Medicaid Enrollment Surge Under Obamacare

The Hill: “Enrollments in Medicaid under ObamaCare surged to 6 million by the end of April, with significant increases in Nevada, Oregon and West Virginia, the Obama administration announced in a blog post Wednesday.”

“In states that adopted the expansion, enrollment grew by 15.3 percent over the pre-ObamaCare rate, according to the HHS. States that failed to widen eligibility to the program saw enrollment increase by only 3.3 percent.”

Sarah Kliff: “One in five Americans now gets their health insurance through the Medicaid program”



Doctors Moving Away from Republican Candidates

Jason Millman: “A new study suggests a profession once solidly aligned with Republicans has become more Democratic in the past 20 years, as the number of female doctors grows and the traditional small physician’s office is on the wane.”

“In the last three election cycles, physician donations to Republicans have instead closely tracked to those made by the general population, according to JAMA Internal Medicine study authors Adam Bonica of Stanford University, Howard Rosenthal of New York University, and David J. Rothman of the Columbia College of Physicians and Surgeons.”

(JAMA Internal Medicine)

The study authors ask: “Now that the medical profession sits on both sides of the political aisle, will the Republican and Democratic parties devote unprecedented energy and shape policy to attract physician loyalty? Or will the increasing polarization of the profession increase the political participation of physicians even as it reduces the ability of physicians to reach consensus on health care policy?”

Obamacare Enrollment Ticks Upward

Kaiser Family Foundation: “The latest figures released by the Department of Health and Human Services put the number of people who have selected a plan on the Marketplace at about 8 million as of the end of the open enrollment period (which extended through mid-April in most states).”

There are some limitations, so “a complete count of people purchasing their own coverage is still unavailable. However, if the insurers that were not included in these initial filings experienced similar growth rates to the insurers with available data, this would yield a net increase of roughly 3 to 3.5 million people for a total of about 15 million people in the individual market with coverage in effect by March, 2014.”

Figure 1: Percent change in enrollment from previous quarter

Obamacare ‘Repeal It!’ Cries Are Now a Whisper

The New York Times Editorial Board argues that campaigning Republicans are now realizing that they may not find victory by shouting “repeal Obamcare!”

“Though the law itself has never been widely popular, most people say they like its component parts, and a large majority now says it wants the law improved rather than repealed.”

“That sentiment conflicts with the Republican playbook, which party leaders are suddenly trying to rewrite. The result has been an incoherent mishmash of positions, as candidates try to straddle a widening gap between blind hatred of health reform and the public’s growing recognition that much of it is working.”

“Many … Republican candidates have also switched from brimstone to mush on the issue, no longer claiming they will repeal the law but instead will ‘replace’ it or ‘fix’ it in some unspecified way that could not possibly work.”

“The good news is that some Democratic candidates … are beginning to campaign on the law’s benefits. Improving access to health care was the right thing for the country, and supporting it may turn out to be good politics, too.”

Then vs. Now: Have Those Dire Predictions About Obamacare Materialized?

California Healthline: “It may be too soon to know if the Affordable Care Act is making Americans healthier. But there’s a smattering of data that suggests the law is making the health care industry healthier, at least.”

“A tracker indicates that newly insured patients aren’t overwhelming doctors.”

“A batch of anecdotal reports suggests that hospitals’ uncompensated care spending is falling.”

“And a survey of physicians finds that — while many doctors are upset about the law’s added complexity — they’re generally happy with the pay that they’re seeing through the ACA’s new marketplace plans.”

“Taken together, the slew of upbeat reports for the industry isn’t surprising … But the positive findings are in contrast to a dire batch of predictions that accompanied the ACA’s bumpy rollout across the past year.”

Food Fight Begins Over Healthy Food Nutrition Standards

Politico: “The House Appropriations Committee voted, 31-18, Thursday to advance a fiscal 2015 agriculture spending bill with a controversial rider that would allow schools to opt out of nutrition rules requiring more fruits and vegetables, less sodium and more whole grain-rich products if they are losing money from the healthier meals.”

“The move sets up what promises to be a contentious conference between the House and Senate bills, although the measures have yet to clear either chamber.”

New York Times: Agriculture secretary Tom Vilsack said on Wednesday “that claims that the nutrition rules had led to a decline in schools participating in lunch and breakfast programs were misleading, and that the rules had no effect on food waste, which had been an issue since 2007, before the nutrition standards were in place.”
Michelle Obama, writing in The New York Times, argues that the Let’s Move! initiative has seen “glimmers of progress,” but “we’re now seeing attempts in Congress to undo so much of what we’ve accomplished on behalf of our children.”

“Remember a few years ago when Congress declared that the sauce on a slice of pizza should count as a vegetable in school lunches? You don’t have to be a nutritionist to know that this doesn’t make much sense. Yet we’re seeing the same thing happening again with these new efforts to lower nutrition standards in our schools.”

Obamacare Winners Are ‘Invisible’ and Need to be Heard

Jonathan Cohn – using a case of an individual who switched from COBRA to Obamacare – highlights an Obamacare success story.

“According to the most reliable government surveys, enrollment in COBRA has vacilated between 2.5 and 3.5 million people over the last few years. On the whole, the premiums for Obamacare marketplace plans are probably lower than the premiums for employer plans. And while in many cases those lower prices will correspond to less comprehensive coverage or more restricted provider accessa large number of people buying coverage on the marketplaces will also get subsidies that discount the prices much more. Others will qualify for Medicaid, which is basically free.”

“By itself, these facts don’t clinch the case for the Affordable Care Act. An honest assessment of the law must include not just the ‘winners’ but also the ‘losers’ …  You read a lot about those people in the fall and, while many of the stories were exaggerated, some were not. But one reason it’s been so hard to settle the debate over Obamacare is that many of the winners are more or less invisible. Nobody has noticed them, let alone listen to their tales, even though they have some pretty good stories to tell.”

Kentucky Governor Reponds to McConnell’s Obamacare Contradictions

Kentucky Gov. Steve Beshear responds to Sen. Mitch McConnell’s calls for repealing Obamacare while keeping Kentucky’s “kynect” health exchange.

“At best, of course, his promise represents a fundamental misunderstanding of the ironclad link between the ACA and ‘kynect.’ At worst, it’s a blatant attempt to mislead Kentucky families for his political benefit.”

“While that is fun to ponder, the salient point is this: Even critics are acknowledging that the ACA is bringing health care to those who desperately need it. In short, it’s working.”

“In fact, over 421,000 Kentuckians have signed up for health insurance through ‘kynect’ — about 75 percent of whom didn’t previously have insurance and about 52 percent of whom were under age 35.”

“Those numbers — and the testimony of the people behind them — contradict the mindless nattering of partisan-minded critics who need to leave their Washington D.C. echo chambers and talk to the people they represent.”

“Rather than continue trying to tear out the ACA ‘root and branch,’ as Sen. McConnell has advocated, he should understand why it’s been embraced and why it’s working.”

Obamacare Still Unpopular

Gallup: “Although the Obama administration is boasting higher-than-expected enrollment for the Affordable Care Act, Americans’ attitudes toward the healthcare law have changed only marginally since the open enrollment period ended for 2014.”

Approval of the U.S. Healthcare Law

Implications: “Public opinion has remained mostly static and oriented against the healthcare law, suggesting that most Americans have made up their minds on this issue and see no reason to revisit their opinion. This is likely a consequence of the polarizing effect of the law — Republicans are solidly opposed, while the bulk of Democrats support it. It’s uncertain what role this still unpopular law will play in the midterm elections; Americans say the economy and unemployment overshadow healthcare in terms of the most important problem facing the U.S. But many Republican candidates … are highlighting their opposition to the law.”

Millions of Uninsured Now Eligible for Obamacare Assistance

A new analysis by the Robert Wood Johnson Foundation and the Urban Institute finds that “under current legislation, just over half (56 percent) of the uninsured became eligible for financial assistance with health insurance coverage” under Obamacare.

Key findings:

  • In states that have expanded Medicaid eligibility under the ACA, 68 percent of the uninsured became eligible for assistance, compared with only 44 percent in states that have not expanded Medicaid.
  • If nonexpansion states were to expand Medicaid eligibility, 71 percent of their uninsured would be eligible for assistance.
  • Among states expanding Medicaid, the ACA is projected to reduce the number of uninsured people by 56 percent, compared with a 34 percent reduction in the uninsured among states not expanding Medicaid.
  • If the states that have not expanded eligibility were to do so, the number of uninsured in those states would decrease by 59 percent.

How Many Uninsured People Are Eligible for Assistance Under the Affordable Care Act?


The Economic Crisis as a Contributor to Obesity

NBC News: “The rate of obesity is climbing in some of the most developed countries, with women and the poor hit harder by the recent economic crisis consuming cheaper, less-nutritious food,” according to a new report by the Organization for Economic Cooperation and Development.

“While rates are rising as much as 3 percent a year in countries such as Australia, France, Mexico and Switzerland, they have been fairly stable in other countries such as the United States, Canada, South Korea and Italy.”

“Even in nations that fared better in the economic slowdown, certain groups of people, particularly women and those who are less educated and have lower incomes, were also more likely to be obese.”

“Rising obesity rates can also add economic burden as governments grapple with the costs of chronic conditions linked to obesity such as diabetes, heart disease and even cancer.”

Health Care Prices at the Slowest Growth Rate in Fifty Years

Sarah Kliff: “New data from the White House suggests that’s not the case: health care prices are actually growing at the slowest pace they have in decades, according to charts from the Council of Economic Advisers.”

“This chart shows both how quickly health care prices are going up — and how quickly the price of everything else is increasing. And since about 2010, both have been growing at nearly the same rate. Health care prices grew 0.9 percent since between January and March of this year, which the White House says is the slowest rate of growth in 50 years.”


Insurers View Obamacare as a ‘Good Business Opportunity’

New York Times: “In a sign of the growing potential under the federal health care law, several insurers that have been sitting on the sidelines say they will sell policies on the new exchanges in the coming year, and others plan to expand their offerings to more states.”

“’Insurers continue to see this as a good business opportunity,’ said Larry Levitt, a health policy expert at the Kaiser Family Foundation. ‘They see it as an attractive market, with enrollment expected to ramp up in the second year.’”

“Federal officials said they were heartened by the continued interest from insurers. ‘We are still early in the process but it’s a positive sign that after just one open enrollment season we are already seeing new entrants and more competition in the marketplace,’ said Erin Shields Britt, a spokeswoman for the Department of Health and Human Services.”