ObamaCare not high on voters’ priorities, poll finds | TheHill

The poll finds that the 2010 healthcare law ranks eighth on voters’ list of issues important to them in the election. Twenty-three percent of registered voters said ObamaCare is extremely important to their vote, compared to 38 percent who said terrorism and 34 percent who said the economy. Coming in third, with 28 percent, is “the cost of your healthcare or health insurance.”

Source: ObamaCare not high on voters’ priorities, poll finds | TheHill

Healthcare License Turf Wars: The Effects of Expanded Nurse Practitioner and Physician Assistant Scope of Practice on Medicaid Patient Access | Mercatus

A new study for the Mercatus Center at George Mason University explores how the licensing requirements for physician assistants and nurse practitioners affect medical outcomes for Medicaid recipients. It finds that prohibiting physician assistants from prescribing drugs to patients significantly raises costs, by more than 11 percent on average, translating to about $109 in extra expenses for each Medicaid beneficiary. Relaxing these restrictions would result in savings for Medicaid beneficiaries and would not cause any changes to the availability of health care.

Source: Healthcare License Turf Wars: The Effects of Expanded Nurse Practitioner and Physician Assistant Scope of Practice on Medicaid Patient Access | Mercatus

House lawsuit could doom Obamacare: Report | Washington Examiner

Some Obamacare enrollees may pay an extra $1,040 if the House’s lawsuit against Obamacare succeeds in stripping funding for the law’s cost-sharing reductions, a new analysis finds.A brief released Wednesday by the center-left think tank Urban Institute concluded that an abrupt halt of payments to insurers for covering low-income enrollees could lead them to pull out of the marketplace or mean enrollees paying higher premiums.

Source: House lawsuit could doom Obamacare: Report | Washington Examiner

HEALTH CARE 2.0, Part 1: How to Think About Market Forces in Health Care | Manhattan Institute

The Manhattan Institute’s HEALTH CARE 2.0: USHERING IN MEDICINE’S DIGITAL REVOLUTION series delves into the details of how government policy stifles innovation in the delivery of health care. This paper, Part 1, surveys the key economic principles that drive innovative, dynamic sectors of the economy—and explains why American health care does not live up to those principles.

KEY FINDINGS

• Health care-market distortions have considerably worsened since Kenneth Arrow famously described them in 1963; but in other industries less dominated by misguided government intervention, similar distortions have gradually eroded, thanks to technology, especially the rise of the Internet.
• The tech world is full of stories of individuals who dropped out of college to design software and hardware that changed the world; but such innovation is far less common in health care—for reasons largely determined by public policy.
• Each current barrier to a more innovative, competitive, affordable health care system was created for a reason; but the cumulative weight of these policies has been to make U.S. health care less innovative, less patient-centered, and less affordable.

Source: HEALTH CARE 2.0, Part 1: How to Think About Market Forces in Health Care | Manhattan Institute

Review: ‘Remaking the American Patient’ – The New York Times

As the historian Nancy Tomes outlines in a seamless and utterly fascinating narrative, the good old days never really existed. (Read an excerpt). For more than a century now, American health care has been a fraught marketplace, hosting a power struggle among consumers, providers and regulators that may have escalated over the decades but is otherwise remarkably unchanged.

Source: Review: ‘Remaking the American Patient’ – The New York Times

Did Obamacare reduce un-insurance in 2015, or not? | TheHill

That total of $52.6 billion helped reduce the number of uninsured by 8.8 million on net in 2014, an average per capita cost of nearly $6,000.

Of course, the government incurred other costs in getting ObamaCare up and running—financing the creation of exchanges, launching its website, bankrolling star-crossed co-ops, promoting enrollment, and undertaking other efforts to implement and hype the law. Then there were the costs ObamaCare imposed on households and businesses—cancelled policies, premium hikes, higher deductibles, narrow physician networks, erroneous subsidy payments that resulted in loss of coverage among low-income households, a tax on the uninsured, and new levies on insurance premiums, drugs and medical devices—all of which have combined to make the law unpopular.

The eventual Democratic presidential nominee will nonetheless cite the reduction in the uninsurance rate as proof that ObamaCare has succeeded.  That is a mistake.  Though most Americans favor government intervention to make health insurance more widely available to people with low-incomes and pre-existing medical conditions, they chafe at the disruption the law has inflicted on their own coverage.  They will likely be as skeptical of presidential candidates who declare the law a success as they are of those who merely insist on its repeal.

