady~

The subtitle in the article above is correct: Enrollment in every other major type of coverage grew or held steady.

But this should not surprise anyone.

“Why the other major types of coverage increased, is the more important question. And examining this also reveals that the real, or net, uninsured rate probably went up much less than 5%.

The CBO data, based on their own definition of “insurance”, was destined to over-state the number of uninsured based on these data…

“CBO includes only major medical insurance that meets ACA minimum essential coverage standards in that definition. It excludes people who belong to health care cost sharing ministries. It also excludes people who are using products such as short-term health insurance as alternatives to major medical coverage.”

Nor does the number of “uninsured” mean that those folks went without care, especially those who might have cash-friendly Primary Care providers, or a Direct Primary Care physician.

And, as premiums continue to rise in the individual market we will see a shift from Unsubsidized plans to subsidized plan; and just as the data indicates we’ve witnessed a 300,000 shift in that direction.

Let’s examine some recent history as a perspective.

The first two enrollment periods after implementation of ACA in late 2013 and 2014, which also corresponded to economic recovery (no cause and effect) showed that the largest portion of newly insured (following the nadir of the uninsured rate) came from the Employer group market as hiring increased; and the second largest portion came from Medicaid and the smallest percentage from the individual market in form of ACA exchanges.

When you measure the effects directly attributable to ACA, the largest percent gains in insured rate have come from new Medicaid, followed by subsidized ACA plans.  This is a crowd-out phenomenon at work, catalyzed by subsidized coverage (Medicaid expansion) on one end and rising premium prices in the Individual market on the other.

This is horrible public policy as it doesn’t promote insurance to be more affordable or efficient, it simply shifts the burden to the public sector while making premiums more expensive.  And those premium increases are a direct result of regulations placed on the Individual Market: Community Rating, guaranteed issue and compression of the age ratios to 3:1, in an attempt to force it to “behave” more like the group market.

So does it really make sense to purposefully, by design, cause the price of insurance to rise and then turn around and subsidize the same product to make it “affordable”?  I guess we know how they justify the name… Affordable Care Act… but there certainly isn’t any buyer protection from soaring prices!

All of which goes to show, that the net effect of the ACA has been to make the individual market UNAFFORDABLE which effectively shunts the demand into gov’t sponsored and/or subsidized coverage!

This is NOT a sound healthcare policy.  But it is a very effective form of legal plunder accomplished by using the law to benefit a few special interests at the expense of the many.

Posted in Access to healthcare, big government, Crony Capitalism, Dependency, Economic Issues, Government Regulations, Healthcare financing, Medicaid, Medicaid Expansion, Medical Costs, Medical Practice Models, News From Washington, DC & Related Shenanigans, Organizational structure, Policy Issues, Reforming Medicaid, Reforming Medicare, Tax Policy, Uncategorized

The Medicaid Scam: Higher Taxes Are an “Investment” to Generate More Spending | International Liberty

Why would an industry support and bankroll an initiative to give more of their money to government?!?

It turns out that the industry isn’t filled with masochists (like the neurotic trust fund leftistswho posture in favor of higher taxes). Instead, the special interests such as the hospital lobby viewed a couple of hundred million of taxes as an “investment” that will generate about $1 billion of taxpayer-financed loot.

https://danieljmitchell.wordpress.com/2018/01/26/the-medicaid-scam-higher-taxes-are-an-investment-to-generate-more-spending/

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Health Insurance, Healthcare financing, Individual Mandate, Individual Market, Insurance subsidies, Large group insurance market, Medicaid, Medicaid Expansion, Medical Costs, Policy Issues, Small group market, Subsidies, Tax Policy, Uncategorized

Who Wouldn’t Have Coverage If the Obamacare Mandate Is Repealed | The Heritage Foundation

…a recent review of the academic literature on the subject finds a mixed bag, but with the strongest link between coverage and health outcomes in cases where health insurance coverage improves access to care, “particularly among people with lower incomes and chronic conditions.”

That makes sense. Having health insurance makes less of a difference to people with higher incomes who can afford to pay for more of their medical care directly. 

That leads us to the crucial, practical question that this academic debate largely misses: Who are the people that would no longer have health insurance if the mandate penalty were repealed?

Notice what CBO is not saying. CBO is not saying that those Americans will “lose” coverage. Rather, CBO is saying is that—absent the mandate penalties—those Americans, will voluntarily forego enrolling in health coverage. CBO is explicit on this point…

That explains CBO’s somewhat counterintuitive projection that, without a mandate penalty, millions of poor people will turn down the offer of free Medicaid coverage. The reason is that they don’t think they need it (because they are healthy) and if they become ill and seek care at a hospital, they know the hospital will enroll them in Medicaid to get paid. Indeed, it is also why, long before Obamacare came along, that there was a persistent and notable gap between the number of people eligible for Medicaid and the number of people enrolled in the program.

It also explains CBO’s other counterintuitive projection: that eliminating the mandate penalty will generate higher tax revenues.  While not collecting mandate penalties brings in less revenue, CBO projects that there will be new revenues coming from the healthy people who decide to turn down tax-free employer health insurance in exchange for higher (taxable) cash wages. Presumably, CBO thinks that being healthy and very much alive are basic prerequisites for expecting those folks to generate additional tax revenues.

