Major New Study On Obamacare Premiums Should End The 'Rate Shock' Hysteria Once And For All | ThinkProgress

 

The most comprehensive study on Obamacare to date finds that Americans’ insurance premiums under the health law will be “lower than expected.” Many Americans will pay even less than the top-line rates after factoring in government subsidies for their health coverage, with some paying nothing at all for crucial medical coverage.

The Kaiser Family Foundation (KFF) looked at individual policy prices in the 17 states, plus the District of Columbia, that have released comprehensive numbers for their Obamacare insurance marketplaces. Since premiums under the law will vary based on factors such as age and geographic location, KFF chose to examine how much the second-least expensive “Silver” mid-level plan and the least-expensive bare-bones “Bronze” level plan would cost for 25-year-old, 40-year-old, and 60-year-old Americans in those 17 states’ largest cities. The report includes both the top-line prices for those demographics, as well as what their costs would be after factoring in government subsidies based on varying income levels.

According to KFF’s findings, a single 40-year-old in Los Angeles could buy the second-cheapest mid-level plan for $255 per month — but if that person makes just under $30,000 per year, he or she will only have to pay $193 per month after receiving a government subsidy.

Strikingly, in every city analyzed, a family of four with two 40-year-old adults and a household income of $60,000 per year would pay $409 per month for the second-cheapest Silver plan after receiving subsidies. That’s more or less in line with the average $4,565 per year that workers currently contribute towards their employer-sponsored health insurance plans.

The report also finds good news for younger and older Americans. In Seattle, a 25-year-old making $28,725 per year will pay $193 per month for a Silver plan after subsidies and $138 per month for the cheapest Bronze plan after subsidies. For a single 60-year-old with the same income, those number would be $193 per month and $44 per month, respectively, after factoring in subsidies. And in Burlington, Vermont, both a single 25-year-old making $25,000 per year and a 60-year-old couple making a combined $30,000 per year would pay nothing at all for the cheapest, bare-bones Bronze plan.

While the KFF researchers emphasized that there will be significant variation in Obamacare premiums depending on geographic location, they concluded that premiums would be lower than what the government expected, writing, “the latest projections from the Congressional Budget Office imply that the premium for a 40-year-old in the second lowest cost silver plan would average $320 per month nationally. Fifteen of the eighteen rating areas we examined have premiums below this level, suggesting that the cost of coverage for consumers and the federal budgetary cost for tax credits will be lower than anticipated.”

Major New Study On Obamacare Premiums Should End The 'Rate Shock' Hysteria Once And For All | ThinkProgress

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Doctors and Their Medicare Patients - NYTimes.com

In the critics’ most dire scenarios, baby boomers nearing retirement age could find that their current doctors are no longer willing to treat them under Medicare and that other doctors are turning them down as well. Those concerns have always been greatly exaggerated. Now a new analysis by experts at the Department of Health and Human Services should demolish that mythology for good.
The analysts looked at seven years of federal survey data and found that doctors are not fleeing Medicare in droves; in fact, the percentage of doctors accepting new Medicare patients actually rose to 90.7 percent in 2012 from 87.9 percent in 2005. They are not shunning Medicare patients for better-paying private patients, either; the percentage of doctors accepting new Medicare patients in recent years was slightly higher than the percentage accepting new privately insured patients.
Medicare patients had comparable or better access to medical services than the access reported by privately insured individuals ages 50 to 64, who are just below the age for Medicare eligibility. Surveys sponsored by the Medicare Payment Advisory Commission, an independent agency that advises Congress, found that 77 percent of the Medicare patients — compared with only 72 percent of privately insured patients — said they never had an unreasonably long wait for a routine doctor’s appointment last year.
The findings from this survey and others can be sliced and diced in many ways. But the overall picture is clear: nationwide there is no shortage of doctors for Medicare patients. It is likely to stay that way, because Medicare is a big insurer that few medical practices can afford to ignore.

