Voice and Exit in Health Care Policy

Voice and Exit in Health Care Policy

What can we learn from the recent controversy

over mandated birth control coverage?

By M. Todd Henderson

http://www.cato.org/sites/cato.org/files/serials/files/regulation/2013/3/v36n1-9.pdf

Smoking Is a ‘Preexisting Condition’ – Kevin D. Williamson – National Review Online

Obamacare is designed to destroy the insurance market. Markets do not function without prices, and Obamacare ensures that prices will not be allowed to emerge. There is a medical price associated with smoking, but the District of Columbia has decided to suppress that price by law. Pretending that smoking has no relationship with health-care costs does not make it so — it is only a way to push costs around in a way that is agreeable to the likes of Barack Obama, converting a system that prices risk into a system of entitlements.

via Smoking Is a ‘Preexisting Condition’ – Kevin D. Williamson – National Review Online.

The Affordable Care Act and Reproductive Health: Potential Gains and Serious Challenges

After nearly a century of failed or incomplete legislative efforts, the Patient Protection and Affordable Care Act (PPACA), enacted by Congress in March 2010, establishes the principle that every American is entitled to affordable and effective health insurance coverage regardless of income or health status. Although many aspects of the act have received broad attention, its impact on reproductive health has received considerably less scrutiny, except when debated through the specific lens of particularly polarized ideological concerns. If fully implemented as planned, the PPACA has the potential to improve reproductive health in the United States in at least three ways: increasing the number of women and men with insurance coverage; increasing the value of insurance coverage for addressing reproductive health needs; and improving access to reproductive health services and information more generally. Several PPACA provisions stand out as having particular importance for reproductive health, including Medicaid family planning expansions, standards for an essential health benefits package, expanded coverage for contraception and other clinical preventive services, and teen pregnancy prevention programs. All these potential gains, however, are threatened by political, economic, and logistical challenges to the PPACA and by flaws in the legislation itself.

via The Affordable Care Act and Reproductive Health: Potential Gains and Serious Challenges.

Obamacare insurance plans will be bare bones – and expensive – Health – AEI

There’s mounting evidence that come fall, the health plans sold through the Obamacare exchanges will be bare bones affairs – with narrow networks of providers to select from, and heavy co-insurance once patients go “out of network.”

In many ways these plans will be a throwback to insurance schemes of the late 1990s, when managed care was dominant and restrictive networks standard fare.

With one difference: The Obamacare plans won’t be cheap.

via Obamacare insurance plans will be bare bones – and expensive – Health – AEI.

Final Rule Issued On Required Coverage Under Health Law – Capsules – The KHN Blog

Insurers must cover 10 broad categories of care, including emergency services, maternity care, hospital and doctors’ services, mental health and substance abuse care and prescription drugs.

Essential benefit requirements apply to individual and small group plans sold within and outside the new online, state-based exchanges scheduled to launch in 2014. The requirements also apply to benefits provided to those newly eligible for Medicaid coverage. These requirements do not apply to self-insured health plans, which is how most large companies cover their employees.

via Final Rule Issued On Required Coverage Under Health Law – Capsules – The KHN Blog.

Trends and Characteristics of Preventive Care Visits Among Commercially Insured Adolescents, 2003-2010 by Yuping Tsai, Fangjun Zhou, Pascale Wortley, Abigail Shefer, Shannon Stokley :: SSRN

Background: The proportion of adolescents making an annual preventive visit has been considerably low compared with infants and children. During 2005 and 2007, the Advisory Committee on Immunization Practices (ACIP) recommended three vaccines targeted at this age group. One potential benefit of these recommendations is that they could increase the number of outpatient visits in which other clinical preventive services could also be provided. This study examines the time trend in preventive visits by commercially insured adolescents during 2003-2010.

Methods: We use data from the MarketScan database. Our study population includes adolescents aged 11 to 21 continuously enrolled in the same insurance plan during the calendar year. We calculated the annual proportion of adolescents with at least one preventive and one vaccination-related visit. Longitudinal analyses were conducted by following individual enrollees for 8 consecutive years.

Results: The proportion of adolescents making at least one preventive visit increased from 24.7% to 41.1% during 2003-2010. The rate of vaccination-related visit increased from 12.3% to 26.4%. The magnitude of the increase in preventive and vaccination-related visits was greater during the years in which ACIP issued recommendations. The rates of preventive and vaccination-related visit were higher among female and young adolescents and adolescents in managed care insurance plans. Longitudinal analyses indicated that 2.4% of adolescents had a yearly preventive care visit during the 8 years.

Conclusions: Our findings provide suggestive evidence that ACIP recommendations might have improved the preventive visit rate of adolescents, implying that vaccine recommendations might result in additional benefits for adolescents.

via Trends and Characteristics of Preventive Care Visits Among Commercially Insured Adolescents, 2003-2010 by Yuping Tsai, Fangjun Zhou, Pascale Wortley, Abigail Shefer, Shannon Stokley :: SSRN.

A New Round of Intolerance – By Yuval Levin – The Corner – National Review Online

I think it is just perfectly clear that the government has forced a needless and completely avoidable confrontation and has knowingly put many religious believers in an impossible situation. It is no secret that most of America’s largest religious denominations are opposed to abortion, and that some are opposed to contraception as well. And there are many alternative means by which the government can (and does) make abortive and contraceptive drugs and procedures available to people. The purpose of refusing to provide a religious exemption from this rule would therefore appear to be to force religious employers themselves to make those drugs and procedures available—to bend a moral minority to the will of the state. It is not only a failure of statesmanship and prudence, it is a failure of even the most minimal toleration.

via A New Round of Intolerance – By Yuval Levin – The Corner – National Review Online.

Another Non-Accommodation – James C. Capretta – National Review Online

This shell game was thoroughly debunked months ago when the administration first tried it. Under the administration’s proposal, a non-exempt religious employer choosing to offer insurance at all would know in advance that this coverage would automatically come with a rider covering everything the employer would like to avoid. That’s essentially no different from doing it directly in the employer plan. It’s not a solution.

via Another Non-Accommodation – James C. Capretta – National Review Online.

Depends What Your Definition of ‘Independent’ Is – By Kathryn Jean Lopez – The Corner – National Review Online

So I’m reading what the Department of Health and Human Services has released this morning (80 pages — enjoy) — which continues the administration’s posture of managing religious liberty and cheerleading for its institutionalization of sexual-revolutionary ideology by regulatory mandate — and I’m stuck on its applause for the “independent Institute of Medicine” recommendations that gave birth to the HHS abortion-drug, contraception, sterilization mandate. The Institute of Medicine’s panel was not independent, but quite biased toward the abortion lobby.

via Depends What Your Definition of ‘Independent’ Is – By Kathryn Jean Lopez – The Corner – National Review Online.

Birth Control Rule Altered to Allay Religious Objections – NYTimes.com

The proposal could expand the number of groups that do not need to pay directly for birth control coverage, encompassing not only churches and other religious organizations, but also some religiously affiliated hospitals, universities and social service agencies. Health insurance companies would pay for the coverage.

The latest proposed change is the third in the last 15 months, all announced on Fridays, as President Obama has struggled to balance women’s rights, health care and religious liberty. Legal experts said the fight could end up in the Supreme Court.

via Birth Control Rule Altered to Allay Religious Objections – NYTimes.com.