Top 10 Failures of ObamaCare After Six Months

[JBeukema]

President Obama today is proudly touting the success of the biggest disaster of his presidency: ObamaCare.
The trillion-dollar, government takeover of our health care officially kicks in tomorrow, but it has already had a destructive impact on our economy and health care system.
Obama’s crowing about his health care debacle shows how totally out of touch he is with the American people. Polls show that 56 percent of likely voters believe that ObamaCare is bad for the United States and 71 percent think the health care law will hurt the economy.
The facts speak for themselves, here are the top ten failures of ObamaCare after only six months:

Top 10 Failures of ObamaCare After Six Months - HUMAN EVENTS

 

[Zander]

ObamaCare was good for one thing - it started the Tea Party Movement.

 

[Greenbeard]

1. Premiums Have Gone Up: Obama promised that families will pay less for their healthcare premiums under his plan. Quite the opposite has happened. Insurance companies are making double-digit rate increases to consumer premiums in anticipation of the cost of new mandates by ObamaCare. The estimated premiums rate increase for consumers is between 1% and 9%, a direct impact from the new regulations.

Double-digit increases of 1-9%, eh? Yes, premiums are always going to go up. The price of milk is always going to go up. The key is to decrease the rate of increase with time so that premiums aren't always rising faster than incomes (and thus eating up an ever larger share of the national income). There are two general strategies for doing this: 1) indiscriminately limit access, slash spending, cut treatments, and limit care; or 2) improve the way health care is delivered, addressing the vast inefficiencies that characterize our system.

The former is faster but doesn't have particularly good outcomes for health, nor is it popular. The latter takes time because systemic improvement can't be conjured overnight. You'll have to weight the pros and cons of these approaches for yourself. The ACA, however, takes the latter approach to cost control. Which means it's in it for the long haul.

2. You Can’t Keep Your Current Plan And Doctor: Businesses will be forced to change their employees’ healthcare plans in order to meet the new regulations. An estimated 69% of businesses will be forced to change their plans, forcing countless millions of Americans to change plans and doctors.

This is a bit backwards. The number they use here comes from the federal rule itself, in which the high-end estimate that one-third of grandfathered plans will relinquish that status each year (leading to a cumulative ~69% giving up grandfathered status by the end of 2013) is derived. But that isn't "to meet the regulations," it's because those employers choose to make changes to the plans (e.g. in terms of cost-sharing) that cause them to lose grandfathered status.

Using these estimates, if employers value grandfathering enough that they are willing to allow premiums to increase by three percent more than their otherwise intended level (or can make changes to benefits other than cost-sharing that achieve a similar result), then 14 percent of small employers and 11 percent of large employers would relinquish grandfather status if they made the same changes in 2011 as they had in 2009. Adding in the employers who would relinquish grandfather status because they change issuers, the Departments’ lower bound estimate is that approximately 21 percent of small employers and 13 percent of large employers will relinquish grandfather status in 2011.​

That an employer can and will change insurance issuers at some point shouldn't be a shock. But a failure of ACA? That's a stretch.

3. National Budget Deficit Is Worse: Sixty-one percent (61%) of all voters nationwide say the healthcare law will increase the federal deficit.

The statement "national budget deficit is worse" is defended using an opinion poll of what "voters nationwide" believe will happen? Moving on.

4. More Children Are Uninsured: Anthem Blue Cross, Aetna Inc. and other insurance agencies are dropping child-only policies, citing huge, unexpected costs from ObamaCare. An estimated half a million children in the United States will be affected by the policies.

No, more children aren't uninsured. No one is dropping existing policies; what certain insurers are doing in certain states (though not all) is refraining from issuing new policies.

But this is certainly the first item in the list that actually looks like a failing of the ACA. Child-only policies are a cash crop for insurers; some insurers are now losing interest in that limited market now that they can't necessarily underwrite themselves to a profit on the backs of those kids.

And therein lies a legitimate criticism of the ACA. It retains the private insurance market as the centerpiece of the payment side of our system. The profit motive remains the driver of many key decisions, even when that logically leads to limiting access for children.

5. Small Business Taxes Increased: Small businesses—the engine of the U.S. economy—are suffering from increased tax filing regulations and anticipated healthcare mandates. Over 40 million small businesses will be required to file new tax reports for health care. The tax credit for the regulations only covers one-tenth of these business’s losses.

