Economics, Health Care

What we learned about Obamacare March 19-24, 2014

Image Credit: https://twitter.com/obamacare

Image Credit: https://twitter.com/obamacare

1.) “President marks Obamacare’s anniversary with ‘last call’ for enrollment,” reports the Washington Examiner: “President Obama on Sunday hailed the fourth anniversary of the Affordable Care Act and said it was ‘now last call’ for consumers to sign up for 2014 coverage…. The enrollment drive, though, will likely fall short of the administration‘s initial 7 million target and numbers show that the share of young, healthy consumers needed to keep costs down is only 25 percent, below the 40 percent initial goal.”

2.) AEI’s Karlyn Bowman and Jennifer Marsico give “Five reasons neither party is winning politically on the ACA.” Here are reasons one through three:

  • 1. Most people who have health care (about 80 percent of Americans) are highly satisfied with the care they have.  A new Gallup poll shows that 72 percent of the insured say they are satisfied with “how the health care system is working” for them….  For a subject as fraught as health care decision-making is for ordinary mortals, then, any effort to make significant alterations to a fairly satisfactory system was bound to be greeted with skepticism. It hasn’t gone away.
  • 2. One particular provision, the mandate, was unpopular at the outset and is unpopular today.  Students of public opinion know that Americans don’t like being told what they have to do by the government in Washington. Whether the decision is to smoke or wear seat belts or even to take your own life, people like to make decisions themselves. The mandate goes strongly against that grain, and its low favorability ratings show that.
  • 3. Americans don’t like radical change. That explains both many Americans’ opposition to the ACA and also many Americans’ unwillingness to support full repeal. Support for outright repeal hovers around 40 percent.

3.) The Hill reports that Obamacare premiums will “skyrocket”:

Health industry officials say ObamaCare-related premiums will double in some parts of the country, countering claims recently made by the administration. The expected rate hikes will be announced in the coming months amid an intense election year, when control of the Senate is up for grabs. The sticker shock would likely bolster the GOP’s prospects in November and hamper ObamaCare insurance enrollment efforts in 2015….

[One] insurance official, who hails from a populous swing state, said his company expects to triple its rates next year on the ObamaCare exchange. The hikes are expected to vary substantially by region, state and carrier. Areas of the country with older, sicker or smaller populations are likely to be hit hardest, while others might not see substantial increases at all…. But insurance officials are quick to emphasize that any spikes would be a consequence of delays and changes in ObamaCare’s rollout.

4.) AEI’s Scott Gottlieb presents “14 ways to avoid the Obamacare tax.” Here are the first seven of the “circumstances” that “make you eligible for skirting the tax, and the documentation you’ll need to prove that you qualify for the waivers”:

5.) “For some who are married but filing taxes separately, another HealthCare.gov hurdle,” says Amy Goldstein:

In May 2012, when the Internal Revenue Service proposed its rules for Americans to get government subsidies for health insurance, officials acknowledged that a legal quirk needed to be fixed: The Affordable Care Act was written in a way that inadvertently denied such help to some people who live apart from spouses who abuse them, are in prison or are on the cusp of a divorce. The problem is that the law’s authors, in creating tax credits to help pay for health plans bought through the new insurance marketplaces, had overlooked the fact that some married people file their tax returns separately. The IRS said in the preamble to those 2012 rules that it would correct the mistake, yet in the nearly two years since then, the Treasury Department has not made the change. And battered spouses have become the leading edge of a small army of people — legally married but filing taxes on their own — stepping up pressure to get an equal chance at affordable health plans.

6.) The Philadelphia Inquirer has discovered “A glitch in Obamacare marketplace no one noticed”:

Nearly six months after the disastrous launch of Healthcare.gov, with the website running smoothly and more than five million people signed up as open enrollment heads to a close, a new glitch has come to light: Incorrect poverty-level guidelines are automatically telling what could be tens of thousands of eligible people they do not qualify for subsidized insurance. The error in the federal marketplace primarily affects households with incomes just above the poverty line in states like Pennsylvania that have not expanded Medicaid. The mistake raises the price of their insurance by thousands of dollars, making insurance so unaffordable many may just give up and go without.

