A project of the Galen Institute

Issue: "Business Impact"

As Obamacare Batters Device Makers, Lobby Snuggles With Hillary Clinton In Chicago

Bruce Japsen, Forbes
Thu, 2014-10-30
"Hillary Clinton, the front-runner for the Democratic party’s nomination for President in 2016, is giving a speech at this week’s annual meeting of the powerful Advanced Medical Technology Association, or AdvaMed, in her hometown as the lobby prepares to derail a tax key to funding the Affordable Care Act. The former U.S. Secretary of State, who has yet to officially declare her presidential candidacy, is also in Chicago to campaign for Illinois Gov. Pat Quinn, who is in a tight race with billionaire Republican Bruce Rauner as the incumbent gains momentum here. During her visit, which has been kept under wraps until this week, Clinton has been given a prime spot during the three-day AdvaMed event, delivering a keynote at Wednesday’s midday plenary session at Chicago’s McCormick Place."

Obamacare’s Success Has Small Business Dropping Coverage

Kelly Gilblom and Caroline Chen, Bloomberg
Thu, 2014-10-30
"U.S. small businesses are dropping health insurance for their workers, as Obamacare lets them send employees to new marketplaces where they can often get subsidies from the government to buy coverage. WellPoint Inc. (WLP)’s small business insurance products lost 300,000 people this year, the company said today. Business owners are dropping coverage they previously bought through WellPoint and other insurers, and instead sending employees to shop for it on the government exchanges created under the Patient Protection and Affordable Care Act known as Obamacare."

Nearly 1/4 of doctors may opt out of Obamacare exchanges in 2015

Jazz Shaw
Hot Air
Thu, 2014-10-30
"Do you suppose any of the 2014 candidates will find time in the closing week to talk about Obamacare again, in the midst of all the other slow rolling disasters? (Aside from the occasional Root and Branch repeal call, that is.) If they do, they might want to mention a new study from the Medical Group Management Association which has some rather depressing figures in terms of medical services availability next year for participants. Barbara Boland has the story. Over 214,000 doctors won’t participate in the new plans under the Affordable Care Act (ACA,) analysis of a new survey by Medical Group Management Association shows. That number of 214,524, estimated by American Action Forum, is through May 2014, but appears to be growing due to plans that force doctors to take on burdensome costs.

Want To Fix The "Doc Fix"? Experiment!

Yevgeniy Feyman
Forbes
Thu, 2014-10-30
"For health policy wonks, the end of the year isn’t just the holiday season. With the falling temperatures will come a renewed “doc fix” debate, as Congress deliberates on ways to avoid a scheduled double-digit (24 percent last year) cut in Medicare’s physician payments. And avoid it they will. As health economist Austin Frakt put bluntly: “Good luck getting physicians to keep Medicare patients if the payments are suddenly cut 24 percent.”"

This Democratic 'reform' would make Obamacare more expensive. Bad idea.

Michael Hiltzik
Los Angeles Times
Thu, 2014-10-30
"A caucus of seven nervous Democratic senators, led by Mark Begich of Alaska, has been pushing a plan to "reform" the Affordable Care Act by allowing insurers to offer an even skimpier insurance plan than the skimpiest permitted now. . The idea of their "Expanded Consumer Choice Act" is to create a new "copper" tier of health plan permitted in the individual and small-business markets under the ACA. The copper tier would undercut the current tiers of health plans by covering only 50% of expected health costs. Under the current law, the stingiest "bronze" tier covers 60% of costs."

Aetna Boosts Profit Forecast as Health Enrollment Climbs

Caroline Chen, Bloomberg
Wed, 2014-10-29
"Aetna Inc. (AET), the third-largest U.S. health insurer, raised its profit forecast for the year as enrollment increases. Operating earnings this year will be $6.60 to $6.70 a share, above the previous forecast of $6.45 to $6.60, the Hartford, Connecticut-based company said today in a statement."

Some doctors wary of taking insurance exchange patients

Jayne O'Donnell
USA Today
Wed, 2014-10-29
"Now that many people finally have health insurance through the Affordable Care Act exchanges, some are running into a new problem: They can't find a doctor who will take them as patients. Because these exchange plans often have lower reimbursement rates, some doctors are limiting how many new patients they take with these policies, physician groups and other experts say."

Soft launch for O-Care's business exchange

Elise Viebeck, The Hill
Wed, 2014-10-29
"Businesses in five states received early access Monday to select features at ObamaCare's online health insurance marketplace for small employers. The soft launch for the SHOP system is an effort by federal health officials to troubleshoot any problems at the exchange before Nov. 15, when it will open to all states that did not elect to build their marketplaces. Small businesses in New Jersey, Delaware, Illinois, Ohio and Missouri can establish accounts, complete an application, receive a determination of eligibility and upload an employee roster, the Centers for Medicare and Medicaid Services said. In November, employers will also be able to browse plans and pricing."

Casting light on a simpler pricing system

Merrill Goozner, Modern Healthcare
Wed, 2014-10-29
"Remember the excitement surrounding Castlight Health's initial public offering? Last March, the San Francisco startup's stock price soared when investors bought into the idea that online price transparency would transform the healthcare marketplace. Castlight's business plan calls for offering software through insurers and employers that allows people to comparison shop for healthcare services. With employers rapidly moving their workers into high-deductible plans, patients looking to lower their out-of-pocket expenses could use Castlight to find low-cost providers."

Speculation swirls around what happens if federal subsidies go away

Lisa Schnecker, Modern Health Care
Wed, 2014-10-29
"New language in contracts between the CMS and insurers operating on HealthCare.gov is grabbing attention, with some calling it an admission by the government that it might lose upcoming court battles dealing with insurance subsidies on the health portal and others saying the new wording is just a practical precaution. The new language appears to allow insurers to stop offering their plans should federal premium subsidies disappear. A number of cases regarding the legality of the subsidies in states without their own exchanges are now working their way through the courts. The language says, “CMS acknowledges that (the insurer) has developed its products for the (federal exchange) based on the assumption that (advance payments of the premium tax credit) and (cost-sharing reductions) will be available to qualifying enrollees.

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