There's actually widespread support for repealing the 1099 provision. But paygo rules require that the repealing legislation contain offsets to cover the revenue that would've been collected under that provision of ACA. The Senate could only muster 56 votes for the more popular 1099 repeal bill, which isn't enough to make things happen.

6. Small Businesses Health Care Burden Increased: Almost half of all smaller employers are anticipating “significant increases in healthcare costs in the short term.” These business owners are likely to cut back on hiring and expansion because they fear a new healthcare burden.

There's no reference to ACA here. But it's interesting to note that the survey in that link found:

Most respondents agreed that health care coverage remains an important tool to attract and retain employees. More than eight out of ten employers (85%) said that health care benefits will either continue to be just as important, or more important, in the future.​

7. More Government Spending: The Congressional Budget Office has already adjusted the cost for ObamaCare since it passed, adding another $115 billion to the taxpayer’s tab. The Centers for Medicare and Medicaid Services has adjusted upwards its cost prediction since the bill took effect from 6.1% per year to 6.3%. By 2019, U.S. spending on health care will reach $4.6 trillion.

CBO didn't add $115 billion of discretionary spending to the tab; as they clarified:

CBO’s discretionary baseline, which assumes that 2010 appropriations are extended with adjustments for anticipated inflation, already accounts for much of the potential discretionary spending under PPACA.​

If you look at the recent national spending estimates from CMS actuaries, you'll see only two years this decade in which spending grows appreciably faster than under prior law: 2010, as high risks pools open across the nation, and 2014, as tens of millions of the uninsured join the ranks of the uninsured (in 2015 and 2016 it's very slightly higher).

After that, spending slowly starts falling (that is, 3 years after the law goes full into effect). These projections only go to 2019 (i.e. 5-6 years after the coverage expansions begin) but that's right about where the cost growth is really going to start falling, as the CMS actuaries wrote:

Enrollment shifts associated with the Affordable Care Act coverage expansions are projected to continue, contributing to continuing relatively faster spending growth rates through 2016. Thereafter, spending growth is projected to decelerate more substantially as a result of Affordable Care Act–mandated reductions to Medicare provider payment updates and the excise tax on high-cost insurance plans starting in 2018.​

A substantial deceleration of spending growth is generally something people are eager to see.

8. Senior Citizens Suffer from Medicare Cuts: The Medicare Advantage program which covers nearly a quarter of seniors will cut plans from $3-$5,000 per beneficiary. Doctors are refusing to take seniors because Medicare only covers part of their bills.

Medicare Advantage plans are given more money from the government than traditional Medicare plans but that doesn't mean reducing those additional payments means less money flowing to beneficiaries. The reason, as Austin Frakt has shown, is that the vast majority of those overpayments doesn't result in additional value for beneficiaries.

Payment to MA plans has gone way up since 2003. Did the payment increase largely benefit beneficiaries or not? This is a current political and policy debate, about which much has been written in the media (both traditional and blogospheric). It turns out the answer is known and quantifiable. My work (with Steve Pizer and Roger Feldman) shows that for each additional dollar spent by the federal government (taxpayers) on the program since 2003, just $0.14 of it can be attributed to additional value (consumer surplus) to beneficiaries (see also: findings brief).

What do we make of the other $0.86? That goes to the insurance companies but doesn’t come out “the other end” in the form of value to beneficiaries. In part it is accounted for by the costs of the additional benefits and in part it is captured as additional insurer profit.

So, do higher MA payments produce little value to beneficiaries, as Obama claims, or are the benefits they fund important to maintain, as Republicans would have us believe? The balance of the evidence is on Obama’s side. In fact, it is a landslide: for each dollar spent, 14% of the value reaches beneficiaries and 86% of it goes elsewhere (profit or cost).​

Medicare Advantage premiums are going down next year for beneficiaries, by the way.

9. Minorities Get Worse Health Care: ObamaCare forces 16 million Americans into Medicaid, a poorly performing welfare program. The President considers moving Hispanic and blacks into Medicaid an improvement in their healthcare. No one else does.

I'm not sure where the racial component of this one came from. That said, the suggestion here is that you're better off being uninsured than being on Medicaid. I guess it makes sense for this to turn into another "rah, rah, uninsurance!" piece.

