Category Archives: Uncategorized

Government Buries Evidence of Poor Access to Care under Obamacare

From John R. Graham:

Thank providence for USA Today, which has given us yet another story describing how poor access to health care is under Obamacare.

People who fell for navigators’ sales pitches and signed up for Obamacare are discovering that it is junk insurance:

“The exchanges have become very much like Medicaid,” says Andrew Kleinman, a plastic surgeon and president of the Medical Society of the State of New York. “Physicians who are in solo practices have to be careful to not take too many patients reimbursed at lower rates or they’re not going to be in business very long.”

Kleinman says his members complain rates can be 50% lower than commercial plans.

“I definitely feel like a bad person who is leeching off the system when I call the doctors’ offices,” she says. Shawn Smith of Seymour, Ind., spent about five months trying to find a primary care doctor on the network who would take her with a new, subsidized silver-level ACA insurance plan.

Note: This person had a silver plan, not a bargain basement bronze plan.

More: Government Buries Evidence of Poor Access to Care under Obamacare | Health Policy Blog | NCPA.org.

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ObamaCare: Three Years of Broken Promises

At National Review, Cato’s Michael Tanner writes:

The Patient Protection and Affordable Care Act, a.k.a. Obamacare,  turned three years old this week. But unlike fine wine, the ACA is not getting better with age. A torrent of recent studies and reports has provided new evidence — as if we needed more confirmation — that nearly everything we were told about this law was untrue.

Tanner takes on these promises:

If you like your doctor, you will be able to keep your doctor, period. If you like your health-care plan, you’ll be able to keep your health-care plan, period.

— President Obama, June 15, 2009

This law will cut costs and make coverage more affordable for families and small businesses.

— President Obama, June 22, 2010

This legislation will also lower costs for . . . the federal government, reducing our deficit by over $1 trillion in the next two decades. It is paid for. It is fiscally responsible.

— President Obama, on signing the Affordable Care Act

It’s about jobs. . . . In its life [health-care reform] will create 4 million jobs, [and] 400,000 jobs almost immediately

— Nancy Pelosi, February 25, 2010

Quality, Affordable Health Care for All Americans

– Title 1 of the Patient Protection and Affordable Care Act

Read more: Three Years of Broken Promises – National Review Online.

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Arkansas Deal with HHS on Medicaid Expansion a Model for Colorado

At Complete Colorado, Linda Gorman of the Independent Institute writes:

Health and Human Services has agreed that Arkansas can pay premiums for commercial insurance purchased through the state’s health insurance exchange using the federal funding that would have gone to expand Medicaid.  …

For those who are not disabled, commercial insurance is more flexible than Medicaid and offers better access to health care. Medicaid reimbursement for specialist care lies far below commercial reimbursement amounts. People with Medicaid coverage often also have a difficult time accessing specialists. …

The possibility of a deal with Health and Human Services gives Colorado officials a rare chance to improve the medical care available to low-income people by shaking off the shackles of Medicaid.

Read more: Arkansas Deal with HHS on Medicaid Expansion a Model for Colorado | Complete Colorado – Page Two.

See also: “Arkansas’s unusual plan to expand Medicaid,” in the Washington Post.

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Plan for fighting Obamacare: Delay, Repeal, Replace

In the Weekly Standard, James C. Capretta and Jeffrey H. Anderson* write:

Disappointing as [the Supreme Court ruling and presidential election] were, they do not remotely constitute the end of the fight to repeal and replace Obamacare. Indeed, this is a fight conservatives couldn’t walk away from even if they wanted to, because health policy is absolutely central to the struggle over the size and scope of governmental power. If Obamacare remains on the books, the federal government will become the dominant actor in nearly one-fifth of the American economy, tens of millions more Americans will become dependent on taxpayer support for their health care, the quality of American medicine will decline, and the spending commitments in the law will increase the pressure for ever-higher taxes​—​even as they add to the risk of national insolvency. …

Delaying the implementation of Obamacare would be important for three reasons: It would save hundreds of billions of dollars in federal spending. It would spare Americans from having their health care premiums spike until a somewhat later date. And it would move the onset of Obamacare much closer to the 2016 presidential election, which would put Obama’s centerpiece legislation at center stage in that race​—​as the future health of the nation demands that it be. …

Beyond resisting and delaying the implementation of Obamacare, the most important thing for the GOP at this point is to develop and unite behind a practical replacement proposal​—​one that will actually solve the very real problems plaguing American health care. …

If Republicans were to advance a replacement along these lines​—​a plan that would provide stable insurance options, consumer choice, and high-quality health care without the heavy-handed mandates and regulations of Obamacare​—​the American people would be more than happy to throw Obamacare overboard.

