Obamacare may increase emergency room use

Expanded health insurance coverage for poor people may place a bigger burden on hospital emergency rooms--

"... The study’s authors report that in 2008, Oregon initiated a limited expansion of a Medicaid program for uninsured, low-income adults, drawing names from a waiting list by lottery. According to the report, “This lottery created a rare opportunity to study the effects of Medicaid coverage using a randomized controlled design. Using the randomization provided by the lottery and emergency-department records from Portland-area hospitals, we study the emergency-department use of about 25,000 lottery participants over approximately 18 months after the lottery. “We find that Medicaid coverage significantly increases overall emergency use by 0.41 visits per person, or 40 percent relative to an average of 1.02 visits per person in the control group. We find increases in emergency-department visits across a broad range of types of visits, conditions, and subgroups, including increases in visits for conditions that may be most readily treatable in primary care settings.” The New York Times reports that the study contradicts what President Obama said during a town hall meeting in Albuquerque in 2009..." source: ACA may increase emergency room use - South Florida Business Journal

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Obamacare blew it on health cost transparency

Another way Obamacare blew it -- no transparency on health care providers' charges --

How much for a new hip or knee? Depends on the hospital - Miami-Dade - MiamiHerald.com: ". . . .“We don’t fully understand the reasons,” she said. “But we want people to know that, when they go to the hospital for something, there may be another hospital two miles away that charges significantly less. We hope [the new data] gives folks the information they need to do some selective shopping.” Jackson Memorial and the University of Miami Hospital are much less than two miles apart — they’re right across from each other along Northwest 12th Avenue — but they charge far different prices for the same procedures. Jackson’s average cost for a pacemaker implant was $127,000, about twice as much as the $66,000 that UM Hospital charged. Treatment for pneumonia cost about $32,000 at Jackson — and $60,000 at UM. Similar cost discrepancies are apparent throughout South Florida and the rest of the country. . . ."

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Big Talker Obama Lied -- Millions of People Are Losing Their Insurance Under Obamacare

Yes, People Are Losing Their Insurance Under Obamacare - Businessweek: "How big a deal is this? Politically, it’s awful for Obama. The promise to let people keep their doctors and health plans was one of his biggest talking points when he sold the health law to Americans. The line underplayed how Obamacare’s many moving parts would affect the health insurance market, with some unforeseen consequences for consumers. People are getting letters from their insurance companies saying their old plan is ending just as the healthcare.gov marketplace, where they theoretically could shop for new plans, is limping along. The situation angers and confuses ordinary consumers . . . ."

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Millions Of Consumers Get Health Insurance Cancellation Notices

Obamacare causing massive cancellation of Health Insurance Policies nationwide -- Obama lied when he promised you would be able to keep your current policy --

Thousands Of Consumers Get Insurance Cancellation Notices Due To Health Law Changes - Kaiser Health News: "Florida Blue, for example, is terminating about 300,000 policies, about 80 percent of its individual policies in the state. Kaiser Permanente in California has sent notices to 160,000 people – about half of its individual business in the state.  Insurer Highmark in Pittsburgh is dropping about 20 percent of its individual market customers, while Independence Blue Cross, the major insurer in Philadelphia, is dropping about 45 percent.. . .." (read more at link above)

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Dental Care, Startup, Obamacare, Gaps

A Dental Care Startup Sees Profit in Obamacare's Gaps - Businessweek: "The Affordable Care Act is expected to bring millions of Americans into the health-care system, increasing market opportunity for industry incumbents and startups alike. Less heralded is the business potential from individuals who slip through Obamacare’s gaps. A startup called Brighter, which helps people without dental insurance get better prices from dentists, sees itself in the latter category. Noting that Obamacare isn’t likely to improve access for the more than 135 million Americans who lack dental coverage (PDF), it aims to do what traditional insurers do: use economies of scale to negotiate better prices for them. As of today, Brighter Chief Executive Officer Jake Winebaum says that patients who use his company’s platform to book appointments with 350 participating Los Angeles dentists will pay, on average, 53 percent less than standard out-of-pocket costs. The Santa Monica (Calif.)-based company, which has raised $15 million in venture capital, plans to profit by charging dentists to access uninsured patients. . . ." (read more at link above)

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Trader Joe's, Part-Time Workers, Obamacare

Trader Joe's To Drop Health Coverage For Part-Time Workers Under Obamacare: Memo: "While the stakes for workers aren't clear, the benefits to Trader Joe's under the new arrangement are obvious. The implementation of Obamacare provides an opportune moment for the company to get in line with less generous competitors, and the savings the company finds in dropping coverage for part-timers will almost certainly outstrip the $500 it will give employees to defray what they end up paying on the exchanges."