Repeal of the Obamacare mandate will not result in social catastrophe. Supporters of the mandate would have a more compelling argument if millions of poor and sick persons would be thrown out of their existing coverage, struggling with potentially fatal chronic illnesses and unable to get insurance to maintain continuous access to regular care. But that is not what CBO is projecting. Their argument is hardly compelling, to say the least, when the cohort of the future uninsured are healthy people who simply choose not to buy Obamacare coverage because they believe they don’t need it or want it.

http://www.heritage.org/health-care-reform/commentary/who-wouldnt-have-coverage-if-the-obamacare-mandate-repealed

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Community Underwriting, Economic Issues, Free-Market, government incompetence, Government Regulations, Health Insurance, Healthcare financing, Individual Mandate, Individual Market, Insurance subsidies, Medicaid, Medicaid Expansion, Medical Costs, medical inflation, Medicare, Organizational structure, outcomes, Policy Issues, Uncategorized

Hard Truths about Health Care ‌ by Michael Tanner

Micheal Tanner
Michael Tanner

“Every health-care system in the world rations care in some way, either through bureaucratic fiat (Scandinavia, the U.K.), waiting lists (Canada), or price (that’s us). One can argue about which of these rationing mechanisms is fairest or most efficient, but let’s not pretend that it won’t occur.”

http://www.nationalreview.com/article/446439/health-care-basic-facts-and-hard-truths

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Consumer-Driven Health Care, Economic Issues, Free-Market, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Insurance subsidies, Leadership, Medicaid, Medicaid Expansion, Medical Costs, Medicare, Organizational structure, Patient Choice, Policy Issues, Reforming Medicare, Subsidies, Tax Policy, Uncategorized

Republican Health Care Fiasco, Part II

John C. Goodman

“Only a few years ago, the party was united behind three reforms that are consistent with individual empowerment and limited government: (1) a universal health refund that transfers all government tax and spending subsidies to ordinary citizens each year with no strings attached other than the requirement that it be used for health care, (2) a flexible Health Savings Account that allows people to manage some of their own health care dollars and (3) pre-existing condition protection for people who lose their insurance because of government policies.

For well over a decade House Speaker Paul Ryan (R-WI) was a steadfast supporter of all three ideas, including replacing tax and spending subsidies for health care and health insurance with a universal tax credit. John McCain ran on these ideas in the 2008 election. The legislative embodiment of McCain’s plan was the Patients Choice Act, which Ryan cosponsored in 2009 along with Devin Nunes (R– CA) in the House and Tom Coburn (R–OK) and Richard Burr (R–NC) in the Senate.”

“The American Health Care Act (AHCA), proposed by the House leadership, was not about health care. It was about taxes. Over and over, Ryan said he needed to do health reform before tax reform. In particular, he said he needed to reduce Obamacare taxes by $1 trillion and to reduce spending by more than $1 trillion.

As noted, a tax cut tied to health care is part of good health reform. But the Ryan tax cut wasn’t tied to health care. It consisted of repealing the very revenues that were funding Obamacare. (See below.)  Since the tax cut took money out of the system, the spending cuts paired with it also removed money from the system.”

Source: Republican Health Care Fiasco, Part II

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, Healthcare financing, Individual Market, Individual ObamaCare Market, Insurance subsidies, Medicaid Expansion, Medical Costs, medical inflation, out-of-pocket costs, Policy Issues, Re-insurance fees, Subsidies, Uncategorized

Overwhelming Evidence That Obamacare Caused Premiums To Increase Substantially – Forbes

obamcare_individual-MarketPMPM-Chart-MercatusTwo scholars at the renowned Brookings Institution, Loren Adler and Paul Ginsburg, have published an analysis finding that “average premiums in the individual market actually dropped significantly upon implementation of the ACA [Affordable Care Act].” This contrasts with a plethora of evidence, including a rigorous 2014 Brookings study, showing the ACA significantly increased premiums. In this post, I discuss methodological concerns with the Adler and Ginsburg approach as well as evidence that leads most scholars to reach a very different conclusion.

Source: Overwhelming Evidence That Obamacare Caused Premiums To Increase Substantially – Forbes

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, government incompetence, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Individual Mandate, Individual Market, Individual ObamaCare Market, Insurance subsidies, Medicaid, Medicaid Expansion, Medical Costs, medical inflation, Policy Issues, Reforming Medicaid, State-Run Insurance Exchanges, Subsidies, Uncategorized

Single-Rural Heath Care: Obamacare Insurers Retreat, Leaving Only One ACA Insurer In Some Areas – Matt Vespa

Monopoly?

Obamacare has been disastrous for health insurers, like UnitedHealth Group, billions have been wasted on state exchanges, which are hanging by a thread, and the law’s enrollment projections (calculated by the CBO three years ago) were off by 24 million for 2016. Now, more Americans are opting to pay the penalty and remain uninsured because it makes more sense for their finances. No wonder why this law is unpopular. Oh, and did I mention that premiums are projected to rise (again) this year. Given the expensive nature of the Obamacare market, some insurers are dropping like flies, giving Americans in some rural areas just one choice when it comes to their health care. Of course, some folks are worried about monopoly dynamics

Source: Single-Rural Heath Care: Obamacare Insurers Retreat, Leaving Only One ACA Insurer In Some Areas – Matt Vespa