Fix Health Care Policy

Obamacare Insurance Exchanges: States Have Options

Governor John Kasich (R) is expected to opt not to set up a state Obamacare exchange. This is the right decision for Ohio. The President’s health care law is unworkable and unsustainable. Rejecting the health insurance exchanges, and equally as important, the Medicaid expansion, are two opportunities states have to push back on this law and instead push forward on a better health reform agenda for Ohio.

These exchanges are used in the law to funnel subsidies to government-controlled health plans. Some proponents of the law will undoubtedly criticize the Governor’s decision. But, there are more practical and sound reasons why opting not to adopt a state exchange is best for the states.

First, under the exchange regulations promulgated by the Secretary of Health and Human Services (HHS), states would gain no meaningful flexibility or advantage by operating their own exchanges, relative to a federally facilitated exchange. They would simply be acting as vendors to HHS.

Second, states still regulate insurers (including those participating in exchanges) in all matters not otherwise preempted by federal law, regardless of who operates the exchange. States can also regulate exchange “navigators” through state professional licensure statutes, to ensure equal standards/level playing field with other insurance producers, again, regardless of who operates the exchange.

Read the rest on The Foundry…

Tags: federal mandate, health insurance exchange, HHS, ObamaCare, options, repeal the law, States

The Public Option: Alive and Well in Obamacare

Thought the “public option” was dead? Think again. Chief among the most dangerous provisions in Obamacare is the creation of government-sponsored national health plans, which are, in effect, another embodiment of the public option.

Through its multi-year implementation, the law steadily evolves into a national single-payer health care system.

Here’s the background: In 2014, the Office of Personnel Management (OPM), the small agency that runs the federal civil service, will administer at least two nationwide health plans to compete against private insurance. OPM will be responsible for negotiating the new health plans’ medical-loss ratio, profit margins, and premiums.

The OPM-sponsored plans will automatically qualify to compete against private health plans in the new state exchanges and thus will not be subject to the same qualifications and standards outlined in Obamacare for private plans in the exchanges. OPM must contract with an already existing large insurer, because such a plan must be offered in 60 percent of states in year one.

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Tags: medical loss ratio, Office of Personnel Management, premiums, private coverage, profit margins, public option, sponsoring health plans, state health exchange

Obamacare: The Battle Intensifies

Obamacare is not here to stay. Despite the 2012 election, the assumption that the health care law will stay on course is another example of the left’s wishful thinking.

Of course, efforts for a complete repeal will likely face the same fate as efforts in the last Congress did. But there are ample reasons, as well as opportunities, to change the course of this law.

Public opinion has not changed. Exit polls show that more Americans still want the law repealed in full or in part. Former House Speaker Nancy Pelosi (D–CA) was absolutely right when she famously remarked in 2010 that “we have to pass the bill so that you can find out what is in it.” With continuing revelations of increasing costs, higher taxes, and a flood of directives from Washington bureaucrats, the polls have since shown that the American people still do not like the law.

There is still so much more to know—and not like. Americans know that this law was enacted in haste and that critical details are still to be decided and enforced. What is a qualified health plan? What will be in the essential benefit package? How will the employer and individual mandate be implemented? The list goes on.

The law is already becoming a managerial nightmare, as Administration officials have missed deadline after deadline, failing to provide crucial information—doubtlessly to avoid further political fallout from exposing their controversial plans, such as the contraception mandate undermining religious freedom, or because overhauling one-sixth of the economy is riddled with innumerable unintended consequences that are nearly impossible to avoid.

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Tags: Americans, elections, ObamaCare, qualified health plan, repeal the law

By the Numbers: Medicare Costs for Seniors to Rise Under President’s Plan

Under current law, as amended by Obamacare, seniors enrolled in traditional Medicare can expect to face higher Part B and Part D premiums. Moreover, President Obama has planned in his 2013 budget proposal to increase income-related Part B and Part D premium coverage by 15 percent. As a result, out-of-pocket costs are expected to rise by 2017 under the president’s budget proposal.

Under Obama’s plan, “seniors will pay more — a lot more — and they will pay this steep price in many different ways,” Heritage’s Robert E. Moffit, Rea S. Hederman and Alyene Senger explain in a new paper analyzing the impact on seniors.

Americans may have diverse opinions on Medicare reform but what remains certain is that Medicare “as we know it” is already a thing of that past.

Tags: by the numbers, impact, Medicare, ObamaCare, Part D, premium support, traditional program

Medicare Roundup 11/2: Setting the Record Straight

In recent weeks, liberal politicians, editorialists, and policy analysts have vigorously attacked reform of Medicare based on defined-contribution financing. In fact, this approach to reforming Medicare has a long bipartisan tradition going back to the 1980s and Representatives Richard Gephardt (D–MO) and David Stockman (R–MI). In fact, much of this criticism is distorted, misleading, or just plain wrong.