The key to turning back the singular threat that Obamacare poses to our liberty and fiscal solvency is for the GOP to have a plan of attack that extends across the next four or five years

So the fight must go on. The only question, at this point, is how to proceed.

Read the whole article: Delay, Repeal, Replace | The Weekly Standard.

* James C. Capretta is a senior fellow at the Ethics and Public Policy Center and a visiting fellow at the American Enterprise Institute. Jeffrey H. Anderson is a senior fellow at the Pacific Research Institute

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Instead of expanding Medicaid ghetto, Colorado should emulate Florida’s Medicaid premium support program

Colorado Governor John Hickenlooper wants to drag more low-income people into Medicaid, which is notorious for fraud, delivering lousy care, poor access.  Instead of expanding this failed government dependency program, Colorado should look at Florida as an example of effective Medicaid reform.

Benjamin Domenech of the Heartland Institute summarizes the Florida’s pilot program involving premium support for commercial insurance. (“Premium support” differs from a voucher.)  Domenech  writes:

A little more than six years ago, Florida Gov. Jeb Bush established a pilot program in five large counties in Florida with a total overhaul of Medicaid. Under the pilot program, more than 300,000 Medicaid recipients—bigger than the total programs in 17 states—were given the choice of a wide variety of plans created by multiple insurers. …

In the program, Medicaid recipients get to choose among a dozen different plans with different offerings. The plans compete on benefits, copays, and provider networks, and offer risk-adjusted capitated rates, allowing for better matching of payment to risk to prevent insurers from avoiding sick people. …

The program has achieved results. According to the Florida Agency for Health Care Administration, the health outcomes are 64 percent better than under a managed care system, with 83 percent higher satisfaction from those in the program. Florida is currently saving roughly $118 million a year on Medicaid in the five counties, with better outcomes for the people in it.

Read more:

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Obamacare lawsuits keep coming

At National Review Online, Jonathan H. Adler reviews the pending lawsuits against Obamacare. Some excerpts:

The largest set of PPACA cases are the various challenges to HHS’s contraception mandate, under which employer-provided group-insurance plans must cover all forms of FDA-approved contraception and sterilization procedures.  … They contend that such a mandate contravenes the Religious Freedom Restoration Act of 1993 (RFRA), if not the First Amendment’s protection of religious practice too. …

Physician-owned hospitals have raised constitutional challenges to PPACA provisions limiting their reimbursement under Medicare, and other service providers are likely to challenge implementation decisions that compromise their bottom lines.

In addition, the Goldwater Institute filed the first challenge to the Independent Payment Advisory Board (IPAB) on separation-of-powers grounds.

The Obamacare Cases Keep Coming – Jonathan H. Adler – National Review Online.

There’s also the lawsuit, Oklahoma v. Sebelius, concerning subsidies for exchanges not set up by states: Oklahoma Challenges Obama’s Illegal Employer Tax.

See also: healthcarelawsuits.org.

 

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Why seniors should fear Obamacare

Economist John C. Goodman nicely summarizes why seniors, and anyone who plans to qualify for Medicare, should worry about Obamacare:

As is by now well known, the legislation will lower Medicare spending over the next 10 years by $716 billion in order to fund health insurance for young people. This reduction will primarily consist of lower payments to physicians, hospitals and other providers — reductions that are so severe that they will seriously impair access to care for senior citizens.

In the last two Medicare Trustees reports, the Office of the Medicare Actuaries has predicted that these cuts will force one in seven hospitals out of the Medicare system in the next eight years. Payments to doctors under Medicare will fall below Medicaid levels in the very near future and will fall continuously behind Medicaid in the years ahead. From a financial point of view, seniors will be less desirable patients to doctors than welfare mothers. Harvard health economist Joe Newhouse envisions that seniors may have to seek care in the same places that now cater to Medicaid beneficiaries: at community health centers and in the emergency rooms of safety net hospitals.

During the election campaign, Barack Obama claimed that his administration had found $716 billion of “savings” and Democrats generally claimed that the money would come out of the pockets of doctors, hospitals and insurance companies, with no bad effects on seniors. In fact, no “savings” have been found and seniors will indeed be affected by low reimbursement rates — just as low-income patients must deal today with the fact that almost one in three doctors is not taking any new Medicaid patients.

Read about more damaging aspects of Obamacare; Did the Election Save ObamaCare? – John C. Goodman.

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