According to a May 22 Hill article by Elise Viebeck and Peirre de Dreuzy, states are trying to narrow down dates for the release of 2015 premium costs under Obamacare. Their decisions may well “guarantee a drumbeat of news about rate hikes all the way to the November midterm elections.”
Premiums are anticipated to increase in several states, as they do yearly. What is key, though, are the actual amounts of such increases, as they, “could go a long way toward determining how much political damage Obamacare inflicts on vulnerable Democratic lawmakers.” Some areas could see significant increases, the Hill report adds.
States with fewer insurance carriers on the exchanges, those with a more elderly and ill demographics, as well as those not meeting sign-up goals, will have a tendency to see costlier premiums.
Viebeck and de Dreuzy report, “Health rates on the individual and small-group markets usually attract little to no attention from the political press. This year will be different.”
A May 20 story by Jeff Manning and Nick Budnick on the Oregonian’s ‘Oregon Live’ page, says the federal investigation into Oregon’s faulty health insurance exchange is becoming increasingly public, as the U.S. Attorney’s Office has issued broad subpoenas to both cover Oregon and the Oregon Health Authority. Federal prosecutors and the FBI are, “seeking documents, memos, and e-mails between the two state entities that oversaw the botched health exchange with U.S. authorities in charge of dispensing federal money for the project,” according Manning and Budnick.
In three years the state spent $250 million on a challenging technology initiative – one falling short, giving Oregon a glitch-filled, incomplete marketplace. The Oregonian account also relates that the FBI also wants to know if state officials intentionally, “misled their federal counterparts about progress on the exchange in order to get more federal funding.”
The Cover Oregon exchange remains a weighty political liability for Gov. John Kitzhaber. A federal investigation is not helping matters. In a recent poll, nearly 50 percent of registered voters surveyed said Kitzhaber should not win re-election.
Seniors face an unexpected healthcare broadside: charges for “observation care.” According to a May 21 report in Human Events, older Americans are finding their healthcare skimped on.
Earlier in May, the Obama White House bragged that the Affordable Care Act was increasing care quality for seniors. Nationally, hospital readmission rates are declining because Section 3025 of the ACA penalizes hospitals if a senior is re-admitted within 30 days.
When a senior previously was treated by a hospital and returns (after only a few days) to that hospital, the facility found a way to avoid the penalty. Hospitals simply put the patient under observation. Just a word on a chart? Yes, but a powerful one. Unless the patient is there at least two nights, “The hospital won’t bill Medicare for a stay and the patients gets clobbered with the cost. Many seniors don’t even know they were under observation until they get the bill,” says Human Events.
Also, according to the Human Events report, “The Obama Administration plans to expand the readmissions penalties in 2015 to apply to many more conditions.”
According to Monday’s Red State.com, Obamacare’s staunchest supporters explain widespread ACA unpopularity by blaming the number of negative ads trying to sell the nation on the idea that Obamacare is the wrong healthcare option. A recent report, released by the nonpartisan analysts Kantar Media CMAG, says “spending on negative ads has outpaced positive ones by more than 15 to 1.”
“No other law has come close to these amounts, much less within such a short period of time. It speaks to the intensity of the opposition among the ACA’s political critics,” said Elizabeth Wilner of Kantar.
Red State.com adds that the analysis also found, “In 2014 congressional races, 85 percent of the anti-Obama were also anti-Obamacare ads. In some competitive races, 100 percent of the pro-Republican TV ads aimed at Democrats contained anti-health law messages.”
According to The Hill.com of May 8, a report by a leading healthcare analyst, claims Obamacare-related insurance premiums may increase by as much as double-digits in 2014.
Avalere Health says such increases will not be the result of enrollees’ age disparities. Avalere explains young enrollment levels are not consistent nationwide and that the ultimate ACA success depends on whether they continue to join up.
“Enrollees between the ages of 18 and 34 have been critical to Democrats’ hopes of success for Obamacare, as they are expected to balance costs to cover older and sicker enrollees,” said Ferdous Al-Faruque, the article’s author.
“The group also said the federal government will have to take a disproportionate amount of the healthcare cost in states with larger populations that qualify for government healthcare subsidies.”
