Those who figure may find figures don’t lie. The debate (at least on media outlets’ and think tanks’ web pages) continues about real Obamacare enrollment numbers.
According to the Wall Street Journal, the RAND Corporation released one such study, entitled, “Changes in Health Insurance Enrollment Since 2013.” The Wall Street Journal on April 9, describes Obamacare cheerleaders such as Michael Hiltzik of the Los Angeles Times, who said, “At least 9.3 million more Americans have health insurance now than in September, 2013, virtually all of them as a result of the law.”
The Journal claims the term “at least” is misleading. The actual findings by RAND: the number of uninsured Americans has declined by between 5.8 million and 12.8 million with only a 1 in 20 chance that the actual number is outside this range. Also according to RAND’s estimates, only 3.9 million have insurance through Obamacare exchanges. This is purportedly 3.2 million fewer than the 7.1 million “sign-ups” the Obama Administration took credit for last week.
The 3.2 million gap may be explained by the timing of RAND’s survey. Data was collected through March 28, says RAND, but the majority of participants, “responded earlier in the month, and some may have made new insurance choices since participating in our survey.”
A surprise is the biggest growth category was Employer-Sponsored Insurance (ESI).
The U.S. House rejected a bipartisan piece of legislation, one altering how expatriates and their insurance carriers adhere to ACA rules. This amid strong opposition from long-serving Democrats – who claim it establishes loopholes in Obamacare. Specifically, the Bill, H.R. 4414, failed to pass by 257-159. If passed, it would have eased rules for insurance companies who cover those who work outside of the United States, or alternately, foreigners who live in the U.S.
Included in the groups opposing the bill are both immigration and labor organizations, such as the AFL-CIO and the SEIU. Such opposition stemmed from concerns that companies would be encouraged to hire foreign workers, not Americans, simply because of the fact those businesses would not have to offer comprehensive health coverage.
Obamacare is increasingly becoming an episodic tale of websites, enrollments, and surveys. Yet another is poll is out. An April 11 article in Gannett’s USA Today by Robert Farley’s FactCheck.org, claims that premiums are up by 90 percent. Morgan Stanley, surveyed 148 insurance brokers. The purpose of this latest survey was to help in guiding investor decisions about stock purchases. Morgan said survey respondents: “[P]oint to significant acceleration in small group and individual market rate increases.” He also added, “We expect the increases are largely due to changes under the ACA.”
Robert Santos, “chief methodologist” at the Urban Institute and president of the executive council at the American Association of Public Opinion Research, was dismissive of the Morgan Stanley study, describing it as, “typical financial marketing material where they pull together some data and create insights.” Santos added that absent any details regarding methodology employed or margin(s) of error – the study does not have ‘scientific validity.’”
“Anyone would be on very tenuous ground in trying to make a state-specific inference,” Santos concluded.
Chad Stone, chief economist at the Center on Budget and Policy Priorities, says the think tank has been tracking the latest, anticipated budget burdens caused by the proposed “Ryan Budget.” Specifically, Mr. Stone argues, if passed, the Ryan budget would adversely affect “tens of millions already struggling Americans, further translating into discernible harm for the U.S. economy in general.”
This reflects Ryan’s efforts to balance the federal budget over a 10 year time frame. The potential cuts include: a $2.1 trillion reduction in healthcare coverage expansions with Medicaid and SNAP grants reduced by $0.9 trillion, and Medicare be slashed by $0.1 trillion.
Scott Brown (Part 2). The Think Progress website recounts how Brown rode the Tea Party wave to the U.S. Senate in January of 2010. At that time, he promised to become the “41st vote to block Obamacare.” Yet, soon after attaining his Massachusetts U.S. Senate seat, he admitted depending on one of the ACA’s provisions, “to keep his elder daughter on his congressional health insurance plan.” Brown argued in May, 2010, that keeping his daughter on his healthcare plan, “is not inconsistent with his criticism of the federal law”. . . “because the same coverage could be required by individual states.” As a state senator, Brown voted for the state’s 2006 healthcare reform law, which established the pattern for the Affordable Care Act. It also extended dependent coverage.
