A project of the Galen Institute

Issue: "Social Impact"

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."

Gov. Kasich's four Obamacare tricks

Philip Klein
Washington Examiner
Wed, 2014-10-22
"Ohio Gov. John Kasich, the Republican governor and possible 2016 contender, had a dust-up this week when the Associated Press reported pro-Obamacare comments he made. In reality, he subsequently said, he was only praising the Medicaid expansion — which he’s trying to argue is totally separate. I’ve already written about why this is a dishonest distinction, but his office has decided to dig in further. In a statement released on Twitter on Tuesday, his press department attempted to trick conservatives by using several cynical strategies often employed by Republicans trying to explain their big government policies."

71% of Obamacare Signups Traced to Government’s Expansion of Medicaid

Melissa Quinn
The Daily Signal
Wed, 2014-10-22
"The vast majority of Americans gaining health coverage under Obamacare actually qualified for Medicaid because of loosened eligibility —and that’s what boosted enrollment among those previously uninsured, according to a new report from The Heritage Foundation. The Obama administration has boasted that the Affordable Care Act, popularly known as Obamacare, would allow those previously uninsured to purchase quality, affordable health care. “The inescapable conclusion is that, when it comes to covering the uninsured, Obamacare so far is an expansion of Medicaid,” Heritage Foundation health policy experts Edmund F. Haislmaier and Drew Gonshorowski write in a research paper scheduled for release today."

'•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.

Jeanne Shaheen's Dishonest Claim That Obamacare Doesn't Cut Medicare

Avik Roy
Forbes
Wed, 2014-10-22
"In last night’s U.S. Senate debate in New Hampshire between incumbent Jeanne Shaheen (D.) and challenger Scott Brown (R.), Shaheen uttered a flat-out, bald-faced lie: that Obamacare doesn’t cut Medicare spending to pay for its expansion of coverage to the uninsured. It’s a talking point that a number of Democratic Senate candidates—and their enablers in the lefty blogosphere—have been clinging to. And it’s embarrassingly dishonest."

Paul Krugman's Late Obama Valentine

Brent Bozell, Media Research Center
Townhall
Wed, 2014-10-22
"Knowing the way our political press works, it's easy to predict that Barack Obama's presidency is just about over. Journalists will soon treat him as the lamest of lame ducks, and suggest nothing consequential will happen in the last two years of his presidency. Instead, they'll obsess over who will come next. So the timing is perfect for Rolling Stone magazine to reassert itself as Obama's most shameless house organ. They've published a 4,000-word tribute by liberal New York Times columnist Paul Krugman insisting that "Obama has emerged as one of the most consequential and, yes, successful presidents in American history.""

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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