Welcome to healthcare’s brave new world. An article by Trevi Troy on Politico.com, May 12, 2014, states that employer-sponsored healthcare plans may soon only be a memory. A new study by financial research firm, S&P Capital Research, suggests that employer-based coverage in the U.S. may possibly fade away by the year 2025.
Ezekiel Emanuel, brother of former White House Chief of Staff Rahm Emanuel, and one of the developers of the administration’s healthcare agenda, claims that the healthcare marketplaces will ultimately replace the current framework. His remarks were made in his book.
Traditionally, employers have provided health coverage for their workers. While health benefits can serve as recruiting and retention leverage, employers as a whole would save $700 billion by dropping coverage and paying the employer mandate fine. “If true, this would be a disruptive development, as 170 million Americans now get their insurance via their employers,” said Trevi.
The White House contends employers will remain the source of healthcare for Americans. Dropping coverage would not be a cost-free proposition for businesses.“If employers all pull out, the employer mandate penalty could become a lever that politicians use to milk employers.”
A May 15 report by the PBS NewsHour details how the Obama White House has given approval to insurers and businesses implementing a new cost-control mechanism ─ one placing a hard dollar limit on which health coverage pays for costly treatments such as hip and knee surgeries. The report highlights healthcare experts’ concerns that such a move could catch some patients choosing more expensive hospitals off-guard. Cost differences for those in that category would result in huge out of pocket expenses.
The scenario is viewed as one potentially undermining significant financial safeguards in Obamacare, protections applicable in the insurance exchanges. Most job-based coverage would also possibly be undercut. Others view this latest move as “a valuable tool to reduce costs and help check premiums,” according to the PBS NewsHour.
The PBS report also cites observations by Robert Berenson, who worries that advocates of reference pricing may be ignoring degrees of quality. Berenson is a physician and health policy expert with the Urban Institute. “There are differences in MRIs and in how a hip replacement is done. If you are going to say ‘Our judgment is better than your doctor’s,’ then you’ve got to meet tests that you are actually assuring quality and safety.”
According to a May 9 CNBC report, new analytical research suggests eliminating the ACA employer mandate compelling employers to offer workers inexpensive health coverage, or pay a tax, or fine, would have little impact on the overall insurance rate. Yet, it could also diminish business opposition to the controversial ACA. Research by the Urban Institute found that eliminating the mandate, due to go into effect in 2015, would reduce the number of people, as of 2016, who would have some kind of insurance.
The reduction would be from 251.1 million, down to 250.9 million. John Holahan, one of the Urban Institute researchers argues this is a minimal number. He also cites strategic options to get some 200,000 uninsured individuals coverage, as opposed to mandating employers to offer it.
One possibility is having the government increase subsidies available to people who buy insurance on Obamacare exchanges, including broadening Medicaid eligibility.
Holahan also says getting rid of the mandate would remove any incentive for employers to cut workforce size and hours to get under the mandate’s thresholds.
According to The Hill.com on May16, 2014, if Obamacare’s risk corridor provisions can’t cover private insurer losses, “insurance companies can count on funds from the government.” Risk corridors are structured to fend-off rising premiums by shifting money from insurers with better than projected earnings to those with less-than-expected results.
Previously, the Obama administration guaranteed the temporary program would get off the ground in a “budget-neutral” way – without government money. Recently, though, federal health officials appeared to backtrack. Republicans negatively assess the corridors as an insurance industry bailout.
Also, according to the Hill, a 436-page rule as promulgated by the Department of Health and Human Services (HHS) says, “[I]n the unlikely event of a shortfall for the 2015 program year. . . [The Department of Health and Human Services] will use other sources of funding for the risk corridors payments.”
A negotiator who bargains down medical bills for self-insured employers said that Obamacare will do little to cut their costs, which he said are starting to “escalate” in the latest round of heath plan renewals.
The burden of not getting price-gouged by doctors and hospitals still falls on self-insured employers, even in the age of Obamacare, Steve Kelly, CEO of the health-cost management firm ELAP Services LLC, told Newsmax TV on Wednesday.