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Obamacare Limit on Consumer Costs Delayed

The Obama administration has put off another provision — on deductibles and co-payments — until 2015 --

A Limit on Consumer Costs Is Delayed in Health Care Law - NYTimes.com: " . . . . For people with serious illnesses like cancer and multiple sclerosis, Ms. Weinberg said, out-of-pocket costs can total tens of thousands of dollars a year . . . In promoting his health care plan in 2009, Mr. Obama cited the limit on out-of-pocket costs as one of its chief virtues. “We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick,” Mr. Obama told a joint session of Congress in September 2009.

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ObamaCare and Dysfunctional Healthcare

Jenkins: The Young Won't Buy ObamaCare - WSJ.com: "Independent websites like Edmunds.com, AutoTrader.com and Kelley Blue Book publish detailed pricing information for consumers and do so for free. Why? The answer is obvious. Consumers want such information and businesses see opportunity in providing it, even for free, in order to attract eyeballs for advertising. Such information doesn't exist in health care because consumers don't demand it, because somebody else is almost always paying for our health care. Those of us who aren't subsidized directly by Medicaid, Medicare and the Veterans Administration are subsidized through the tax code to channel all our aches and pains through a third-party payment mill, disguised as employer-provided "insurance." Not being able to analyze "why" also leads to all kinds of anomalous conclusions." (read more at link above)

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Why a Health Insurance Penalty May Make Sense

Obamacare unintended consequences--

Why a Health Insurance Penalty May Look Tempting - NYTimes.com: "Once new health insurance exchanges are up and running in October, companies with 50 or more full-time employees will face a choice: Provide affordable care to all full-time employees, or pay a penalty. But that penalty is only $2,000 a person, excluding the first 30 employees. With an employer’s contribution to family health coverage now averaging $11,429 a year, taking that penalty would seem to yield big savings."

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Obamacare: Health Insurance questions for the IRS

6 new IRS questions for 2014 - Diana Furchtgott-Roth - MarketWatch: "The recent Internal Revenue Service scandal — career officials deliberately delaying applications of certain organizations for tax-exempt status, and the IRS commissioner and acting commissioner are accused of lying to Congress about the matter — suggests that the agency should be smaller, rather than larger. But the IRS is about to balloon to accommodate new responsibilities under the Affordable Care Act. . . . What qualifies as health insurance? . . .Who has to pay the penalty, and how much? . . ." (read more at link above)

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Obamacare: better figure out if you’re self-employed

Employed, self-employed--it makes a difference in tax and other consequences--

6 new IRS questions for 2014 - MarketWatch: "The IRS has been spending a lot of time recently deciding whether workers are independent contractors — self-employed — or employees of a business. Under the ACA, the self-employed who purchase health insurance on the exchange will have an advantage in paying for premiums, because the premiums can be paid out of pre-tax income. Someone who works for a firm which does not offer health insurance, and who earns above 400% of the poverty line, will have to buy insurance on the exchange. The IRS calculates that annual premiums for the cheapest family plan will be $20,000 for a family of five in 2016. If you’re self-employed, you can deduct the $20,000 from income before you pay taxes. Otherwise, premiums are nondeductible. Depending on income level and federal and state and local tax rates, premiums could cost as much as $40,000 in pre-tax income." (read more at link above)

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ObamaCare Nightmare?

Review & Outlook: ObamaCare's 'Baby Elephant' - WSJ.com: " . . .. Some Republicans are folding apparently because trying to stop ObamaCare is too hard. Though he "never liked the Affordable Care Act," said Governor Brian Sandoval, "I am forced to accept it as today's reality and I have decided to expand Nevada's Medicaid coverage." Now there's a statement of vaulting political ambition. The reality is that ObamaCare remains deeply unpopular with the public and it will only get worse next year when individuals and small businesses are forced to buy coverage that is 20% or 30% more expensive than what they have. Some younger people will see premium shocks as high as 150% or 200%. HHS will manage the exchanges in 32 states starting in October but has released only 19 pages of regulatory guidance. ObamaCare is so convoluted, and HHS so incompetent, that the entitlement may explode on the launchpad. Why any Governor would climb on to this ship is a political mystery, but then they have their bad reasons."