Unless they're for opening up private premium assistance to everyone. It would make the law significantly more expensive but it would do away with Medicaid.

10. Democrats Losing Elections: Current polls show that 61% of likely voters want the bill repealed and the Tea Party movement has demonstrated America’s anger toward ObamaCare. The primaries this summer have shown that Americans are voting for members of congress who will repeal Obamacare.

From shortly after it passed, we have:

If their representative votes with Republicans to defeat the bill, 34 percent say they would be less likely to re-elect that member, 31 percent say they would be more likely to vote for the member, and 34 percent say it makes no difference.

But if their member of Congress votes with Democrats to pass the legislation, 36 percent say they would be less likely to re-elect that member, 28 percent say they would be more likely to vote for the member, and 34 percent say it makes no difference.

Translation: "There is no easy place right now in the health care debate," says McInturff, the GOP pollster.​

Is there a more recent poll indicating radically different voting influences?

 

[RDD_1210]

I believe that I'd rather die and go to heaven than be cured by tax payers dollars.

I guess it's a shame that there is no heaven.

 

[rdean]

The year Obama took office, insurance rates rose 29% and the number one cause of bankruptcies was "medical bills".

Republicans look back on this and say, "Ahh, the good old days, miss me yet?"

 

[CrusaderFrank]

What does reporting all purchases over $600 to the IRS have to do with health Care?

 

[Trajan]

What does reporting all purchases over $600 to the IRS have to do with health Care?

shusshhh we have the dem house defender of the faith depositing more boiler room gobbledygook.....you're supposed to be convinced now.

 

[Trajan]

?

sure why not, I'll play a round-

How Seniors Will Pay for ObamaCare
In many areas, Medicare Advantage enrollees will lose about one-third of their health insurance benefits. The cuts will finance new subsidies for younger people.

Today marks the six-month anniversary of the enactment of the Patient Protection and Affordable Care Act, widely known as ObamaCare. It is a day when the first significant round of benefits kicks in, and the Obama administration is taking every opportunity to tout them to the American public.

Insurers, we are being told, will no longer be able to impose annual limits or lifetime caps on benefits, and they will face a higher standard before than can drop anyone's coverage. Children will be guaranteed access to insurance, regardless of health condition. And there is more to come in the future.

Yet the administration is strangely silent about who will bear the cost of these benefits. Search the government's own health-reform website and you'll get the idea that the whole thing is one big free lunch.

The reality is that the cost of ObamaCare will be quite high for some people. By 2017, thousands of people in Dallas, Houston and San Antonio will be paying more than $5,000 a year in lost health-care benefits to make ObamaCare possible, according to a study published this month by Robert Book at the Heritage Foundation and James Capretta at the Ethics and Public Policy Center. For some New York City dwellers, the figure will exceed $6,000 a year. Unfortunate residents of Ascension, La., will pay more than $9,000 in lost benefits.

Who are these people? Are they the rich and the comfortable—the folks presidential candidate Barack Obama told us could afford to pay for health reform? Are they people who have excessively profited during a recession that's caused hardships for so many? Are they the ones who gained the most from the Bush tax cuts?

None of the above. According to the Book/Capretta study, the people getting hit with these very expensive tabs live in predominately low-income households. They are disproportionately minorities. They have trouble paying their own medical bills.

These are the enrollees in Medicare Advantage plans, health plans operated by private insurers (Cigna, Aetna, United Health, etc.) that provide extra benefits to the elderly and the disabled on top of standard Medicare coverage. The price they will pay for health reform will be a double whammy: less spending on Medicare coupled with reduced subsidies for their Medicare Advantage plans. In many areas, Medicare Advantage enrollees will lose about one-third or more of their health-insurance benefits.

Despite its popularity, conventional Medicare is actually a lousy health-insurance plan. It doesn't cover most drugs and it leaves beneficiaries exposed to thousands of dollars in potential out-of-pocket expenses. To protect themselves, most seniors purchase additional coverage known as "Medigap" insurance (either from an employer or purchased directly) and buy drug coverage (Medicare Part D) as well.

Many low-income seniors, however, have trouble paying three premiums to three plans, and all too often they find a decent Medigap plan unaffordable. For these retirees (about one in every four Medicare beneficiaries) Medicare Advantage plans have been a godsend. They have been able to enroll in comprehensive health plans that resemble the coverage many nonseniors have—often with no extra premium.