Source: Did Obamacare reduce un-insurance in 2015, or not? | TheHill

Are Certificate-of-Need Laws Barriers to Entry? How They Affect Access to MRI, CT, and PET Scans | Mercatus

KEY FINDINGS

CON Regulations Have a Negative Effect on Nonhospital Providers

• The association of a CON regulation with nonhospital providers is substantial, ranging from −34 percent to −65 percent utilization for MRI, CT, and PET scans.
• Nonhospital providers in CON states experience significant decreases in the utilization of imaging services compared to hospital providers.

CON Regulations Have No Effect on Hospitals, Thus Increasing Their Market Share

• CON regulation has no measurable effect on hospitals’ utilization of imaging services. The volume of services provided in hospitals is not affected by CON regulation.
• This may explain why hospital providers have a stronger market presence in CON states than in non-CON states.

Consumers Are Driven to Seek Imaging Services in Non-CON States

• CON regulations are associated with 3.93 percent more MRI scans, 3.52 percent more CT scans, and 8.13 percent more PET scans occurring out of state.
• CON regulations may have a negative effect on consumers because patients living in CON states have to travel out of state more often than patients living in non-CON states. This propensity for traveling out of state to obtain medical services might be attributable to any of several factors: higher costs, a smaller selection of services, or restricted access to care.

CONCLUSION

CON laws act as barriers to entry for nonhospital providers and favor hospitals over other providers. In consequence, consumers of MRI, CT, and PET scanning services are driven to seek these services either out of state or in hospitals. More research is needed to determine whether additional costs and barriers in the healthcare industry restrict specific market providers and affect where procedures occur.

Source: Are Certificate-of-Need Laws Barriers to Entry? How They Affect Access to MRI, CT, and PET Scans | Mercatus

The Incidence of Mandated Health Insurance: Evidence from the Affordable Care Act Dependent Care Mandate

The dependent care mandate is one of the most popular provisions of the 2010 Affordable Care Act (ACA). This provision requires that employer-based insurance plans cover health care expenditures for workers with children 26 years old or younger. While there has been considerable scholarly and policy interest in the effects of this mandate on health insurance coverage among young adults, there has been little scholarly work measuring the costs and incidence of this mandate and who pays the costs of it. In our empirical work, we exploit the fact that some states had dependent care mandates in years prior to the passage of the ACA. Using data from the Survey of Income and Program Participation (SIPP), we find that workers at firms with employer-based coverage – whether or not they have dependent children – experience an annual reduction in wages of approximately $1,200. Our results imply that the marginal costs of mandated employer-based coverage expansions are not entirely borne only by the people whose coverage is expanded by the mandate.

Source: The Incidence of Mandated Health Insurance: Evidence from the Affordable Care Act Dependent Care Mandate

2016 Obamacare Premium Increases by State

In most states, health insurance premiums on the individual marketplace are rising by double digits under Obamacare. 17 states will face average premium increases of 20 percent or more. Iowans, for instance, will see their premiums spike by 22 percent this year. In Minnesota, Alaska, Tennessee, and Hawaii, rates will rise by 30 percent or more.

Source: 2016 Obamacare Premium Increases by State

Impact of State Scope of Practice Laws and Other Factors on the Practice and Supply of Primary Care Nurse Practitioners | ASPE

This study assessed individual and state-level factors which affect decisions by Nurse Practitioners (NPs) about whether to practice in primary care. Of particular interest was the impact of state scope of practice (SOP) regulations on elements of NP practice such as patient load, the flow of patient care, and the management of a patient panel decision. Data from the Health Resources and Services Administration ‘s 2012 National Sample Survey of Nurse Practitioners (NSSNP) were merged with state-level data from a variety of sources to examine and compare the effects of three categories of state SOP laws and regulations: ·restricted practice and prescribing, full practice authority only, and full practice and prescriptive authority.

Findings from multivariate regressions analyses demonstrate that both facets of SOP -practice authority and prescriptive authority -have independent and cumulative effects on the decision to practice in patient care. However, independent prescriptive authority appears to be the key SOP factor affecting the decision to practice in primary care. Moreover, while SOP has statistically significant effects on both outcomes, rural location was a far more potent predictor of working in primary care. The analysis also found evidence that SOP effects on the probability of practicing in patient care are more pronounced in urban areas.

Source: Impact of State Scope of Practice Laws and Other Factors on the Practice and Supply of Primary Care Nurse Practitioners | ASPE