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, Affordable Care Act (ObamaCare), Economic Issues, Government Regulations, Government Spending, Health Insurance, Healthcare financing, Individual ObamaCare Market, Medical Costs, Patient Choice, Patient-centered Care, Policy Issues, State-Run Insurance Exchanges, Subsidies, Uncategorized

California’s Public Option Would Not Rescue Obamacare | Health Policy Blog | NCPA.org

The wheels are falling off Obamacare in California. UnitedHealth Care, the nation’s largest health insurer, only participated in the state’s exchange, Covered California, for one year before deciding to bail out. Participants are much older and sicker than the Administration or health insurers expected. So, premiums are spiraling up, beyond people’s ability to pay.

Covered California is already responsible for a significant taxpayer-funded cash flow. Currently, only a very small share is borne by the state. That will change if a public option relieves beneficiaries of their sky-high premiums. Last March (after the dust had settled on Obamacare’s third open season), Covered California had just under one million policies in force, covering almost 1.4 million enrollees. Total annual 2016 premiums would amount to $6.8 billion.

However, nine of ten enrollees pay significantly discounted premiums, because the insurers who write the policies receive significant tax credits to induce them to participate. Only $2.4 billion of the estimated total 2016 premium will have been paid by enrollees. Fully $4.4 billion will have been funded by federal taxpayers. So, if the public option eliminates enrollees’ responsibility to pay premium, state taxpayers would be on the hook for $2.4 billion.

But wait, there’s more! The U.S. Department of Health & Human Services estimatesthere are 313,000 Californians who are eligible for subsidized health insurance in Covered California, but chose to buy unsubsidized individual policies outside the exchange. It is not clear why they forgo the subsidies. Perhaps they want access to more doctors and hospitals than are available in Covered California’s infamously narrow networks. If they were freed from the responsibility of paying for any part of their premium in Covered California, surely many would get onboard.

If they are similar to the current enrollees, they would add almost half a billion dollars to the state taxpayers’ tab…

(A version of this Health Alert was published by the Orange County Register.) Dave Jones, California’s Insurance Commissioner, has lifted a page from Hillary

Source: California’s Public Option Would Not Rescue Obamacare | Health Policy Blog | NCPA.org

Posted in Access to healthcare, Affordable Care Act (ObamaCare), CPT billing, Dependency, Economic Issues, Government Regulations, Government Spending, Healthcare financing, Insurance subsidies, Job loss, medical inflation, Policy Issues, Tax Policy, Uncategorized, Welfare State

The Perverse Economics of Obamacare: Earn Less, Get More | International Liberty

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Dan Mitchell

The left-leaning San Francisco Chronicle has a financial advice column that inadvertently show how Obamacare discourages people from earning income.

To put it in even simpler terms, this couple has figured out that they can get almost $14,000 of other people’s money by reducing how much they earn by just $2,000.

That, in a nutshell, is the perfect illustration of the welfare state. It tells people that they can get more by producing less. And the system is based on the theory that there will always be some suckers who work hard to provide the subsidies.

Obamacare was put together by people who don’t understand economics. This is probably the understatement of the year since I could be referring to many features of the bad law. The higher tax…

Source: The Perverse Economics of Obamacare: Earn Less, Get More | International Liberty

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Deductibles, Economic Issues, Employer Mandate, Employer-Sponsored Health Plans, Federal Exchanges, Individual Mandate, out-of-pocket costs

What Republicans Should Be Doing: Holding Hearings On Obamacare – Forbes

John C. Goodman
John C. Goodman

Now that Paul Ryan is the presumptive new leader of the House of Representatives, what happens next? The single biggest domestic policy issue the country faces is Obamacare. So far, Republicans in Congress haven’t done anything very useful in addressing it. The House has voted 54 times to repeal some or […]

Source: What Republicans Should Be Doing: Holding Hearings On Obamacare – Forbes

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Economic Issues, Federal Exchanges, Health Insurance, Insurance subsidies, State-Run Insurance Exchanges, Subsidies

SCOTUS Rulings: a twitter poll would be quicker and just as meaningful | Robert Nelson, MD | LinkedIn

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Robert Nelson, MD

As noted by Justice Antonin Scalia in a scathing dissent, the Court rules that the term “established by the State,” which appears seven times in the statute, can also mean “not established by the State.”

For those of us opposed to the economic catastrophe that is PPACA, this ruling may be a blessing in disguise.  More tomorrow on the intended and unintended consequences of the SCOTUS ruling.

But for starters, here is something to think about. We now know (per Gruber and many others) the portion of the law that ties subsidies to formation of State Exchange was intentional and DEFINITELY NOT an oversight as Judge Roberts as other apologists for PPACA would have us believe – leaving him “no choice” but to intervene in order to prevent chaos…. as if there was no other financial option besides the subsidies as prescribed and ineptly administered by the ObamaCare mandate.

via SCOTUS Rulings: a twitter poll would be quicker and just as meaningful | Robert Nelson, MD | LinkedIn.

Posted in Affordable Care Act (ObamaCare), Economic Issues, Health Insurance, Job loss, Medical Costs, News From Washington, DC & Related Shenanigans, Organizational structure, Policy Issues, Subsidies, Tax Policy, Uncategorized, Unemployment

Obamacare Inflicts IRS Paperwork on New Victims – Hit & Run : Reason.com

-irsForget the incompetent launch of the Healthcare.gov website. Forget the soaring costs of coverage under Obamacare. Forget what the healthcare scheme’s impositions have wrought upon employment. Perhaps the Affordable Care Act’s most-resented wrong against the American people will be initiating those previously exempt to the dull, often incomprensible grind of Internal Revenue Service paperwork.

Since the tax agency is tasked with enforcing compliance with Obamacare, it is responsible for figuring out, after the fact, whether the people who received subsidies for their coverage—really, advance tax credits—received too little, too much, or just enough. Actually, it leaves the calculations to the recipients, many of whom are low-income and so have previously avoided the mental and logical gymnastics inherent in IRS forms. Well, aren’t they in for fun!

According to Kathy Kristof of CBS’s MoneyWatch:

Read entire story via Obamacare Inflicts IRS Paperwork on New Victims – Hit & Run : Reason.com.