Fix Health Care Policy

Two Cheers for the Coburn–Lieberman Medicare Proposal

Senators Tom Coburn (R–OK) and Joseph Lieberman (I–CT) unveiled a major Medicare proposal. Based on preliminary estimates provided by the Congressional Budget Office (CBO), the proposal would reduce total Medicare spending by more than $600 billion in the next 10 years and cut the program’s long-term (75-year) unfunded liability by approximately $10 trillion.

This is a serious start. Without remedial action, Medicare faces a long-term unfunded liability of almost $37 trillion. The Medicare hospitalization trust fund is running a deficit of $34.1 billion this year alone. While the program has become an engine of deficits and debt, the first step toward reform is revamping the traditional Medicare program. That is what the Coburn–Lieberman proposal would accomplish. The next step would be to move the program from a defined benefit to a defined contribution for the coming generation of retirees.  (Read the rest on The Foundry…)

Tags: deficit, entitlement reform, Medicare reform, Sen. Joe Lieberman, Sen. Tom Coburn

Doctors, Medical Students Abandon AMA in Search of Alternatives

The American Medical Association lost 5 percent of its membership last year as the physician group faced fallout from its endorsement of Obamacare and refusal to retreat from the law’s most controversial provisions.

As physicians and medical school students back away from the well-known organization, they’re turning to upstarts like Docs4PatientCare and the Benjamin Rush Society, two alternatives to the AMA.

Docs4PatientCare maintains contact with about 4,000 physicians who are primarily concerned about preserving the doctor-patient relationship. Many of them became active after the AMA’s endorsement of Obamacare in 2009. That endorsement was touted by President Obama and liberals in Congress to build support for the Patient Protection and Affordable Care Act.  (Read the rest on The Foundry…)

Tags: American Medical Association, Docs4PatientCare, doctor-patient relationship, membership loss, ObamaCare

Obamacare Dumps Millions More into Failing Medicaid Program

Yet another newly revealed flaw of Obamacare promises to add billions to the cost of the new health law. Due to what was presumably an oversight in the drafting of the legislation, it could potentially unload 24.7 million additional Americans onto the Medicaid program.

That’s 50 percent higher than the Congressional Budget Office’s (CBO) original projection of 16 million. As Medicare Actuary Richard Foster explained in testimony before the House Budget Committee, the definition of income to determine eligibility excludes Social Security benefits, allowing couples in early retirement who make even $64,000 per year to qualify for benefits that should be reserved for those in genuine need. Like so many complexities within Obamacare’s unpopular stipulations, expensive and harmful mistakes lurking in the fine print are surfacing every day.

In an AP report yesterday, Foster said the broad conditions of the Medicaid expansion were similar to “allowing middle-class people to qualify for food stamps.”  (Read the rest on The Foundry…)

Tags: failing health program, food stamps, Medicaid, middle class, ObamaCare, regulations

Breaking Research: Obamacare Tax Subsidies a Drag on the Economy

While economic growth remains sluggish, the last thing the United States needs is another weight holding it back. Unfortunately, the new health care subsidy program created under Obamacare for low- and middle-income Americans does precisely that.

In recent research, Heritage’s Paul Winfree lays out exactly how the Obamacare subsidies will negatively impact the economy. According to Winfree, “tax subsidies are available for certain households who purchase federally approved coverage in the newly created state health insurance exchanges…unless they are eligible for Medicare or Medicaid or they can receive coverage through their employer that meets standards established in Obamacare.”  (Read the rest on The Foundry…)

Tags: ObamaCare, repeal the law, sluggish economy, state health insurance exchanges

More Americans Using HSAs—Under Threat from Obamacare

Spending in the U.S. health care system is growing too fast to ignore. Yet, the Patient Protection and Affordable Health Care Act (PPACA), also known as Obamacare, does nothing to “bend the cost curve.” Containing health spending requires engaging consumers in their health care expenditures, and one way to achieve this is through high-deductible health plans paired with Health Savings Accounts (HSA), which a recent report shows are gaining in popularity.  (Read the rest on The Foundry…)

Tags: bend the cost curve, health savings accounts, high-deductible health plans, HSAs, ObamaCare

“No More Waivers for You!”

In a classic case of the “Friday afternoon news dump,” last week the Department of Health and Human Services (HHS) announced that it is closing the process to apply for a waiver to Obamacare’s annual limits provision in September.

Both the timing and substance of this decision confirm that HHS’s annual limit regulations and the decision to grant waivers was a public relations strategy gone bad. Friday’s announcement was little more than a move by the Obama Administration to limit further damage from a self-inflicted wound.   (Read the rest on The Foundry…)

Tags: annual limits provision, HHS, ObamaCare, public relations strategy, waivers

Shocking Study Results Reveal Moral Imperative to Fix Medicaid

This week, The New York Times highlighted a study on Medicaid, the federal–state partnership to provide health care to the poor and disabled, and its failure to offer enrolled children access to care. The researchers used a “secret shopper” technique to see how many specialists in Cook County, Illinois, turned away children with Medicaid compared to private insurance.

The results were jaw-dropping. While specialists turned away 11 percent of privately insured children, 66 percent of children with Medicaid were unable to get an appointment. For those who did, the waiting time was 22 days longer than for other patients.  (Read the rest on The Foundry…)

Tags: children, federal-state partnership, Medicaid, ObamaCare, private coverage, The New York Times

Ezra Klein’s F on Medicare Part D

At the time of its enactment in 2003, the Medicare drug benefit—known as Medicare Part D—had many critics. Some said the program, which is built on consumer choice and vigorous competition among private plan options, wouldn’t work because private plans would decline to participate. Others said seniors wouldn’t sign up for the voluntary benefit because the competitive structure would be too complex. Still others said the program would explode in costs without government-regulated price controls.

All of these predictions were dead wrong. The program is now in its sixth year of operation and has exceeded all expectations. Some 90 percent of Medicare participants are now in secure drug coverage of some sort, and public opinion surveys show that seniors are very satisfied with the new program. Most importantly, the drug benefit’s costs for the first decade are coming in 42 percent below what was predicted at the time of enactment.  (Read the rest on The Foundry…)

Tags: drug benefit, drug coverage, Ezra Klein, government price controls, Medicare Part D

VIDEO: Sen. Orrin Hatch Outlines Comprehensive Plan to Reform Medicaid

Sen. Orrin Hatch (R-UT), ranking member on the Senate Finance Committee, outlined a comprehensive plan for reforming Medicaid yesterday at Heritage. Medicaid is a program for low-income Americans, one of the big three entitlements.

Hatch’s vision corresponds with the wishes of more than two dozen Republican governors, who wrote him this week to express their desire for greater flexibility with Medicaid. Democrats, including 41 of Hatch’s Senate colleagues, have publicly voiced their opposition to any meaningful reforms to the program offered by Republicans.

Before his Heritage speech, Hatch sat down to talk about why reform is needed, how he would do it and why it matters in the context of the debt crisis facing America. Hatch also used the opportunity to attack Obamacare, legislation that made the Medicaid problem even more challenging.

Tags: entitlement reform, Medicaid, Medicare, Republican Governors, Sen. Orrin Hatch

Obamacare’s Premium Subsidies Will Stifle Small Business

As small business goes, so goes the economy. They have been responsible for creating almost two-thirds of all net new jobs over the last 15 years. Indeed, one reason Obamacare is such a concern is that it will significantly reduce the incentive for small businesses to hire. Especially once the premium subsidies become available in 2014.

The premium subsidies are Obamacare’s way of making health insurance more affordable for low-income earners who buy coverage in the new exchanges. Eligibility for a subsidy is limited to people who lack public or employment-based insurance and have incomes less than four times the poverty level. The values of the subsidies are set so as to limit the amount one contributes towards insurance as a percent of income.

The actual implementation, however, is complex.

Say you’re under 65 and not on Medicaid (or CHIP), and the year you would be eligible to purchase insurance through an exchange is 2014. Your premium subsidy is determined by your income and family structure from two years earlier (in this case, 2012), applied against the poverty level for the calendar year in which you purchase the insurance (2014).

The consequences of this complicated formula are far worse.  (Read the rest on The Foundry…)

Tags: family income, federal poverty level, health insurance, Medicaid, Medicare, Obamacare subsidies, small businesses