The hostility of the White House and many congressional Democrats toward these health plans is hard to explain. Ostensibly, they do everything President Obama says he wants to accomplish with health reform. They provide subsidized coverage to low- and moderate-income people who could otherwise not afford it. They have no pre-existing condition limitations, and some plans actually specialize in attracting and caring for patients with multiple illnesses. They provide an annual choice of plans.

On measures of quality and efficiency, they also score well. According to a study published in June by America's Health Insurance Plans (a trade group that represents Medicare Advantage insurers):

• Medicare Advantage enrollees had 33% more doctor visits (presumably representing more primary care), yet experienced 18% fewer hospital days and 10% fewer hospital admissions than conventional Medicare patients.

• They had 27% fewer emergency-room visits, 13% fewer avoidable admissions, and 42% fewer readmissions.

Other studies report similarly impressive results.

This is not to say that the Medicare Advantage programs could not be improved. Right now, almost all the enrollees are in HMOs. Very few have a health savings account plan. And there is no practical way for the chronically ill to manage their own budgets. By contrast, the Medicaid disabled—as part of pilot programs that have been in force for a decade—can hire and fire the people who provide them with services, and use any money they save to purchase other medical care.

Some complain that the government has been paying Medicare Advantage plans about 13% more than what would have been spent under conventional Medicare. This is partly explained by the influence of members of Congress who represent rural areas that would not otherwise be able to support these plans. In any event, these "overpayments" allow members to get about $825 in extra benefits each year, including lower out-of-pocket payments and better coverage for drugs, preventive care, and chronic disease care.

According to a report published in April by the administration's own Medicare Office of the Actuary, about 7.4 million people who would have been enrolled in Medicare Advantage plans in 2017 will lose their coverage completely. Those who are able to retain their coverage will lose significant benefits. These cuts are financing lavish subsidies for health insurance for young people at about the same income level as the seniors who are being penalized.

To those economic libertarians who view this as an entitlement wash, don't be misled. Many of the seniors losing their health plans will enroll in taxpayer-funded Medicaid, in addition to Medicare. The rest will be on the steps of Capitol Hill in the near future asking to have their benefits reinstated.

John C. Goodman: How Seniors Will Pay for ObamaCare - WSJ.com

 

[JBeukema]

I believe that I'd rather die and go to heaven than be cured by tax payers dollars.

Those poor vets @ the VA...

 

[NYcarbineer]

I believe that I'd rather die and go to heaven than be cured by tax payers dollars.

Sorry, there are no rightwingers in Heaven.

In fact, that's why they call it Heaven.

 

[auditor0007]

President Obama today is proudly touting the success of the biggest disaster of his presidency: ObamaCare.
The trillion-dollar, government takeover of our health care officially kicks in tomorrow, but it has already had a destructive impact on our economy and health care system.
Obama’s crowing about his health care debacle shows how totally out of touch he is with the American people. Polls show that 56 percent of likely voters believe that ObamaCare is bad for the United States and 71 percent think the health care law will hurt the economy.
The facts speak for themselves, here are the top ten failures of ObamaCare after only six months:

Top 10 Failures of ObamaCare After Six Months - HUMAN EVENTS

The first item in this list states that insurace premiums will be increasing between 1-9 % due to Obamacare. This is the smallest increase in premiums we have seen in years. What great news!!! Apparently, quite a few people here don't remember the double digit premium increases year after year for most of the last ten to fifteen years before "Obamacare".

 

[geauxtohell]

As a med student who is at a school that services a population that is completely covered by Medicaid, If find this dubious:

9. Minorities Get Worse Health Care: ObamaCare forces 16 million Americans into Medicaid, a poorly performing welfare program. The President considers moving Hispanic and blacks into Medicaid an improvement in their healthcare. No one else does.

And wonder what kind of experience Ms. Miller has to make such a comment.

Miss Miller is a senior editor of HUMAN EVENTS. Previously, she served as the deputy press secretary at the State Department during the George W. Bush administration and the communications director to the House Majority Whip, Tom DeLay. Miller also served as an associate producer at ABC News and started her career at NBC News.

Oh, Ms. Miller has NO experience in healthcare and her sole job in life has been as a talking head.

