A project of the Galen Institute

Issue: "Business Impact"

Experts question MNsure average rate increase of 4.5 percent

Ricardo Lopez, Minneapolis Star-Tribune
Fri, 2014-10-24
"Almost immediately after the state’s insurance regulator earlier this month announced that rates for plans sold through MNsure would rise 4.5 percent on average, Republicans, health policy experts and other critics decried the figure as bogus and misleading. The state Commerce Department has steadfastly defended the figure — a straight average of rate changes reported by the four returning carriers to MNsure — acknowledging that some consumers will see higher or lower rate changes. State agency officials said consumers can shop around once open enrollment begins Nov. 15 “to find the best option that fits their individual health and financial needs.” But other states, like California, Colorado and Washington, report their increases in premiums for their respective exchange plans as weighted averages. Calculated that way, Minnesota’s figure for next year is not 4.5 percent, but 11.8 percent."

New for 2015: Obamacare insurers' opt-out clause

Dan Mangan, CNBC
Thu, 2014-10-23
"These insurers will sell you some Obamacare—at least as long as the government is footing the bill for most of their customers. Insurers doing business on HealthCare.gov will be allowed to terminate their health plans if there's a halt on federal tax credits that help most Obamacare customers buy the coverage, according to new language for 2015 contracts. The language giving insurers the new opt-out does make clear, however, that individual state laws still may force insurers to continue the coverage."

Australia will raise $5 billion by Privatizing its Biggest Health Insurer

John Graham, National Center for Policy Analysis
Thu, 2014-10-23
"Australia’s federal government is about to raise almost $5 billion by privatizing its largest health insurer: Australia hopes to raise up to Aus$5.51 billion (US$4.82 billion) through the sale of the country’s largest health insurer in an initial public offering, Finance Minister Mathias Cormann said Monday. Cormann said the sale would remove the current conflict where the government is both the regulator of the private health insurance market and owner of the largest market participant. Medibank provides cover to 3.8 million people. The government has previously said Medibank is one of 34 competing funds in the private health insurance market in Australia and that a scoping study had found no evidence that premiums would rise as a result of the sale."

'•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."

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)"

A recent poll shows that most doctors give Obamacare low grades – but should this influence voters’ evaluation of the program?

Ilya Somin
Washington Post
Tue, 2014-10-21
"A recent survey of doctors by the Physicians Foundation finds that most give low grades to Obamacare. Some 46% of the doctors polled gave Obamacare a grade of “D” or “F” and 29% gave it a “C.” Only 25 percent give it an “A” or a “B,” including just 4% who gave it the highest grade. It’s possible that some of the doctors who chose C really meant to say that it was at least reasonably good. But in modern America, thanks to grade inflation, a C is generally considered a very bad grade. Thus, it seems likely that a large majority of doctors have strongly negative view of the program."

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."

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""

Why doctors give Obamacare a failing grade

Jeffrey Singer
The Hill
Sun, 2014-10-19
"The Physicians Foundation made shockwaves last month when it released its 2014 Survey of America’s Physicians. The survey’s top-line finding: Of the 20,000 doctors surveyed, almost 50 percent stated that Obamacare deserves either a “D” or an “F.” Only a quarter of physicians graded it as either an “A” or a “B.” Count me among the discontented. Obamacare has harmed too many of my patients. It has done so by disrupting the doctor-patient relationship and thereby worsening the quality of patients’ care. This is the heart and soul of medicine, as I have learned in in my 33 years as a practicing physician. The doctor-patient relationship is critical for positive health outcomes because it allows both parties to work together to identify and ultimately treat medical problems. Simply put, a relationship of trust and continuity is essential to our professional mission."

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