Could it be a combination of both businesses and labor unions who are seeking to do away with the so-called “Cadillac Tax” of the Affordable Care Act? For some time, economists of different philosophies have griped that the an open ended tax-break under the auspices of the Affordable Care Act for companies providing healthcare coverage to their employees actually increases healthcare costs, while simultaneously and unfairly benefitting the more well-off. Thus, some now complain that the Affordable Care Act’s “Cadillac Tax” is actually discriminatory. This is at least the word coming from a report in Politico.com (online, Apr. 6) by Brian Faler, whose story also says, “Experts say a majority of employers could eventually face the tax on health care.”
By way of background, according to Politico, “It’s one of the last big parts of the Affordable Care Act to go into effect – law makers delayed the levy until 2018 in part because it is so controversial – but companies are wrestling with it now as they plan employee benefits. Some are already negotiating with unions over benefits that could spill into 2018.”
The Medicare Payment Advisory Commission is saying that Medicare Advantage, on average, expends “about 2 percent more per person,” according to a recent report in The Hill, over “traditional Medicare.”
The report, by Peter Sullivan, also adds, that The Centers for Medicare and Medicaid Services (CMS) had suggested a rate cut of .95 percent in those instances in which the government contracts with private insurers to dispense care to senior citizens.
Now, CMS says a 1.25 increase is forthcoming. The Obama administration also chimed in, “the new rate is not because of a change in policy but because of changes in actuarial estimates,” so says Sullivan’s Hill article.
An article by Jeff Merline (IBD.com, Apr. 7) suggests “[T]he public doesn’t seem to share Obama’s enthusiasm,” for the Affordable Care Act.
Obama administration touts, over the past five years, of the benefits of Obamacare are arguably well-known. Merline’s IBD report explains, “When discussing Obamacare, President Obama has repeatedly bragged about what great products the insurance plans are. Subsidized premiums. No medical underwriting. Rich benefits. Free preventive care. Choice of plans.”
But, has such purported Obama-ACA trumpeting truly made an impact on Obamcare enrollment numbers? Actual totals in that regard tell a different story. Obamacare sign-up results are hitting a brick wall. In both Vermont and Washington state enrollments decreased slightly in 2015. In 11 other states the gain in enrollment has only been 7.5 percent, according to Merline’s Investor’s Business Daily account.
The IBD report quotes Jon Kingsdale, who at one time headed up the healthcare exchange in Massachusetts — prior to the advent of the Affordable Care Act. According to IBD, Kingsdale recently told The New York Times “the concern about running out of momentum is legitimate.” Merline’s IBD report adds, ”Exchanges need to enroll up to 75 percent of their eligible markets” . . . “but states are having trouble getting over the 40 percent mark.”
Since passage of the Affordable Care Act, “Perhaps the most blatant anti-innovation provision in the ACA is the tax on medical devices. In an effort to partially pay for the law’s massive spending hikes. Democrats included a 2.3 excise tax on revenue – not profit – from the sale of medical devices.” This is according to a new report in The New American (online, Apr. 9) by Michael Tennant.
Such effects are being felt in the insurance marketplace, and at companies now shrinking staff and their work hours. Such moves comprise efforts to avoid Obamacare’s employer mandates.
Dr. Scott Atlas, a physician and also a senior fellow at Stanford University’s Hoover Institution is quoted by Tennant’s New American article as saying that the Affordable Care Act’s “threat to innovation” is “one of the ‘least noticed,’” negative effects, ultimately having a severe consequences for the health of Americans.
Meanwhile, Stephen Ubl, who heads up AdvaMed, a medical technology trade association, said in a recent press release, “The effects of this tax could have a damaging ripple effect for decades to come if left unaddressed. This tax is not just a tax on medical technology companies, it’s a tax on medical progress,” so says The New American.
According to a recent report (Apr. 7) by Dan Mangan, who regularly writes about healthcare for CNBC. Those persons classified as “young adults” in 2014, especially those “with low or moderate incomes experienced significant reductions in their uninsured rate,” under Obamacare.
The chief causes? According to Mangan‘s CNBC report, “[T]he expansion of the Medicaid program to include more people, and the launch of government-run insurance exchanges selling subsidized health plans that went into effect that year.” That information is based on a report in “Health Affairs,” a peer reviewed journal focusing on health policy. At the same time, those young adults with higher levels of annual income did not reflect additional reductions in their uninsured rate. This is in spite of Medicaid expansion in some states and the debut of government-sponsored insurance marketplaces purveying plans subsidized with federal dollars.
Stacey McMorrow, a researcher at the Urban Institute who co-authored the study in Health Affairs, is quoted by Mangan’s CNBC report as saying, “One would think that the low-income folks are much less likely to have parents with access to private health plans.”
Young adults with higher income levels “would not be eligible for Medicaid or subsidies on Obamacare private insurance exchanges, because they earn too much to qualify for either program,” so says CNBC.
The now well-publicized case of King v. Burwell, pending before the U.S. Supreme Court could eliminate “healthcare subsidies for people in 34 states.” That, at least is according to a recent report in The Hill (online, Apr. 7) by Sarah Ferris.
