How Well is Obamacare Working?

The Hill: “ObamaCare left 2015 in a stronger position than it began, though the threats of rising premiums, skittish insurers and challenges from Washington loom for the president’s signature health law during his final year in office.”

“So how well is ObamaCare actually working?

“’We’re through the risk of ‘Oh my goodness, it might not work,’  said Bob Kocher, a former Obama White House adviser on health reform. ‘I think we’re now in the figuring out how to make it work well mode.’”

“’The risk of the law collapsing is very slim if not non-existent,’ Levitt said. ‘Enrollment is still growing, the risk pool is likely improving. At this point, the law seems perfectly sustainable.’”

“Still, it appears unlikely that the sign-up numbers will approach what the Congressional Budget Office projected they would be: as many as 20 million enrollees in 2016. Defenders say that’s partly because fewer employers are dropping coverage and pushing people into ObamaCare.”

LA Times: “Customers are shifting their attention from premiums to deductibles and co-pays, and insurers are testing new cost-sharing designs.”

“‘Consumers haven’t been used to shopping’ for the most cost-effective plans, says Tim McBride, a healthcare economist at Washington University in St. Louis … Insurers are experimenting with how to make deductibles and co-pays more effective in keeping costs down.”

2015’s Anti-Abortion Laws, Mapped

Vox: “States have enacted an unprecedented number of anti-abortion laws in the past five years, and 2015 continued that trend. According to a new report from the Center for Reproductive Rights, state lawmakers proposed nearly 400 bills restricting abortion in 2015, and 47 of those bills were enacted. Some of those 47 bills contained more than one restriction, and the Guttmacher Institute estimates that a total of 57 new abortion restrictions became law. Arkansas passed six new anti-abortion laws, the most of any state in 2015.”

“Five states enacted or extended waiting periods, which typically require a woman to make two trips to the doctor in order to get an abortion.”

Screen Shot 2016-01-03 at 8.21.25 PM

“This was a new one for 2015, and a potentially dangerous trend for abortion access: Kansas and Oklahoma banned the most common and safest form of second-trimester abortion, dilation and extraction (D&E). This could effectively eliminate second-trimester abortion in those states, or make it more complicated to perform.”

iScreen Shot 2016-01-03 at 8.21.33 PM


Big Surge in Obamacare Enrollment

L.A. Times: “A big surge of consumers this fall is pushing up enrollment in health coverage offered through the Affordable Care Act, providing an unexpected boost to insurance marketplaces created by the law, according to new data from the federal government.”

“Through this week, nearly 6 million people have selected health plans for 2016 through”

“The strong demand for Obamacare coverage in the law’s third enrollment period may further solidify the markets, which are still evolving as insurance companies and consumers continue to adapt to the new healthcare environment.”

“Polls and other surveys indicate some 17 million previously uninsured Americans have gotten coverage through marketplaces, Medicaid and other sources.”

“Thus far, 2.4 million of the nearly 6 million enrollees have been new to the marketplace, more than a third more than signed up at this point last year, according to HHS officials.”

Obamacare Sign-ups Surge Due to ‘Unprecedented Demand’

The Hill: More than 1.3 million people signed up for ObamaCare plans in the week leading up to a key December deadline, a demand that federal health officials have called “unprecedented.”

Nearly 40 percent of those who signed up are new customers, a sign that uninsured people have paid attention to the Dec. 15 deadline to get insurance and avoid a penalty next year.

The 1.3 million figure reflects data from Dec. 12. That means the busiest days of traffic were not counted in the tally.

The early enrollment figures are far above the administration’s goal of adding 900,000 new customers for the entire signup season, which lasts through Jan 31.

A Jump in Obamacare Premiums Projected for 2016

USA Today: “Consumers buying health insurance through federal and state exchanges will see their monthly premiums for the popular silver-level plans jump by an average of more than 11%, while also likely facing higher deductibles, a new analysis of exchange data by the Robert Wood Johnson Foundation shows.”

“These increases will hike the cost of health insurance especially for customers who don’t receive federal subsidies to buy insurance, which may also limit the number of people insured under the Affordable Care Act. Average health insurance premiums for silver plans rose to nearly $300 a month for a 27 year old male, while deductibles were up 8%.”

“These increases will hike the cost of health insurance especially for customers who don’t receive federal subsidies to buy insurance, which may also limit the number of people insured under the Affordable Care Act. Although the 7.5% average premium increase for the benchmark plan was higher than the 5% increase in 2015, the Department of Health and Human Services said in an October report that ‘this rate increase is relatively modest compared to those in the individual market before the Affordable Care Act, when consumers in the individual market regularly experienced double-digit rate increases on average.'”

The Reason Behind the Obamacare Premium Increases

Sarah Kliff in Vox: “Insurance markets are complicated. But the story of Obamacare’s 2016 premium increase is actually pretty simple: Many health plans — even those with decades of experience selling insurance — underestimated how sick health law enrollees would be.”

“This meant that in 2014, many insurers spent more paying out medical bills than members paid in premiums. Premera Blue Cross Blue Shield of Alaska lost $9 million covering just under 8,000 Obamacare enrollees that year. In Colorado, Rocky Mountain HMO found medical bills to be about 36 percent higher than premiums.”

“Now insurers are raising their rates to make sure premiums do cover claims. In some states, that means double-digit rate hikes.”

