A project of the Galen Institute

Issue: "Premiums/Costs"

Study: Out-Of-Pocket Prescription Costs Under A Typical Silver Plan Are Twice As High As They Are In The Average Employer Plan

Health Affairs
Mon, 2015-10-05
The health insurance Marketplaces created under the Affordable Care Act have attracted nearly ten million enrollees, including many people who were previously insured by an employer-sponsored plan. The most popular Marketplace plan—the silver plan—has significantly higher cost sharing than does a typical employer-sponsored plan, which may cause patients to reduce the use of cost-saving services that are essential for managing chronic conditions.

Phil Galewitz: Chronically Ill Pay More in Obamacare Plans Than Employer Coverage

Kaiser Health News
Mon, 2015-10-05
Chronically ill people enrolled in individual health plans sold on the Affordable Care Act insurance exchanges pay on average twice as much out-of-pocket for prescription drugs each year than people covered through their workplace, according to a study published Monday in the Health Affairs journal.

Erica E. Phillips: West Coast Port Contract Has Employers Covering ‘Cadillac Tax’

The Wall Street Journal
Thu, 2015-05-28
The U.S. West Coast port labor contract ratified by dockworkers will require shipping companies and terminal operators to cover the tax on high-cost health plans beginning in 2018 under the Affordable Care Act, widely called the “Cadillac tax.” Health care benefits were an important part of the negotiations that culminated in an agreement in February and last week’s vote by the cargo handlers in favor a five-year contract that included wage increases, pension upgrades and substantial health care coverage. Under the contract, the Pacific Maritime Association, a group of port terminal operators and shipping companies, will provide full health care benefits for members of the International Longshore & Warehouse Union, their dependents and retirees including full coverage with no premiums, no in-network deductibles or co-pays, $1 prescriptions and 100% coverage of hospital care.

Tara O’Neill: Obamacare Failed to Address ER Overcrowding

American Action Forum
Mon, 2015-05-18
One primary goal of the Affordable Care Act (ACA) was to expand access to affordable health care. However, in the five years since the ACA’s passage, we have found that while more people have health insurance, they do not necessarily have access to affordable health care. In order to pay for the subsidies that have facilitated the expansion of health insurance coverage, many recipients of federal funds were forced to accept payment reductions. Hospitals were faced with cuts of $260 billion over ten years.[1] These reductions came in the form of delayed payment updates for Medicare hospital services and reduced Disproportionate Share Hospital (DSH) payments meant to compensate hospitals for treating a high percentage of patients for whom the hospital is often inadequately reimbursed.

Scott Gottlieb: How Many People Has Obamacare Really Insured?

Thu, 2015-05-14
One of the key questions surrounding Obamacare is just how many people have been newly insured under the law. The answer is clouded by the fact that the White House and others have changed some rules of math for making these assessments. For example, several years ago, the Obama Administration fiddled with Census Bureau’s definition of what it means to be “uninsured.” The new parameters, which were looser than the old factors, make it hard to construct comparisons between today’s figures for the total number of uninsured and the historical trends. The Obama team also abruptly started to exclude uninsured illegal immigrants from the national tally on total number of uninsured Americans. Before Obamacare, these individuals were counted in that reporting, inflating the numbers.

Grace-Marie Turner: Cleaning Up The ObamaCare Mess

Mon, 2015-05-11
Republicans are being ridiculed by the right and the left for weighing ideas that would rescue ObamaCare health insurance policies for people in 37 states if the petitioners prevail in King v Burwell. “Republicans Are Now Trying To Pass Obamacare Extension To Save Their Own Asses,” writes Allen Clifton in Forward Progressives. “GOP Gets Ready to Save the Day If the Court Strikes Down Obamacare Subsidies,” says Rush Limbaugh. If the Supreme Court decides against the Obama administration in the case, leaders in Congress are indeed determined to pass legislation to protect coverage for an estimated six million people. ObamaCare has so distorted the market for individually-purchased and small group health insurance that Congress has little choice but to throw them a safety net.

Megan McArdle: Life Under Obamacare

Bloomberg View
Fri, 2015-05-08
Two years in, there's a lot we still don't know about Obamacare. How many people will it end up insuring? What will the premiums look like? How much will the program cost? Some of these questions won't be answered satisfactorily for a while, if ever. Even the most basic data point, on how many people have gained coverage, comes from Gallup polls and is a little murky. The percentage of people saying they don't have health insurance has fallen from about 17 as enrollment kicked off to about 12 now. The easing of the recession has presumably helped that. Other answers, however, will come into focus in the next year or so. The most important being: What will the market for individual insurance look like once Obamacare is in full effect?

Chris Jacobs: An Obamacare Lesson for Small Health Insurers?

The Wall Street Journal
Fri, 2015-05-08
In 2011, analysts were speculating that Assurant Health might exit the insurance business, the Milwaukee Journal Sentinel reported last week. So the recent news that Assurant’s parent company was looking to “sell or shut down” the insurance carrier by year’s end was not a total surprise. The issue now is whether its demise holds larger lessons about Obamacare’s impact on insurance markets. One analyst called Assurant, which reported operating losses of nearly $64 million in fiscal 2014 and $84 million in the first quarter of fiscal 2015, a “casualty” of the law. The Affordable Care Act “required health plans to cover a package of basic benefits and required health insurers to spend at least 80 cents of every premium dollar on medical care or quality initiatives,” the Journal-Sentinel reported.

ObamaCare Exchanges Are A Model Of Failure

Investor's Business Daily
Wed, 2015-05-06
Waste: After spending billions on state-run ObamaCare exchanges, the federal government is only now writing clear rules on how that money can be spent, while half of the exchanges head toward bankruptcy. state-run exchanges were supposed to form the beating heart of ObamaCare. And the Obama administration dumped almost $5 billion in an effort to make it a reality. The results have been a disaster. Of the 37 states that received $2.1 billion in grants to establish an exchange, only 17 did so, and they got an additional $2.7 billion from the feds. Of those 17, two went bankrupt in the first year. One of them, Oregon, had received a $60 million "early innovator grant." Residents of those states now use the federal Healthcare.gov site. A memo from Health and Human Services' Inspector General Daniel Levinson warns that some of the remaining may be violating federal law in an effort to stay afloat.

Peter Sullivan: Senators demand better oversight of state ObamaCare spending

The Hill
Wed, 2015-05-06
Two Republican committee chairmen are pressing the Obama administration to improve its oversight of how state-run ObamaCare marketplaces use federal dollars, citing an inspector general report on potential violations of law. Sens. Orrin Hatch (R-Utah) and Chuck Grassley (R-Iowa) wrote to the head of the Centers for Medicare and Medicaid Services (CMS) on Monday asking for the agency to issue clarifying guidance on how the federal dollars can be spent. State-run ObamaCare marketplaces received federal funds to help set themselves up, but after Jan. 1 of this year, they marketplaces are supposed to be self-sustaining. They are now prohibited by law from using federal funds for “operating expenses.” They can only use the money for “design, development, and implementation.” The problem is that the definition of these two categories can be unclear, as noted by an HHS Inspector General report late last month. The senators want clearer definitions from CMS.

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