A project of the Galen Institute

Issue: "Quality/Access"

Replacing the ACA: What Women Want

Grace-Marie Turner, Galen Institute
Real Clear Politics
Fri, 2014-10-24
"Americans are angry about the manifest failure of Obamacare. Many have felt the impact directly, from the millions who lost their health plans after being promised they could keep them, to those facing sky-high deductibles and premiums, to those -- including some in the midst of cancer treatments -- who are losing access to their family doctors. But at the same time, Americans want insurance that is secure and covers treatments they need. They want the uninsured and those with preexisting conditions to have access to coverage, and they know costs are rising dramatically. They know a safety net is needed for those who lose coverage, particularly those undergoing treatments for serious diseases."

Obamacare: Largest NC Insurer Announces Double-Digit Premium Increases

Guy Benson, Townhall
Thu, 2014-10-23
"It's been a tough week for North Carolina Senator Kay Hagan, who's clinging to a razor-thin lead in her re-election fight. She chose not to attend a 'debate' this week, ceding an hour of statewide airtime to her surging Republican opponent, Thom Tillis. Her chair sat empty throughout the forum. What didn't she want to discuss? Perhaps it was her decision to skip a key classified briefing on ISIS in favor of a New York City fundraiser. Or maybe it was the explosion of reports that her immediate family benefited directly from the "stimulus" law she voted for. It could have been President Obama's endorsement of candidates like Hagan as strong supporters of his agenda in Washington; the extent of Hagan's fealty was underscored again in yesterday's CQ analysis of 2014 voting records:"

Now There Can Be No Doubt: Obamacare Has Increased Non-Group Premiums In Nearly All States

Chris Conover
Forbes
Thu, 2014-10-23
"Remember this categorical assurance from President Obama? “We’ll lower premiums by up to $2,500 for a typical family per year. .  .  . We’ll do it by the end of my first term as president of the United States” OK, it’s probably a little unfair to take some June 2008 campaign “puffery” literally–even though it was reiterated by candidate Obama’s economic policy advisor, Jason Furman in a sit-down with a New York Times reporter: “‘We think we could get to $2,500 in savings by the end of the first term, or be very close to it.” Moreover, President Obama subsequently doubled-down on his promise in July 2012, assuring small business owners “your premiums will go down.” Fortunately, the Washington Post fact-checker, Glenn Kessler, honestly awarded the 2012 claim Three Pinocchios (“Significant factual error and/or obvious contradictions”)."

Sorry, Obamacare Is Still Unfixable

Ramesh Ponnuru
Bloomberg View
Thu, 2014-10-23
"For the most part, the political debate over President Barack Obama's health-care overhaul has become a duel between vague slogans: Republicans say they want to "replace" the Affordable Care Act but generally don't say with what. Democrats say they want to "fix" it but usually don't say how. So Democratic Senators Mark Warner and Mark Begich deserve credit for advancing specific legislation to change the law. The main change they're advocating, though, is unlikely to make people any happier with the law -- and could cause new problems."

The $500 Billion Medicare Slowdown: A Story About Part D

Loren Adler and Adam Rosenberg
Health Affairs
Thu, 2014-10-23
"A great deal of analysis has been published on the causes of the health care spending slowdown system-wide — including in the pages of Health Affairs. Much attention in particular has focused on the remarkable slowdown in Medicare spending over the past few years, and rightfully so: Spending per beneficiary actually shrank (!) by one percent this year (or grew only one percent if one removes the effects of temporary policy changes). Yet the disproportionate role played by prescription drug spending (or Part D) has seemingly escaped notice. Despite constituting barely more than 10 percent of Medicare spending, our analysis shows that Part D has accounted for over 60 percent of the slowdown in Medicare benefits since 2011 (beyond the sequestration contained in the 2011 Budget Control Act)."

GOP 2016 contenders: Repeal Obamacare, reform Medicaid

Jennifer Rubin
Washington Post
Thu, 2014-10-23
"Gov. John Kasich of Ohio was the first potential 2016 candidate to get snared in the Obamacare/Medicaid media snafu. As one of several GOP governors who expanded Medicaid, he naturally defends that move, which in an Associated Press interview came out as a defense of Obamacare, to which the Medicaid extension was attached. Kasich clarified his view, but the liberal media, Democrats and potential 2016 opponents may think they have their gotcha quote. Kasich, however, is correct that one can be for repealing Obamacare and still support states’ expansion of Medicaid. But other governors should be forewarned: You better be crystal clear about what you want to do."

State-by-State Estimates of Individual Mandate Payments

Conor Ryan, American Action Forum
Thu, 2014-10-23
"Using data on household income and health insurance coverage maintained by the Census Bureau and McKinsey estimates on previously uninsured households enrolled through the Health Insurance Marketplace, the American Action Forum was able to construct state-level estimates of individual mandate payments. After accounting for exemptions, AAF estimates that 5.2 million people will be subject to the individual mandate penalty for being uninsured in 2014 and will pay a total of $5.8 billion in additional taxes. The AAF estimates include the exemptions for unauthorized immigrants, households that do not file income taxes, households that earn less than 138 percent of the federal poverty level, and households that cannot purchase a Bronze plan with 8 percent of household income, but do not attempt to project how many households may apply for one of the many hardship exemptions."

'•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."

Oregon gives up on Oracle technology, will use another state's Medicaid system

Nick Budnick, The Oregonian
Wed, 2014-10-22
"State officials have given up on trying to salvage a portion of the troubled Cover Oregon technology project, essentially abandoning all hope of getting any lasting benefit from the $240 million paid Oracle America on the health insurance exchange and related work. Instead, Oregon will look to use successful technology built by another state, and is trying to determine which one."

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