A project of the Galen Institute

Issue: "Premiums/Costs"

Gruber Model Errs in Colorado as Vermont Prepares to Rely on Data

Vermont Watchdog
Tue, 2014-12-16
By Bruce Parker | Vermont Watchdog Jonathan Gruber’s health care forecasting is failing in Colorado as Vermont’s Gov. Peter Shumlin prepares to use the economist’s math for single-payer health care. As Vermonters anxiously await a Gruber-modeled financing plan for Green Mountain Care, modeling done for Colorado’s health exchange by Jonathan Gruber Associates has proven wildly erroneous. In 2011, following Colorado’s decision to set up a state health exchange for Obamacare, the state hired Gruber to forecast enrollment trends from which the state and federal government could estimate costs. According to a presentation delivered to the Colorado Health Benefit Exchange Board on Sept.

If the Supreme Court Breaks Obamacare, Will Republicans Fix It?

National Journal
Mon, 2014-12-15
By Sam Baker and Sophie Novack: Republicans want the Supreme Court to blow a major hole in Obamacare next year, but they are still debating whether they would help repair it—and what they should ask for in return. There's a very real chance the high court will invalidate Obamacare's insurance subsidies in most of the country, which would be devastating for the health care law. It would become almost entirely unworkable in most states, and the cost of coverage would skyrocket. That loss for the Affordable Care Act might seem like a clear-cut political win for the GOP, but the reality would be far messier. Such a ruling would weaken the law's individual mandate and make coverage unaffordable for millions of people.

A Post-ObamaCare Strategy

The Wall Street Journal
Mon, 2014-12-15
With the Supreme Court due to rule on a major ObamaCare legal challenge by next summer, thoughts in Washington are turning to the practical and political response. If the Court does strike down insurance subsidies, the question for Republicans running Congress is whether they will try to fix the problems Democrats created, or merely allow ObamaCare’s damage to grow. The time to define a strategy is soon, as King v. Burwell will be heard in March with a ruling likely in June. As a matter of ordinary statutory construction, the Court should find that when the law limited subsidies to insurance exchanges established by states, that does not include the 36 states where the feds run exchanges. But in that event one result would be an immediate refugee crisis. Of the 5.4 million consumers on federal exchanges, some 87% drew subsidies in 2014, according to a Rand Corporation analysis. Continued... http://www.wsj.com/articles/a-post-obamacare-strategy-1418601071

Security Flaws Found in IRS ObamaCare Fee System

The Fiscal Times
Wed, 2014-12-10
By Aliya Sternstein, A core Internal Revenue Service system for calculating Obamacare fees for health insurers and drug manufacturers has security weaknesses, according to an internal audit. Under the Affordable Care Act, insurers must report their net premiums to the tax agency annually, and pharmaceutical companies must submit sales data from certain government programs. Related: Can IRS Collect Obamacare Taxes When It Can't Handle Tax Complaints? The Treasury Inspector General for Tax Administration recently examined a new computer application, called the ACA Information Returns system and known as AIR, that processes these returns. The IG's heavily redacted 44-page report, released Tuesday, suggests, specifically, the agency neglected to check source code for bugs and fix security vulnerabilities.

ObamaCare’s Threat to Private Practice

The Wall Street Journal
Mon, 2014-12-08
By Scott Gottlieb Dec. 7, 2014 5:12 p.m. ET Here’s a dirty little secret about recent attempts to fix ObamaCare. The “reforms,” approved by Senate and House leaders this summer and set to advance in the next Congress, adopt many of the Medicare payment reforms already in the Affordable Care Act. Both favor the consolidation of previously independent doctors into salaried roles inside larger institutions, usually tied to a central hospital, in effect ending independent medical practices. Republicans must embrace a different vision to this forced reorganization of how medicine is practiced in America if they want to offer an alternative to ObamaCare. The law’s defenders view this consolidation as a necessary step to enable payment provisions that shift the financial risk of delivering medical care onto providers and away from government programs like Medicare.

Exploring the shortcomings and fault lines of the Affordable Care Act

Physicians for a National Health Program
Mon, 2014-12-08
The case for single payer – Medicare for All By Jeoffry B. Gordon, M.D., M.P.H. December 3, 2014 The Patient Protection and Affordable Care Act (ACA) has as its main and overriding purpose the expansion and subsidization of health insurance coverage for many (usually poor and uninsured) Americans who were previously unable to reliably access medical services. Under its auspices, the federal law has provided for health insurance enrollment for 1 million to 3 million additional 19- to 26-year-olds; 6 million new, expanded Medicaid enrollees; and 7.2 million commercial Qualified Health Plan enrollees. Of the latter, about 80 percent qualify for financial subsidy. Taking into account additional factors, e.g. the fact that some of the new enrollees were previously insured, there has been a net gain of about 10 million people who have coverage. Yet even at full expansion, it is estimated that the ACA will not insure another 30 million U.S.

How to Replace Obamacare

James C. Capretta
National Review
Tue, 2014-12-02
In the 2014 midterm elections, opposition to the Affordable Care Act — i.e., Obamacare — was a clear political winner. That’s obvious from the election results themselves but also from polling that consistently finds that far more of the electorate disapproves of the law than approves of it. It is therefore to be expected that the incoming Congress, fully under the control of the GOP, will vote on a straight repeal bill, probably very early in next session. In the House, such a bill will pass easily. But in the Senate, Democrats will control at least 46 seats in the new Congress, giving them plenty of votes to filibuster most legislation they oppose. Consequently, the most likely scenario is that the repeal legislation will die in the Senate and therefore never get sent to the president for a certain veto. Perhaps that’s just as well, because repeal without a replacement plan is not the best long-term position for ACA opponents anyway.

Obama order extends benefits to immigrants

Elise Viebeck, The Hill
Wed, 2014-11-26
"Illegal immigrants protected from deportation under President Obama's executive action will be eligible for Medicare and other benefits once they enter the federal system. The sweeping White House announcement last week means that up to 5 million people will be considered lawfully present in the United States despite having entered the country illegally. This status makes them eligible for programs such as Medicare and Social Security if they work and submit payroll taxes that flow to those programs. This fact was noted Tuesday in a report by The Washington Post."

Administration Warns Employers: Don’t Dump Sick Workers From Plans

Jay Hancock, Kaiser Health News
Wed, 2014-11-26
"As employers try to minimize expenses under the health law, the Obama administration has warned them against paying high-cost workers to leave the company medical plan and buy coverage elsewhere. Such a move would unlawfully discriminate against employees based on their health status, three federal agencies said in a bulletin issued this month."

A Quarter Of Uninsured Say They Can’t Afford To Buy Coverage

Mary Agnes Carey, Kaiser Health News
Wed, 2014-11-26
"Just days before the health law’s marketplaces reopened, nearly a quarter of uninsured said they expect to remain without coverage because they did not think it would be affordable, according to a poll released Friday. That was by far the most common reason given by people who expect to stay uninsured next year, according to the latest tracking poll by the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) Forty-one percent of individuals without health insurance said they expected they would remain uninsured, while about half said they plan to get coverage in the coming months."

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