A project of the Galen Institute

Issue: "Mandates"

'•The ACA will push more women than men into part-time work.'

Casey Mulligan
Mercatus Center
Wed, 2014-10-22
"Much of the ACA’s tax effect resembles unemployment insurance: both encourage layoffs and discourage people from returning to work. The ACA’s overall impact on employment, however, will arguably be larger than that of any single piece of legislation since World War II. •The ACA’s employment taxes create strong incentives to work less. The health subsidies’ structure will put millions in a position in which working part time (29 hours or fewer, as defined by the ACA) will yield more disposable income than working their normal full-time schedule. •The reduction in weekly employment due to these ACA disincentives is estimated to be about 3 percent, or about 4 million fewer full-time-equivalent workers.

Obamacare’s small-business exchanges to see major changes in the coming months

J.D. Harrison, Washington Post
Wed, 2014-10-22
"One year in, the new small-business insurance marketplaces born out of the new federal health-care law have fallen short of their promise in nearly every state, both in terms of functionality and enrollment. However, many are scheduled to see some important updates heading into year two — ones that health officials say should make them much more useful and appealing to small employers and their workers. In the nation’s capital, for example, officials are preparing to roll out the third major update to the District of Columbia’s health-care marketplace, which already houses one of the country’s most robust small-business exchanges, often called SHOP (Small Business Health Options Program) exchanges. District small businesses have already been able to shop for and select plans online — an option that was delayed by at least a year in most states."

Kaiser Health Tracking Poll: October 2014

Liz Hamel, Jamie Firth, Bianca DiJulio and Mollyann Brodie, Kaiser Health News
Wed, 2014-10-22
"In the final Kaiser Health Tracking Poll before the 2014 midterm elections in November, the Affordable Care Act (ACA) continues to be just one of several issues on voters’ minds. Less than 1 in 10 registered voters (8 percent) identify the ACA as the most important issue to their vote, ranking 5th behind the economy (16 percent), dissatisfaction with government (12 percent), education (10 percent) and the situation in Iraq and Syria (9 percent). The ACA ranks 4th for Democrats, Republicans, and independents alike. Just over half of voters say they’re tired of hearing Congressional candidates talk about the ACA and wish they would move on to other issues, while 44 percent say they want candidates to continue the discussion. Meanwhile, as campaigns make their final appeal to voters, 6 in 10 report seeing political advertising related to the ACA, with more saying they have seen mostly negative advertising about the ACA rather than mostly positive."

HHS-Funded Study: Obamacare Will Suffer ‘Death Spiral’ If Subsidies Fail

Sarah Hurtubise, Daily Caller
Tue, 2014-10-21
"The Obama administration has funded a new study by top consulting firm RAND Health that startlingly finds that if taxpayer subsidies are eliminated, Obamacare exchanges will fall into a “death spiral.” The study comes in the wake of a number of lawsuits which are challenging the Obama administration’s implementation of Obamacare subsidies. Three lawsuits have made it to U.S. Circuit Courts, just one step from the Supreme Court, arguing that the text of the Affordable Care Act allows premium subsidies for state-run exchanges only. (RELATED: Second Court Strikes Down Obamacare Subsidies In Federal Exchanges)"

Ebola: Obamacare’s Ultimate Pre-Existing Condition

Eric Pianin and Brianna Ehley, Financial Times
Tue, 2014-10-21
"With the new Obamacare enrollment period scheduled to begin on November 15, here’s an intriguing question: If you’re one of the rare Americans to have the misfortune of contracting Ebola, can you apply for a new insurance policy on one of the government-run health exchanges without being rejected? Currently, only four people are being treated for Ebola in the United States, and a few hundred who may have been exposed to it are either being monitored or have been notified – so this is an extremely unusual situation. Still, while no insurance company would relish the prospects of taking on a consumer suffering from one of the worst viruses to occur in today’s modern world, the Affordable Care Act prohibits insurance companies from turning down applicants with pre-existing conditions, such as cancer, heart disease, kidney disease, or even – yes – Ebola."

