Kathleen Brown’s recent post on the Forbes Web site (online, 10/7) indicates Obamacare continues its overall restructuring of the healthcare industry. How so? Ever since the U.S. Supreme Court ruled and declared that the Affordable Care Act is constitutional, the ACA has been overturning insurance industry standard operating procedures – some lingering for generations. Now, health insurance providers are transforming their business models, with:
● Different, new approaches top patient outreach; those stressing preventative care, lifestyle changes, and next day doctor visit guarantees.
● “Bundled Payments”. A one-time fee for one service, which includes “the entirety of the procedure,” according to Forbes.
● “Capitation”. Paying providers a flat fee for each patient regardless of the frequency that patient is treated. This creates an incentive for preventive care, according to Forbes (online).
While Obamacare’s Medicaid expansion and the Employer Mandate remain hot topics, another is on the rise — again. Much resentment broke out earlier this year when it was revealed a chain of family owned restaurants – – in Florida – – Gator’s Dockside, began including a 25 cents surcharge on patron’s bills. The purpose of such a dining fee? Not an added gratuity, rather an “Obamacare Surcharge.” A recent article in the Huffington Post (online, 10/7) by Alexander C. Kaufman claims this wrinkle in dining fees makes little to no sense, because:
● The ACA Mandate for Small Business is not yet in effect.
● Such surcharges don’t foster positive business-customer relationships.
In 2013, the city of San Francisco, CA. began investigating nearly 100 restaurants who may have redirected such fees – into their pockets.
A recent article (online, Oct. 6) in the Washington Times, by Stephen Dinan, recounts that one of the most politically, and otherwise, controversial aspects of the Affordable Care Act has been its commonly known Medicaid expansion provision. Something Congress, early on, had attempted to implement as a mandatory component of Obamacare. A report by the Government Accounting Office (GAO) may now further fuel those debate fires. This time the controversy is over the incarcerated. According to the GAO, expansion of Medicaid, under the umbrella of Obamacare, renders 80 percent of those jailed in New York, and 90 percent of such persons – in Colorado, Medicaid-eligible. For the state of California, that percentage is 72.
Other inmates do not qualify, because they do not have lawful residency in the U.S.
Obamacare, generally as a rule, does not permit illegal immigrants to receive benefits.
Jeffrey H. Anderson, writing in the Weekly Standard (online, Oct. 1) says, “Obamacare is like a house that’s built on a poor foundation by the world’s worst architect, with cost-overruns and maintenance expenses that make each year’s tab higher than the last.” The Weekly Standard article also features a review of some recent poll findings. The advent of Obamacare has literally meant millions have seen their current health plans excluded. Arguably, it’s no surprise that some 59 percent (that is, of likely voters surveyed) now say they would advocate the scrapping and outright supplanting of Obamacare. Some have even suggested that at least one Obamacare alternative not feature the individual mandate, nor an “auto-enroll” requirement — or any other perceived blatant intrusions on freedom. The survey, in this instance, according the Weekly Standard, was conducted by McLaughlin and Associates. Other findings, by Real Clear Politics, for example, are also included in the Weekly Standard report.
According to the Washington Post Wonkblog (Web page edition of Sept. 30) some 279,000 individuals may lose a portion or all of their Obamacare premium subsidy – that is if they don’t reconcile factual disparities – their reported income versus what the federal government has on record. This scenario is also directly related to the very real possibility that they may have failed to produce verifying documents – the sort proving they are either U.S. Citizens, or at the very least, are legally entitled to be in the United States. The Department of Health and Human Services (HHS) previously sent warning notices out in only English and Spanish. Now complaints have been filed by groups working with Asians and Pacific Islanders. It seems that while the notices offered avenues of communication to those receiving them, they did not volunteer that they would soon be losing coverage. Those in the United States with such legal residency issues have until November 5 of this year to clarify their status with HHS, according to the Washington Post report.