Our patients get the full workup since they are covered by Medicaid. There is no insurance company to interfere with patient care. Is it superior to private health insurance? Probably not. Is it superior to no insurance or using the ED as a primary care provider? Absolutely.

 

[theDoctorisIn]

As a med student who is at a school that services a population that is completely covered by Medicaid, If find this dubious:

9. Minorities Get Worse Health Care: ObamaCare forces 16 million Americans into Medicaid, a poorly performing welfare program. The President considers moving Hispanic and blacks into Medicaid an improvement in their healthcare. No one else does.

And wonder what kind of experience Ms. Miller has to make such a comment.

Miss Miller is a senior editor of HUMAN EVENTS. Previously, she served as the deputy press secretary at the State Department during the George W. Bush administration and the communications director to the House Majority Whip, Tom DeLay. Miller also served as an associate producer at ABC News and started her career at NBC News.

Oh, Ms. Miller has NO experience in healthcare and her sole job in life has been as a talking head.

Our patients get the full workup since they are covered by Medicaid. There is no insurance company to interfere with patient care. Is it superior to private health insurance? Probably not. Is it superior to no insurance or using the ED as a primary care provider? Absolutely.

95 cents out of every dollar spent on Medicaid and Medicare goes to medical services.
60 cents out of every dollar spent on private insurance goes to medical services.

 

[Quantum Windbag]

The year Obama took office, insurance rates rose 29% and the number one cause of bankruptcies was "medical bills".

Republicans look back on this and say, "Ahh, the good old days, miss me yet?"

Bullshit.

Why have you never even attempted to back up this ridiculous claim?

 

[Quantum Windbag]

President Obama today is proudly touting the success of the biggest disaster of his presidency: ObamaCare.
The trillion-dollar, government takeover of our health care officially kicks in tomorrow, but it has already had a destructive impact on our economy and health care system.
Obama’s crowing about his health care debacle shows how totally out of touch he is with the American people. Polls show that 56 percent of likely voters believe that ObamaCare is bad for the United States and 71 percent think the health care law will hurt the economy.
The facts speak for themselves, here are the top ten failures of ObamaCare after only six months:

Top 10 Failures of ObamaCare After Six Months - HUMAN EVENTS

The first item in this list states that insurace premiums will be increasing between 1-9 % due to Obamacare. This is the smallest increase in premiums we have seen in years. What great news!!! Apparently, quite a few people here don't remember the double digit premium increases year after year for most of the last ten to fifteen years before "Obamacare".

Premiums will go up an additional 1-9%.

Fail.

 

[geauxtohell]

As a med student who is at a school that services a population that is completely covered by Medicaid, If find this dubious:

9. Minorities Get Worse Health Care: ObamaCare forces 16 million Americans into Medicaid, a poorly performing welfare program. The President considers moving Hispanic and blacks into Medicaid an improvement in their healthcare. No one else does.

And wonder what kind of experience Ms. Miller has to make such a comment.

Miss Miller is a senior editor of HUMAN EVENTS. Previously, she served as the deputy press secretary at the State Department during the George W. Bush administration and the communications director to the House Majority Whip, Tom DeLay. Miller also served as an associate producer at ABC News and started her career at NBC News.

Oh, Ms. Miller has NO experience in healthcare and her sole job in life has been as a talking head.

Our patients get the full workup since they are covered by Medicaid. There is no insurance company to interfere with patient care. Is it superior to private health insurance? Probably not. Is it superior to no insurance or using the ED as a primary care provider? Absolutely.

95 cents out of every dollar spent on Medicaid and Medicare goes to medical services.
60 cents out of every dollar spent on private insurance goes to medical services.

Shocking.

Actually, not at all.

I'd lay money down that Ms. Miller has never walked the floor of a major metropolitan hospital that services a medicaid population.

We do a damn good job, IMO.

 

[CountofTuscany]

ObamaCare was good for one thing - it started the Tea Party Movement.

Very good point. It was the impetus for the movement. It was the frustration that got people to start complaining at town hall meetings.

 

[BlindBoo]

The biggest failure of the Health Care Overhaul passed by Congress is to allow the MSM and the pseudo-cons to control the dialog by allowing it to be called "Obamacare" and scaring the shit out of all dumb-smucks who believe everything they hear on Faux News.