7.) Louise Radnofsky at The Wall Street Journal writes, “Worries over fines aid health-insurance sign-ups”:

In launching the Affordable Care Act, the Obama administration has emphasized the appeal of inexpensive insurance policies and financial subsidies to lure people to new online marketplaces. But what seems to be motivating many as the final deadline for signing up looms is more the fear of financial penalties…. Some pollsters say enrollment could be stronger if groups making the push explicitly reminded people about the penalty.

“We’ve been telling people to switch out the messaging now for these final two weeks, telling people please, please, they’ve got nothing to lose,” said Mike Perry, whose polling firm PerryUndem researches consumer motivations for enrolling in coverage. Mr. Perry said it’s clear in his focus groups that people know about the penalty and cite it as a factor in looking at getting coverage, especially younger people and Latinos.

8.) AEI’s Scott Gottlieb is interviewed by Charles Ornstein about the “final Obamacare push.” Here is the final question:

Q. Finally, people tend to blame everything on Obamacare — rising premiums, narrow networks — when a lot of factors and changes in the health care system have been going on for a very long time. How do you parse out what should appropriately be attributed to the law and what’s just a complex, and some would say malfunctioning, health care system?

A. The health care system certainly wasn’t a free-market utopia that worked well before Obamacare. I think that’s absolutely right. I think the insurance companies have either implemented things they’ve long wanted to implement or accelerated the implementation of certain changes under the guise of the dislocation created by Obamacare. And so there are things that would have happened, but probably happened a lot more slowly. There are certain things that they probably were reluctant to do but were able to implement here, for example businesses kicking spouses off of health plans.

It’s really hard to parse it. At the 10,000-foot level, the costs imposed by Obamacare forced people to take a hard look at their health care costs and created a reckoning in a lot of places. I think there are a lot of things going on that were already underway, that were accelerated by Obamacare, and then there are things that businesses long wanted to do but now they have the political cover to implement it. There clearly are things that are directly attributable. I think the rising premiums in the existing individual and small group market are very clearly attributable. The things that are directly related to mandates that they imposed and new regulations that’s causing premiums to go up is directly attributable. To me those are the most immediate negative impacts of the law.

9.) The Supreme Court will hear the health law contraceptive case this Tuesday. Kaiser Health News says, “At issue is whether for-profit companies, such as Hobby Lobby, are entitled to the same religious protections as individuals or religious organizations.” For more information, check out this round-up, with such articles as “High court with vocally devout justices set to hear religious objections to health-care law,” and “Health law birth control coverage before justices.” Also check out KHN’s other round-up on the subject here, which covers various viewpoints on the matter and includes “If the contraceptive mandate passes, it will ruin a core US ideology,” “Crying wolf on religious liberty,” and “Obamacare shackles religious freedom.”

10.) Check out Scott Gottlieb on the “Kudlow Report” discussing Obamacare:

11.) For the latest on the Halbig v. Sebelius case, check out this piece from The Wall Street Journal, which asks if the White House can “simply declare that the federal government is the 51st state,” and this piece from Forbes, titled “Amicus brief of public-health scholars tries, fails to explain away the ACA’s clear language.” The Journal comments:

On Tuesday the D.C. Circuit Court of Appeals will hear one of the more important legal challenges to ObamaCare’s lawless implementation. Unlike the challenge to the individual insurance mandate, Halbig v. Sebelius involves no great questions of constitutional interpretation. The plaintiffs are merely asking the judges to tell the Administration to faithfully execute the plain language of the statute that Congress passed and President Obama signed.

12.) Joe Antos, a resident AEI scholar, discusses “Obamacare’s disappearing insurance mandate.” He predicts “Given the problems with the health insurance exchange websites, look for an announcement in the next few months that the tax will not be imposed on anyone this year.”

13.) Karlyn Bowman and Jennifer Marsico present an “AEI special poll report: Health care and the Affordable Care Act, March 2014.” In it they find:

  • We examine the trends from nine major pollsters. Almost all polls show more opposition to the law than support for it. A March 2014 CNN/Opinion Research Corporation poll shows that 39 percent of Americans support the law, while 57 percent oppose it.
  • According to a March Gallup survey, 4 in 10 Americans believe the health care law will make their family’s health care situation worse. Only about 2 in 10 believe the law will make their situation better.
  • A vast majority of Americans believe that the ACA needs to be altered at least somewhat. A February 2014 CBS poll finds that half of Americans believe the law needs some changes, while 42 percent say the law has so much wrong with it that it needs to be repealed entirely.

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