Doctors and Their Medicare Patients - NYTimes.com

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Obamacare Showdown Over a Ham Breakfast in Kentucky - NationalJournal.com

 

Beshear's advocacy, by contrast, was striking in its intensity and in how personally he approached the issue, picking up on the idea that many people who don't have health insurance are embarrassed by that and don't talk about it.

The governor compared health insurance to "the safety net of crop insurance" and said farmers need both. He said 640,000 Kentuckians—15 percent of the state—don't have health insurance and "trust me, you know many of those 640,000 people. You're friends with them. You're probably related to them. Some may be your sons and daughters. You go to church with them. Shop with them. Help them harvest their fields. Sit in the stands with them as you watch your kids play football or basketball or ride a horse in competition. Heck, you may even be one of them."

Beshear went on to say that "it's no fun" hoping and praying you don't get sick, or choosing whether to pay for food or medicine. He also said Kentucky is at or near the top of the charts on bad-health indicators, including heart disease, diabetes, cancer deaths, and preventable hospitalizations. He said all that affects everything from productivity and school attendance to health costs and the state's image.

"We've ranked that bad for a long, long time," he said. "The Affordable Care Act is our historic opportunity to address this weakness and to change the course of the future of the commonwealth. We're going to make insurance available for the very first time in our history to every single citizen of the commonwealth of Kentucky."

About half the audience burst into applause at that point while the other half sat on their hands. But he wasn't done. He cited a study that showed the law would inject about $15.6 billion into the Kentucky economy over eight years, create 17,000 new jobs, and generate $802 million for the state budget.

"It's amazing to me how people who are pouring time and money and energy into trying to repeal the Affordable Care Act sure haven't put that kind of energy into trying to improve the health of Kentuckians. And think of the decades that they have had to make some kind of difference," Beshear finished pointedly.

Obamacare Showdown Over a Ham Breakfast in Kentucky - NationalJournal.com

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Health costs are growing really slowly. Americans haven’t noticed.

Health costs are growing really slowly. Americans haven’t noticed.

Ask any health economist and they’ll no doubt tell you that health care cost growth is slowing, growing at a low, unprecedented rate.

They can point to the National Health Expenditures report, which shows health care costs now growing at the same rate as the rest of the economy. Or, they can pull up new data out Tuesday from the Kaiser Family Foundation, showing that premiums grew 4 percent in 2013. That’s way lower than growth in the late 1990s and early 2000s.

Ask any American about what direction health costs are moving, and you’ll likely get a completely different story. Preliminary results for a forthcoming Kaiser Family Foundation poll show that most Americans think that health care costs are actually growing faster than usual right now. Fewer than 10 percent say the growth is slowing down.

“We have a very moderate increase this year, but premiums go up each year,” Kaiser Family Foundation president Drew Altman says. “People see what they pay for their premium going up and perhaps more forms of cost-sharing. We’ve been seeing a quiet revolution from more comprehensive coverage to less.”

Altman said that preliminary results from his group’s survey show that 54 percent of Americans think health care costs are growing faster than average. “A tiny number said they were growing slower,” he says. “I think that’s because, if we look at this as a long term trend, health care costs have increased in excess of wages and inflation.”

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The Affordable Care Act And People With Disabilities - Forbes

 

“ACA changes the world for persons with disabilities and funds who will now have a choice between public or private health insurance. For significant financial as well as health reasons, we believe that private health insurance, not Medicaid, will be soup d’jour for the vast majority of (Special Needs Trusts) SNT clients. We cannot know for certain, but I would not be surprised to see persons with disabilities leaving public health insurance (Medicaid) for the private market in January, 2012.

The most obvious and most significant health industry reform important to our SNT clients is the elimination of pre‐existing conditions as a bar to purchasing private health insurance. However, ACA also eliminates annual or lifetime caps, rescission of insurance policies, non‐renewability, and higher premium costs for persons with pre‐existing conditions. For individuals with significant medical problems, elimination of cost‐containment ceilings is just as important as access to the door of private medical care. It is not unusual to see clients who have maxed out their lifetime cap and are now seeking public health insurance.

