Are Democrats crippling Obamacare? – POLITICO

December 28, 2015

The White House’s defeat on that, as well as several other Obamacare taxes, comes as a series of problems have piled up since coverage expansion kicked in two years ago, from collapsing co-op health plans to double-digit premium increases. No single one of them is likely to prove fatal, but together they have significantly weakened the law that Obama spent much of his presidency fighting for.

By joining with Republicans to delay the Cadillac tax, in particular, the president’s party chose the short-term demands of organized labor — a key ground-game player going into an election year — over the long-term goals of Obamacare. They offered fresh ammunition to Republicans who say the law is a money pit. And they showed a lack of political will to make Americans change their habits on health care spending.

“Is it the death knell? No. But it is harmful,” said Peter Orszag, Obama’s OMB director during the drafting of the law.

Source: Are Democrats crippling Obamacare? – POLITICO


Cheer Up, Obama’s Legacy Can Be Erased – WSJ

December 21, 2015

The Affordable Care Act also grants substantial flexibility in its implementation, a feature Mr. Obama has repeatedly exploited. The new president could suspend penalties for individuals and employers, enforce income-verification requirements, ease the premium shock on young enrollees by adjusting the community rating system, allow different pricing structures inside the exchanges and alter provider compensation. These actions could begin dismantling the most pernicious parts of ObamaCare and prevent its roots from deepening as Congress debates its repeal and replacement.

Source: Cheer Up, Obama’s Legacy Can Be Erased – WSJ


The Costs to Different Generations of Policies That Close the Fiscal Gap: Working Paper 2015-10 | Congressional Budget Office

December 17, 2015

Based on the projections in CBO’s The 2014 Long-Term Budget Outlook, we analyze five stylized changes in federal fiscal policy that would close a fiscal gap of 1.8 percent of GDP by immediately and permanently increasing tax revenues or decreasing spending. Those policy changes would stabilize the debt-to-GDP ratio at the 2014 level of 74 percent. We conduct our analysis using a heterogeneous-agent overlapping-generations model of the U.S. economy and examine how the stylized policy changes would affect the economy over time and the well-being of different generations. Importantly, the significant benefits of stabilizing the debt-to-GDP ratio do not depend on the specific policy used. As a result, we focus on measuring the costs that the stylized policies would impose on different generations. We find that for households containing working-age adults or retirees, tax increases are less costly than benefit cuts, whereas for future generations, cuts to Social Security and Medicare benefits are the least costly of the options we analyze. The choice of policy has a relatively small effect on the economy’s output in the long run, and a policy’s effect on output is a poor predictor of how its implementation would affect households’ well-being.

Source: The Costs to Different Generations of Policies That Close the Fiscal Gap: Working Paper 2015-10 | Congressional Budget Office


State by state data show bigger 2016 exchange premium, deductible jumps

December 16, 2015

Consumers buying health insurance through federal and state exchanges will see their monthly premiums for the popular silver-level plans jump by an average of more than 11%, while also likely facing higher deductibles, a new analysis of exchange data by the Robert Wood Johnson Foundation shows.

Source: State by state data show bigger 2016 exchange premium, deductible jumps


We’re All Being Pretty Quiet About Obama’s Failures, Aren’t We

December 16, 2015

A seven-minute video that made the case for re-electing Obama includes the now-even-more-outlandish promise that 32 million uninsured Americans would be covered under Obamacare by 2016 [2:40], along with various other domestic claims

Source: We’re All Being Pretty Quiet About Obama’s Failures, Aren’t We


Two Models of Federalism Highlight Growing Divide Among States | Mercatus

December 15, 2015

Affordable Care Act. The ACA’s expansion of Medicaid and its health care exchanges embody a comprehensive cartel regime, financed through federal transfer payments and subsidies. Competitive states opposed the ACA in NFIB v. Sebelius (2012); cartel states supported the act.

Source: Two Models of Federalism Highlight Growing Divide Among States | Mercatus


America’s Bitter Pill: Managed Care 2.0, the CBO and the ACA’s approach to Cost Containment | THCB

December 11, 2015

Steven Brill’s latest book, America’s Bitter Pill, is a frustrating mix of excellent history and muddled health policy analysis. The book is a very good addition to the literature on the history of the Affordable Care Act and by far the best reporting I’ve read on the bungled implementation of the federal health insurance exchange. But Brill’s analysis of why the ACA cannot reduce health care costs is naïve and confusing. Brill claims a few smart men on the White House “economic team,” including Peter Orszag and Ezekiel Emanuel, fought hard to push “game-changing” cost-containment into the ACA but were defeated by others who were less interested in cost containment.

That explanation is wrong on two counts:(1)There was little evidence in 2009, and little today, to support the claims by Orszag et al. that the methods they promoted would cut costs;(2) The ACA in fact contains most of what Orszag et al. fought for.What Brill unquestionably gets right is his conclusion that the ACA cannot cut costs.

Source: America’s Bitter Pill: Managed Care 2.0, the CBO and the ACA’s approach to Cost Containment | THCB


Explaining the Growth in US Health Care Spending Using State-Level Variation in Income, Insurance, and Provider Market Dynamics

December 10, 2015

The slowed growth in national health care spending over the past decade has led analysts to question the extent to which this recent slowdown can be explained by predictable factors such as the Great Recession or must be driven by some unpredictable structural change in the health care sector. To help address this question, we first estimate a regression model for state personal health care spending for 1991-2009, with an emphasis on the explanatory power of income, insurance, and provider market characteristics. We then use the results from this simple predictive model to produce state-level projections of health care spending for 2010-2013 to subsequently compare those average projected state values with actual national spending for 2010-2013, finding that at least 70% of the recent slowdown in health care spending can likely be explained by long-standing patterns. We also use the results from this predictive model to both examine the Great Recession’s likely reduction in health care spending and project the Affordable Care Act’s insurance expansion’s likely increase in health care spending.

Source: Explaining the Growth in US Health Care Spending Using State-Level Variation in Income, Insurance, and Provider Market Dynamics


Obamacare Is Now on Life Support | The Fiscal Times

December 10, 2015

So let’s recap. Obamacare has depressed job growth, costs are escalating at a higher rate, barely a dent has been made in the numbers of uninsured, and insurers are either exiting the markets or failing altogether. Under any other circumstances, a program that failed on its promises so badly would have all sides moving quickly to repeal it and work on a replacement. Don’t bet on that outcome from this White House and its dwindling number of Democratic supporters on Capitol Hill. They will surely try to sell us the illusion of competence and success.

That doesn’t mean we have to buy it.

Source: Obamacare Is Now on Life Support | The Fiscal Times


Employment Projections: 2014-24 Summary

December 9, 2015

Healthcare occupations and industries are expected to have the fastest employment growthand to add the most jobs between 2014 and 2024, the U.S. Bureau of Labor Statisticsreported today.

9 of the 15 fastest growing occupations are in health care.

Source: Employment Projections: 2014-24 Summary