"Obamacare: Where's The Train Wreck?"
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Lots of untapped potential: Not even one-third of those eligible for ACA exchanges used them. "In their first year, the Affordable Care Act's insurance exchanges signed up 28 percent of the people eligible to use them — mainly people who don't get health benefits from their jobs or from a government program like Medicare or Medicaid — according to an analysis by the Henry J. Kaiser Family Foundation. And there was a lot of variation among the states....Using data from the Census Bureau and the Department of Health and Human Services, the Kaiser Family Foundation estimates 28.6 million U.S. residents are eligible to buy health insurance via an exchange, compared to the 8 million who did." Jeffrey Young in The Huffington Post.
The new challenges in year two of Obamacare enrollment... "The first year of enrollment under the federal health care law was marred by the troubled start of HealthCare.gov, rampant confusion among consumers and a steep learning curve for insurers and government officials alike. But insurance executives and managers of the online marketplaces are already girding for the coming open enrollment period....One challenge facing consumers will be wide swings in prices....At the same time, the Obama administration is expected to try to persuade about five million more people to sign up while also trying to ensure that eight million people who now have coverage renew for another year." Reed Abelson in The New York Times.
Obamacare is big business for hospitals. "In the 27 states that have accepted the Medicaid expansion, hospitals' profits are climbing while more patients are getting access to care....But in states that haven't signed on to the expansion, hospitals are in a bind — they're getting the bad parts of Obamacare without the good. All hospitals agreed to take payment cuts as part of the law, on the theory that an influx of new patients would make up for those losses. In states that haven't expanded Medicaid, that influx isn't happening. The discrepancy...helps explain why hospitals are at the front lines of the debate over Medicaid. While states' decisions about whether to expand are largely political, millions of dollars are also at stake for the health care industry." Sam Baker in National Journal.
More generally, next year, even more employees will take on high-deductible insurance. "And at a rising share of large companies, it will be the only option remaining....Just as employers replaced pensions with retirement savings plans, more large companies appear to be in a similar cost-sharing shift with health plans. Besides making workers responsible for more of their care, employers hope these plans will motivate employees to comparison-shop for medical services — an admirable goal but one that some say is hard to achieve....Next year, nearly a third of large employers will offer only high-deductible plans — up from 22 percent in 2014 and 10 percent in 2010." Tara Siegel Bernard in The New York Times.
Is Massachusetts's grand experiment to rein in health costs working? "Massachusetts is running the country's most aggressive experiment in controlling health-care costs — and the first year results suggest it could be working. Two years ago, Massachusetts set what seemed like an ambitious goal: it would be the first state in the entire country that would put a firm cap on health-care spending. By 2017, the state planned to have health-care costs grow slower than the rest of the economy — something that never happens anywhere in the United States. Massachusetts' budget cap kicked in last year and, earlier this morning, the state reported a victory: it stayed within the 2013 growth limits." Sarah Kliff in Vox.
Other health care reads:
Putting the teeth in health care reform — literally. Ann Doss Helms in Kaiser Health News and the Charlotte Observer.
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