According to a another Washington Post Wonkblog post (online, Oct. 2,) those companies described as “Digital health firms”, like mHealth (or Mobile Health) Wireless Health, Health 2.0, eHealth, e-Patients, Connected Health, Wearable Computing, and Personalized Medicine, as well as others, are jumping on the bandwagon of “digital health”, as it is relatedly described. Such firms have garnered $5 billion in revenue, which greatly outpaces their 2013 performance.
The report in the Washington Post, by Jason Millman, goes on to say: “Health care has been notoriously slow to go digital” . . . ”There is a pretty major shift in the way that patients, care providers and payers are all thinking about their health care. At one sixth of the nation’s economy, that makes for a pretty big opportunity that the number is trying to capitalize on.” Millman’s Washington Post report also alludes to the digital health marketplace as new, but one which is developing at the same time.
A new report in the Daily Caller (online, 9/30) says when the Obama administration granted extensions to non-Obamacare compliant health insurance policies, it did so to quiet the backlash resulting from the public’s perception that Barack Obama had gone back on his now famous ‘if you like your plan you can keep it’ pledge. Yet the White house-based reprieve left some insurers in a conundrum. Health insurance companies have wound up not seeing healthier, previously covered consumers, those types of customers they had been anticipating would materialize. Now health insurers nationwide are due to send out approximately 50,000 cancellation notices, before November of this year.
The Daily Caller Report, adds – with respect to the 2013 cancellation notices sent by insurers advising consumers their plans were now unlawful – “The millions strong cancellations were partially intended to push already –insured customers – who are typically healthier and with less pent-up need for health care services – onto Obamacare exchanges by taking away their other options.”
A recent story in the Chicago Tribune (online, Sept. 26) cites a Bloomberg Government study, one not offering the best news for incumbent Senate Democrats.
Contributing as a backdrop to the Bloomberg Government findings is the historically glitch-ridden Obamacare Website, Healhtcare.gov. According the Chicago Tribune Report, HealthCare.gov issues have purportedly cost the American taxpaying public in excess of $2 billion, a number obviously and painfully well-beyond the $34 million previously projected as cost by the Obama White House. Other cost overruns exist as well. The Chicago Tribune additionally cites information coming from Bloomberg. Lanhee Chen of Bloomberg News later says in the article, that Sens. Kay Hagan of North Carolina, Mark Pryor of Arkansas, and Mark Begich of Alaska, are now discovering their current approval ratings are running at an approximately 40 percent range — in some current public opinion surveys. Will these poll results cause some Democrats seeking election, or re-election, to the U.S. Senate in the 2014 Mid-Terms, to back away from, or abandon altogether, endorsements of Obamacare?
Will current negative impressions of the Affordable Care Act, held by some eligible voters, end the political careers of at least some at-risk incumbent Democrats in November?
The Affordable Care Act receives its share of coverage regarding its requirement that insurance companies cover individuals with pre-existing conditions. Yet, a mystery remains. Why can’t vision care be purchased – under Obamacare? A recent Bloomberg Businessweek article by John Tozzi (online Sept. 30) provides insight. According to the Bloomberg account, only a handful of states: Colorado, Nevada, and Hawaii – currently offer vision coverage under auspices of the Affordable Care Act (ACA) – and at that only through their state-level healthcare exchanges. The scarcity, or lack of, vision care coverage is now an even more urgent issue, as HealthCare.gov will (attempt to) re-open on November 15, of this year.
Bloomberg’s Tozzi adds, “Lawmakers became concerned about how subsidies to help people afford coverage would be split among medical, dental, and visual providers, so glasses got left out.”
Apparently Bloomberg attempted to get some answers from a spokeswoman for the Centers for Medicare and Medicaid Services (CMS). They were referred to an agency-based PDF file, a document verifying that “stand-alone vision plans can’t be offered on the health exchanges,” according to the Bloomberg report.