ObamaCare Disaster Lurches On

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This week’s health policy news roundup curated by Jane Orient, M.D.

It was already apparent in 2014 that the Affordable Care Act forces people to buy catastrophic policies at first-dollar coverage prices. Less well known is that although the ACA requires health plans to spend 80% – 85% of premiums on medical care, corporate data systems and intrusive analysis that are used to limit care have been defined as “medical care,” decreasing the amount of money health plans must spend on actual medical care provided to patients and allowing them to use premium dollars to control doctors. Also, a federal ACA “risk adjustment” program allows health plans with sophisticated data systems to annually claim “sicker patients” and strip premium dollars from smaller health plans that are less tech-savvy. http://www.cchfreedom.org/cchf.php/857

Consumers are catching on: Only 150,000 customers signed up for ObamaCare coverage on the HealthCare.gov website between Mar 15 and Apr 30, far short of the estimated 3-6 million who were subject to the penalty for lacking insurance last year. Officials offered the extension because ObamaCare’s Feb 15 signup deadline didn’t match up with the tax deadline on Apr 15, leaving two months of in-between for filers to discover the tax penalty on Americans who do not acquire insurance and do not qualify for an exemption. http://www.washingtontimes.com/news/2015/may/19/150k-penalty-payers-signed-obamacare-extension

Some health insurers are in trouble too. Through 2016, health plans losing money in ObamaCare can rely on taxpayers to help them out. After that, they are on their own. Already, many plans are finding participation painful and are increasing ObamaCare premiums significantly—from 30% to 52%—for 2016. http://www.forbes.com/sites/theapothecary/2015/05/28/headwinds-for-health-insurers-as-obamacare-stumbles/

Rate increases are so large because ObamaCare enrollment is coming up way short of what is needed to assure a sustainable risk pool—enough healthy people signed up to pay the costs for the sick. http://www.forbes.com/sites/realspin/2015/06/10/why-are-the-2016-obamacare-rate-increases-so-large/

The main engine for ObamaCare’s insurance expansion—Medicaid—is providing enrollees with only 20-40 cents of benefit per dollar spent. http://www.forbes.com/sites/michaelcannon/2015/06/09/more-bad-news-for-obamacare-enrollees-see-little-benefit-from-medicaid-expansion/

Unidentified non-poor people get three times as much benefit from Medicaid as the enrollees themselves, writes John Goodman. http://www.forbes.com/sites/johngoodman/2015/06/10/how-much-is-medicaid-really-worth/2/

The great technology for saving money and improving quality—the electronic health record—is itself a disaster. The industry is having to spend billions to protect the records it spent billions to install. http://www.politico.com/story/2015/06/health-care-spending-billions-to-protect-the-records-it-spent-billions-to-install-118432.html

State Exchanges are in trouble. Of the ObamaCare burn pits, none quite compares to the $300 million for Cover Oregon, which enrolled no one by the time it was killed in April. http://townhall.com/columnists/neilmccabe/2015/06/14/prosecutor-oregons-obamacare-snowden-free-to-go-n2012155/page/full

ObamaCare’s Big Dig, the Massachusetts Exchange, is under federal investigation. http://www.wsj.com/articles/obamacares-big-dig-1431299268

Consumer Watchdog has called for investigation of Covered California, which reportedly awarded $184 million in no-bid contracts, some to firms or people that had professional ties to Covered California executive director Peter Lee. http://www.sacbee.com/news/politics-government/capitol-alert/article2704641.html

The Obama administration has paid almost $2.8 billion to insurers from January through April 2014, without being able to verify accuracy. http://www.wsj.com/articles/u-s-payments-to-health-insurers-still-lack-verification-1434427615

Toward what goal is ObamaCare lurching? ACA has accelerated the trend toward consolidation that began in the 1990s. “The antitrust cops are irrelevant when government’s overwhelming priority is to create and entrench cartels,” opines the Wall Street Journal. “The only disruptive force under ObamaCare is government. So five years into the glories of ‘health-care reform,’ the same antiquated incumbents dominate as they did before, only with less accountability to patients. Cartels don’t care about quality, safety or costs to consumers.” The oligopoly may have a fabulous run, but the ultimate single health system will be the federal government. http://www.wsj.com/articles/obamacares-oligopoly-wave-1434755295

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