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Obamacare - Employers Must Offer (Unaffordable) Family Health Care

Employers Must Offer Family Health Care, Affordable or Not, Administration Says - NYTimes.com: "In a long-awaited interpretation of the new health care law, the Obama administration said Monday that employers must offer health insurance to employees and their children, but will not be subject to any penalties if family coverage is unaffordable to workers. Related Times Topic: Health Care Reform The requirement for employers to provide health benefits to employees is a cornerstone of the new law, but the new rules proposed by the Internal Revenue Service said that employers’ obligation was to provide affordable insurance to cover their full-time employees. The rules offer no guarantee of affordable insurance for a worker’s children or spouse. To avoid a possible tax penalty, the government said, employers with 50 or more full-time employees must offer affordable coverage to those employees. But, it said, the meaning of “affordable” depends entirely on the cost of individual coverage for the employee, what the worker would pay for “self-only coverage.”"


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Judge grants company injunction against health-care law contraception efforts

Judge grants company injunction against health-care law contraception efforts
Washington Post
A federal judge on Friday temporarily prevented the Obama administration from forcing a Christian publishing company to provide its employees with certain contraceptives under the new health-care law. . . .

Health Care REITs Should Provide Durable Income in 2013
Forbes
The four healthcare REITs all offer unique operating platforms and the common thread is that they all should capitalize on the attractive tailwinds of low interest rates and the new certainty of the Affordable Care Act. Source: SNL Financial · Brad ...

Forbes

Health care and the fiscal cliff
Philadelphia Inquirer (blog)
Wharton Health Care Management Professor Jonathan Kolstad said that while there are health-care issues in resolving the immediate problem of the fiscal cliff, the long-term problem of deciding how the nation pays for health care extends beyond the Nov. 6 election and the Jan. 2 deadline. . . . .

Health care -- another victim of Sandy for Staten Islanders
SILive.com
doctors19.jpg Dr. M. Fawzy Saleem in his office at 1975 Hylan Blvd. with patient records that were ruined by the flood waters from Hurricane Sandy. Staten Island Advance/Irving Silverstein. STATEN ISLAND, N.Y. - The focus in Hurricane Sandy's deadly ...

SILive.com

Remaking Health Care: Change the Way Providers Are Paid
Wall Street Journal
And if we just get 20% of it, which is a 6% change in health-care costs, we pay for the Affordable Care Act. Enlarge Image. image. Close. image. What happens in our system is if you get paid by a unit of service, you do more units of service. Our ...

Wall Street Journal

Health care law brings double dose of trouble for CCAC part-time profs
Pittsburgh Post Gazette
To Community College of Allegheny County's president, Alex Johnson, cutting hours for some 400 temporary part-time workers to avoid providing health insurance coverage for them under the impending Affordable Health Care Act is purely a cost-saving ...

What States Should Build Instead of Obamacare's Health Insurance Exchanges
Forbes
In the aftermath of President Obama's re-election, in which the implementation of the Affordable Care Act plays a large role, many states are facing an important decision. Should these states act as agents of the ... Exchanges were conceived by ...

Missouri's Voters: Working for the Health Insurance Companies
By J. Bradford DeLong
Missouri State of Mind: Missouri voters have apparently approved a ballot measure prohibiting the governor from using an executive order to authorize the creation of a Missouri health insurance exchange under the Affordable Care Act.
Brad DeLong

Cochrane on Health Care | EconTalk | Library of Economics and ...
"Economic Research on Direct-Purchase Health Insurance: New Models for Real Health Care Reform", by Linda Gorman. Library of Economics ... What we might do with health care if we eliminated not just the Affordable Care Act (ACA), known as Obamacare, but many of the restrictions that the government places on the health care market. The paper is so good I ... We assume that the only way these days you can get health care is if you have health insurance. People say: We need ...
EconTalk

No help anytime soon for poor without health insurance | Online ...
By Lee Shearer
Deal announced Friday that the state won't create a health insurance exchange, another part of thehealth care reform act. Instead, Georgians will have to participate in a planned national health exchange. The health exchanges are supposed ...
Local News

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