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Monday, March 17, 2014

Obamacare: Here To Stay



TED Talk on the transformation of healthcare from "medical intervention model" to health maintenance:

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Obama says enrollment is high enough to ensure his health law's survival. "President Obama said Friday he was confident enough Americans had enrolled under the Affordable Care Act to make the program 'stable.' In an interview with WebMD, Obama said the fact that 4.2 million people have already signed up for plans under federal and state marketplaces mean enough companies will be invested to stay in the system.... Obama noted, however, that the larger question is whether the risk pool is diverse enough to ensure premiums don't skyrocket, since "the more you can spread the risk with more people, the better deal you're going to get"...Even as he touted the virtues of the law, Obama acknowledged that some previously-uninsured Americans may not be able to see the providers they want if they were focused on keeping costs down." Juliet Eilperin in The Washington Post.


And some experts seem to agree with Obama that enough have enrolled. "Health benefits consultants agree with President Obama's assessment this week that enough Americans have signed up to private health plans under the Affordable Care Act that it will work even though there could be up to two million fewer Americans covered than the White House had hoped....Health benefits consultants said there is reason to worry about whether enough younger Americans have signed up due to the website issues early on that may have hurt enrollment. In addition, slow signups in certain states that have continued to have more technical issues, such as Oregon, could trigger health plans to sustain greater losses and consider pulling out of the program, benefits consultants said....So far, however, health insurance companies have said the enrollment is trending younger and there have been few surprises that would require them to pull out of the program."Bruce Japsen in Forbes.

Explainer: This is Obama's explanation for why you might not get to keep your doctor. Jason Millman in The Washington Post.

And then the White House announced that it would seek to expand Obamacare health plans in 2015. "Health plans selling on the federal marketplaces in 2015 must include 30 percent of area 'essential community providers,' which are usually health centers and other hospitals serving mostly low-income patients. That's up from a 20 percent requirement in 2014, the first year of expanded overage under the health care law. The federal Centers for Medicare and Medicaid Services, which oversees the marketplaces, will also take a much more active role in reviewing health plan networks. CMS, which outlined the new standards in a Friday night letter to insurers, will evaluate whether the plans include enough access to hospitals, primary care doctors, mental health providers and oncologists. The updated standards came after a Friday interview in which President Barack Obama acknowledged that pressure to keep down costs could mean consumers may not have access to their choice of doctor." Jason Millman in The Washington Post.

Administration making full-court press with March Madness-themed outreach. "The White House will court basketball fans in a March Madness-themed campaign to increase ObamaCare enrollment ahead of a March 31st deadline. The administration on Monday will release its '16 Sweetest Reasons to Get Covered' bracket listing the top reasons to get health insurance, according to a White House official. Each day, the bracket will be updated based on votes from online users." Kyle Balluck in The Hill.

Video: Speaking of basketball, LeBron helps out with Team Obama's full-court press for Obamacare.

So are some celebrity moms. Dylan Scott in Talking Points Memo.

MILBANK: Why millennials are abandoning Obama on health care. "Young voters, after playing a big role in the campaign, became little more than an e-mail list for the White House and Obama's Organizing for Action group. Then came health-care reform. The millennials, very liberal overall, saw Obama's plan as too timid; they were disillusioned by his failure to fight for the 'public option' of government-run health plans. This cost Obama the young activists he would need to rally enrollment in Obamacare. Polling by the nonpartisan Pew Research Center found that, while the generation looks more favorably on big-government solutions than do older generations, the millennials disapprove of Obamacare in the same proportion as the rest of the population. Even if Obama had worked harder to keep his youth army engaged, it's not entirely clear that the effort would have succeeded. As a group, the generation's attachment is fickle." Dana Milbank in The Washington Post.

COHN: Should Democrats come out swinging on Obamacare? "The Democrats' loss in this week's special congressional election probably wasn't a referendum on Obamacare. But, at the moment, the law still looks seems more like a political liability than an asset. And with Republicans making Obamacare the focus of their midterm strategy, many Democrats have been responding with a mixed message: Acknowledge the Affordable Care Act has flaws, but vow to fix them rather than repeal the whole program. That seems to be roughly consistent with polls, which suggest the majority of Americans don't like the health care law but the majority also don't want to get rid of it. But nuanced messages have problems, even if the nuances reflect public sentiments. A politician who starts with backpedaling ("Yes, the law has problems, but...") is bound to sound weak. And weak politicians don't generally make attractive candidates." Jonathan Cohn in The New Republic.

SCHUCK: Obamacare's market problem. "Parts of the ACA such as the exchanges wisely seek to exploit some of the market's advantages in providing choice and efficiency. But other parts of the program -- including costly mandates for insurance benefits for which even subsidized consumers are unwilling to pay -- seem to ignore those advantages. The program's effectiveness requires striking the right balance between markets and mandates. The ACA's herky-jerky implementation suggests that Washington has not yet gotten it right." Peter Schuck in The Huffington Post
BLOOMBERG VIEW: Don't ruin Obamacare to pay for 'doc fix.' Here's a better way. "The estimated cost to make this change is $138 billion over 10 years. That's a lot of money, but it could be drawn from other Medicare spending on health-care providers, doctors among them. This is not a radical idea; various bipartisan deficit-reduction proposals put forward since 2010 have recommended such measures. Among their good suggestions are using Medicare's buying power to get better rebates from drug makers, ending overpayments to hospitals for training doctors, making it harder for doctors to refer patients to their own businesses, and reducing Medicare's reimbursements to hospitals to cover unpaid deductibles and copayments. These aren't the only possibilities....Of course, cutting some types of Medicare payments to increase others won't win friends in the health-care industry. But Congress's more important and lasting priority must be to curb the long-term growth of health-care spending. Getting started now will easily make it possible to manage a permanent doc fix." The Editors.



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