As of late, Republicans have been in a rush to come up with Affordable Care Act alternatives. The hope on the part of conservatives is that such an alternative is found and / or developed before the King v. Burwell decision – - expected in June, 2015. Concurrently, the Obama administration still holds fast to its contention that “nothing can be done to avert the fallout,” according to The Hill.
Former U.S. Rep. Eric Cantor maintains the GOP will be in position which sees it possessing a strong bargaining position on the issue of healthcare reform, should the King v. Burwell decision not go favorably for the Obama White House. Cantor recently spoke at any NYU Washington Panel.
Former Secretary of Health and Human Services (HHS) Kathleen Sebelius is quoted by Ferris’ Hill account as saying (should the Burwell decision be adverse to Obama, et al.) “You would have a domino effect. Some private insurance companies would see their portfolios in grave jeopardy pretty quickly.”
A recent report (online, Mar .23 – Kimberly Leonard) in U.S. News and World Report cites a Quest Diagnostics study. It may leave some wondering if what is described is correlation, or mere coincidence? The U.S. News and World Report article says, “states that chose to expand Medicaid for low-income Americans under President Barack Obama’s health care law have seen a surge in diabetes diagnoses, a new study shows, particularly during the disease’s earlier stages when changes in lifestyle can have a significant impact on a person’s later health.”
The U.S. News and World Report account further clarifies that the Quest Diagnostic findings show, “newly identified diabetes cases among Medicaid-enrolled patients jumped 23 percent in states that expanded the program, but increased by less than 1 percent – 0.4 percent – in states that did not.”
Without adequate health insurance of any kind, nor the ability to pay for it, it is probable individuals put off getting medical assistance until symptoms of their Diabetes worsen. Dr. Robert Ratner, who is the Chief Scientific and Medical Officer for the American Diabetes Association is quoted by Leonard’s report as saying, “Really, [the study] is telling us the primary reasons why we are not making the diagnosis: It’s access to care and coverage for care.”
How do you measure success or failure of a government program? Is it by how many people it helps? Is it by its costs; or savings – that is, if there are any? Or, do other standards exist by which to judge its overall effectiveness? In the case of Obamacare, the only indicators mattering to many in need of healthcare is just how much money it has (or has not) paid out; and how much medical treatment it has dispensed.
According to a report in Human Events (online, Mar. 23, by Justin Haskins) an appreciable number of physicians are refusing both Medicaid and Medicare patients. The reason? Federal government levels of “reimbursement rates” (Human Events) are not sufficiently high enough for doctors to make the effort in this regard worthwhile. Yet, what this does is give the stark appearance that doctors (as a group) act harshly against patients.
Haskins’s Human Events report adds, “It may seem counterintuitive to some since doctors spend their whole lives healing sick people, including many sick and poor people, but the reality is that doctors actually make easy political targets for the Democrat machine.”
Another component in the care versus cost conundrum (the Human Events report outlines) is that “[M]ost doctors are not politically active and are poorly represented in government.” Only 17 serve in Congress, for example, who are actually physicians.
Haskins further explains, doctors who are “specialists” are convenient targets. Their annual earnings easily place them in the “1 percent.” Thus, they are lumped in with that more affluent segment of the population comparatively recently demonized by the Occupy Wall Street movement.
A number of hospitals concentrated in the American South have closed their doors or are facing closure. Such hospitals are also found in more rural areas. According to a new report in World Net Daily (Mar. 22, online by Paul Bremmer) a noted physician who has authored a book about the healthcare crisis in the United States believes the closure of these hospitals is actually part of an overall Obamacare scheme. Bremmer’s report quotes Dr. Lee Hieb, former president of The Association of American Physicians and Surgeons as saying, “I think that’s what the ACA was really designed to bring about.” Hieb continues, “You can say it’s an unintended consequence. I’m not sure; I think it’s an intended consequence.” Dr. Hieb also believes that pro-Obamacare forces want a thoroughly concentrated healthcare system which (as she sees it) ultimately means a decrease in the number of rural hospitals and their accompanying specialized healthcare providers.
Also, according to the World Net Daily report, rural hospitals are more likely to close to because of their tendency to serve that segment of society which is elderly and impoverished. Translation? They treat an increased number of Medicare and Medicaid patients.
Dr. Lee Hieb is the author of “Surviving the Medical Meltdown: Your Guide to Living Through the Disaster of Obamacare.”
Holly Wade is Research Director for The National Federation of Independent Business’s Research. Recently, according to a recent report in Reason by J.D. Tuccille (online, Mar. 23) Wade testified before the Senate Finance Committee. Regarding Obamacare’s effects on U.S. small business, she said, “The problems that many predicted have arrived but most of the promises for small business owners remain unfulfilled. We found that 62 percent of small business owners are paying higher premiums while only eight percent say their costs have dropped.”
Tuccille’s Reason account also cites the Federal Reserve Banks of New York and Philadelphia who have found the following after receiving reports from small businesses in their locales: