Sunday, December 28, 2014

The ACA Cadillac Tax Rabbit Hole

“The Cadillac Tax is supposed to raise $80 billion over ten years to finance the expansion of health coverage.”

“The $80 billion of tax revenues will never appear. Companies as well as government entities will limit their medical insurance plans to the "predetermined thresholds". It is difficult to imagine virtually any entity continuing with any plan that results in an Obamacare Cadillac Tax.” - Kill the Obamacare Cadillac Tax Now, Hank Adler, 12/27/2014

-Upon Further Review-

If the $80 billion in tax revenue never occurs through tax avoidance, and the tax revenue was a component of the financing of ACA, then either a deficit occurs, government supplied items of another variety are reduced, revenue must be raised from another source (the other revenue source can only come from another set of taxpayers) -or- a combination of increased deficit, reduced government supplied items of another variety and increased tax upon some taxpayer group.

Not only does the tax revenue not appear due to tax avoidance, the Cadillac plans scrapped mean those individuals currently with the Cadillac plan must now have less-than a Cadillac plan (a less generous plan to avoid the tax) meaning those individuals absorb more health-care expense than under any previous Cadillac plan they were enrolled in.

The final result being zero tax revenue raised for ACA and more health-care expense for the individual. Judging intentions is always a mistake. Judging this particular lose-lose result might be more enlightening.

Link to the entire article appears below:


Obamacare: Re-enrollment vs. Automatic Renewals

Opinions Regarding Obamacare Remain Negative

“Most voters continue to hold a negative opinion of Obamacare and remain committed to the belief that consumers should have choices when it comes to health insurance. They also still strongly belief employers and individuals should be able to buy health insurance across state lines.

A new Rasmussen Reports national telephone survey finds that 42% of Likely U.S. Voters now have at least a somewhat favorable opinion of the national health care law, while 53% view it unfavorably. These findings are generally consistent with surveys since early 2013 and include 17% with a Very Favorable opinion and 38% with a Very Unfavorable one. (To see survey question wording, click here.)” - Voters Remain Strongly Pro-Choice When It Comes To Health Insurance, Rasmussen Reports, 12/22/2014

Link to the entire article appears below:

Tuesday, December 23, 2014

How Many Really Did Sign Up for Obamacare in the Initial Open Enrollment of 2013-2014? Answer: Less Than Advertised.

“The Obama administration said it erroneously calculated the number of people with health coverage under the Affordable Care Act, incorrectly adding 380,000 dental subscribers to raise the total above 7 million.

The accurate number with full health-care plans is 6.7 million as of Oct. 15, a spokesman for the U.S. Department of Health and Human Services confirmed today, saying the U.S. won’t include dental plans in future reports.”

“The error was brought to light by Republican investigators for the House Oversight and Government Reform Committee, using data they obtained from the U.S. Centers for Medicare and Medicaid Services.

“A mistake was made in calculating the number of individuals with effectuated Marketplace enrollments,” said Kevin Griffis, a spokesman for the U.S. Health and Human Services Department. “Individuals who had both Marketplace medical and dental coverage were erroneously counted in our recent announcements,” he said in an e-mail.

The new count puts enrollment short of a 2013 estimate by the Congressional Budget Office, adopted last year as a goal by the Obama administration, that 7 million people would be enrolled this year. Federal officials said in September they had 7.3 million people enrolled in coverage through new government-run insurance exchanges. They didn’t distinguish between medical and dental plans, breaking from previous practice without notice.”

“Blending dental and medical plans let the administration assert that enrollment was more than 7 million. The move also partly obscured the attrition of more than 1 million in the number of people enrolled in medical insurance.

The administration had supplied information about dental plans separately in earlier disclosures. In May, the government reported that 8 million were signed up for health plans and 1.1 million were in dental coverage.

Then in September, the numbers became less transparent. The Medicare agency’s administrator, Marilyn Tavenner, released a new enrollment figure, obtained from insurance companies participating in the exchanges: 7.3 million people were “enrolled in the health insurance marketplace coverage,” she said at a hearing by the Republican-led Oversight committee.”

‘“After touting 8 million initial sign-ups for medical plans, four months later they engaged in a concerted effort to obscure a heavy drop-out rate of perhaps a million or more enrollees by quietly adding in dental plan sign-ups to exchange numbers,” Republican Darrell Issa of California, chairman of the Oversight committee, said in an e-mail from a spokeswoman.’ - Obamacare Sign-Ups Were Inflated With Dental Plans, Bloomberg, 11/20/2014

Link to the entire article appears below:








Monday, December 22, 2014

American Health Care and the Fortress Mentality

“For decades America’s health care debate has pitted Left against Right, federal against state, public against private. All sides, however, have shared a similar, inhibiting mindset—an excessive aversion to risk and deference to medical insiders—instead of stressing the ideal goal of better health care for more people at lower cost on a continuous basis.

A new study published by the Mercatus Center at George Mason University shows how this “Fortress”-like mentality has limited innovation in health care, constraining medical advances and raising costs. Shifting to a “Frontier” approach—one that tolerates risk and opens the field to other participants and disciplines—would bring to health care the kinds of creativity seen in many other fields, such as information technology.

The study illustrates these ideas in part through a set of unconventional characters, including a Hollywood actress who figured out how to stop Nazis from jamming American torpedo controls, a small-town doctor who pioneered stem-cell therapy, an injured carpenter and a puppet-maker who saw $40,000 prosthetic hands and produced a workable alternative that costs less than $50, a dying rodeo enthusiast who successfully battled the Food and Drug Administration (FDA), and—on the other side of the coin—a well-meaning educator who helped destroy African-American medical education.” - Fortress and Frontier in American Health Care, Robert Grabayes, George Mason University

Link to the summary:

Link to the entire paper:





Wednesday, December 3, 2014

Regarding Proponents of ACA and the Bumper Sticker Sized Slogan: “Bending the Cost Curve”. Maybe Not so Much.

“The American middle class has absorbed a steep increase in the cost of health care and other necessities as incomes have stagnated over the past half decade, a squeeze that has forced families to cut back spending on everything from clothing to restaurants.

Health-care spending by middle-income Americans rose 24% between 2007 and 2013, driven by an even larger rise in the cost of buying health insurance, according to a Wall Street Journal analysis of detailed consumer-spending data from the Bureau of Labor Statistics.

That hit has been accompanied by increases in spending on other necessities, including food eaten at home, rent and education, as well as the soaring cost of staying connected digitally via cellphones and home Internet service.

With income growth sluggish, discretionary spending on things like clothing and movies, live shows and amusement parks has given way.” - Basic Costs Squeeze Families, Wall Street Journal, 12/01/2014

Link to the entire story appears below:

Tuesday, December 2, 2014

Why Isn’t Big Business Complaining About ACA? Answer: Self-Insurance

"Have you ever wondered why the largest companies almost never criticize the Affordable Care Act? That may be because they are getting a deal that the rest of us aren’t getting.

The mandate to provide health insurance to employees kicks in for large employers on January 1st and applies to smaller companies the following year. Surprisingly, firms that are large enough to self-insure (and pay employees’ medical expenses directly) can satisfy the mandate without covering hospitalization. They can also avoid paying for mental health care, the services of specialist doctors and even emergency room visits.

In a nutshell, the largest firms can offer the skimpiest plans.

Perhaps aware of the embarrassing implications of these loopholes, the Obama administration made an election eve announcement that there would be limits on the ability of firms to exploit them going forward. On Election Day, a Treasury Department notice alerted employers that any health plans not already finalized will have to cover hospitalization and doctor services—but not other benefits that are required of small-employer plans and plans purchased by individuals.

The timing of these announcements suggests that the administration wanted absolutely no media attention for them. Who is going to pore over changes to Obamacare technicalities when exciting election results are coming in? There are two issues here that the administration doesn’t want discussed: Why does the law have a huge gaping loophole for the largest companies? And how is the Obama administration able (once again) to re-write the law without any act of Congress?

If you work for a self-insured company and have an above-average income, you probably don’t have much to worry about. Employers are going to provide higher-income employees reasonably good health insurance in the future, just as they have in the past. But if your income is below-average, you could end up with worse coverage than you had before." - Obamacare’s Gift to Big Business: The Largest Firms Can Offer the Skimpiest Health Plans, The Independent Institute, 11/25/2014

Link to the entire article appears below: