Health

Obamacare: Americans Oppose it but Want it to Stay

Bloomberg: “Fifty-three percent of Americans oppose the law, even as the proportion of those saying it should be repealed has dropped to 32 percent, a Bloomberg National Poll shows.”

Americans’ views on the Affordable Care Act, a.k.a. Obamacare:

“Several of the Affordable Care Act’s provisions do enjoy modest to robust popularity. That suggests Republicans may also need to update their message from the calls for repeal in the 2010 and 2012 elections, if they want to appeal to voters beyond their party’s base.”

“Fifty-six percent favor keeping Obamacare with perhaps ‘small modifications,’ while 10 percent would leave it as is. That’s the highest level of acceptance yet in a Bloomberg poll.”

“Even among Republicans, the proportion of those who want to see the law abolished has dropped significantly. Only a modest majority — 56 percent — want repeal, down from 67 percent in a Bloomberg poll taken in July 2010.”

The High Cost of Insurance Before Obamacare

From 2008 to 2010, premiums grew by 10 percent or more per year, according to a new study by the Commonwealth Fund.

health insurance premiums

The Hill: “Critics of the Affordable Care Act have warned premiums will soar under the rules and regulations of the law. But until now there has been little data available with which to compare the premium increases.”

David Blumenthal, president of the Commonwealth Fund: “These findings provide a benchmark to compare future trends against to help determine if the Affordable Care Act is achieving one of its major goals and that is to provide comprehensive health insurance to nearly all Americans at a price they can afford.”

Insurers Scramble to Join Obamacare

The Hill: “A growing number of insurers say they intend to offer coverage on the ObamaCare exchanges next year.”

“Insurance plans in New Hampshire, Michigan and Illinois are planning to enter into the federal marketplaces after deciding not to participate during ObamaCare’s first enrollment period, according to news reports.”

“HealthPocket, a consumer research group, says many insurers who initially held back from joining the new exchanges are angling to get involved after the first year’s enrollment total surpassed expectations.”

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Chart from Dan Diamond

Number of Uninsured in Minnesota Plummets to 4.9%

 Star Tribune: “The percentage of uninsured Minnesotans has dropped to the lowest level in state history, and the second-lowest level in the nation, following the end of enrollments under the Affordable Care Act.”

“About 180,500 Minnesotans gained health insurance from last September to this May, with the vast majority getting coverage through one of the state’s public health programs, a report from the University of Minnesota found.”

“’A change in the uninsurance rate like this is pretty much unprecedented in Minnesota,’ said Julie Sonier of the university’s State Health Access Data Assistance Center and a co-author of the report.”

Gov. Mark Dayton: “It really confirms the wisdom of the Affordable Care Act and MNsure’s part of that.”

Number of uninsured plummets

Expanding Medicaid Increases Educational Benefits, Reduces Inequality

Emily Badger: “Give people access to health care, in short, and a lot of other things become possible, too. For instance: Children are better able to learn.”

“In a National Bureau of Economic Research working paper, Sarah Cohodes, Samuel Kleiner, Michael F. Lovenheim and Daniel Grossman found that the expansion of public health care to many more children in the 1980s and 1990s produced long-term educational benefits.”

“Specifically, the researchers found that a 10 percentage point increase in Medicaid eligibility among children in a state translated into a 5.2 percent decline in high school dropouts (among all students), a 1.1 percent increase in college attendance, and a 3.2 percent increase in students completing bachelor’s degrees.”

“‘Our estimates suggest that the long-run returns to providing health insurance access to children are larger than just the short-run gains in health status,’ the authors write, ‘and that part of the return to these expansions is a potential reduction in inequality and higher economic growth that stems from the creation of a more skilled workforce.'”

Cantor’s Defeat and Obamacare

Politico: “Cantor’s loss could also dramatically alter the Republican legislative agenda for the next five months. Cantor had been scrambling to craft GOP health care bill to replace Obamacare — trying to piece together plans from wide corners of the party that could win support from a majority of Republicans. GOP leadership aides were tentatively planning for a series of health care related votes following the July 4th recess.”

“If a number of Republican Study Committee members hop into the race, it could raise the prominence of their health care alternative. Scalise launched a push just last month to pressure Cantor to schedule a vote on that bill.”

And what are primary winner David Brat’s views on Obamacare?

Huffington Post:  “Brat said he will never increase taxes and vowed to repeal the Affordable Care Act. ‘We need to also scrap employer-based health insurance, and give those incentives to individuals to carry their own portable health insurance,’ he said of health care, adding that ‘If we did that, the issue of pre-existing conditions largely goes away.'”

Massachusetts Near Zero Percent Uninsured

WBUR: “Between December 2013 and March of this year, when the federal government was urging people to enroll, the number of Massachusetts residents signed up for health coverage increased by more than 215,000. If that number holds, the percentage of Massachusetts residents who do not have coverage has dropped to less than 1 percent.”

Burns Stanfield, president of the Greater Boston Interfaith Organization, “says a report out last month that found mortality rates dropped in the first four years of expanded coverage, coupled with the insurance numbers, show that ‘our statewide move to universal access is working, and it’s a powerful witness to the nation.’”

Click to see the full enrollment trends document from the Massachusetts Center for Health Information and Analysis.

Obamacare Creates New Opportunities for State Health Care

Wall Street Journal: Obamacare “was intended to create a uniform standard of health coverage across the U.S. But the law also is creating opportunities for states to pursue their own solutions.”

“For states like Vermont, that means pursuing liberal experiments that go further than the Affordable Care Act; for others, it means expanding coverage for the poor in a way that’s more palatable to conservative lawmakers.”

Even states that oppose Obamacare have used the law for their own benefit.

“Wisconsin Gov. Scott Walker [(Rep.)] saw in the new health law an opportunity to reshape his state’s Medicaid program. Wisconsin had long provided Medicaid benefits to a wider income range than most other states, allowing adults at up to twice the poverty level to enroll. Since some of those enrollees now qualify for tax credits to buy private insurance under the ACA, Mr. Walker has pushed through a plan to remove them from the state’s Medicaid rolls, clearing the way for more of the state’s lowest-income residents to join the program.”

Is Obamacare Really a ‘Job Killer?”

Dan Diamond writing for Forbes notes that Obamacare was “once called ‘The Job-Killing Health Care Law.’ But the latest jobs report suggests that the broader economy—and the health care sector, specifically—is adding jobs at a healthy rate.”

“We’ve tracked health care employment growth pretty closely on the Advisory Board Daily Briefing, and below, you can see how we’ve modeled out the monthly gains.”

DB_HCjobs_Update_060614_lg

“Booming growth in the heath care industry shouldn’t come as a surprise. The health care sector was gaining about 25,000 jobs per month in the years before the Affordable Care Act, and the law’s infusion of newly insured patients will help bolster providers’ bottom lines.”

“Already, hospitals in states that have opted into the Medicaid expansion are reporting lower charity care spending and fewer self-pay (read: uninsured) patients … It’s one sign that while the law may be creating new pressures on providers, it’s creating new sources of revenue. And that added revenue has a trickle-down effect for employers: It’s prompting them to add more staff, too.”

Competition Boosts Obamcare Exchanges

Jason Millman: “State health insurance marketplaces that offered consumers very few health plan choices in 2014 are starting to add more insurers — slowly, in most cases. But this is a sign that insurers are feeling confident about the second year of the Affordable Care Act’s coverage expansion.”

“The development is important for a few reasons. For one, recent research suggests that more competition in the exchanges could help temper premium increases. Other new analysis shows that exchange plans, on average, are cheaper than individual plans offered outside the insurance marketplaces. And given the narrow networks in exchange plans, more insurers could mean better access to providers.”

Uninsured Rate Holds Steady at 13.4%

Gallup: “The uninsured rate for U.S. adults appears to be leveling off since the open enrollment period for buying health insurance coverage through the marketplace ended in mid-April. The uninsured rate so far in the second quarter of 2014 is 13.4%, with the rate in April and May as individual months also averaging 13.4%, respectively.”

The sharpest declines since the fourth quarter of 2013 have been among blacks (from 17.6% to 14.7%) and Hispanics (from 37% to 33.1%).

Percentage Uninsured in the U.S., by Quarter

Obamacare War Ends With a Whimper

Sam Baker: “This is the way the Obamacare war ends—not with a bang, but a whimper.”

“Anti-Obamacare bills in the House have gotten tamer lately—some of them look an awful lot like fixing obvious problems with the law, something conservatives once swore they’d never do. There are fewer big-ticket hearings, and even those are often poorly attended. Anyone who’s been around Capitol Hill and health care for the past four years can see it—the anti-Obamacare fire just isn’t burning as hot as it used to.”

“In part, any fire dies down over five years. But the temperature on the right also got a lot lower after 8 million people signed up for coverage through the health care law’s exchanges.”

“The law is unpopular, and its critics feel more strongly than its supporters. But with public opinion locked in place for months, ‘Obamacare’ has become almost a party-ID question or a buzzword, rather than a dynamic issue.”

Only 13% of Uninsured Predicted to Pay Obamacare Penalty

Jason Millman: “About 4 million people in 2016 are expected to pay the penalty for skipping health insurance, the Congressional Budget Office and the Joint Committee on Taxation say in a new report. That’s down from 6 million in their September 2012 projection, mostly because of an increase in those who qualify for an exemption from the individual mandate.”

“The CBO/JCT also expect people earning more than 400 percent of the federal poverty level — the cut-off point for federal tax credits to purchase coverage on Obamacare exchanges — will pay the greatest share of the penalty in 2016.”

(Congressional Budget Office/Joint Committee on Taxation)