Why would clients opt to pay for private health insurance rather than “free” Medicaid? The two major reasons are first, securing health insurance without a payback on death and second, access to significantly better medical care…

Change makes most of us uncomfortable, but change is a constant in our lives. This is one time when special needs attorneys can both lament the negative impact of national legislation on our personal financial well‐being, but rejoice in the concomitant good fortune of our clients with disabilities who can now join the private health insurance market with the rest of us as equal citizens with their dignity intact.”

The Affordable Care Act And People With Disabilities - Forbes

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Engaging confidently on health care reform | Battleground Surveys

 

Republicans will run on health care reform in 2014 and 2016, so get used to it. But do not believe that it will give them a better chance of securing their seats or the best shot at putting competitive Democratic seats in danger.  Democrats in the most rural and the strongest Romney seats will have to be inventive as usual, but Democrats have a lot to say on health care: fix it, don’t repeal it, don’t put the insurance companies back in charge and take your hands off Medicare.

Health care is just not a wedge issue that threatens to change these races very much – as we saw in the 2012 elections where Republicans played out this strategy.  This is basically a 50-50 issue in the battleground districts and the country, and it remains a 50-50 issue after voters have heard all of their toughest attacks, including one on the role of the IRS in the new system.  These attacks have power, and it is important to engage on the issue.  But there is no reason to think the debate changes the dynamic in these competitive House seats: we actually show Democrat members gaining on handling health care reform in their own seats.

Why is it that the popularity of the Republican Congress keeps going down as the Republicans vote now 40 times to repeal the Affordable Care Act, despite that the law is not popular with the public?  We suspect because the House Republicans are associated with gridlock, extreme partisanship, and intense anti-Obama sentiment; because voters have other serious priorities and their steadfast focus on health care alone says Republicans are not focused on them and their issues; because Democrats are more trusted than Republicans on health care; and most important because voters do not want to repeal the law.  The more voters hear “repeal,” the less they are interested in voting Republican.

We know Republican base voters feel intensely about health care reform, but voters rank “government takeover of the health care system” pretty low as a concern about Democrats in Congress.

These results suggest Democrats should engage the issue with some confidence -- they can undermine the Republican attacks and indeed gain an advantage by educating the public on the reforms. 

Engaging confidently on health care reform | Battleground Surveys

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Special Deal by Haley Sweetland Edwards | The Washington Monthly

Another piece on the RUC. Follow the tags to learn more…

Over the past few years, a few well-placed health care figures from both parties have spoken out—at least once they’ve left office—about how crazy this system is. “The RUC is really just a giant cabal run by the AMA,” Thomas Scully, former head of the CMS under George W. Bush, told me. “A private trade association should not have that sort of control over the biggest spending account in the government. It’s an outrageous travesty of democracy.” Bruce Vladeck, former head of the CMS under Bill Clinton, agrees, calling the RUC “a significant part of the problem.”

There have also been scathing reports issued by the Government Accountability Office, and by MedPAC, the agency that advises Congress on Medicare-related issues, as well as some hard-hitting investigative reporting by the Wall Street Journal and the Center for Public Integrity. In 2011, a bipartisan panel participated in a Senate roundtable, during which three former heads of the CMS took turns lamenting the RUC.

Yet, for the most part, the RUC continues to operate exactly as it always has—behind the scenes, without anyone, including actual doctors laboring in the clinics and hospitals across the country, even really knowing about it. (This spring, Scully told me that he went to lunch with a very high-ranking official at the CMS who had no idea how the RUC actually worked.)

The Affordable Care Act, for its part, includes a few lines that could potentially, if incrementally, limit the RUC’s power. But in general, it doesn’t much change the way the reimbursement system works. Taking on the RUC would have “started a nuclear war with the AMA,” as Scully put it, and alienated other key political allies that the administration needed to pass the law to begin with. Fixing the RUC, however, is essential to fixing health care in this country.

Special Deal by Haley Sweetland Edwards | The Washington Monthly

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