The Obama administration has, for months now, been peddling nice-sounding numbers as to how many people are gaining health coverage due to Obamacare. But their numbers have been inflated on two fronts. First, not everyone who has “selected a marketplace plan” under Obamacare has actually paid the required premiums, payment being required to actually gain coverage. Second, only a fraction of people on the exchanges were previously uninsured. A new survey from McKinsey gives us a better view into the real numbers. Of the 3.3 million people that the White House has touted as Obamacare exchange “sign-ups,” less than 500,000 are actual uninsured people who have actually gained health coverage.
Evaluating the “Keep Your Health Plan Fix”: Implications for the Affordable Care Act Compared to Legislative Alternatives | RANDMarch 7, 2014
A RAND study of various options to extend non-qualified health plans reached the following conclusions:
Premium increases are small to moderate
ACA-compliant market premiums in 2015 would rise from a low of 1 percent under the optional extension proposal to a high of 10 percent under the optional extension plus buy-in proposal.
ACA-compliant market enrollment declines are modest to substantial
Under the optional extension proposal, enrollment in the ACA-compliant market would decline by 500,000 (4 percent). The optional extension plus buy-in proposal would lead to a decrease of 3.2 million enrollees (26 percent), the largest of the three proposals.
The number of uninsured decreases
The optional extension and mandatory extension proposals lead to small decreases in the number of uninsured of 260,000 and 450,000, respectively. Under the optional extension plus buy-in proposal, the number of uninsured would drop by 2.5 million. One important caveat to this seemingly positive outcome is that the non–ACA-compliant plans may have a significantly lower actuarial value than plans offered in the ACA-compliant market and provide more limited coverage.
The findings from HRMS show that nearly one in five (18.6 percent) of those with nongroup health insurance at the time of the survey report the plan they had in 2013 will no longer be offered to them because it did not meet new coverage requirements. Estimates from the NHIS indicate that approximately 14 million people had non-group coverage at a point in time. Identifying the number of people enrolled in non-group insurance is challenging. Estimates in Abraham et al. (2013) ranged from 9.55 million in the Medical Expenditure Panel Survey to 25.3 million in the American Community Survey. We use the NHIS estimate since it corresponds with more recent estimates based on new NAIC enrollment data reported in the Supplemental Health Care Exhibit (SHCE).
Using this estimate, our findings imply that roughly 2.6 million people would have reported that their plan would no longer be offered due to noncompliance with the ACA. Another 6 percent reported that their plan was cancelled for other reasons, and 75.4 percent reported that they did not receive a notice of cancellation
Only about 40 percent of family doctors and pediatricians remain independent, according to the American Medical Association — and many, including Dr. Ragland, feel that harsh economic winds that were already pushing against them have been accelerated by the Affordable Care Act.
With the release of the new Affordable Care Act health plans, HealthPocket examined what medical services were most frequently excluded from health insurance coverage in 2014 and compared the results to the most common exclusions in the pre-reform health insurance market. HealthPocket found that 80% of exclusions were the same between the 2013 and 2014 lists of medical services most frequently not covered by plans in the individual health insurance market.
Percentage of Medicare Beneficiaries at Risk of Losing Part D Plan | Insights | American Action ForumFebruary 19, 2014
The administration’s proposed Medicare Part D rule, released in January 2014 will have a far-reaching and harmful impact on beneficiaries enrolled in the popular prescription drug program. The most damaging to plan enrollees is CMS effectively doing away with preferred networks in Part D, which negotiate prices that are key to keeping monthly premiums and drug prices low. This decision could force as many as 14 million enrollees out of their current plans, and into a new, higher cost plans.
The map and table below display, respectively, the percent and total number of Medicare beneficiaries in each state that are at risk of losing their drug coverage in 2015, if the rule is allowed to go into effect.
For now, nearly five million people ages 18 to 64 get no financial help to buy coverage because of the gap, according to estimates by the Kaiser Family Foundation. Many of those people are clustered in the South, living in states where income limits for Medicaid coverage have historically been among the lowest in the U.S.
Eugene Steuerle, an Urban Institute economist and former Treasury Department official who served under presidents in both parties, said he couldn’t recall a social program that excluded beneficiaries because they earn too little.
Administration will allow people to switch Obamacare plans to a limited degree – The Washington PostFebruary 7, 2014
The Obama administration has quietly reworked rules and computer code for HealthCare.gov to try to stem an outpouring of discontent by some Americans who have discovered that the health plans they bought do not include their old doctors or allow them to add new babies or spouses.
Under changes that have not been disclosed to the public, the government will temporarily allow consumers who have gotten coverage through the new online insurance marketplace to switch health plans to a limited degree.
Here’s the bottom line: Obamacare has failed miserably on nearly every major promise made about it (Grade: F). The processes used to enact and implement the law have been tarnished by actions of questionable legality and a pervasive lack of transparency (Grade: D). On actual outcomes, Obamacare has fared better in the short term (Grade: C+), but there are worrisome signs that by most measures, the law’s performance will get significantly worse by the time final grades are handed out.
I’ll admit, I’m a pretty tough grader. In this era of grade inflation, some Americans may be inclined to be more generous. But after doing this for nearly four decades, I think I’m a fairly good judge of health policy work and its likelihood of success when put into practice. We’re only at midterm, but I’d have to say the long-term outlook for Obamacare is very poor indeed.
The ACA’s cuts to Medicare threaten home health care jobs, patients | Other Views | NewsObserver.comFebruary 6, 2014
steep Medicare home health cuts implemented as part of the Affordable Care Act put this growth at considerable risk. Newly implemented administration policies, which slash home health care funding by 14 percent over the next four years, are already resulting in a downturn in job growth, according to the U.S. Bureau of Labor Statistics.
Now, unfortunately for our patients and our state’s economy, these new cuts will force approximately 40 percent of all home health providers to operate at a net loss – meaning they will face the risk of bankruptcy and closure. The federal Medicare agency’s own estimate means that this regulation will directly affect nearly 5,000 small-business providers that today serve nearly 1.5 million seniors and are responsible for nearly 500,000 jobs from coast to coast.
In North Carolina, estimates indicate that nearly 28 percent of our home health agencies will be forced to operate at a net loss by 2017. These agencies at greatest risk serve 29,224 seniors and employ 11,356 North Carolinians – who will likely find their care and their jobs in peril.