In neighboring New Hampshire, Brown’s anti-Obamacare stance is not picking up much support. An estimated 22,000 have signed up for health insurance through the new law.
According to an article in SF Gate, the website sister of the San Francisco Chronicle, several corporations have reaped millions of dollars from Obamacare, concurrent with their backing of GOP candidates who vow the law’s doom. The “condemn-while-benefitting strategy” angers Democrats, who see some of their top congressional candidates struggling against waves of anti-Obamacare ads which are partly funded by these companies.
Among those businesses is a leading Democratic nemesis, Koch Industries, the diversified entity run by billionaire brothers Charles and David Koch. They and some conservative allies continue spending millions to hammer Democratic senators in North Carolina, Alaska, Colorado, Iowa, and elsewhere. Senate Majority Leader Harry Reid renewed his criticisms of the Kochs this week: “It’s OK for Koch Industries to save money through Obamacare, even as Koch-related groups seek the law’s repeal.”
When passed in 2010, the ACA designated $5 billion for the temporary reinsurance program. The goal of it was to subsidize employer costs for workers who retire prior to their becoming Medicare eligible. As a result, hundreds of employers, largely corporations, applied. Others applying included municipalities and public colleges. Virtually all of the monies involved were soon distributed.
Factual-based analysis by the Center for Responsive Politics does not include 2014’s purported heavy “political spending.” Many weighty political players are not required to report donations. Thus the Koch-funded group, for example, Americans for Prosperity, is among these “Super-PACS,” maintaining secrecy on finance details as it controls the airwaves. Such control is ever-present in states like North Carolina – a state with competitive Senate Races.
More insight from Politico’s Brett Norman: Medicare payments revealed in April for the first time by the Obama administration discloses tens of billions of dollars paid to physicians. It is an imposing revelation casting a broad, bright light on some of the top billing doctors around the U.S. Norman adds, “Physician groups have long resisted such a specific accounting of individual providers’ pay, and they continue to warn that the raw payment information –lacking the right context – could ruin the careers of quality docs.”
Yet the omnibus release brings what the federal health officials tout as a measure of transparency to a disreputable system. Academics and media outlets are anticipated to immediately begin dissecting the information attempting to identify potential causes of waste or fraud. Such disclosure is welcomed by researchers, consumer advocates, businesses and non-profits seeking to increase access to details they contend are needed to improve healthcare. Yet, the AMA (American Medical Association) opposes the “data dump.” In a statement issued early on April 9, the AMA said releasing the information absent “context” will “likely lead to inaccuracies, misinterpretation, false conclusions and other unintended consequences.” “Thoughtful observers concluded long ago that payments or costs were not the only metric to evaluate medical care,” says AMA President Ardis Dee Hoven.
According to Politico, the non-profit research Altarum Institute says national health spending increased by 6.7 percent in over a year. A portion of such growth is due to the newly insured under the healthcare law. Much of the acceleration in growth occurred in 2013, before the new coverage kicked in. By January, 2014, the healthcare spending share of the GDP reached a record of 17.7 percent.
The New York Times’ Katie Thomas sheds more detail on the recently released Express Scripts study. Multiple observers question whether the new marketplaces (or healthcare exchanges) will attract an appreciable amount of the sick; a scenario possibly leading to higher premiums, even eventually destroying the new law.
Express Scripts, suggests that early enrollees face far more serious health problems and are older than those covered by employers. The study also shows higher utilization of specialty drugs, often used to treat diseases like cancer and rheumatoid arthritis. The use of such drugs possibly alludes to even more costly medical problems. The article cites Carl E. Schmid, deputy executive director of the AIDS Institute, expressing worries over high out-of-pocket costs connected with a significant number of marketplace plans. The Express Scripts study found that consumers with such plans paid a larger percentage of drug costs in the first two months of 2014, in comparison with those in employer plans.
