This week’s health policy news roundup curated by Jane Orient, M.D.
In September, yet another Affordable Care Act tax will hit, starting at $8 billion a year and increasing to more than $14 billion annually by 2018—more than $145 billion over the next 10 years. It affects every health plan with more than $25 million dollars of premiums: Exchange plans, private plans, Medicare, and Medicaid. It will affect the poor, the elderly, and financially stressed states. Hidden in Section 9010 of ACA, it is, according to Sen. John Barrasso (R-WY), “another example of how the president’s health care law was designed so the most painful parts of the law kick in years later.” http://www.cchfreedom.org/cchf.php/1076
Health plans are doing just fine. Health plans that do not meet a minimum medical loss ratio (MLR) must pay rebates to customers. While rebates are cheered by the Administration, the MLR regulation could simply allow insurers to pass increases in medical costs to their subscribers. John Graham explains: An MLR of 85 percent, which is the quotient of $850,000 in medical claims divided by $1 million in premium, is the same MLR as $950,000 in medical claims divided by $1,117,647 in premium. But challenges lie ahead. Two taxpayer-funded backstops, risk corridors and reinsurance, which protect insurers from losing too much money in the exchanges, are set to expire in 2016. http://www.forbes.com/sites/theapothecary/2015/08/07/health-insurer-earnings-and-merger-update/
Because of tax law confusion and failure to file needed paperwork, 40 percent of households could lose their Obamacare subsidies. http://townhall.com/tipsheet/mattvespa/2015/08/20/40-percent-of-households-could-lose-obamacare-subsidies-due-to-tax-law-confusion-n2041782
But an unknown number of people are receiving subsidies because healthcare.gov has no way to verify identities and no plan to prevent the kind of fraud and abuse found to be possible by “secret shoppers” employed by the Government Accountability Office (GAO). Eleven of 12 phony applicants got subsidies in 2014—and were re-enrolled in 2015, writes Stanley Feld, M.D., on Aug 22. http://stanleyfeldmdmace.typepad.com/repairing_the_healthcare_/
The vaunted cost slowdown appears to be done, in time for the 2016 election. http://www.forbes.com/sites/theapothecary/2015/08/22/americas-health-care-cost-slowdown-goes-kaput-what-should-republicans-say-and-do-about-it/print/
The number of uninsured may have dropped by 16 million, but it is not clear that ACA is responsible. Much of the drop is from Medicaid expansion (6.5 million), and much from an increase in employer-sponsored plans (9.6 million) even though the employer mandate was delayed. http://www.forbes.com/sites/robertlaszewski2/2015/08/17/has-obamacare-really-reduced-the-uninsured-by-16-million-and-continued-to-show-strong-growth/
Seen on Social Media:
Evidence-based mania: an intellectual amputation. (New post) http://t.co/dfhRPKyVXR cc:@jorient @timothyterrell #Rothbard
— Michel Accad MD (@michelaccad) August 10, 2015
Will Doctors On-Demand Disrupt Health Care? http://t.co/rnIxVkRmvT by @ZoeLaHenry @Inc + Quote http://t.co/B1yZtizqh8 pic.twitter.com/dQcySE9dhN
— Eric Topol (@EricTopol) August 12, 2015
Obamacare ‘Cadillac tax’ to hit 1 in 4 employers that offer health care benefits http://t.co/vgRhUngmhy via @washtimes
— Grüss Gott (@clasicaliberal) August 25, 2015