More Plans Setting Spending Limits For Some Medical Services

Michelle Andrews, Kaiser Health News
Tue, 2014-10-21
"Aiming to contain health care costs, a growing number of employers and insurers are adopting a strategy that limits how much they’ll pay for certain medical services such as knee replacements, lab tests and complex imaging. A recent study found that savings from such moves may be modest, however, and some experts question whether “reference pricing,” as it’s called, is good for consumers. The California Public Employees’ Retirement System (CalPERS), which administers the health insurance benefits for 1.4 million state workers, retirees and their families, has one of the more established reference pricing systems. More than three years ago, the agency began using reference pricing for elective knee and hip replacements, two common procedures for which hospital prices varied widely without discernible differences in quality, says Ann Boynton, CalPERS’ deputy executive officer for Benefit Programs Policy and Planning."

ObamaCare — Why, sure, it's 'paid for'

Bob Moffit, The Heritage Foundation
The Hill
Mon, 2014-10-20
"Republican Senate Budget Committee analysts reported last week that the Patient Protection and Affordable Care Act (ACA) — a.k.a. ObamaCare — would increase the federal deficit by $131 billion over the period from 2015 to 2024. Drew Hammill, a senior aide to House Minority Leader Nancy Pelosi (D-Calif.), dismissed the report as "complete garbage." Name-calling is no substitute for analysis. The Senate budget analysts' work is fully transparent. Based on Congressional Budget Office (CBO) data on medical spending and labor market effects, it is quite easy to check out. In fact, the Senate Budget analysts do not question any of the CBO's assumptions concerning ObamaCare's biggest fiscal problem: massive government spending. The CBO now says that the Medicaid expansion and the new exchange subsidies will cost taxpayers $1.9 trillion by 2024. It will account for more than half the cost-growth in federal health programs by 2023."

Ask Your Doctor About Obama's Affordable Care Act

Jason Fodeman
Investors.com
Mon, 2014-10-20
"You shouldn't judge the Affordable Care Act based on headlines or by listening to politicians or talking heads. I tried for a while, but only heard wildly conflicting stories that seemed to have little basis in reality. Instead, you should ask someone who actually deals with the law on a daily basis — a doctor, for instance. The Physicians Foundation did exactly that in its "2014 Survey of American Physicians," which was released last month. The survey, which reached over 80% of doctors in the U.S. and elicited responses from some 20,000, is doctors' collective report card on the Affordable Care Act's first four years. The grades aren't good. Only 25% of doctors give it an "A" or a "B" grade. Nearly half ( 46%) give it a "D" or an "F""

Obamacare cancellations, again: Column

Tim Phillips
USA Today
Sun, 2014-10-19
"Last fall, millions of Americans breathed a sigh of relief when Obamacare didn't cancel their health care plans. Now they're holding their breath once again. Hundreds of thousands of Americans will soon receive cancellation letters affecting their 2015 health care plans — and that number may quickly rise into the millions. This wave of cancellations will fall into two categories. The first group hit will be in the individual market, the same group that suffered through at least 6.3 million cancellation letters last year. They will almost certainly be joined by millions of people in the small-employer market, which has 40 million plans and will be under Obamacare's control starting next year."

Cost, confusion stall hunt for insurance

Katie Kerwin McCrimmon, Health News Colorado
Fri, 2014-10-17
"Cost and confusion prevented many uninsured people from signing up for health coverage this year in Colorado, according to two new reports. A Rand study, Barriers to Enrollment in Health Coverage in Colorado, found that some consumers didn’t want to sign up because they opposed the individual mandate. Others were frustrated that they first had to apply for Medicaid in a cumbersome process. Still others found Colorado’s exchange website confusing. And many people said costs for insurance and co-pays seemed too high."

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