Overall, early users of the marketplace plans seemed to be filling prescriptions for drugs at rates similar to people with coverage through their employers. Another pharmacy-benefit manager, Prime Therapeutics, said it was seeing slightly higher rates of prescription-drug use among its marketplace customers. Others with their eye on ACA ramifications have cautioned that it’s too early to properly evaluate the health of those who are signing up. The Express Scripts overview looked at a sample of 650,000 consumers receiving coverage in January and February. It did not capture information about those signing up closer to the enrollment deadline. Insurers have said those who enrolled later tended to be younger and were presumably healthier.
A spokeswoman for Regence, a Blue Cross/Blue Shield provider serving the Oregon and Utah areas, told the New York Times the company’s new plans covered a broader array of drugs, also combining medical and drug costs under a single deductible. This allows some customers to meet their limits earlier. She also said that policyholders might be required to contribute toward drug costs if a less expensive medication was available that treated the same condition.
Does the resignation of Kathleen Sebelius as head of HHS signify the end of a tumultuous phase of the Obamacare debut? A recent report in the Christian Science Monitor says President Obama will attempt to nudge budget director, Sylvia Matthews Burwell, towards accepting the nomination as Secretary of Health and Human Services (HHS). The CSM story by Linda Feldman also outlines how repeatedly Sebelius faced varying criticism for the misfortune-plagued web-based healthcare system.
While accepting responsibility for perceived ACA failings of HHS, the Obama administration, at one point, mulled scrapping the Healthcare.gov website. Moreover, Sebelius seemed surprised by Obamacare roll-out issues. Even beyond preliminary website malfunctions, Obamacare remains controversial. Anyone thinking Sebelius’ resignation will even mildly quiet Obamacare opposition, may want to consider a position rethink. Republicans will continue to cry ‘Obamacare’ as Democrats battle to hang on to a Senate majority. The CSM article quotes David Yepsen, director of the Paul Simon Public Policy Institute at Southern Illinois University, who recently told Reuters that Sebelius’ resignation “is just going to embolden Republicans.”
The departure of Sebelius will put Burwell (the new nominee), as well as the Affordable Healthcare Act, squarely back in the hot seat. While a graduate of Harvard and Oxford, she has only served as budget director since April, 2013. If Burwell is confirmed, she will still have her political work cut out for her. Healthcare.gov is arguably functioning, but the website is due to go through extensive upgrades in preparation for the next enrollment period, beginning November 15. Additionally, insurers will be setting rates for next year.
Republicans are steadfastly entrenched in their respective positions that the ACA should be both defunded and scrapped. Ironically, Democrats could now also pose a challenge for Burwell, as they face uphill re-elections.
Greg Giroux writes in the industry-related Insurance Journal about the politically charged healthcare atmosphere of 2014. Republican legislators on Capitol Hill see the nomination process of Budget Director Sylvia Matthews Burwell as the new HHS Secretary, as an opportunity to ask renewed ACA questions. Conservatives are seeking information on how many enrollees have paid for their plans, the age make-up of enrollees, and how that steers insurers in policy pricing for next year. Kathleen Sebelius, secretary of health and human services, claimed Sunday on NBC’s “Meet The Press,” that she was not edged out as HHS Secretary.
Yet, the politics involved in finding a new HHS Secretary who will largely be shepherding Obamacare through its next phase cannot be denied, especially in light of comments from Senator Tim Scott, a South Carolina Republican on the Health, Education, Labor and Pensions Committee, saying Burwell’s confirmation hearings will be used to: “figure out first and foremost who actually has benefitted from the success of Obamacare and its rollout.”
Sen. Scott’s comments were heard Sunday on Fox News Sunday. “There’s no doubt that she was a good choice for OMB, that does not necessarily make her a good choice for HHS.”