Screen Shot 2015-12-15 at 9.54.42 AM

“Insurance plans are likely going to watch 2016 to see whether enrollment continues to increase, which would be a sign of healthier consumers entering the market after sitting out earlier sign-up periods.”

“‘Enrollment has to grow to make the market attractive,’ Kaiser’s Levitt says. ‘If it plateaus, some might think twice about participating.'”

Kentuckians: Luke Warm on Obamacare, But Like Medicaid Expansion

According to the Kaiser Family Foundation 12/11/15 newsletter, A Kaiser Family Foundation poll of Kentucky residents finds that a strong majority opposes scaling back the state’s Medicaid expansion to cover fewer people as new Gov. Matt Bevin proposed.

About seven in ten Kentuckians (72%) say they would prefer to keep the state’s Medicaid expansion as it is today rather than change it to cover fewer people. A much smaller share (20%) say they would prefer to scale back the expansion to cover fewer people.

Taken before Gov. Bevin’s inauguration on Tuesday, the poll finds Republicans in the state are more divided about the Medicaid expansion, but a majority (54%) favors keeping it over changes that would reduce the number of people with coverage. Among those who say they voted for Gov. Bevin on Nov. 3, somewhat fewer (43%) support the Medicaid program as it exists, while half (50%) say they want it scaled back to cover fewer people.

“Kentuckians don’t particularly like the Affordable Care Act, but they do like their state’s Medicaid expansion and marketplace, and most want to keep them,” Foundation CEO and President Drew Altman said. “The findings in a red state may show other governors considering expansion that it could be equally popular with their state’s residents, and illustrate to Republicans in Washington how difficult it may be to take away health coverage from people who have it.”

Screen Shot 2015-12-11 at 10.04.56 AM

Obamacare on Track to Beat 2015 Enrollment Goal

The Hill: “ObamaCare officials are on a path to beat this year’s enrollment goal just about halfway through the current sign-up season.”

“More than 1 million new customers — and 2.8 million people overall — have signed up for ObamaCare in the first six weeks of the new enrollment period, according to data from the Centers for Medicare and Medicaid Services (CMS) released Wednesday.”

“While not all of the people who signed up will ultimately pay their premiums and become enrolled, it’s a strong sign that the administration will reach, if not outpace, its goal of adding 900,000 new customers to the marketplace this year.”

Average Obamacare Penalty to Rise by 47% in 2016

Kaiser Family Foundation 12/9/15 Newsletter: “A new analysis from the Kaiser Family Foundation finds that among uninsured people who are eligible for an Affordable Care Act marketplace plan, the average penalty for remaining without coverage in 2016 would be $969 per household – 47 percent higher than the 2015 estimated average of $661.”

Screen Shot 2015-12-09 at 8.25.12 PM

“The new analysis finds a bronze plan would cost $0 in premiums or less money than the individual mandate penalty for about 3.5 million uninsured people eligible for ACA marketplace plans, due to premium subsidies. The subsidies are available to low- and middle-income households to defray the costs of premiums in ACA marketplaces.”

Will Obamacare Really Kill Jobs?

Fiscal Times: “The Congressional Budget Office released a new working paper this week predicting that the Affordable Care Act will have a negative effect on the size of the U.S. labor supply over the coming decade.”

“Republican foes of Obamacare and some news organizations seized on the CBO report as evidence that the controversial health care law would eliminate or ‘kill’ 2 million jobs by 2025.”

“But the CBO isn’t looking specifically at job loss. It’s making projections about aggregate hours worked and the total number of workers who choose to stay in the workforce: ‘The labor force is projected to be about 2 million full-time-equivalent workers smaller in 2025 under the ACA than it would have been otherwise,’ the agency wrote. That is, fewer work hours will be logged and paid for, the rough equivalent of 2 million jobs. But those two things — reduced hours across the economy and total jobs — are different things. And it’s important to note that the reduction in hours worked is relative to the number of hours that would have been worked in the absence of the law; in either case, total work hours continue to grow into 2025, it’s just a matter of by how much.”

The Biggest Killer of Them All? Fossil Fuels.

Quartz: “Global warming will affect billions of lives in the future. But, by one estimate, our love for fossil fuels may already be responsible for more deaths than those caused by wars, murders, and traffic accidents combined.”

“These figures come from the 2012 Climate Vulnerability Monitor. In 2010, some 4.5 million deaths could be attributed to air pollution, because of the production of carbon particles and nitrogen oxides. Another 500,000 deaths that year could be attributed to changes in climate, which lead to extreme weather events, flare ups in infectious diseases, and other disastrous phenomena.”

How Will the Newly Insured Vote?

Drew Altman asks: “How will the newly insured behave at the ballot box? Will they vote? Will they become a Democratic constituency? The ACA may be an issue in the 2016 elections, but the newly insured are unlikely to become an important electoral factor themselves.”

“One potential indicator of future behavior is how the newly insured behaved politically when they didn’t have health coverage … While the uninsured shade Democratic as a group, they are a reasonably heterogeneous … The largest share of uninsured independents describe themselves as not leaning Republican or Democratic. These uninsured independents are the most likely to be disengaged from the political process.”

“Surveys have found that most of the previously uninsured like their coverage–a Kaiser Family Foundation poll found that 76% do–but it’s not known whether appreciation for that coverage will be a factor when they vote or if they will vote in significant numbers. It is a fair bet that in the short term the newly insured will behave politically much like the uninsured have: Many will not vote, and they will continue to represent a very small slice of the electorate.”