Here are some articles that set the record straight:

See the full list on The Foundry…

Tags: biased, defined contribution, Medicare, mistruths, myths, premium support system

5 Effects Obamacare Will Have on Working Americans

Obamacare will certainly have a negative impact on every American, but here are five ways it will harm working Americans:

1. Two-thirds of American employees’ wages will decrease as employers deal with increasing costs. Heritage’s Drew Gonshorowski explains the results of an Urban Institute study: “The Urban Institute claims that mid-size firms will see spending per person increase by 4.6 percent, while large firms will see spending increases by 0.3 percent per person. According to the U.S. Census, this accounts for 65.1 percent of employees—or roughly 79 million—in the U.S. who are employed by medium- or large-size firms. The study suggests: ‘Any increase in employers’ health-related costs will be offset by decreases in other compensation—whether wages or other benefits.’ This means that individuals in mid- and large-size firms will receive less in take-home wages (or other benefits) and pay a greater proportion of their compensation to health care due to Obamacare.”
2. Loss of existing insurance coverage. Because of Obamacare’s high costs, experts predict that employers will stop offering employees health coverage, forcing employees into the new government-run exchanges. Although estimates vary, it is likely that millions of Americans will lose their current coverage. For instance, the non-partisan Congressional Budget Office estimates that between 5 million and 20 million Americans will lose employer-sponsored coverage, the American Action Forum estimates 35 million, and McKinsey, a consulting firm, estimates that 30 percent of employers will definitely or probably stop offering coverage after Obamacare takes full effect in 2014.

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Tags: employer drop, existing insurance, increasing costs, loss coverage, ObamaCare, working Americans

The President’s Planned Changes to Medicare: Costly for Seniors

What is President Obama’s plan for Medicare—Obamacare’s changes and beyond?

Heritage has a new Issue Brief, “Obama’s Medicare Plan: Seniors Will Pay More,” that details the future increases in out-of-pocket costs for seniors under current law and President Obama’s 2013 budget proposal.

Over the next five years, under current law, seniors in traditional Medicare are projected to face higher Part B and D premiums, along with other out-of-pocket cost increases. Instead of structurally reforming Medicare, President Obama’s 2013 budget proposal would raise premiums even further for upper-income enrollees in Parts B and D, while also imposing additional deductibles and co-payments (in certain cases) on newly joining baby boomers beginning in 2017.

“Obama’s latest budgetary scheme for cost-shifting to seniors is just another indication that the Administration and its allies on Capitol Hill are running out of options,” the authors write.

Read the full report here.

Tags: Medicare, out-of-pocket costs, pay more, plan, premiums, President Obama, Seniors, traditional program

Why Medicare Must Be Reformed

Medicare is shaping up to be a deciding factor in the debate over our nation’s future.

As Heritage’s Bob Moffit and Alyene Senger explain in a recent paper, “Why Traditional Medicare Must (and Will) Be Reformed,” the status quo in Medicare is unsustainable and unacceptable due to the program’s structural and financing flaws.

Here are a few reasons Medicare needs to be reformed:

• Medicare spending is growing faster than any other federal program. Medicare spending has reached unsustainable levels and is contributing to our budget deficits more quickly than any other program. Further, over the long term, Medicare has made $37 trillion worth of benefit promises to future seniors that are simply not funded. The hospital insurance trust fund is projected to be insolvent by 2024. 
• While seniors have paid for their benefits, their payments do not cover the costs of the program. In 2011, approximately 88 percent of Medicare’s spending was funded by taxpayers. A large part of the problem is the erroneous belief that seniors have fully paid for their benefits. In fact, Moffit and Senger explain that, “on average, a one-earner couple who retired at age 65 in 2011 and earned an average wage will have paid just $60,000 into the program but will receive an estimated $357,000 worth of benefits.”
• Medicare enrollment is set to skyrocket. Baby boomers have already begun to retire. At the current rate of retirement, the program will enroll 10,000 beneficiaries into Medicare every day from 2011 to 2030. Moffit and Senger explain that “enrollment is expected to jump from 48 million beneficiaries in 2011 to 81 million by 2030.” This is coupled with a 50 percent decrease in the proportion of workers contributing to the hospital insurance trust fund over the same period. The outlook: more beneficiaries and fewer workers paying taxes to support them.

Read the rest on The Foundry…

Tags: coverage, graphs, Medicare, myths, ObamaCare, payments, pictures, spending

The Contraception Misconception

The contraception debate in a nutshell: There is no contraception debate.

No one—neither Republicans nor the more than 100 individuals and organizations suing over the HHS mandate—is calling for a ban on contraception.

Governor Romney has said that “with regards to contraceptives, of course, Republicans, and myself in particular, recognize that people should have a right to use contraceptives. There’s absolutely no validity whatsoever to the Obama effort to try and bring that up.”

As for religious employers and organizations, they simply don’t want to have their religious beliefs trampled on by being forced to pay for contraception and abortion-inducing drugs in violation of their faith. Heritage legal expert John Malcolm explains that this position “would not preclude any women, including those who work for religious institutions, from using or obtaining contraception or abortifacients. Employers who favor providing contraceptive and abortion drug coverage to their employees would retain their right to do so.”

So now let’s focus on the real issue: Under Obamacare, the government is mandating which benefits an insurer is obligated to cover, and it’s far more than just the infamous contraception and abortion drug mandate. This will have a deleterious effect on health coverage for both women and men.

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Tags: abortion drug coverage, contraception rule, Gov. Romney, HHS mandate, ObamaCare, President Obama, repeal the law